zlwalker

Dr. Corenman,

I am back after a long hiatus! I have recently started having pain again with my surgery sites from my thoracic discectomy. I had rib pain and stomach pain from my previous surgery, and those have started again. However, the twist is that I am a cross country coach, and I have had a ton of meets in a short amount of time. I have had about eight meets in three weeks with minimal rest in-between. I have these pains, and they are getting worse, but I also know I have done a lot of work recently that my body is not used to. I had an epidural done in February at this site, and it seemed to work well, so it could also be wearing off.

I guess my question is the following: Should I be concerned about a reherniation? I am worried because I have the same pains as before, but I know that I have pushed myself too much recently as well. I am trying to discern the difference between a reherniation and just a flare-up. Do you have any advice on what my next steps should be or general reherniation symptoms? I know that reherniation symptoms are close to the original symptoms, but I am just lost because I have low level pain instead of aggressive levels of pain. I also have more burning and tingling in my feet than before with this pain as well. Any thoughts or helpful advice?

Thanks!

Dr. Corenman,

Thanks for your response! In terms of pudendal neuropathy, what could be causing that issue and what would be a possible solution?

Dr. Corenman,

I did receive an MRI on my lumbar region. In terms of symptoms that sparked the MRI, I had the following: 1. Pins and needles in both feet (this did not occur before surgery, so I am guessing I always had it and didn’t notice). 2. Pain in my butt (it never travels down). 3. My tailbone hurts a lot. It is just this weird pain that always sits in my tailbone. I have posted the MRI results below. What is your interpretation of my results and how serious does it seem? I also did not post the results for

There is normal lumbar alignment. The vertebral body heights are
maintained. There is normal marrow signal. Tip of the conus is normal
in position at the upper L1 level.

From T12-L1 to L3-4, there is no significant central spinal or neural
foraminal stenosis. Minimal disc degeneration is present at these
levels with mild facet hypertrophy at L2-3 and L3-4.

L4-5: Disc degeneration with small broad-based central and paracentral
disc protrusion, eccentric to the left, ligamentum flavum thickening,
and facet hypertrophy. There is mild central spinal stenosis with
mild asymmetric narrowing of the lateral recesses, greater on the
left, and mild bilateral neural foraminal stenosis.

L5-S1: Disc degeneration, moderate-sized right paracentral and
subarticular disc protrusion, and facet hypertrophy result in moderate
overall narrowing of the right lateral recess with abutment of the
descending right S1 nerve root. No significant overall central spinal
stenosis. There is mild to moderate right and mild left neural
foraminal stenosis.

The visualized intra-abdominal structures are grossly unremarkable,
further discussed on same day CT.

IMPRESSION:

1. At L5-S1, degenerative changes (including moderate-sized right
paracentral and subarticular disc protrusion) result in moderate right
lateral recess narrowing with abutment of the descending right S1
nerve root which could produce radicular symptoms. Additionally, there
is mild to moderate right and mild left neural foraminal stenosis.

2. At L4-5, degenerative changes (including small central and
paracentral disc protrusion) result in mild central spinal stenosis,
mild bilateral lateral recess narrowing, and mild bilateral neural
foraminal stenosis.

Thanks for all you do!