[Sean22]

#32220

So no signs of Spinal Infection, blood work came back clean.

My sports medicine doctor believes somehow my L2 – L4 nerve roots are being irritated due to bilateral pelvis, inner thigh, knee, & foot pain/ weakness. Would chronic inflammation of the L5 – S1 root irritate the above nerve roots or is it something else?

[Donald Corenman, MD, DC]

#32230

Your L2-L4 nerve roots go to create the femoral nerve which does not radiate down below the ankle and does not supply motor strength to the foot. These would not be affected by compression at L4-S1 levels generally. Skin around your inner thighs and rectum/perineal region is from the S2-4 nerve (pudendal and perineal nerves). You can develop a pudendal neuropathy from compression but this would be cauda equina syndrome which it appears you don’t have. You can develop a pudendal neuropathy independently when the actual nerves “get sick” but that is unlikely.

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.

[Sean22]

#32263

Okay.

Do you believe this can be SI joint dysfunction? I already had tight hamstrings to begin with, and I unfortunately did not take recovery very seriously, so perhaps my SI joints became very irritated. And perhaps that had a spiral effect on my already weakened legs?

I do feel a lot of pain and pressure in my hips, lower back, inner thigh, hamstrings and knees.

[Donald Corenman, MD, DC]

#32277

SI joint symptoms are rare to begin with. It would be even more rare to have both SI joints cause pain and very highly unlikely that both would cause symmetrical symptoms.

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.

[Sean22]

#32833

Hello Dr. Correnman, it’s been awhile, but just recently received some news about the cause of my problem. I went to a pain management clinic and they found that what I most likely have is scar tissue, what’s call epidural fibrosis.

They want to do is a Racz procedure. Just wanted to know your opinion on that procedure. Would you recommend it or something else. I am already in Physical therapy but they suspect it won’t treat the scar tissue. What would the success rate be?

[Donald Corenman, MD, DC]

#32837

Thia is what one promotional site discussed about the Racz procedure; “Once the catheter is in the proper location where the scar tissue is affecting the nerve root, multiple medications (omnipaque, hypertonic saline, hyaluronidase, local anesthetics, and steroids) are injected into the space in order to dissolve the scar tissue and reduce the inflammation and irritation on the nerve”.

It has been my experience that if there is adhesive scar tissue, simply increasing fluid pressure in the canal outside the dura will have little therapeutic benefit. I would also note that scar tissue does not simply “dissolve” even with the chemicals they are injecting into the canal. Now steroids can be very helpful but they don’t need to be introduced with this technique.

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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