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  • wastate
    Member
    Post count: 5

    I am a 43 year old male. I have had foot and leg pain for 5 months now. Have been to physical therapy and chiro. Recent MRI says. Mild degenerative disk disease at l4-l5 and l5-s1 levels resulting in mild crowding of the lateral recesses and mild left l4-l5 foraminal narrowing. Disk contacts the left traversing l5 nerve root in the lateral recess.
    My symptoms are 90% lower leg pain and foot pain. Mostly below the knee, some pain in buttock but not much. Have also been having depression issues because of findings.
    Doctor says it may get better on its own but recommends a cortisone shot to help.
    What is your opinion of the MRI findings and recommended course of action?

    Donald Corenman, MD, DC
    Moderator
    Post count: 8436

    You report 5 months of foot and leg pain associated with buttocks pain. Without the buttocks pain, the differential would have to include entrapment of the common peroneal nerve at the knee but with buttock pain, the source is most likely the lumbar spine.

    Is your pain worse with standing and walking or with sitting? What activities make it worse and better?

    The MRI report appears incomplete. I generally have trouble with word modifiers such as “mild” as I am forced to view the MRI through the radiologist’s eyes. I have had previous patients place their MRI images on flick’r. This does allow others to view your images if you are OK with that.

    Reactive depression is typical with chronic pain.

    Dr. Corenman

    wastate
    Member
    Post count: 5

    Dr. Corenman,

    Walking usually feels very good. Sitting feels worse. The pain is in the calf and foot with pain also in the ankle. It is mostly a constant feeling in the left foot and then in the left calf. Sitting at my desk chair aggravates it more. It is a consistent tingle in my foot. Sometimes is towards the big toe and then other times is toward the left side of the foot. The left side of calf and front of lower leg will ache and burn and when I walk it generally gets better. The buttock pain is not very consistent and has not been very bad.

    I never seen the whole MRI report-only what the doctor told me. I have the mri on disk and have no problem posting it. There are so many images I am not sure which ones to post. There are over 100 images on my disk. Can you direct me which ones I should post?
    Sorry for not being prepared but I do very much appreciate you help.

    wastate
    Member
    Post count: 5

    dr,
    I did create a account and have posted all MRI photos on Flickr.

    Thank you again

    Donald Corenman, MD, DC
    Moderator
    Post count: 8436

    Sitting pain that improves with standing and walking is normally related to a herniated disc but your films look reasonably good. You have some small tears and minimal bulges but all in all with the smaller images I have seen, there is no obvious compression of a nerve root. The possibility of a peroneal nerve injury is possible. This nerve is exposed at the lateral aspect of the knee and if compressed, can cause these symptoms.

    Ask your doctor if you would be a candidate for a conduction nerve test of the involved leg (EMG/NCV).

    Dr. Corenman

    wastate
    Member
    Post count: 5

    Dr. Corenman,

    THANK YOU VERY MUCH FOR TAKING THE TIME YOU DO TO LOOK AND GIVE YOUR OPINION. It is really a wonderful thing you do here on your forum and it really does matter for me (and I am sure everyone)to hear what you have to say.

    I really appreciate your time and will discuss this with my doctor.
    Thank you again and I really appreciate your advice.

    Best regards

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