Back Pain Forum - Lower Back Pain Into Left Leg

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Q: Lower Back Pain Into Left Leg

asked by: jamesaroo on November 1st, 2007

New User

I hurt my back at work while lifting a heavy door. I have lower back pain and more intense pain in the left buttock. The pain also radiates down into my left calf. I had lumbar surgery in 2001 at the L3-4 and L4-5 level. The doctor ordered a MRI and started me on pain killers and physical therapy, also appointment for steroid injections. I have done 2 weeks of physical therapy with no relief. The physical therapist says he has done all he can do and wants to see me again after the steroid injection. My MRI results are as follows:

Report
LUMBAR SPINE MRI

HISTORY: Low back pain with pain radiating down the left leg; past medical history of lumbar surgery.

LUMBAR SPINE MRI (WITH AND WITHOUT GADOLINIUM): Multiplanar, multisequence MR imaging of the lumbar spine performed with and without gadolinium enhancement. Comparison with radiographic study dated 9/20/2006

For purposes of description, there are assumed to be 5 lumbar type vertebral bodies, L5 is transitional in nature.

Lumbar alignment is anatomic. There is multilevel degenerative disk disease, principally involving the L3-4 and L4-5 levels, as outlined below.

L1-2: Unremarkable.

L2-3: Unremarkable.

L3-4: Degenerative disk disease, including mild, broad-based annular disk bulging with mild narrowing of the left lateral recess, but no apparent significant spinal stenosis. Mild, bilateral neural foraminal narrowing is also evident.

L4-5 Degenerative disk disease, including mild focal left paracentral disk protrusion with associated left lateral recess stenosis. The protruding disk may potentially encroach upon the descending left L5 nerve root. Mild right-sided neural foraminal narrowing is also present secondary to facet hypertrophy.

L5-S1: Transitional lumbosacral disk level; no evidence of focal disk pathology.

Left hemilaminectomy changes noted at L3-4 and L4-5. No pathologic enhancement appreciated.

IMPRESSION
1. Mild L3-4 annular disk bulge; no evidence of significant spinal stenosis at this level.
2. Mild, focal L4-5 left paracentral disk protrusion with left lateral recess stenosis and potential left L5 nerve root encroachment.
3. Postsurgical changes.
4. Clinical correlation in regards to current radiculopathy recommended.

Can you explain this to me. I don't understand why the pain isn't getting any better when the word mild is used repeatedly in the MRI report.

Thanks
James

Replies(3)

expatient

replied on November 2nd, 2007

Experienced User

Because the reason for your pain might not be in your spine. Even up to 80% of the cases the reason for pain is not in spine but in somewhere else. Go somewhere where they check your pelvis asymmetry and functions of your sacroiliac joints.

Even people who have no pain ever have similar findings in their spine. So those mild changes do not cause pain.

MRI scans have documented that approximately 30% of 30 year olds have signs of disc degeneration even though they have no back pain symptoms.

In one well-known study, researchers sent 98 healthy people through an MRI machine: two thirds had abnormal discs even though none complained of pain. In other research, experts compared a group of patients who reported back pain with a control group who didn't. Close to two thirds of the pain patients had cracks in their discs, so-called high-intensity zones, or HIZs. But so did 24 percent of the noncomplainers. "The real issue," says Dr. Eugene Carragee, the study's lead author and director of Stanford's Orthopaedic Spine Center, "is, why do some people have a mild backache and some have really crippling pain?"

jamesaroo

replied on November 2nd, 2007

New User

Thanks for your reply. The physical therapist had been trying to manipulate the sacroiliac joints the first week until I recieved the MRI. He originally thought that is where my pain was coming from. After the MRI they said I have a herniated disc and set appointments for SI and he started me on the traction table. There was very little relief in the lower calf and more intense pain in the back when I would lay on the table. After I would get up the pain would be worse until I'd lay down for awhile.

expatient

replied on November 5th, 2007

Experienced User

jamesaroo wrote:

The physical therapist had been trying to manipulate the sacroiliac joints

Try an other one. Trying to manipulate is totally different that correcting the problem. And ask them to explain which one they manipulate and why!

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