At the end of my tether

Viewing 6 posts - 1 through 6 (of 7 total)

1 2 Next

Author

Posts
persiankitty
Member

December 30, 2011 at 11:47 pm

Post count: 4

#5284

Dear Dr Corenman,

I am a 29 year old female, of average build, no previous back problems – and since July 2011 I have had a continuous lower back ache which built up becoming worse and worse – in September I developed pain from basically my right buttock down through my leg into my foot (particular my ankle which is weak due to a couple of sprains in the last few years) which I understand is sciatica. My doctor prescribed Naproxen for the pain but it didn’t touch it. I went for Xrays on my lumbar spine and nothing showed up of note. During all this time, things were gradually getting more painful and difficult and by the middle of November, I could not sit down or get up, or walk without excruciating pain. I had to get signed off work at this point.

During October, I tried acupuncture and basic physio (referred by my doctor) but neither did anything which helped. I felt like the exercises were slightly adding to the pain.

I was referred to the local spinal unit and they tried me on amitryptine, which I know is an AD but they said it can be used for chronic back pain, and it did nothing but give me bad side effects so I stopped that and went onto Lyrica pregabalin, and this has finally done something for the pain, especially when taken with a couple of normal paracetamol/aspirin tablets every day, however the root cause remains undiagnosed. The lady at the spinal unit who is a specialist physio thinks it’s a muscle spasm problem and the normal physio is adamant that’s it’s a bulging disc. I am just at my wit’s end with it all and am finally getting an MRI scan in 2 weeks after begging my doctor to send me there. It is starting to affect my mental health and I am worried that something serious lies behind it all. I recently feel like the pain is spreading to the left side of my lower back but I’m not sure whether it could be my overuse of that side to compensate for my right side.

More recently, my right hip feels like it’s burning sometimes (although this doesn’t happen every day), and i get twinges in the same specific part of my right lower back on and off – it’s not so much a pain, just a sensation like someone’s poking it – the sciatica has remained with pins and needles in my right foot.

Anyway, sorry to go on. I wondered if you had any advice on what sounded most likely from what I describe above please?

Many thanks in advance for your help.

Donald Corenman, MD, DC
Moderator

December 31, 2011 at 3:11 am

Post count: 8660

#5286

By the history of your pain, you most likely have a herniated disc in the lumbar spine at L4-5 or L5-S1. The MRI will help diagnose that. There are some other disorders that can cause these symptoms but the disc herniation is by far the most common one.

Treatment depends upon the amount of pain experienced and the presence of any weakness in the muscles that are serviced by that nerve. If there is weakness present, it is my opinion that surgery needs to be performed. If there is no weakness, then an epidural injection (see website) should be performed. If good long term relief is noted, then that is the only treatment needed. The injection may need to be repeated. If only temporary relief is noted, surgery can be considered. See the video on the lumbar microdiscectomy on the website.

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.

persiankitty
Member

January 1, 2012 at 5:44 am

Post count: 4

#5289

Dear Dr. Corenman,

Thanks ever so much for the quick response – I really appreciate it. May I ask a couple more questions related to this is you don’t mind please?

1) Does it sound ok that I’m getting a lot of pain at the front of my knee of the affected (right) side (as well as the pain I mentioned in my initial post)? It’s only started hurting a lot more recently, but I didn’t know if that was the sciatic nerve again.

2) I have been on Lyrica Pregabalin 300mg daily for the last month now – is it safe to continue taking this for the forseeable future? I have not been told when I can stop taking it but someone at my work said it ‘rewires’ your brain and I shouldn’t take it (they are not a doctor!)

3) Lastly, I don’t have any weakness in my muscles (touch wood) so far – if I was ultimately offered the epidural injection, for someone of my age (29), can it be harmful at all to my body into the long term?

Best wishes (and a happy new year to you)

persiankitty
Member

January 10, 2012 at 2:22 am

Post count: 4

#5329

Dear Dr. Corenman,

I’ve now had my scan – they are keeping me waiting for the results. Is there any way at all that you would comment on a couple of my scans please at: deleted

The time it’s taken to get to this point and the waiting for results is now upsetting me daily and I am becoming a wreck. I have been really worried about what might show up. I understand if this is something you can’t/don’t do through your site, but I would be so grateful if you are able to take a quick look.

