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  • ahmedhelalm
    Member
    Post count: 3

    My mother (47 years old) school teacher, with 3 kids

    It initially started 1 year ago, with pain in her left leg, but then 6 months ago the symptoms that am describing now started happening and got very intense 2 weeks ago, pain is almost there 24/7, and it increases when she does activities like driving, or doing any physical effort, but driving a car is one of the things that increase the pain the most.

    – She suffers from pain (that she describes as tearing, as if she feels a knife cutting through her) in the 2nd half region of her back, mostly concentrated in her Lower back (pain’s strongest point is the lumber area), also she feels the pain extends through the sides of her back not just the back bone/spinal cord area.

    – That back pain extends to both right and left hips, she can feel the pain passing down to the center of both left and right hips.

    – She feels also strong pain in her left leg starting from her back going through hips, leg, back part of the knee, down to the foot, till her feet and fingers down there.

    – In her right leg she feels also pain but its quiet insignificant compared to what she feels in her left leg.

    – She doesnt feel any pain when urinating, and she doesnt complain about any pain in her bladder
    – She doesnt feel any pain in her knee, except that back part area of her left knee where she feels its the same pain extending from her hips down to her feet.
    – She doesnt have any menstrual abnormalities/pain.

    – Occasionaly when waking up from bed after sleep or after walking a lot, she feels that she isnt able to control both her legs, that they almost cant carry her body and she is about to fall

    , feeling both legs almost numb.

    – About once per week, it happens that her left leg makes an involuntarily move that she didnt mean to do, which disorients her and some times causes her to fall.

    – Recently she started also feeling some pain in her left shoulder, and numbness in her left arm also started feeling some pain her whole left body region that turns into numbness after

    minutes.

    We checked several doctors and the problem is each one come up with a different diagnosis, and requiring a different surgerical operation to be done, what is confusing them as they say

    is that the MRI shows disc protrusion at L3 – L4, but the symptoms and pain she is complaining about is more about L5-S1 issues.

    One of the doctors suggested having a some sort of a pain killer injection (a mixture of DIPROFOS/Betamethasone and 2 other things that i do not remember) at L5-S1 disc, and in case
    that the pain went away, they would know for sure that its the disc causing all that pain, after that my mother kept feeling strong pain from the injection itself for 12 hours after the injection operation, and after that all the usual pain came back as it used to be, if not worse.

    MRI Report:

    MRI Images:





    We need your opinion about her illness, what exactly is she suffering from is it spinal stenosis , or foraminal stenosis, is it a protrusion or what ?

    Also what kind of surgery she would need, we fear that after doing a surgery her pain remains as is, before the surgery.

    Please advise

    Note: if you save the above images to your pc, you will be able to view them in a bigger size and zoom at them, as the forum here resizes them

    Donald Corenman, MD, DC
    Moderator
    Post count: 8455

    First, you must differentiate what symptoms are the strongest. Divide the symptoms into back pain and buttocks/leg pain and use percentages. Which pain is the worst? Would she divide the pain into 70% back and 30% legs/80% back and 20% legs and so forth or the reverse with more leg than back pain?

    When is the pain worst? Does the back pain or leg pain increase with standing and walking or the reverse? What activities increase the pain?

    Dr. Corenman

    ahmedhelalm
    Member
    Post count: 3

    Back pain is worst but pain of left leg comes right after it in severity, more like 60% back and 40% legs.

    Pain is the worst after doing a physical activity for about 1 hour.

    Activities that increases the pain in back and left leg the most are driving a car, standing, and walking.

    Currently also she complains that the pain extends through out her whole left side of her back and body down towards the leg.

    Donald Corenman, MD, DC
    Moderator
    Post count: 8455

    The next step is standing X-rays including flexion/extension views. This will determine if she has instability, degenerative scoliosis or degenerative spondylolisthesis.

    Dr. Corenman

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