[Mcnab]

#28899

Thanks again for sharing your expertise with me.
I totally follow you with the neuropathy explanation. The only thing that bothers me is that after a night of rest i feel 70% better. It is only when i stand up that my symptoms begin again.
Also when i go swimming i have almost no pain in the mentioned areas. From the moment i get out of the swimming pool and gravity increases i start having more pain again.
Also when resting and lying down my symptoms get better and i have almost no pain during nightime as you would expect with a neuropathy. It seems like something is wrong at L5 S1 or in that area.

When talking long walks my symptoms get beter and my pelvic floor starts to itch and i feel the nerve next to my tailbone ‘loosening’.
Can an si joint cause these problems because i have lots of tenderness over the l5 s1 and the si joint.
Can the psoas be causing si joint problems or is it the other way around?

[Donald Corenman, MD, DC]

#28903

Standing up aggravating symptoms could be mechanical but every other symptom fits with neuropathy. The notation “When talking long walks my symptoms get better” does not fit with ‘standing causing symptoms aggravation’.

SI joints should not cause these symptoms. Psoas disorders cause hip flexor weakness and groin pain.

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.

[Mcnab]

#28907

Thanks for your explanation dr.
Maybe i expressed myself incorrect.
When standing still or sitting down my symptoms get worse, when i stay mobile my symptoms get better. When walking, first i start to get worser pain, but when walking long distances, like let say 10miles, my pains do get better.

It feels like the pain starts in the l5 s1 region but lets say about half an inch left to the spine. When twisting my torso left and right i get the shooting rectal nerve pain. At first i only had that pain, it is only later the burning feet came round.
3 days before this pains started i hurt my back by bending backwards trying to get a heavy object of me.

I will get some tests done for neuropathy and see wat comes out of that.

Thank you for your time dr.

[Donald Corenman, MD, DC]

#28928

You might have a typical L5-Si disc injury with a highly sensitive nervous system but as I said before, I would be very careful in assuming that as I think there is some nerve inflammation here not explained by your lower disc injury.

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.

[mcalamassi]

#33650

hello doctor,
this is a very old thread but I’d like to ask something related to it.

You stated that an annular tear or disc degeneration at L5-S1 is not compatible with pain in the perineum, anus, testicles etc…..as the Pudendal nerve comes out from the sacral (s2) not the lumbar

BUT

can’t a protrusion at l5-s1….irritate (either mechanically or chemically) ALL the nerves in the cauda equina and indeed also the sacral nerves like the Pudendal ?

I have heard of people suffering from Pudendal symptoms…having annular tears in L5-S1

thanks a lot

[Mcnab]

#33654

Hello,

After al these years i still have the same problems. I recently had another mri and i have degenerarive disc and annular tear at l5-s1 and also a major hernia at l4-l5.

My neurosurgeon told me that in 30% of people the s2 nerve runs through S1 so to answer your question my neurosurgeon says it is possible.

I also would like to know your opinion dr. corenman.

I also have very stiff muscles in my lower back and around the back and left front of my ribs wich radiates to the si joint region and my front hip, testicles and causes penile pain when i stretch that region. Can this be related to thoracolumbar junction syndrome wich makes the quadratus lumborum and psoas verry stiff and causes my left pelvis to lock up and cause pudendal nerve symptoms? Or can this be related to my l4 l5 hernia?

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