Best wishes

Donald Corenman, MD, DC
Moderator

January 11, 2012 at 2:59 am

Post count: 8660

#5334

I cannot look at scans privately when the address is displayed on this forum. This forum is anonymous. If you would like me to look at these scans, please call my office to send the scans in by mail or Fed ex. The phone number is (970) 476-1100 and talk to one of my nurses- Diana or Sarah.

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.

persiankitty
Member

September 26, 2012 at 4:57 pm

Post count: 4

#7021

Dear Dr Corenman,

Since my last posting, i’ve now had microdiscectomy surgery on my L5-S1, L4-L5 discs. This is after having the problem for about a year. I am now in week 11 of my recovery period and I am still getting sciatic pain, although this is a little less than before and I am walking better. I have been off to a slow start with the recovery due to sciatic pain post-surgery first settling, then flaring up again, then settling. I had to see a pain nurse twice. I am also getting a hot sensation on the underside of the foot of the side where I had the back problem and sciatica – this heat goes into my ankle – it comes and goes. It’s new, and I’m not sure why it’s happening. I’ve tried contacting my hospital but noone gets back to me! I guess I am seeking reassurance that this is normal and nothing to worry about – I have no idea what’s going on in my body – I guess I was hoping the pain and discomfort would disappear quite quickly, but it’s not been like that at all. Do some people experience a recovery like this post-surgery, and does it mean that the surgery has not been effective?

any advice appreciated,

Thanks.
Author

Posts

Viewing 6 posts - 1 through 6 (of 7 total)

1 2 Next

You must be logged in to reply to this topic.

Donald Corenman, MD, DC

Average rating:

81 reviews

Eric S

Sep 26, 2021

by Eric S on Donald Corenman, MD, DC

Successful pars repair at 46 years old

Back in November of 2018 (at 46 years old) I came from Vancouver BC to have a pars repair done with Dr. Donald Corenman at the Steadman Clinic in Vail Colorado. I'm finally posting this review nearly three years later in late 2021. The reason I waited so long was I wanted to know the final result before I posted my review. Unfortunately in that time Dr. Corenman has retired. Nevertheless, I want to post this review of Dr. Corenman and his staff at the Steadman Clinic in their excellent treatment of my L5 pars interarticularis.

I fractured my pars at age 42 back in 2014 when rolling on the gym floor, and was denied treatment by the Canadian healthcare system, probably due to my age. First my GP told me there was no surgical option for a pars defect, which was quite incorrect! I tried to live with it, but the symptoms worsened (periodic random spine slippage and weeks of resultant pain after just bending over to tie my shoe, so I eventually learned to mostly squat and hardly bend). When I finally consulted with Canadian spine surgeons, I was told they believed my pars defect had been congenital (since birth). This was absurd, considering I had done extreme martial arts (including jiu jitsu) for years prior, as well as 5 years of reinforcing steel full time in my 20s, probably the hardest job on the back you can find. No pars defect like mine would possibly have allowed this--ergo it was impossible that I had had the defect since birth. I did however have an asymptomatic congenital spina bifida occulta that made me more susceptible to a pars fracture. In 2014 in one instant, I went from having the strongest back people I knew said they'd ever seen, to being unable to safely bend over and tie my shoe without a non-negligible risk of my spine slipping randomly (which would lead to weeks of pain after each occurrence). This was due to the unilateral L5 pars defect, otherwise known as spondylolysis. It was when lying in pain on the floor 4 years later after maybe the 6th spine slippage event post injury, that I had had enough, and resolved to have surgery. If Canada's "universal health care" said no, I would make lemonade from lemons, and find the very best surgeon in the world at pars repairs. That was Dr. Donald Corenman. Dr. Corenman back in 2018 ran a website https://neckandback.com/ that dedicated many pages to the science of every aspect of pars repairs, from eligibility (good discs on MRI), to best surgical techniques (minimal open compared to minimally invasive), best imaging to use (i.e., O-Arm with Stealth imaging vs. older fluoroscopy), the ideal amount of BMP to use and why not use too much or too little, and much more, all to do with pars repairs, pages upon pages of his site just on the pars, with scientific references and his own extensive expert opinion. As a health research statistician, I was very impressed with this. It was in stark contrast to the websites of other spine surgeons which barely gave the pars a word or two, focusing almost exclusively on fusions. I had found the best surgeon in the world for pars repairs, and so after Dr. Corenman personally screened my MRI to ensure my discs were healthy, I booked the surgery.

