Viewing 6 posts - 1 through 6 (of 10 total)
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  • AvatarSean22
    Participant
    Post count: 6

    Hi Dr. Corenman, November 15th I had a microdiscectomy on my L-5 S-1 due to a large protrusion. I’ve dealt with this for about 2 years until I decided to have surgery. Surgery went fine and recovery was going smoothly until about 10 weeks in (3 weeks ago) I woke up with acute back pain. I decided to do some stretching to try relieve it but it didn’t help. As the day continue, I gradually started to develop pain in both legs, buttocks, hips, and on my back near the flank on both sides, pain is more on the right side. Also, I began to lose strength in both legs with extreme pins and needles all around my legs and numbness in my right foot.

    Due to this new alarming and gradual pain, I got a MRI a few days later. Here’s what the report said.
    “ L5-S1: There is loss of the normal intervertebral disc height. A small disc bulge is present with a posterior annular tear. No displaced disc fragment. No evidence of neuroforaminal or spinal canal stenosis.. The patient had a right hemilaminectomy with a microdiscectomy. No hematoma. No fluid collection. No evidence of a leak or infection.

    IMPRESSION: Postoperative changes after a right L5-S1 microdiscectomy. There is a small disc bulge with internal disc desiccation at L5-S1 but no neuroforaminal or spinal canal stenosis. No acute displaced disc fragment. Overall the alignment of the lumbar spine is straightened suggesting paraspinal muscle spasm.

    Good news is that everything looks fine, bad news, what’s causing this pain? More so, what confused me was the flank pain, it never went away. Also, why would I have flank pain to begin with? That’s not a common symptom, at least one I never dealt with. So I suspected perhaps there was something wrong with my kidneys.

    2 days ago I went to my primary provider, they ran a urine sample and found blood in my urine. Went to the ER right after and suspected perhaps this could explain my flank pain. They did a CT scan and what they found was severe constipation. The doctor said my kidneys were fine and it was this constipation that was most likely causing my unexplained flank pain.

    Since then I used a laxative to help with the constipation, and I gotten most of it out. I noticed every time I have a bowel movement, I have pain in my flanks and legs, feel a slight moment of relief in regards to pain, but then the pain would come right back.

    Today, I’m still in pain. Flank pain, leg pain all over with pins and needles, loss of strength in both legs, and numbness in right foot. I used an oral steroid pack 3 weeks ago which help but the pain came right back. My doctor said no to an epicdural steroid shot because he sees no alarming concerns on my MRI.

    Entirely, I’m at a lost on what to do. Where’s this pain coming from and how to manage/ suppress it? I’m starting PT next week to see if that could help. Really hoping you can help figure this one out. This is a complete mystery to me. Thanks for your time.

    AvatarSean22
    Participant
    Post count: 6

    Hello sir, I hope I didn’t break any rules and hope you can give me some insight in my current situation. Symptoms are about the same, I’ve gotten steroid injections in my lower back which helped but bilateral leg pain is still present.

    AvatarDonald Corenman, MD, DC
    Moderator
    Post count: 7523

    You had no significant symptoms after your L5-S1 microdiscectomy for 2 1/2 months until you awoke with lower back pain for no apparent reason. You then had an MRI which noted “No displaced disc fragment. No evidence of neuroforaminal or spinal canal stenosis… No hematoma. No fluid collection. No evidence of a leak or infection”.

    I should note that on rare occasions, a P. Acnes infection can look somewhat benign on MRI but still be present. I would have infection labs drawn just to make sure but I’ll continue assuming you don’t have infection.

    Flank pain (lateral pain a distance away from the spine) is very unusual to be generated by the spine. You note current “leg pain all over with pins and needles, loss of strength in both legs, and numbness in right foot”. I assume you have been ruled out for CRPS (https://www.neckandback.com/conditions/complex-regional-pain-syndrome-crps-reflex-sympathetic-dystrophy-rsd-causalgia/).

    An examination needs to be performed to make sure there are no long tract signs indicating a neck problem along with a chronic radiculopathy of the S1 nerve root (from the prolonged compression of the S1 root) See https://www.neckandback.com/conditions/chronic-radiculopathy/ and https://www.neckandback.com/conditions/cervical-central-stenosis-and-myelopathy/

    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.
    AvatarSean22
    Participant
    Post count: 6

    Well good news is that the flank pain is mostly gone now. I also had an MRI of my Cervical area recently that showed no issues.

    It is just the bilateral leg pain/ that travels to the toes.

    My main symptoms are

    Constant pain in legs
    Pain or weakness when standing of sitting for too long
    Intense episodes of Heating/ Sweating
    Burning Feet
    Headaches
    Lacerating or stabbing pain in legs

    Also

    Cannot do straight leg raise
    Weakness in legs
    Hyporeflexia in Legs
    Abnormal gait

    I don’t meet with my Surgeon until April. I’m worried because perhaps this might be Epidural Fibrosis or Arachnoiditis. Wouldn’t the MRI ruled out these possibilities or can these still be origin of my problem?

    Im schedule for an Epidural Steriod Injection Thursday, would that be advisable?

    AvatarDonald Corenman, MD, DC
    Moderator
    Post count: 7523

    Your symptoms could be from an unrelated neuropathy or just residual root compression recovery symptoms. An epidural steroid injection is a good idea. Make sure you get those lobs and if normal, give it some time for recovery.

    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.
    AvatarSean22
    Participant
    Post count: 6

    Okay, will do, thank you.

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