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  • nadeem1110
    Member
    Post count: 2

    Dear Dr. Corenman,

    I went through all your videos and found them very informative and useful in understanding my back, spine and MRI reports. Thank you very much,

    I am working as an event manager at Sydney. My duties comprises of standing, walking,arranging tables and chairs for 12 to 16 hours a day. Last year on 7th October I met with an accident at my work place while pulling a table of around 20 to 25 kgs. I got sever pain in my lower back that I had to lay down on the floor. I was diagnosed with the disk bugle on L5. I took a rest of 10 days and started my duties again.

    My pain became sever.I consulted many doctors and they said I am having little trouble with the back. They shown me some exercises and gave pain killers. by January 2011 I started getting leg pain in both my legs. I could literally feel that my lower back pain going to my legs. My legs and thighs started getting stiff. My back pain is not too much but all the pain i am having is in my legs. Both the legs. I continued doing the exercises and my work. In June I had to take a leave for two months as my leg pain was troubling me so much. I went to my home country India, and consulted top doctors.

    I done MRI. It says ” Minimal scoliosis of lumbar spine is seen toward right side. Mild exaggerated lumbar lordosis is noted. Mild posterior disc bulge with small, left paracentral/foraminal disc protrusion is noted at L5 S1 level indenting left exiting L5 nerve root. Mild left neural foraminal narrowing is noted at L5-S1. Minimal posterior annular disc bulge is noted at L5S1. Rest Lumbar intervertebral discs appears normal”

    Kindly make me understand about this.

    I consulted physiotherapist and regularly doing exercises. Apart from that I am having Homeopathic medication for the same. All the doctors in India told me that my condition could be worse and I ahve to take so much care to avoid any future problem. My condition today is 40% better than before.

    But my real problem here is I am back to Sydney and I have applied for work cover as it was a work place injury and it has affected my earning capacity this year. As the procedure of work cover, I was advised to consult a neurosurgeon. He said every things normal and there is nothing wrong with my back or my legs. I am having only muscular pain in my legs

    Dr., I am really confused here. Because muscular pain cant be there for years.and this is something related to my back. Every time I walk too much I started getting sharp leg and thigh pain, In morning everyday my legs get stiff like a rock. I feel good only when I sit or sleep. Sometimes I also feel that some thing is pinching in my lower back.

    Please advise me here. Do you think my legs pain is due to nerve compression? Please guide me in this regards It will give me an idea about the treatment like whether to go for back and nerve treatment or muscular treatment. Your words on this will mean a lot to me.

    Donald Corenman, MD, DC
    Moderator
    Post count: 8656

    You note an injury to your back using a pulling action in October. You continue to have pain in your back that starts to radiate into your legs by the end of the three month mark and in fact the leg pain becomes worse than your back pain. You continue to work as an events manager and perform physical therapy. Your leg pain escalated, you took two months off of work and went back to India for treatment.

    Some basic questions- Is the pain bilaterally equal or is the left leg pain worse than the right? If worse, by how much? Is the pain present with standing and walking and improved with sitting and lying or the reverse?

    The pain you have is more likely than not from the spine and probably the disc problem at L5-S1. I would disagree with your neurosurgeon that your back is “fine”. There is a condition called foraminal stenosis (see section on website) that may be producing symptoms (leg pain).

    If you were my patient, I would recommend a selective nerve root block (SNRB- see website) to determine if your pain originated from the L5-S1 level (see pain diary).

    Good Luck,

    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.
    nadeem1110
    Member
    Post count: 2

    Dear Doctor,

    Thank you very much for your reply.

    Further to your basic questions. I have equal pain in both the legs. But sometimes my left leg pains could be 5% more than the right leg. Theres always pain in my legs but it gets sever when I walk say about 30 mins or stand for more than 20 mins. Yes I get relief when I sit down or lay back. But whenever I woke up in the morning my both the legs get stiff from thighs to toes. I can not go to gym or swimming. I also feel good when I do stretching exercises.

    As you are aware that doctors final decision mean a lot to me in my work cover. My neurosurgeon has suggested that I can work full time, lift as much as 20 kgs, and can go to gym.

    I would very much appreciate your reply in this matter as well.

    Thank you very much
    Nadeem

    Donald Corenman, MD, DC
    Moderator
    Post count: 8656

    Your symptoms of bilateral leg pain with standing and walking that improves with sitting does fit with the diagnosis of bilateral foraminal stenosis (see website). Your MRI report is somewhat confusing in that it notes only left foraminal stenosis- however, the radiologist may have missed right foraminal stenosis. The standing X-ray can be revealing in that with a scoliosis, you may have right foraminal collapse that does not show on MRI (which is performed lying down).

    Ask your surgeon if an SNRB can be considered (see previous post) to diagnose and possibly treat the nerve compression. Use a pain diary (see website) to determine if that is your diagnosis by following the instructions both to aggravate the pain prior to injection and to track the pain levels for the first three hours after the injection.

    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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