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  • Scm Clarke
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    Post count: 1

    Hello,

    I shall give you some background to my situation.

    Back in March last year, I stood and performed a shoulder press. Felt around my lower back a sudden shock, couldn’t bend down a few secs then normal again. Few days later noticed a feeling in my right groin so stayed off fitness for a couple of weeks.

    After a few weeks of gentle activity (walking), woke up one morning and felt pain all over my back. A month later, after attempting a pelvic exercise on the floor felt a mild sensation in my right leg, which wore off after a week. However, a few days later went for walk and pain developed in my right leg and buttock, became severe. The buttock pain lasted over 2 months.

    I had an MRI on my lower back in July last year and I have mild to moderate facet joint arthrosis at L5/S1 with central disc bulge. At L3/4, I have mild to moderate degeneration of the facet joint, and at L4/L5 I have some minor degenerative disc with a minor disc bulge on the left side foraminal region with no significant nerve root compression with possible denting of the disc on the nerve.

    I have suffered some left side hip pain, which appears to be separate to the back (I think but am not 100% sure).

    I began to suffer more pain the lower back over time, which is suspected to be the facet joint arthrosis, which has also had some effect on my mobility. This would be quite severe when sitting and is now more central. However, what I have found is that pain/discomfort can build in the lower back when walking and can sometimes protrude down the right groin, I can always feel something going on the lower central back area. From time to time can feel pain in the iliac crest. I feel some pins and needles in right foot. I have also began to suffer pain in the neck and shoulder.

    The constant chronic low back pain, whilst it has centralized more over time, it results in a lot of pain/discomfort when walking. It is not too troublesome when I sit now but I can still feel something going on the central area.

    My concern is whether this is in fact anything to do with the facet joint (is there a annular tear on a disk that can’t brought up on an MRI?). It does appear that the pain is originating in the L5-S1 or L4-L5 area but expands/refers more with activity. I’m doing swimming, some physio (stretching) and walking, which help a little.

    Any views appreciated.

    Thanks

    Simon Clarke

    Donald Corenman, MD, DC
    Moderator
    Post count: 8408

    Lower back pain can be generated by the disc, facet, bone and nerve but in your case, I believe the differential is disc and facet. Standing/walking can lean more to facet than disc. Hopefully, the pain is more facetogenic than discogenic due to the easier treatment of facet pain.

    The first step is physical therapy. a good course of 2-3 months can be helpful, especially if it is pilates based and you do your homework. If ineffective, then a series of diagnostic facet injections can reveal if the facets are the true culprit. If these blocks are effective (please read all hyperlinks to understand this and have the injectionist also read these), then you are a candidate for radio-frequency ablations (RFAs).

    https://neckandback.com/treatments/facet-blocks-and-rhizotomies/
    https://neckandback.com/treatments/diagnostic-vs-therapeutic-injections/
    https://neckandback.com/treatments/pain-diary-instructions-for-spinal-injections/

    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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