I have back pain and I need to know what is the problem

Tagged: back pain

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phanos
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May 14, 2013 at 1:21 am

Post count: 6

#8653

Hello everybody. I came I to this forum after watching some videos of Dr. Corenman (very nice work by the way). The reason was because I was trying to understand my MRI scan of my back.

Six weeks ago I begun having pain at my right leg, starting from the back on the leg and going down almost to my angle. At the start I did not realize that it was something serious (I through it was muscle pain from the gym), so I keep going on my daily routine (going to work, gym etc). After two weeks and since the pain was not going away, I consulted a orthopedic doctor and he mention that the problem was that one my back discs has been swallowed and caused an inflammation that was interfering with the nerve that goes down my leg. He subscribed physiotherapy, medication (arcoxia, B complex vitamins and perskindol gel) and a lot of rest which i tried to follow to the letter.

The good news was that after a couple of days the pain started to go away and I was feeling much better. By although the pain stared to diminished the first few days I continue having some pain on the back of my leg in the upper side. The pain continue for almost a month and finally the doctor sent me to have an MRI scan.

Today I got my MRI scan and although I do not have the report yet only a copy (the report is due to come in a couple of days) I am trying to understand it. The reason for this is because three days ago the original pain has returned and I am getting worried. I do not understand why it did, I do not believe I did anything that might have cause it. After watching Dr. Corenman videos I do not believe that there is something really serious about my back but of course I am not a doctor. Is there a way that someone can give an idea about what is it that I am facing here? Is it really serious or is it something that will eventually go way? Will I ever return to my daily routine as before?

Thank you very much about your time,

Phanos

SpinelessWench
Member

May 14, 2013 at 12:24 pm

Post count: 38

#8657

Since you’re asking no one in particular to address your question, I’ll add an observation. You’ve had an MRI scan, yet don’t have a dictated report of the radiologist’s impressions and primary interpretation of your images. You also haven’t had a follow-up appointment with your orthopedist to discuss the results, which may or may not coincide with your symptoms upon initial presentation to his office. It’s unlikely anyone here, or elsewhere, can begin to offer any explanation for why you’re experiencing intermittent back discomfort and leg pain. Here’s why…

The primary reason for the lack of responses to your question is that you’ve only provided your subjective, personal description of the pain (which could be muscle spasms, a herniated disk, nerve root compression, minor arthritis, a misguided rocket, a cyst impinging on a nerve, inflammation, or any number of countless possibilities). You mentioned your physician’s suggestion that this is possibly related to something “swallowing your disks” and causing episodes of irritation to the nerves. It’s unclear what you mean with regard to “swallowing”, but perhaps you misheard what he was referring to. To my knowledge, there’s not a back condition involving the swallowing of anything, so this is a case of mistranslation during your conversation with the doctor. Next, you stated that at first, “you didn’t realize it was something serious.” There’s no way of concluding this is anything serious, because you have no test results to confirm that. Back pain has been deemed the #1 chief complaint by patients seeking initial treatment by orthopedic specialists, and the #1 pain-related reason people use when they “call in sick” to work. In fact, recent research indicates that back pain costs our healthcare system billions each year, and is unfortunately one of the most commonly “faked” injuries in order to obtain narcotic pain medication. The causes of back pain are still not completely understood within the medical community, so many patients never know the exact cause of why their back hurts.

The majority of back pain cases do not result in paralysis, disability, life-long bouts with severe pain, the need to take drugs forever, or even significant future flare-ups. Plus, back pain doesn’t always equate with “serious.” Believe me, a stubborn or awkwardly located muscle strain, spasms, and inflammation from excessive or strenuous activity can hurt worse than back pain from a disk issue or nerve compression. A good example is a nasty high ankle sprain, which is probably a somewhat common injury seen in emergency rooms close in proximity to Dr. Corenman’s location (Vail). Beginners will set the boot binding too tightly, then when they fall, the boot doesn’t separate from the ski. These ankle injuries can hurt 500 times worse than a fracture, and most people will tell you they would’ve preferred their foot to break off. So again, pain doesn’t translate to serious.

You begin to conclude your post by indicating you have no idea why your back hurts, but that you’re sure you did nothing to cause this pain. Again, it’s not uncommon to experience back pain, and many times, there’s no memorable event that you can connect to it. In other words, back pain isn’t always the result of a fall down a mountain, a car wreck, being hit by an asteroid, or being smashed into the ground while playing football. Pain anywhere in your body can occur from the most subtle, unnoticeable reasons — every year, people strain their backs and suffer from inflammation due to an exceptionally powerful sneeze or cough, two of the most kinetically-violent forces produced in the body. Seven years ago, I woke up one morning to severe elbow pain — imaging revealed a 60% complete tear of the tendon from the epicondyle. To this day, I have no clue how I managed to do that, and my surgeon who repaired it had no answer either.

There’s no possible way anyone here can tell you, “what you’re facing”, “what the problem is”, whether it’s “serious”, whether it’ll “go away”, or if your “daily routine” will return to normal. And, while Dr. Corenman’s videos rank right up there with those action-packed Dirty Harry classics, simply watching these videos won’t lead to the reason behind why your back and leg hurt. Nor can you watch these brief videos and exclude every possible cause for your back problem just because your pain doesn’t match the pattern of pain associated with back problem “X” in Video #4.

Again, it’s impossible for anyone to answer what you’re asking unless you have something to actually interpret.

phanos
Member

May 14, 2013 at 1:49 pm

Post count: 6

#8658

Dear SpinelessWench thank you for the length explanation it is very helpful. I have booked an appointment today with my doctor to see the (copy) MRI scan. I will also booked another appointment to see him when the report becomes available.

I will return to this forum when I have more info. Thank you very much for your time.

Donald Corenman, MD, DC
Moderator

May 14, 2013 at 7:15 pm

Post count: 8660

#8660

Thanks SpinelessWench. That description is helpful.

The causes of leg pain are myriad but most commonly, leg pain is generated by a compressed nerve in the lower back. This can be the result of a disc herniation in the posterolateral position (the most common location for a disc herniation). This disorder will cause increased pain while sitting and somewhat relieved with standing.

Foraminal stenosis can also cause leg pain, worse with standing and improved with sitting. Foraminal stenosis can be caused by a disc herniation, a collapse of the disc height or by a bone spur.

Let us know what the MRI report indicates.

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.

phanos
Member

May 14, 2013 at 8:29 pm

Post count: 6

#8663

Dr. Corenman thank you very much for your response. I have just came home from the meeting with my doctor in which he had a view of my MRI SCAN. According to him my lower disc (I think it was L5) has lost most of it liquid and this causes a lot of stress om my back and nerves. He prescribed physiotherapy and rest.

I just want to know how bad my situation really is and if there is something that I can do. In order to get a better understanding of my problem is it possible to sent you a screenshot of my MRI scan to see?

Thanks

Donald Corenman, MD, DC
Moderator

May 15, 2013 at 8:52 pm

Post count: 8660

#8673

Most spine disorders are very painful but not dangerous. A significant degenerative disc at L5-S1 is not uncommon. If you also have leg pain from this disc collapse, you either have foraminal stenosis, lateral recess stenosis or a disc herniation (see website for those descriptions).

You can if you wish send the CD/DVD of your MRI images to the office. Screen shots are incomplete and can be misleading. Call the office at (970) 476-1100 for further instructions if you so desire.

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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