[PatrickG]

#27274

I am in the uk and may want a telephone consultation if appropriate.
I think I have nerve impingement on s1 because I did the stand on tip toe test suggested on your web site and it proved positive but left me limping all of the next day. I also have urine retention causing repeat Utis so it is also likely s2 and/or s3 are also impinged. I have no significant back pain but my lower back is very stiff and achy in the mornings. If I walk over a hard surface, leg and bladder problems get much worse.
I have had 4 or 5 MRIs which have all shown nothing that would account for it. I now realise these types of MRI do not show impingement by compacted blood vessels. I know I need to get an MRI using dyes and a higher power magnet.
1. Would you think there has been a lack of due diligence in using an MRI incapable of identifying this kind of problem?
2. If the problem turns out to be caused by soft tissue impingement, what treatment options should I have?
And I know there is a slight double kink in my spine – at the bottom it leans about 5 degrees to the left and at my thoracic spine the kink is in the opposite direction. I have been told I have no significant leg length discrepancy, it is about 1cm.
What do you think about this? Is it something you have come across before?

[PatrickG]

#27275

I should have mentioned I am 63. I first realised there was a likely back problem affecting my calf 18 years ago. Since the symptoms have gradually become worse and I can see the way things are going. Worsening uti and testicle infections, not good. Loss of calf mobility and plantar fasciitis now affecting the ball my foot, toes and side of foot. Then because I my knee is not properly supported likely problems to come on the knee and hip.

[PatrickG]

#27276

I have just read the article on how to describe a back problem. As I have no significant back pain but do experience weakness, I tend to make a note of what preceded the weakness. I am finding a pattern of sorts which I do not understand which is along these lines. I do an activity like a Mackenzie Exercise, Ride a Bicycle or do the the tip toe test. I notice nothing wrong at the time but hours or a day later, I start to encounter weakness of one kind or another and the link is not obvious.
However, it does seem something happens in the time between doing the activity that appears to cause the problem and then a subsequent activity where I experience calf weakness.
I think this may be neuropathy, irritation or inflammation of some kind.
These problems have gradually become even worse after taking antibiotics like nitrofurantoin frequently and to a lesser degree ciprofloxacin. Both have been linked to neuropathy. I am not saying the antibiotics cause the problem because I do not think that is the case. I do think it is possible they may well exacerbate the problem for some reason in the same way some activities.
In terms of the activities that cause the problems lifting a heavy weight does not trigger a problem. Any activity that puts a sudden pressure wave through my back does So walking on a hard surface, riding a bike over a bumpy surface, sawing or chopping wood do.

[PatrickG]

#27277

Measuring pain is a tricky business but one thing I have measured is the distance I walk against the volume of urine I retain. It shows the more I walk, the more urine I retain. I have to self catheterise twice daily and in these circumstances, this is easy to measure.
This probably causes the repeat Utis.

[Donald Corenman, MD, DC]

#27316

If you have urinary retention, based upon your discussion, it does not appear to be based upon cauda equina syndrome, the compression of the group of nerve roots that exit from the end of the spinal cord at L1. Generally, one-sided compression (only left or right without opposite side involvement) will not cause bladder loss of control. If one side is still intact, this seems to be enough to allow normal function. There probably is some other reason for bladder loss of control. Urinary tract infections (UTIs) are uncommon in a male unless self-catheterization is used. Self-catheterization can introduce bacteria into the bladder and urethra and cause an infection.

I don’t think that blood vessel plexus compression would not be apparent on a standard MRI. Why do you think that you have this disorder?

Progressive weakness without root compression along with urinary problems does sound like a neuropathy so you might be on the right track. A consultation with a good neurologist would be a good next step.

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.

[PatrickG]

#27914

I have decided to opt for a dye contrast MRI as soon as possible. I was looking at past EMG results to find at one point, there wee signs of radiculation At L1-3, then none, then at S1. I am told this suggests impingement on the outside of the sacral spine.
I have no back pain but a lot of incidents suggesting a back problem. For example, a few weeks ago I lost foot and big toe strength for a few hours, then the next day pain under my foot and on my instep…then a few days later, I find myself experiencing urinary urgency.
What seems to trigger problems is either walking over a hard surface – or a knock from the front as in 2 people going through a door from opposite directions.
What I wonder is what is likely to be found and what can be done about it.

[Author]

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