Big nerveParticipantJune 26, 2012 at 12:55 pmPost count: 11
Thanks for the great service that you provide I had back surgery abut 14 months ago decompression surgery on that level still not right but now i have a broad based posterior disc bulge at this level so I was wondering if my symtoms wich are sore lower back constant and numbness in my front thigh sore buttocks numbness in my toes and many other pains but I know my L5 S1 is causing me trouble and i might need a fusion at that level but at the L3-L4 level is not great either so I have gone the long way around but do those levels cause the same pain in the same areas or do they affect different levels please help I am going out of my mind can not cope I just ache in different areas of my body thanks again doctor for this great service you provideDonald Corenman, MD, DCModeratorJune 26, 2012 at 11:29 pmPost count: 8455
You have had decompression surgery 14 months ago but do not note the level. Was it at L5-S1 or at L3-L4?
You complain of “soreness” in the lower back, numbness in the front of the thigh (which thigh?), sore buttocks (which one?) and numbness in the toes (which side?). Is the ratio of pain greater in your lower back or greater in your legs?
L3-4 will cause different type of nerve pain than L5-S1 will. L3-4 can cause anterior thigh pain and numbness from the L3 or L4 nerves but these nerves are incapable of radiating pain and numbness into the foot as they stop at the ankle. L5-S1 can radiate pain or numbness to the toes as this level will involve the L5 or S1 nerves.
As far as lower back pain causes, the L3-4 level can produce about the same symptoms as L5-S1 but there are some subtle differences. If the back pain is “higher” than the base of the back, this could originate from L3-4 but that is not a “rule”.
To truly understand origins of leg pain, selective nerve root blocks are utilized (see website section for further information). If lower back pain is the main complaint and surgery is being contemplated, discograms by a very experienced interventionist are used.
Dr. CorenmanBig nerveParticipantJune 27, 2012 at 8:50 amPost count: 11
Sorry for not giving you the right info or not a very informed info I had decompression surgery on the L5 -S1 I ache wverywhere and have done since my last surgery it is my front thigh that goes numb and is sore both my toes go numb i get sore in both buttocks but they dont go numb at the same time in saying that not both buttocks ache and go numb at the same time and that goes for my toes and all the other numbness and aches i get from my lower back to my feet I have had a discogram an the L3-L4 leek fluid and was very painful same pain as i suffer with now when he did L4-L5 it was not that bad it was more the procedure that hurt was different pain then the first needle then the last one was L5-S1 and that was very painful as well the first and last needle hurt like yu would not beleive even the doctor doing the procedure said that he did not like doing because he new it was going to cause me pain but had to make sure what disc were causing the symtoms been four days and still very sore from the procedure thanks for this great service DoctorDonald Corenman, MD, DCModeratorJune 28, 2012 at 2:10 amPost count: 8455
I would be very careful regarding the results of the discogram. Patients with non-adjacent fusions have poorer results and patients with three levels also do not do as well. Other than back pain, your symptoms also are diffuse and do not seem to reflect any one specific nerve root. Great care must be taken to make a decision regarding surgery.
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