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Lower back pain and leg numbness (Page 1)

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Hello. Smile

I am having a medical condition that is taking way too long to diagnose. I was hoping that maybe somebody has had a similar situation and could help. I am a 26yr old male.

This started late August of this year. I noticed a small patch of numbness in my pelvic area on the right side. I didn't think anything of it and thought it would go away. However, it progressed to my right hip area and down my right leg over the course of 3 months. It was a gradual progression.

I have loss of sensation on the inner part of my thigh, shin, knee, and inside part of my foot. I also have stomach irritation in my lower right abdomen. My leg is also weak and I limp a little bit when I walk. Sometimes when I twist and pop my back, my right leg will jump like a reflex bounce.

The other weekend, I was bowling and about half way through my second game my lower back started hurting really badly. When I got home, I could not walk from my car to the house.

I went to see my doctor the following week and he decided to send me to a specialist, orthopedic. I am to get an MRI of my lumbar soon, pending insurance approval. I have not seen the specialist yet, my appt is pending the MRI.

I have been reading, and the symptoms for my leg seems to fit a lumbar herniated disc. However, I am curious about the stomach irritation. I know some stomach nerves are stemmed from a vertebrate in the lower back.

Any advice, insight, recommendation would be greatly appreciated. This illness/injury is greatly affecting my life. Thanks in advance. Smile
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replied November 25th, 2009
Extremely eHealthy
hi
with those symptoms your dr was smart to refer you to specialist who i hope specializes on the spine.
as for stomach trouble if there is impingement on the nerves that control the excretory system it usually causes less control of bladder and bowels. it doesnt sound like spinal nerves but mention it to the specialist...pete
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replied November 30th, 2009
Thx for the reply, the specialist is in Orthopedics. I am having the MRI this Wednesday. Finally went through with insurance.
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replied November 30th, 2009
Extremely eHealthy
hi again
glad you will get some answers. please tell us results...pete
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replied December 2nd, 2009
Extremely eHealthy
good job on the images. i'm no doc so dont bet the bank on my diagnosis. my eye sees nerve root impingement at l5/s1 from herniation on right side. disc at that level has dark color which means the disc has dried out. i dont see impingement on the spinal canal. to me it looks like surgery. i think it is good that mri seems to agree with symptoms. this should be a no brainer for the surgeon.
let us know what he says....pete
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replied December 3rd, 2009
You have the exact same problem as me! I thought i was looking at my own MRI scans for a second looking at them.
I know exactly how you feel with the pain and leg numbness. The surgeon i went to said there was an steroid injection that he could give me, but because of my age (20) he really didn't want to. I find it very fruistrating, he said it isn't bad enough to have surgery yet! I don't understand why i have to wait for it to get worse - which is almost certain that it will - before i can have surgery.

I am currently having a few physio sessions, although there is not much it can do for me. My advice to you is to try and keep it moving and to do some light stretches as i have found it to slightly help me when the pain gets at its worse.

Good luck, and let us know what happens.

Cheers

James
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replied December 3rd, 2009
Thanks Pete and James,

I appreciate the replies. Oddly enough, I have ran into so many people in the last couple of weeks who have had similar symptoms. I suppose that is because I have been going to the right places for treatment/diagnosis.

I just got a referral to a new chiropractor that I think I will try. The lady who gave me the information had surgery when she was about 20 and the surgeon told her she would have problems about every 5 years. The chiropractor seems to help her a lot.

I would like to avoid surgery at all costs. Mainly because it is uber expensive. I have insurance, but it is new insurance because of lack of work. Yay economy! Sad I figured I was 26 and would be ok until I found a new job. Haha... If you want to make God laugh, tell him your plans. Right?

Your replies are very comforting. Before I made headway with the MRI and your posts, I was trying to self diagnose and the mind likes to fear the worst. Know what I mean?

I do stretches often James, and swim at my YMCA on my back to keep my leg strength up. Jacuzzi helps me relax too. I have an inversion table that I have been using to do my own at home decompression therapy. If you have access to one of those, you might want to give it a try. Just be careful and don't flip it all the way inverted starting out! lol

John
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replied December 3rd, 2009
Oh, on another note.

Do you have any advice on physical activity? I have read that I should try and stay active to avoid weakening the muscles in my back, but not to overdo it. I am an avid bowler and bowl at least two nights a week(3 games a night). I wear a support brace when I bowl. Do you think it is safe to continue bowling? I don't want to make the disc worse, but I don't want to stop bowling either!! Smile
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replied December 3rd, 2009
Well, John, i was adviced not to lift anything heavy, but i like to do my weights and also like ten pin bowling on a sunday. I'm not allowing it to stop me doing the things i enjoy, so i just do more stretches every night and morning to keep it from stiffening up.

