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  • Typical
    Participant
    Post count: 10

    I know you can’t give a definitive answer based off of a forum post, I’m just running it by you.

    31 years old
    Male

    Had L4/L5 microdiscectomy December 2019.

    Flare ups on and off, since.

    Effected side: left. Pain was typical. Mostly originated in the left glute and radiated down to the toes with some tingling and numbness.

    This time, it’s real bad.
    It was aggravated by sitting down.
    Not aggressively,not plopping down, just normally sitting down.

    It happened after about 4 hours of sitting in a work vehicle. 5 hours that morning if you count my commute to work.

    Got back up and my lower back muscles and gluten, piriformis,etc.
    They all started tensing up and I could hardly walk.
    Spasming resulting in a canted to the side posture started soon after and remains.

    Urgent care was visited, X-rays of the lumbar spine were taken and showed nothing as far as the Doctor was concerned.

    400mg Naproxen, 300mg-30mg Aceteminophen-codiene and 10mg cyclobenzaprine was prescribed and it helped.

    Once that ran out, its back to being unbearably painful. Excruciating to sit, stand, and even lie down. Pillows under the knees in a supine position does not alleviate any pain.

    The only success MAY come from sleeping sideways on the non painful side with a pillow between the legs.

    Can’t stand for longer than a minute without intense pain and instability.

    Walking down stairs if fine.
    Walking UP stairs is a sure way to activate intense pain in the effected side.

    Sitting hurts the effected side.

    Any load bearing on the effected side results in pain.

    The pain radiates from the upper left glute down the middle, the side glute, posterior hamstring and finally ending in the lateral calf.

    What stands out to you?
    What’s your hunch?
    Sound like an SI joint problem or disc problem?

    I’ll be seeing my orthopaedic surgeon, regardless, and possibly a chiropractor.

    But, I’ve always respected your opinion and point of view and am genuinely eager to read your response.

    Have a great day.

    Typical
    Participant
    Post count: 10

    Also, I do remember a physical therapist ,recently (this year), telling me my effected leg was slightly shorter than my other leg.

    I understand this can cause these types of problems.

    Donald Corenman, MD, DC
    Moderator
    Post count: 8660

    I did a study on SI region pain and found the SI joint was the culprit only 6% of the time. Most likely, you have a recurrent disc herniation. A new MRI and an injection might be in your future. I assume you were examined and do not have motor weakness in your ankle or your buttocks.

    Dr. Corenman

    PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
     
    Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.
    Typical
    Participant
    Post count: 10

    You assumed correctly!

    I WAS just checked out a few days ago by my orthopaedic surgeon and he believes the same.

    No weakness in buttocks or ankle.

    Noticed that the uneffected leg would set off nerve pain in The effected side!
    Odd.

    Also, I barely caught it, but he was orally dictating his notes to an assistant and during the straight leg raise tests, he noted them as “C-SLR”.
    Not sure what that could mean.

    I mentioned wanting to see a Chiro and he shot me a look that basically said “don’t do it.”
    So that’s that, lol.

    I’m going to get another MRI and we’ll take it from there.

    Anyways, looks like you’re dead on the money, as usual.

    Donald Corenman, MD, DC
    Moderator
    Post count: 8660

    “He was orally dictating his notes to an assistant and during the straight leg raise tests, he noted them as “C-SLR”. That is a contralateral straight les raise test (pain in opposite leg lifting up the “good” leg). This is also an indication of a new HNP.

    Dr. Corenman

    PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
     
    Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.
    Typical
    Participant
    Post count: 10

    Quick update.
    An MRI revealed it’s a recurrent disc herniation at L4/L5 at 9mm.
    The previous herniation pre microdiscectomy, was 5mm.
    Not much disc material left to work with.
    Looks like it’s gonna be a fusion.
    I’m not thrilled about it and the recovery is scary looking.
    But it’s better to get these things done while I’m still young, imo.

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