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What symptoms does your daughter have exactly? Try to be specific. Pain, numbness, weakness (caused by pain or weakness without pain), inability to stand upright and why (pain, mechanical block, malalignment, weakness). When do the symptoms come on? Can she sit without pain, lie down without pain, stand without pain, walk without pain etc….
How are the sacroiliac joints as with a four level fusion, these joints can occasionally cause pain over time?. Is the level above (L1-2) OK or worn out. What does her physical examination reveal? Does she have specific weakness or generalized weakness? Does she have long tract signs? Could this be a central syndrome (CNS)? As you can see, there are many unanswered questions.
Piriformas syndrome is exceedingly rare but I can understand at this point you would be willing to try anything.
Call the radiologists I identified for further information.
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.My understanding of your history is that you have osteoporosis or osteopenia from years of use of a steroid inhaler, hypertension and had one year of lower back pain. That pain increased in the middle of February and by the middle of March, the lower back pain increased and you developed leg symptoms. This was from a herniated disc at L5-S1. You underwent a decompression surgery- most likely a microdiscectomy.
I don’t understand the sentence “After the surgery I was fine accept weakness of my right leg and burning at time of discharging urine and stool.” Did you have residual weakness of your leg or new onset of weakness after surgery? Discharging urine and stool- did you have bowel and bladder malfunction prior to surgery or new onset of these symptoms after surgery? Did you have burning on urination which could indicate a urinary tract infection?
You state you have continued symptoms in the right and left “back hip”. Is this area the buttocks, the sacroiliac joint or the back of the thighs? When does this pain become more severe?
Most microdiscectomies do not require further surgery but it is unclear what is currently causing pain. You need to have experienced eyes look at a new MRI of your spine and you need a detailed physical examination.
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.in reply to: Pain relieved and now worried?! #4833At 24 years of age, you underwent a microdiscectomy with good results. You have now developed another disc herniation at the same level and I assume the same side. This is not unexpected as another disc herniation at the same location (called a recurrent disc herniation) occurs about 10% of the time.
If you have no motor weakness, chiropractic and physical therapy are very good avenues for treatment. You have responded very well to chiropractic treatment and there should be no worries unless you develop further pain, weakness or bowel/bladder symptoms (which are very rare).
You still have a chance of another disc herniation at the same site but don’t worry about that as there is really nothing you can do to prevent it.
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.in reply to: Back pain in the T11-T12 and L4-L5 #4832For your age of 22 years with a history of three years of pain, this is unusual. You mention you have been in the hospital on and off for the last three years. Why? Were the admissions for pain control or a work-up to determine what is causing the pain? Is your pain local only to the levels at T11-12 and L4-5 or are there many more areas involved? How did you find out that those two levels were a problem. Did you have an MRI, CT scan, X-rays, consultations with spine experts or?
What treatments have you undergone? How have the symptoms changed since they first started? There are many unanswered questions that need to be addressed.
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.Arachnoiditis is the adhering together of nerve roots floating in the CSF (cerebral spinal fluid- essentially salt water). See the website for further detail. Arachnoiditis is commonly found after going through the old oil-based myelograms. Thankfully- these myelograms are not used anymore. I am sure that she had this condition prior to the new onset of symptoms. There are times that quiescent arachnoiditis can become symptomatic but the clinician must rule out everything else that can cause new symptoms prior to blaming this preexisting condition.
You do not mention where the pain is, what quality of pain (burning, stabbing, electrical, dull) and when it becomes more severe. Is she pain free with sitting or lying down and only develops pain with standing? Does she hunch forward because of pain or because she can’t physically stand up straight? What did the physical examination reveal?
The real question is what has changed since she was so active to cause her current pain.Arachnoiditis is very easy to diagnose on a well done MRI. If you want a great radiologist to read the films- contact Marin Magnetic Imaging in Oakland, California as I think they have some of the best radiologists in the country (Dr. Jay Kaiser and Dr. Betsy Holland). Also, Dr. Frank Crnkovich and Dr. David Solsberg both in Denver are top notch.
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.in reply to: middle back pain #4830Let me summarize your history and complaints. 5 months ago you were lifting boxes and felt and heard a click or pop type sound from your midback (I assume the area in between the bottom of your shoulder blades). This pain disappeared and three weeks later the same pain reappeared with lifting again. Pain also occurred in both arms and legs.
You rested for two months without improvement and then saw a chiropractor. He or she treated you without relief and obtained an MRI that noted a small herniated disc at T7-8 that slightly compresses the cord or at least distorts the cord pathway.
Your arm symptoms improved but your leg symptoms are just as significant as at onset of initial pain. You have no weakness. Your thoracic pain is a 7-8 on a VAS scale and the pain does not radiate around the ribs. I imagine you have no bowel or bladder symptoms and have no imbalance. The leg pain is less than your thoracic pain and is bilateral with left leg more intense.
First off- if the thoracic disc herniation is causing your thoracic pain and is not causing cord compression (you report no myelopathy- see web site), continue non-surgical treatment. Surgically treating thoracic disc herniations is difficult and can cause symptoms that were not present previously. Epidural injections can be helpful and occasionally, the facets can cause local pain. Facet blocks and rhizotomies (see web site) can be helpful.
Your leg pain is most likely not originating from the thoracic spine. You indicate that you have no lower back pain but there are circumstances that nerve compression may not be associated with back pain. If you underwent a thorough physical examination, was there any evidence of nerve root pathology?
It would be unusual to have onset of a thoracic disc herniation and onset of a lumbar disc herniation at the same time, especially a lumbar herniation that caused compression of both sides but stranger things have happened. You could have a systemic neurological problem and a neurological consult may be in order.
Another set of eyes may be helpful to determine what disorder is causing your 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. -
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