I would say keep on bowling and just make sure you strecth. Keeping it moving is supposed to help, and bowling....well is keeping it moving, right? lol

Just see what the doc's say though. But i have carried on and it isn't getting any worse, so hopefully you will be ok to carry on too.

Regards

J
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replied December 3rd, 2009
Extremely eHealthy
hi john...
its great you can do as much as you can physically.
maybe you can beat this disc trouble. if the disc deteriorates enough eventually you get bone on bone. then the two vertebrae fuse themselves together. drs will tell you thats the best fusion you can get. i guess its all about whether you can take the pain. ask dr if you are in danger of permanent nerve damage. that would be my only worry. as for bowling are you a righty? if so i would think the delivery of ball would just be bending the left side so maybe it wouldnt bother the nerves on the right...does it hurt to deliver ball?....pete
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replied December 3rd, 2009
It does irritate it some when I bowl. The part when I lift to give the ball rotation probably does the most irritation. Or when I pick up the ball off of the rack. I don't really feel it when I bowl, but sometimes the tingling increases.

I got the results from the radiologist if you would like to read it. Not that I can understand most of it. But it pretty much says what you did earlier Pete.
I will probably bowl this Sunday evening. I will hold off on Tuesday night, since I see the specialist that day.
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replied December 3rd, 2009
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hey now you have good excuse if youre a bit off the mark...lol....pete

ps...i thought it was a bit worse than report so maybe doc will just recommend physical therapy...we shall see
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replied December 8th, 2009
Well, went to see the specialist today. He took x-rays of my spine to see it while I was standing, since an MRI is laying down. He said at my age, I should not have disc problems so there must be something additional. This guy has 30 years under his belt, I wasn't going to argue too much.

He got the x-ray back and he said my lumbar spine was almost perfectly straight. I heard him talking to a nurse, and he was like, "Wow, look at this spine, it is so straight it's almost as if there is a rod in it." We all know, the spine has a curve, mine- not so much atm. He said my muscles were so tense that it was making my spine straighten.

Neway, not sure what that has to do with my disc, but he seems to think it is contributing. He put me on Methylprednisolone (aka steroids) and a different muscle relaxer. He said that in most cases, like 95%, I should see improvement in 2-3 days. If I see only temporary improvement they will give me a shot to shrink the disc, and if all that fails, then surgery.

He said given the length of how long this has been going on, my nerves should be OK.

And what you have all be wondering... he said no bowling. Sad Told me to go home, take my meds, and have a slice of pizza. lol Little did he know I bowled Sunday and shot a 705 series! Razz
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replied December 9th, 2009
Extremely eHealthy
Frost_Trunks wrote:
Well, went to see the specialist today. He took x-rays of my spine to see it while I was standing, since an MRI is laying down. He said at my age, I should not have disc problems so there must be something additional. This guy has 30 years under his belt, I wasn't going to argue too much.

He got the x-ray back and he said my lumbar spine was almost perfectly straight. I heard him talking to a nurse, and he was like, "Wow, look at this spine, it is so straight it's almost as if there is a rod in it." We all know, the spine has a curve, mine- not so much atm. He said my muscles were so tense that it was making my spine straighten.

Neway, not sure what that has to do with my disc, but he seems to think it is contributing. He put me on Methylprednisolone (aka steroids) and a different muscle relaxer. He said that in most cases, like 95%, I should see improvement in 2-3 days. If I see only temporary improvement they will give me a shot to shrink the disc, and if all that fails, then surgery.

He said given the length of how long this has been going on, my nerves should be OK.

And what you have all be wondering... he said no bowling. Sad Told me to go home, take my meds, and have a slice of pizza. lol Little did he know I bowled Sunday and shot a 705 series! Razz


Generally speaking, you should not have disc problems at your age, BUT, it does happen and your doctor should know that and not be ignoring that possibility.

It's also quite possible that you injured a disc while bowling and this doctor is ignoring that possibility.

X-rays are very poor tools to diagnose the spine, other than the actual vertebrae. An MRI is needed to check on the discs and see if there is any nerve compression and what, if anything, may or may not be going on with the discs.

He's also far from accurate to say that because of the length of time you have had this problem

Your leg symptoms are all classic nerve compression symptoms, all that numbness, tingling, burning, feeling, that's all nerves.

To outright say it has to be "something else", and not a disc, IMHO, is crazy.

Your spine surgeon may have 30 years experience, but that doesn't necessarily make him a good doctor and his comments about not a disc is not smart or accurate or very good practicing medicine.

There are many, many, many young adults with disc problems and to actually say that it has to be something else because of your age is just plain crazy.

