As someone who suffered from sciatica (not hip related- was many many moons ago), I can offer some reassurance that, at least in my experience, sciatica is pretty unmistakable. Nerve pain tends to radiate or travel instead of a throbbing in one particular spot. It also tends to be constant. Also associated with nerve pain:
Burning
Cold
Feeling like the back of your leg has a guitar string that gets plucked when you stand or walk (and the music ain't pretty)
Tingling/pins and needles
Weakness/loss of reflexes
Nerve pain just feels dramatically different from muscle pain, at least to me. If you've ever had a dentist hit a nerve while working on your teeth....imagine that pain except in your leg or back.
I grilled my surgeon about sciatica before the surgery and it was one of my main hesitations about posterior approach. I told him that, bad as the hip was, I would ALMOST rather live with that than go through sciatica again. He explained that the sciatic nerve is pretty deep and not exposed during surgery. What can happen is that, if the muscles are retracted too fast, that can cause nerve pain. Also, if you are experiencing sciatica when you have the surgery, it can get exacerbated. So, I'd take the surgeon's extra love note to heart and I don't think, in my layperson's opinion, sciatica is going to be a concern.
I remember, at my two week post op with the physician's assistant, asking him whether he could ID the various achy breakies I was experiencing. Bone? Muscle? Tendon? Nerve? Skin? Other? He pointed to my x-ray, circled his hand around my hip area and said, "This." Oh. Right. Okay, then!
For the quad - my PT showed me a stretch that I found really helpful. Stand against a wall with toes on the wall and hands on the wall. Move affected leg about eight inches back. Balance on both feet and then shift your weight onto the front leg, bending back leg knee until you can feel a stretch, which you should feel primarily at the top of your quad. You know the rules, of course: go slow, go gentle. I was 6 weeks post op before I attempted this, but I was having problems with the top of my quad and wanted to do something that didn't involve getting on the floor or doing any kind of grabbing my foot and pulling like you usually do with quad stretches.
. I heard today that the reason doctors prescribe exercise for this kind of recovery is for nerve regeneration, which really motivated me to get moving.
Interesting - this makes me think of the recovery timelines for each soft tissue type I've seen here frequently. Almost every other type of tissue heals faster than nerves. I think 6-8 weeks is the general time for muscles, etc. Nerves, though, are up to several months. I wonder if that gap in healing time is what lands people in the ODIC. The muscles are healed and feel good but the nerves can't yet recover from more intense activity. I did notice that when I started to move more, that's when I felt the tingles and zaps typically associated with nerve healing/regeneration. I was really happy about that, actually, because it meant things were coming back online in response to the exercises.
Always something to think about and learn here!
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