[agpt69]

#7125

i am 20 years old , having pain in left leg and buttock from about 7-9 months , in MRI results is

(i]Reduction of the usual lumbar lordosis is seen.
The L4-5 and L5-S1 discss how early desiccativec hanges.
Broad based posterior protrusion is seen atL4-5level causing mild thecal sac compression.
Asymmetric right lateral tlisc bulge with posterior central protrusion is seen at LS-SI level
cuusing effucement of anterior epidural fat und mild thecal sdc compression. In uddition, mild
degenerative .facetal urthroputhic changes are also seen at this level (left > right) causing
moderute narrowing of biluteral lateral recess und neuralforamen.
Intravertebral disc herniations are also seen at L3′ L5 level.
None of the discs show any acute annulus tear or peridiscal inflammation.
Visualized dorsal cord is unremarkable.
The anteroposteror diameter of the lumbar canal ure given in table below:
LEVEL DIAMETERS COMMENT
L] -12 20.5 mm W.N.L
L2-13 1 7 . 7m m W.N.L
L3-L4 18.5 mm t4/.N.L
L4-L5 I3.9 mm W.N.L
L5-SI I 1.8 mm W.N.L
Normal AP diameter is >11.5mm “AFea” is >100 mm
Minimul fluitt is seen in the left L4/5 ancl LS/SI facet joints …could be acute partial ligament/
OPINION: MR OF THE LUMBOSACRAL SPINE SHOWS
O PARTIAL LUMBRALIZATION OF SI VERTEBRA
O BROAD BASED POSTERIOR PROTRUSION AT L4-5 LEVEL CAUSING MILD
THECAL SAC COMPRESSION.
O ASYMMETRIC RIGHT LATERAL DISC BULGE WITH POSTEKIOR CENTRAL
PROTRUSION & MILD DEGENERATIVE FACETAL ARTHROPATHIC
CHANGES (left
. ANTERIOR EPIDURAL FAT, MILD THECAL SAC COMPRESSION &
MODERATE NARROWING OF BILATERAL LATERAL RECESS AND NEURAL
FORAMEN.
o MINIMAL FLUID IN THE LEFT L4/5 AND L,/SI FACET JOINTS …/uld be
Please giltelate clinically for any compressive rudiculopath
[/i][/b][/b]

. what should i do ?

sometimes there is problem in walking too , and in leg rise test , it only rises upto 20 degrees .

[agpt69]

#7126

i’ve mailed the full mri to your mailing address

[Donald Corenman, MD, DC]

#7128

MRI images are very important to understand the “geography” of the back but must be correlated with symptoms and physical examination findings to fully understand the pathology present. Please see the section under “Conditions”- “How to describe symptoms” to fully convey what problems you are experiencing.

I can say that at twenty years of age with two levels of degenerative disc disease, you have a genetic prdisposition for degenerative changes. If you can describe your symptoms in more detail, I can give you more information.

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.

[agpt69]

#7145

There is very little and rare pain in lower back , the pain starts from the left side or sacroiliac area and extends up to left buttocks , thigh and up to calf . the pain is mild in normal walking but it is very much when I stand up after sitting for a long time , then its sometimes difficult to even stand on left leg , I cannot run or move swiftly . There is no thickening, color change or nail changes or any other skin changes.
My pain is 80% in buttock and thigh and 20% in sacroiliac area, normally walking and when get up from resting there is no pain in sacroiliac area and calf and about 2-3 VAS on buttock and thigh, but when getting up after sitting for quite a while sacroiliac area(2-3 VAS) , buttock(4-5 VAS) , thigh(5-6 VAS) calf(2-3 VAS), lower back(2-3 VAS)
I don’t feel any weakness in my legs; however I cannot use my full strength of my legs due to pain and fear of aggravating the problem.
pain started in October last year I don’t know why , it was very mild before , I thought it to be a muscle stretch or stiffness so I started working out , stretching and jogging , then the pain started growing . , in December I visited a physiotherapist , she also thought it to be stiffness and she also did stretching and gave hot patches and ultrasound treatment on my lower back and left thigh, then I did it for a week and then left as I have to join college again . I continued jogging , then in February pain increased about(2-3 VAS) and I went for MRI , then I started resting and took muscle relaxants and neuropathic pain relievers, they just did short time relieve
Standing does not cause pain however prolonged walking causes pain in thigh and buttock. Sitting is what actually causes pain, sitting does not create problem but when it’s time to get up, the problem starts . I cannot stand straight for a few seconds after getting up , I have to straighten my back . while bending left thigh and buttock pains. I have to come and lie fro about 30 mins down to give rest at least twice in 12 hours.
Pain is less in morning but it is large in evening time, majorly it is after sitting for a long time .
The pain has changed my lifestyle a lot, I cannot run nor jump from a little height, its very sad seeing my friends playing football, dancing and just jumping around and I cannot do so. I don’t get involved in rushed areas where I can get a push or jerk and I avoid road travelling for long distances as you know Indian roads are sometimes not that flat, I prefer railways now. I avoid being in a 5D show which was best earlier.
I am pursuing my bachelors in civil engineering, it’s not a kind of job of sitting for a long time but it sometimes involves doing some physical work in college, like lifting little weight and standing for a long time (say 2-3 hours). I live in hostel so we have to walk to college (1 mile), now I leave about 30 minutes before as I walk slowly with respect to earlier 10-15 mins .
As I have told you I have taken muscle relaxants, neuropathic pain relievers, I have seen a chiropractor, but he does not hold any degree to do so , he just didi this on the basis of his 20years of experience , he has cured many patients before . in march, he gave a little jerk in my back producing knuckling sound, it got some relieve , but then I have to go to hilly areas in june as a part of my college internship and there problem aggravated. I have seen a surgeon, he told me to rest a lot , but due to my college I cannot do so , he also told to give some injection in my back or surgery , but I didn’t go for anything . now I do some exercises told by the chiropractor, like folding the legs while lying down on a hard bed , and doing Bhujangasana (a form of yoga)

As of your previous reply of heredity, my mother used to have back pain , but it wasn’t disc problem .
My height is 184 cms and wight is 85Kg(188 pounds)

Please help me Dr.Corenman.

[Donald Corenman, MD, DC]

#7153

Your pain is classic for lateral recess or foraminal stenosis. The pain is generated by the congenitally narrowed region that the nerve root passes through. When you stand from a sitting position, the nerve moves and translates not unlike a brake cable on a bicycle. This transitional movement of the nerve can cause it to “catch’ in a narrowed zone. Also, the act of standing causes the lower back to change from a flexed position to an extended position.

This change to extension narrows the two transitional zones (lateral recess and foramen- see website for more details). If these zones are congenitally or developmentally narrowed (you were either born with this narrowing or degenerative changes have narrowed it), the nerve will become pinched and pain in the buttocks and thigh will occur.

Your MRI notes this narrowing (” ANTERIOR EPIDURAL FAT, MILD THECAL SAC COMPRESSION & MODERATE NARROWING OF BILATERAL LATERAL RECESS AND NEURAL FORAMEN”.

If this is the case (a good physical examination and careful evaluation of the images will reveal this), epidural injections can be very helpful. Also, a flat back therapy program will be effective in reducing the lumbar lordosis and therefore reducing the pressure on the nerve 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.

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