If your muscles are causing a problem, it is no doubt due to the pain you are in and not using them correctly. You aren't going to be able to do that until you have decreased the pain you are in and are able to move and walk properly.

Limping or dragging a leg will make core muscles weak very quickly. With weak core muscles, they will tense up and will but a strain on the spine and just add to the pain.

He's also wrong to say that your nerves should be OK because of the length of time this has gone on. He's 100% wrong, and not only am I a perfect example of that, but so is the 27 year old young man that lives down the street.

My spine problems began with a sudden onset of severe, acute pain the first week in Feb. 2006. Went to bed fine and couldn't get up the next morning because of the pain. That was a Monday. By Wed. the nerve pain had started and it was all but impossible to move.

Diagnosed with spinal stenosis in less than 2 weeks, and gave all the conservative measures a try. By April, I was limping like you. By May the limb was far worse and became more of a dragging my right leg. By June 1, I dragged my right leg as if I had had a stroke and could barely move. On June 13, I had sudden total loss of bladder control and had surgery early AM on June 14. That was emergency surgery, as the loss of bladder control is an emergency surgery that must be one within 24 hours or there is no chance of regaining the nerve use that goes to the bladder and bladder control. The end result could have been permanent nerve damage and total incontinence and that was in 4 1/2 months.

The young man down the street injured his back working in his yard. After 2 weeks he started having all your symptoms and went to a spine surgeon for diagnosis. He injured a disc, tried the conservative measures and ended up with surgery done as an emergency for cauda equina syndome, the same bladder issues I had, and he's been fine.
He had to get a new spine surgeon because his doctor kept saying he couldn't have done anything to the disc, he's too young.
He ended up with my spine surgeon just in the nick of time.

The medrol pack steroids (did you give you the 7 day medrol pack/) may help ease the pain for you, but if it does, then it more or less confirms that you have nerve compression, no doubt being caused by a disc.

I really suggest that you get a second opinion as I honestly don't think you have a very good spine surgoen and he is giving you substandard care.

You really need an updated MRI done right away with a new spine surgeon, and if the steroids help ease the pain, you need to have some physical therapy to try and heal what is going on and strengthen the cores and if that doesn't work to ease your pain and heal a potential disc problem, you might be discussing some surgical options.

But those surgical options can only be discussed after having an MRI and real diagnosis of what is going on with your spine.

Good luck

Fran
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replied December 9th, 2009
Extremely eHealthy
hi FRAN...just so you have the whole story john actually had an mri done and he posted the images here. apparently a MOD deleted the link to the images. the l5/s1 disc was black and it appeared to be putting pressure in the exiting nerve roots on the right side. the fact that johns dr is considering an injection into the disc shows he is aware of a disc problem...to my amateur eyes it appeared to be a lateral recess problem....take care...pete
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replied December 9th, 2009
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HI john...i just went back in your post to view the mri images you posted and the link to the images was deleted apparently by an ehealthforum moderator. this particular web site is sensitive about what links are posted ....anyway i like the approach the dr is using. The procedure the dr mentions he might try as a next step is most likely the percutaneous nucleoplasty. you can google it for detailed information. it is not as invasive as surgery and like your dr says may help the protrusion in your disc. i hope things improve and keep us posted...oh by the way make sure the dr performing any procedure is very experienced in performing it....take care...pete
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replied December 9th, 2009
Thanks for the replies.

Heh, I was reading your post Fran, and kept thinking to myself, 'huh?' on a lot of items. Then I saw the posts being reviewed by a moderator. Not sure why they would strip the images. I didn't post anything with personal information other than my birthday and name. And I didn't use the forum's disc space, I linked them externally.

But yes Fran, I had an MRI and what pete said is accurate. I am seeing some improvement with the steroids. Hopefully more in a couple days. They are disrupting my sleep cycle though. I had a rough night. Pretty tired today.

Thanks for the info pete, I will look up that procedure. The surgeon seems pretty competent. He didn't totally dismiss the disc issue, he was just curious why I was having disc trouble seeing as I am in relatively decent shape and stay moderately active. Less now because I was swamped with homework, but soon to be better as I finish college. My job was not physically stressful, I write software.

I will keep you posted. If anyone wants to view the images PM me and I will supply you with a link.

-John
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replied December 12th, 2009
Extremely eHealthy
Hi John,

I saw the post being reviewed, and assumed that someone had posted something to you that was not appropriate, a link to some quack site, a blog or something similar, didn't know that it was pics of your MRI.

Not sure why that would vanish from the thread either, but it could be a concern that posting the MRI pics and getting an answer about it, is kind of like a member playing doctor and a risk to the site owners, etc.
I don't really know, but anyways.

