rizwMemberMay 4, 2013 at 11:31 amPost count: 2
Dear Dr Coreman,
Writing below my history as best as I can. I have had back pain after shovelling for 3 hours eight months ago. I also have lower foot discomfort in the bottom of the left foot. I developed simultaneous depression. The back pain eased a bit after 4 weeks but never cured. There have beenn varying symptoms since then. I persisted working for six months. CT and xray did not show anything. Ct was done because of non availability where I lived. During this whole six months it was agonising and I could not stand at the end of the day. I gave up work after this and have been bed ridden ever since. Had a recent MRI is showing broad disc protrusion at l5 s1 with moderate foraminal compression and left sided protrusion at l4 l5 with moderate foraminal compression. I am currently experiencing left sided muscle twitching and back pain. From the very begining the symptoms have been left sided. The back pain is more to the left side. It varies in intensity and nature, sometimes burns, sometimes aches. At times it is all thru the lower back and buttocks. Long standing is not possible. I am bed ridden these days and cannot take up a whole day. I also have left sided lower foot pain and sensations and muscle twitching.
As I am bed ridden and unmotivated I do not believe I can do more in terms of actively seeking treatment. However, I would like to know what would be the natural history of this condition if I let this condition go on without doing much ? I do not think I would explore surgical treatment as probably post op I would remain unmotivated and not do whatever is required to get going.Donald Corenman, MD, DCModeratorMay 4, 2013 at 8:14 pmPost count: 8455
Lower back pain can originate from the discs, facets, occasionally nerve roots and rarely, the sacroiliac joint. Even more rare is neuropathic pain, chronic pain mediated by small filamentous nerves that were injured by an unknown mechanism.
Most pain originating in the lower back is disc mediated. You have two degenerative discs in your back with “bulges” or herniations toward the left. I assume you have already undergone a thorough rehabilitation process. If not, this is the first step along with getting your depression treated. If you have failed rehab, you need to see an experienced spine surgeon and undergo a workup possibly including facet blocks and discograms.
More likely than not, there is a surgical solution to your pain.
Dr. CorenmanrizwMemberMay 6, 2013 at 2:11 pmPost count: 2
If surgery were to be done as there are two disc, woul it mean fusionDonald Corenman, MD, DCModeratorMay 12, 2013 at 8:45 amPost count: 8455
If you have foraminal stenosis, fusion may or may not be required. If the disc space is collapsed on the side of the foraminal stenosis, surgery without realigning the two vertebrae has a much lower success rate. If this is simply nerve compression from lateral recess stenosis or a disc hernation compressing the root, a microdecompression (like a microdiscectomy) would be all that is required.
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