Being 46 years old at the time of surgery in 2018, with a 4-year-old pars fracture from 2014 combined with a congenital SBO meant my pars fragment was somewhat atrophied, but it was "very solid", said Dr. Corenman in the operative report. Nevertheless, it was challenging with two things to fix, the pars and SBO, and OR time was around 4 hours. Recovery over the following months was guided by a very clear "Spine binder" from the Steadman Clinic with strict rules of "no BLT" (no bending, lifting or twisting), and illustrated physiotherapy guidelines. They even warned patients to avoid fish oil supplements, which could excessively dampen inflammation and hence slow bone healing. They answered many questions I had during months of recovery, with responses coming from the very supportive Lori Fugate (then director of Dr. Corenman's practice), and Ehrich Bean (then physician's assistant at the practice), as well as a couple calls with Dr. Corenman himself after two of the CT scans. Ehrich Bean offered great advice for taking the spine binder conservatively due to the nature of pars repairs vs. fusions. The final post-op CT scan I had was a couple weeks ago at 34 months post-op, and Dr. Corenman had retired, but I got a very positive and informative call from Eric Strauch (current PA at the Steadman Clinic under Dr. Corenman's replacement there, and who had also worked with Dr. Corenman previously). The staff at the Steadman Clinic were extremely supportive all the way through the process. I should mention, the local Canadian spine surgeon did offer me very good post-operative support including antibiotics as needed to deal with a mild surface incision-site infection early on, booking numerous x-rays when I felt something was amiss, as well as booking all four of my post-op CT scans. I am very grateful for that support also.

My final result shows plenty of solid bone across the pars and a healed SBO, with my vertebral body now a solid bone ring instead of being broken at two places as it was pre-op. Does my spine hold up in the real world? You bet! I have recently dug and moved several yards of dirt and sand and gravel by myself (shovel and wheelbarrow!) to fix our water main, pulled roots from the yard, moved several "portable" (these are HUGE) air conditioners up several flights of stairs my myself, and lifted weights. I now run 2 miles (3.2 KM) several times weekly with a hard 100 meter dash in the middle. I bend deeply before each run I go on, with no spine slippage. My spine feels amazing. I can bend over to do exercise, or real word tasks, with no risk of spine slippage.

My sincere thanks to God, Dr. Donald Corenman, Lori Fugate, Ehrich Bean, Eric Strauch, and the Steadman Clinic, as well as the Canadian spine surgeon who offered me excellent post-operative care back in Canada. You have all given me a new lease on life.

Sincerely,
Eric S

Robert S

May 11, 2021

by Robert S on Donald Corenman, MD, DC

Back Fusion Surgery

I had my entire lumbar spine fused in November of 2018. I had scoliosis , with pinched nerves that were so painful I could hardly walk - and standing for more than a few minutes was impossible. Even sitting was painful.
The fusion surgery produced immediate relief! And the recovery was much easier than I expected.
To this day I can do all the activities I love from hiking, to standing in a stream fly fishing to riding my bike long distances - or just walking down the street with my wife.
Kudos to Dr. Corenman and his staff, (including the two Erics) for taking such good care of me!

Leslie R

Jul 9, 2020

by Leslie R on Donald Corenman, MD, DC

TLIF

I had my TLIF surgery on 6/24/2020 by Dr. Corenman, I can not say enough good things about the Dr or his staff. I was always treated with respect and explained everything throughly, that made it easy for everyone to understand. I highly recommend Dr. Corenman and the Steadman Clinic.

Submit your review
First Name, Last Initial:
Email:
Review Title:
Rating:	1 2 3 4 5
Review:

Check this box to confirm you are human.
Submit Cancel