I'm glad that you did get an MRI and that the steroid is helping.

If Pete is correct and it is the lateral recess area, then you have more to be concerned with than just the disc bulge and a percutaneuos disectomy may not be what you should have.

If nerves are being compressed in the lateral recess area, that indicates that, that area of the vertebrae has narrowed and needs to be widened to release the nerve compression. If that is done, then the disc will have the room that it needs. It isn't the disc that is the problem but rather the lateral recess area has become narrow from excess bone growth and is forcing the disc to bulge.

Actually, lateral recess stenosis that causes the disc to bulge or just plain traps the nerves in the area, is one of the most common causes of failed decompression surgery that ends up having the patient undergo repeated decompression, disectomies and even fusion, yet the patient remains in pain because of the lack of decompression in the lateral recess area.

It's sad that this goes on, because it has been known since the early 1980's when the Burton Report was released.

Yet there are still far too many spine surgeons that either just ignore that information and do nothing about the lateral recess area or they don't know about it and do nothing.

Several years ago I was diagnosed with lateral recess stenosis and a bulging disc, just like you where.

I did all the conservative stuff and failed and still tried to find a way around spinal surgery as my symptoms and condition deteriorated rapidly.

My spine surgeon wanted to do a laminotomy and release of the lateral recess and believed that once that was done there would be nothing wrong with the disc.

My head was just not wrapped around letting anyone "put a knife in my spine", so I went to 7 different spine surgeons for opinions.

I went to some of the huge major Boston hospitals to their spine surgery departments and the diagnosis all varied, but not one of them agreed with the lateral recess stenosis diagnosis. They all said it didn't exist, even when I showed them the info that I had.

A couple of them told me the report was just a "quackery job", but I knew it wasn't and had spoken with a pediatric spine specialist I know personally and he fully agreed with the report and told me to stay with the spine surgeon I had, he knew what he was talking about.

Anyways, 4 of the seven said i need a disectomy and that was all, and the other 2 wanted to do a fusion.

I ended up back with my spine surgeon, had the surgery he wanted me to have. As soon as he widened the lateral recess area of the vertebrae, the disc bounced right back into place, the nerves where released from compression, the pain was fully gone and has been ever since.
That is until an auto accident, rear end type that caused a disc to bulge. But that can't be blamed on surgery or not having a disectomy.
Before considering any surgery, please get at least one other opinion, if not more. That is always recommended before spine surgery.

As for you surgeons surprise that you have a disc problem and are in good shape and young. There are many well trained atheletes that have had spine problems and they are usually in good shape unless they are using steroids and then that's a whole other story.

Fran
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replied December 14th, 2009
Steroids not showing much improvement. Probably going to have to get the injection now. Not looking forward to it. Will find out more Tuesday.

Fran - I was reading about lateral recess stenosis, and after looking at my MRI images, I am pretty confident that is not the case with me. I am no expert, but my deductive reasoning skills seem to think it is just a herniated disc. My MRI result from the radiologist states "Small tear of the annulus fibrosis accompanies paracentral to right L5-S1 disc herniation."

Your symptoms were far more severe than mine. I only limp because it feels weird walking with the slight muscle weakness. I am not dragging my foot at all like you indicated with your symptoms. I get around alright, just not as well as I would like to.

Stopped bowling. Not because I can't, but because the specialist said not to... Driving me nutso... Sad
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replied December 14th, 2009
Extremely eHealthy
John,

My symptoms progressed to dragging a leg after 4 months, they didn't start out that way.

I did have a bulge in the disc as well, not a huge one, but there was some bulging of the L4/L5 disc and a small annulus tear as well.

I did have some right leg weakness that began to develop about 3 days after the initial onset of pain, but the limp was more the result of a combo of both weakness and numbness in my right thigh, that progressed over a period of time further down my leg to my right foot.

I wasn't able to get around that well, even before the leg dragging began by the end of May or so.

How symptoms progress becomes an individual thing, and apparently I had this problem for quite some time, just didn't have any symptoms to speak of, that would have indicated a spine problem.

Good for you that you stopped the bowling. The specialist is correct to stop. You may be able to bowl still, but all you are going to do is risk making that disc worse, making the tear worse and that is something you don't want to do.

I can understand how it is driving you nuts. I couldn't do any of my gardening before the surgery or after either. Then slowly after the surgery the doc let me start doing bits and bits.

Drove me nuts too, especially when down on hands and knees everything felt so much better. The problem was getting back up again put a terrible strain on the spine and disc and would make things worse for me "inside" with the disc.

It will get better, Frank. One way or another, you will improve and be able to go back to bowling.

Patience is the word with spine stuff. It's a nasty word, a pain to deal with, but it is needed.

Fran
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