My wife has been suffering from what started  out as back pain several years ago, it has now progress to severe shooting pains down her left leg to her knee as well as numbness tingling feeling in her foot.We have seen doctors over years the pain is now constant day and night even with her medication the doctor say her pain is from the L4 area , what i would like to ask is there other ways getting this pain other than the sciatic nerve , could there been a combination of different things that her this amount of pain.We been told that her sacroiliac joint is approx 50 millimetres out of aliment with restricted movement. Regards John
HiT hank you for asking ChatDoctorI have gone through your query. The back pain which radiates to knees, foot and tingling feeling is most likely neuropathic pain sciatica. It can be due to compression of nerve root by lumbar disc herniation like you mentioned, from L4 area which is a common place. But conditions like sacroiliac joint dysfunction can coexist. In such case local corticosteroid injection will be helpful. If you were my patient then I would recommend muscle relaxants like cyclobenzaprine, NSAIDs like nimusulide and neotropic Chat Doctor.  I also advise physiotherapy and muscle strengthening exercises along with this. Wearing Lumbar supporting belts also will be helpful. Hope this may help you. Let me know if anything is not clear. Thanks.