When the fire house alarm blared at 3 a.m. one morning in March 2021, Captain Vincent Messina thought he was ready. It was a typical cold start to the job – jumping out of bed the second a call comes in. Getting himself and his crew out the door in 90 seconds.

But this time, a stabbing pain shot down the back of his leg. He could barely get out of bed. He was stunned.

“I grew up being rough on myself and having a job that’s rough on me,” said Messina, 42. “But this back pain was very, very different. I knew something was wrong. I just didn’t know how wrong.”

He ended up going straight home. Not long after, his wife drove him to the emergency room. “If I could give you a 20 of 10, that would be my pain scale,” he said. “It was unbearable. And I’m not trying to sound dramatic, but it’s something I never want to experience again.”

The unexpected diagnosis

One MRI later, the reason was clear: Sciatic pain caused by two disc bulges in his spine.

Sarah Bush

“When a disc bulges out, the nerve that comes out from the spinal canal gets pinched,” said Sarah Bush, family nurse practitioner at Novant Health Brain & Spine Surgery - Kimel Park. “That can cause pain, it can cause numbness and it can cause weakness. Those are the three biggest symptoms that people have.”

Sciatica is the umbrella term for these symptoms, which radiate around the sciatic nerve. The nerve – the largest in the body – runs from the lower back, through the hips and buttocks, and down both legs.

“It can be from a bulging disc, but it can also be from inflammation, swelling or fluid that can compress the nerve,” Bush said. “Usually in the younger population, it’s bulging discs that are the most common reason for sciatic pain.”

Typically a patient with sciatica will be referred to a physical therapist to try to alleviate the symptoms and avoid surgery. If that doesn’t work, they’ll return to their spine specialist to move forward with an MRI and further investigate the pain source.

Messina skipped those steps. It all seemed to happen so fast.

“In hindsight, I had some days over the last year where my foot was hurting and the back of my left leg was hurting,” he said. “I wasn’t sure what was going on, but I never thought it was my back.”

Messina is among the 40% of Americans who experience sciatica at some point in their lives While the frequency of occurrence increases with age, Bush has seen patients across age groups and lifestyles dealing with sciatic pain.

“Primarily it’s just what you’re dealt,” she said. “Your genetics play into it, how good your bone quality is, how healthy you are, how much you’re exercising. Another large population is men who do a lot of heavy lifting, whether it’s for fun or it’s their job.”

Lifting is actually a huge part of Messina’s job. “There’s a lot of patient lifting on medical calls, a lot of getting on and off of trucks, wearing and carrying 50 to 70 pounds’ worth of gear and tools,” he said. He just never thought it would send him into surgery.

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Surgery took less than two hours

Messina went into surgery with orthopedic spine surgeon Dr. Chase Bennett, alongside Bush. The decision was simple. “He explained to me how tissue was putting pressure on nerves all the way around my discs,” Messina said. “And how this was not going to go away.”

Until he woke up in recovery.

“I was able to roll over,” he said. “And I was like, ‘Oh wow, I can roll over.’ Within an hour, I was able to sit on the edge of the bed, and stand up, and move my legs. From the time I went to sleep to the time I woke up, it was two different worlds.”

Getting back to work

Overall, Messina missed about three months of work. “The whole time off, I couldn’t wait to get back,” he said.

But he had plenty of personal work to do with his physical therapist. The months since surgery have been devoted to stretching and core strengthening.

In June, Messina returned to work on a light-duty status. In July, he got back to full-duty status.“I've had no back pain at all, just residual nerve pain, nothing unbearable,” he said. “It’s made me a lot more conscious of how I’m doing my job and properly lifting, and being more disciplined in my movement day to day.”

He’s also grateful that he’s back to doing the job he loves. “It’s ever-evolving, and it keeps you busy and it keeps you training, and if you want to be good at it and you want to do well, you have to maintain levels of education and stay engaged. There’s nothing else I’d rather do.”