Viewing 4 posts - 1 through 4 (of 4 total)
  • Author
    Posts
  • Anonymous
    Guest
    Post count: 8

    Injuried back in July resulting in a series of epidural injections that didn’t help. I was having some numbness down left leg with some discoloration in feet. I do have djd in L5 S1 with more pain on left side of back into buttocks. The surgen decided to do a discogram since the mri didnt show any pinched nerve. I also had a ct of the pelvis and hips cause of where alot of my pain is and it was normal. I was injected at L3,4, and 5 during the discogram and 3 and 4 were normal but 5 about blew me off the table with pain. It started in low back radiating to lower left side where my pain is now. Upon follow up, dr said all the contrast leaked out everywhere on L5S1 so he feels this is where my pain is coming from. I’m scheduled for a fusion on Oct. 24th. My big question is why would I have more left side burning and pain than in the L5S1 area where the problem is suppose to be? I’ve had Chrio care and nothing has worked and I can’t live like this. I hope you can help me feel better about my decision for surgery. Thank You. I am 46 years old

    Donald Corenman, MD, DC
    Moderator
    Post count: 8427

    You report that you injured your back in July- some 3-4 months ago. You have pain in your back that radiates into your left leg and report degenerative disc disease in the L5-S1 level. You have tried chiropractic care but the symptoms did not improve. The MRI did not note nerve compression so a discogram was completed. The levels L3-4, L4-5 and L5-S1 were tested. L3-4 and L4-5 did not cause pain but L5-S1 was extremely painful and apparently reproduced your typical pain but at increased intensity. The test prompted your surgeon to recommend a fusion of L5-S1. Do I have it correct so far?

    Some questions. Do you have more pain in the left buttocks and leg than you do in the back? If so, is the pain worse with standing and walking or with sitting and bending? Do you have more back pain than buttocks and leg pain? What happened with the spidural steroid injections? Did you keep a pain diary (see website for this)?

    If you have more leg pain than back pain and the pain is increased with standing, you may have lateral recess stenosis or foraminal stenosis. There are various surgical treatments for these diagnoses and fusion could be one of them. It all depends upon the pain generator involved.

    Dr. Corenman

    Anonymous
    Guest
    Post count: 8

    Thank you Dr

    I don’t have much leg pain but most of my pain seems to be left side pain leading into the buttocks. However, pain does occur in low back spreading across to left side. Low back hurts more sitting and standing, bending etc. and hurts when coughing or sneezing with a catch on the left side. The 3 injections I had did nothing. The longest one lasted was for a few hours. When I stretch, it seems to help for a short period of time but then comes right back and at times even worsens with stretching. What does it mean when the contrast all leaked out when they injected the L5 S1 level? Is that concidered a herniation? Because the MRI didnt show any nerve pinching, and the discogram recreated my pain, its his determination that the disc is the source of my pain. Dr said I may still have back pain but If the disc is the problem and it’s removed, then why should I still have backpain? My thinking is that if the disc is gone, how can I still have disc pain or would I? They said 60-70% have succes from the surgery so I’m hoping I’m in the percentage. Thank You for your help!!!

    Donald Corenman, MD, DC
    Moderator
    Post count: 8427

    Your back pain is central and left but most of the pain is in the lower back and not in the buttock and leg. If this is true, then your disc at L5-S1 is the most likely source of your pain.

    The discogram noted full tears through and through the disc wall (the annulus) which allowed the dye to lead out of the center part of the disc. This finding is typical for significant degenerative disc disease (see website under lumbar degenerative disc disease and under discogram).

    You have to understand that there are different causes for back pain and leg pain. Leg pain but not back pain is typically caused by nerve compression. The fact that you have no leg pain and no nerve compression would be expected based upon your MRI findings.

    Back pain is typically caused by a degenerative disc. The fact that the discogram at L5-S1 reproduced your back pain and the discogram noted significant wear and tear of the disc also fits with this disc as the cause of your lower back pain. The upper discs tested (L3-L5) that caused no pain indicates that you have no pain processing issues in your lower brain.

    Percentage success for surgical solution of this problem in my hands is about 90% for two thirds relief of back pain. Most likely, this surgeon has the same percentage.

    Dr. Corenman

Viewing 4 posts - 1 through 4 (of 4 total)
  • You must be logged in to reply to this topic.