Extreme lower back and sciatic pain in leg

Tagged: Lower back and sciatic pain

Viewing 4 posts - 1 through 4 (of 4 total)

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Roan
Participant

October 11, 2019 at 9:33 am

Post count: 2

#31285

Good day

For many years ive had some lower back pain and the occasional sciatic flare up for time to time.

About 4 months ago it started but this time it was a bit worse. I went to see my general practitioner and he put me on a course of cortisone and anti inflationary meds. This did not take the pain away. The pain only started getting worse. He then send me for an MRI and referred me to a orthopedic spinal surgeon. My MRI showed a small disc herniation at the L5 and inflammation of the nerve. Surgery was not an option for the and they decided to give me facet blocks. The facet injection did not take the pain away at all. Dr advised me to just be patient because the steroids takes a few weeks to absorb and he gave me pain meds and anti inflamitory.

It’s been 3 weeks after the injections and the pain is still unbearable. I can hardly walk. My leg is sore and burns badly all the time. Only time I have some relief is when I’m lying on my back with heat on my leg and back.

I’ve been back to my surgeon and he still feels that surgery is definitely not necessary. He feels the herniation is to small and not worth the risks of surgery. They say I must just be patient and that the pain will get better.

I’m not convinced of this. It’s been 4 months of extreme pain. The pain is totally controlling my life and it’s extremely hard to walk or do anything.

I see a physical therapist 2 a week to try and manage the pain but that is also getting to expensive.

Should I go and get more opinions or is it normal for a herniated disc to take this long to heal and cause so much pain down my leg?

Im scared of long term nerve damage and I’m desperate to be rid of this pain that’s been ruining my life for the past 4 months.

Any advice will be greatly appreciated.

Thank you in advance

Donald Corenman, MD, DC
Moderator

October 12, 2019 at 3:34 am

Post count: 8660

#31286

I am surprised that you had a disc herniation compressing the nerve root and underwent facet blocks as a treatment. The facet is on the opposite side of the spine from the nerve root and steroid here probably won’t help calm the nerve root. You have had 4 months of pain and there are good studies that indicate that this nerve inflammation should be addressed before 6 months. Why you have continued pain and your surgeon will not consider surgery (as long as the herniation is still compressing the nerve root) is unusual. Maybe he or she feels the herniation is too small to cause pain. At least you should be given the opportunity to have an epidural steroid injection which could help.

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.

Roan
Participant

October 12, 2019 at 4:36 am

Post count: 2

#31290

Thank you for your reply Dr.

It was my understanding from the spinal Dr who did the facet injections that the injections are corticosteroids and local anesthetic. Not sure if it’s for health insurance that they only call it facet blocks. The pain was away for about 24 hours and then it all returned.

I do believe that he feels the herniation is to small for operating and that the risks of an operation is not worth it. But at the same time I am still in a lot of pain. Want me to go and do another MRI to see if the herniation might of increased.
But his personal opinion is that I must just hold out and that the pain will go away.

He did put me on very strong pain meds but I realized that I was developing an habit for them because they are opioid based. We decided that I should leave all the meds and only take over the counter pain meds. So the pain has been very high the last few days.

I decided to give it another 4 weeks of rest and working with the physical therapist. And if there still is no improvement to go and see another Dr (neurosurgeon) for another opinion.

I’m just frustrated and lost at the moment. I hoped that after the facet blocks did not work the next step will be a microdiscectomy and this will finally be over. But now that he said I must just hold out its a bit disappointing and scared there might be something els wrong they not picking up on MRI or scans.

I’m a very active person, paragliding, motorcycle racing, and not being able to even dress myself is very depressing.

Once again thank you for listening to my problem and taking the time to reply. It’s really appreciated.

Donald Corenman, MD, DC
Moderator

October 14, 2019 at 8:54 am

Post count: 8660

#31299

I’m uninformed regarding the herniation location, size and morphology. Your surgeon could be spot on regarding the insignificance of this HNP. Maybe read the radiological report as all MRIs have to be read by a radiologist simply to double-check the information you are obtaining.

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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Donald Corenman, MD, DC

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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.

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