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  • thevisi0na
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    Post count: 1

    Good evening. It has been an arduous journey trying to get to the bottom of this sciatica problem.

    I have sciatic nerve pain exclusively in the right leg. I have had several M.r.i’s done with and without contrast. On the left side I have moderate to significant herniations on 2 levels (l4l5, l5s1) and stenosis, along with facet hypertrophy. On the right side I have herniations on three levels (l3l4, l4l5, l5s1), these have been described as basically being moderate at best. I also have stenosis on the right side.

    I have done months of physical therapy, had at least 10 injections, and had a microdiscectomy/laminectomy on the l4l5 right side. Everything has either done nothing or made the symptoms worse. My last surgeon told me I had a degree of recurrent herniation and he believed that was what was causing the continuation of symptoms. I saw a new surgeon and he is skeptical as to the right side herniations causing the severity of sciatica symptoms I experience. Also citing that most of my spine degeneration was on the left side.

    I was reading a study that suggested that contralateral symptoms can occur in some people, left side herniations causing right side pain. I have never had injections on the left side.

    My two questions are:
    1. How possible is this?
    2. If I receive diagnostic injections on the left, and I do not see relief is it still possible that they are contributing to the symptoms?

    Donald Corenman, MD, DC
    Moderator
    Post count: 8656

    First-did the symptoms change at all after the microdiscectomy, even in the short term?
    Second-do your symptoms come on with standing and waking or with sitting?

    Diagnostic injections should yield temporary relief if the correct structure is anesthetized. You must aggravate the symptoms before the injection and try and reproduce symptoms doing the activity that causes pain for the first three hours after the injection.

    Contralateral symptoms can occur as cross-over symptoms occasionally but only as an “echo” of the severe side. You will not have a right herniation and only a left sided leg pain.

    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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