Viewing 6 posts - 1 through 6 (of 14 total)
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  • Ptb1230
    Participant
    Post count: 7

    Hi there
    For the past year and a half I have had chronic left buttock pain that tends to be mainly at the top but is sometimes located centrally, I have received physio on the NHS in England which consisted of McKenzie stretches for back pain (I have no back pain whatsoever) which only aggravated the symptoms, the pain symptoms tend to be a cold tingling in my buttock that can travel down to the outside of my thigh running down to the knee and are considerably worse when sitting almost instantly. I was a keen runner but had to stop all forms of activity for fear of making things worse, however my physio suggested that if running doesn’t aggravate the pain then do it but cautiously and to build up the pain threshold. Prior to this I have had an MRI Spine Lumbar and Sacral scan that suggests the following; central and left paracentral disc bulge at L5 S1 that impinges the left nerve root within the left lateral recess. Three weeks ago I had a Caudal Epidural that did nothing to relieve my pain when sitting ( this is what gets to me most). I don’t want any form of surgery, but on the other hand this is affecting my hobby of running, my family life and work. I would love any advice that can be offered to help me get back to where I was nearly 2yrs ago.
    Pete.

    Donald Corenman, MD, DC
    Moderator
    Post count: 8656

    You have symptoms of a typical herniated disc at L5-S1 causing S1 root compression. The herniation causes compression of the S1 root when sitting (normal symptoms) as well as standing symptoms (lateral recess stenosis caused). Having this pain for 1 1/2 years means you should consider surgery (a microdiscectomy). The length of time for your symptoms concerns me as chronic injury to the nerve root can occur with prolonged compression of the root.

    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.
    Ptb1230
    Participant
    Post count: 7

    Hi there

    Thank you for your reply to my previous post #23468. I have a couple more question that I would like advice on please. First of all I am still in the same predicament as before only I have had 2 more spinal injections that gave just 2 weeks reduction of pain only for the usual symptoms to reappear (buttock pain and pins and needles on the outer thigh heading towards the knee, sometimes the pain is less severe but it is always there). I have discussed this issue with my consultant (I’m still based in the U.K.) who is now sending me for another MRI scan. He has now said that because the pain has not resided he could perform a spinal decompression but he cannot guarantee that it wil work. I also discussed whether my problem could be Piriformis Syndrome but he said it would have shown up on a previous MRI scan. Could I have Piriformis Syndrome? Or, because the problem is chronic and my last MRI scan shows a mild disc bulge at L5 S1 is this really my core problem? I have been able to perform some very light jogging in which the buttock pain does not appear or hinder me whilst running on the day after. It seems that my pain is aggravated more by sitting or standing in the same position for too long. I have tried swimming which gave some mild reoccurrence of buttock pain. If my surgeon/consultant cannot guarantee a success where does this leave me? I do not want to take medication long term but I need regular exercise as I am now beginning to put on weight which I have no doubt this would aggravate my existing problem. Any advice would be greatly received.

    Pete.

    Donald Corenman, MD, DC
    Moderator
    Post count: 8656

    I think you should go ahead with your decompression. Yes, the results may not be as great as if you had this decompression years ago but the success rate should still be in the 80-85% range. The decompression might not give complete relief but should be satisfactory to you.

    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.
    Ptb1230
    Participant
    Post count: 7

    Hi
    I am replying to chat from several months ago (25453).
    I decided not to go through with any back surgery as the pain in my buttock had gone -this is over a 4 month period now. However, as the pain resided I began to experience severe pain in the groin (opposite side to the previous buttock/disk pain), this was eventually checked out and a direct inguinal hernia was diagnosed. Recently this ‘hernia pain’ had completey resided, only for my buttock pain to return, with exactly the same symptoms as before. How likely is it that the two are connected and is it usual to have sporadic groin/referred back pain?
    I will point out, that throughout these months I was able to get back into jogging and the referred pain did not present itself when jogging. As mentioned before I am reluctant to have surgery, but feel this is where it is heading. Any advice would be great.
    Many thanks
    Pete

    Donald Corenman, MD, DC
    Moderator
    Post count: 8656

    Groin pain can be generated from an L1 nerve compression, a hip disorder, a hernia as you noted, a problem with the testicle or from an S2 nerve disorder (generally not caused by compression). Since your buttocks pain has returned and you probably still have that compression at L5-S1, a new MRI to confirm the herniation should be considered. If still present, you could consider a selective nerve root block to confirm that the compression of the nerve continues to cause your buttocks pain and have the hope that the steroid could control the pain obviating the need for surgery. Finally, if the block is diagnostic but not therapeutic, you could then consider the surgery.

    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.
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