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re: Herniated disc L5: Orthopedist or neurologist help
Posted on 10/29/14 at 10:37 pm to DieSmilen
Posted on 10/29/14 at 10:37 pm to DieSmilen
quote:
I have a knot on my right butt cheek, pain shooting down my right calf/ankle and pain in my lower back.
If there's not a fixable problem that's the focus of your problem, you're probably better off with aggressive conservative care at this time. Early pain management, anti-inflammatory if indicated, and serious rehab routine (physical therapy writes the best ones). You'll be making frequent trips to the doctor for the near future.
From a 9-year sufferer of back pain essentially as you describe it, I can say that sciatica is quite painful. Just the other day, I was stepping out of a vehicle. As I rotated my left hip outward, I had such a bad shooting pain that I actually became pale in the face, saw white, and thought I may pass out. For me, I'm at a point in my life that I've accepted that I will probably always have back pain. You're not at that point yet. Pursue all options. Be very hesitant to go to the operating room early- it's simply not the best option for everyone. A "quick fix" is usually the wrong answer here, as it is most places in life. You're on a road to recovery. Take it step by step. When you quit improving or start to decline, then you should absolutely consider more invasive options. Until that point, though, only 2 weeks out, do your best to pursue good therapy- both medical and physical- and maybe put the idea of surgery on the back burner for now. Again, without a convincing sign (which you may have presented outside of the OP that I didn't see) that is fixable, there's not necessarily an obvious surgical option at this point.
And lastly, to address the spinal cord stimulator nonsense going on in this thread (and I really don't want to, because you're so far from it even being relevant) if everything does move on to that point, focus on the one that gives the maximal pain relief. There are lots of things I could implant in my body that are MRI safe, but what's important isn't that in the future, if you need an MRI you can get one. There are other imaging modalities that are on par or better for most disease processes. What's important is outcomes- the main two being pain reduction and complications of procedure.
1
Posted on 10/29/14 at 10:45 pm to Hopeful Doc
quote:
I was stepping out of a vehicle. As I rotated my left hip outward, I had such a bad shooting pain
This is a common complaint I hear from patients with sacroiliac dysfunction.
Posted on 10/29/14 at 10:54 pm to Upperaltiger06
quote:
sacroiliac dysfunction
I've got a couple of herniated disks; I believe it to be radicular pain from that. I could be wrong though.
quote:
complaint I hear from patients
May I ask what you practice?
Posted on 10/29/14 at 11:01 pm to Hopeful Doc
Chiropractic. Do you have leg pain? If so where?
Posted on 10/29/14 at 11:05 pm to Upperaltiger06
Yes. Transient, shooting pain distributed in a linear fashion from lower lumbar spine to the hip continuing down the lateral aspect of the thigh, terminating just distal to the fibular head.
Posted on 10/29/14 at 11:18 pm to Hopeful Doc
Even texts dating back to the 1800s don't consider referred/radiating leg pain that terminates around the knee as true sciatica (that's not to say that yours could be discogenic in nature). This pattern is more frequently related to the SI being the pain generator. My patients who present with this type of pattern typically have really good outcomes.
Posted on 10/29/14 at 11:21 pm to Traffic Circle
Sorry. I was responding to Otis.
Posted on 10/29/14 at 11:30 pm to Upperaltiger06
Well, it extends below the knee by about 2" and the onset was after a weight lifting accident. I had nagging lower back pain that didn't go away, then severe hip/sciatic pain a few months later that was disabling. MRI of my 16 year old spine revealed two herniated disks. I'm pretty familiar with the normal finding of the herniated disk in the older patient, but in a young person whose pain stems from injury with significant imaging findings, it's much safer to call that the cause. I do have random paresthesias of the same foot, but I've been relatively spared of neurological findings (other than classic nerve pain and parenthesis). Very rarely, but occasionally, I get the same symptoms on the other side.
Posted on 10/29/14 at 11:41 pm to Hopeful Doc
The age, onset, mri, and parasthesias do point to neurological symptoms secondary to disc. Where is you low back pain-midline or lateral? You mention hip....as in coxal?(many people refer to the lumbosacral region as 'hip' is why I ask)
This post was edited on 10/29/14 at 11:43 pm
Posted on 10/30/14 at 7:39 am to Upperaltiger06
The back pain is distinctly midline. It's dull, achy, constant, and almost never relieved. Sometimes it flares. When I say "hip," I'm referring to the femoral head as it sits in the acetabulum.
Posted on 10/30/14 at 7:49 am to DieSmilen
I've got L5-L5 issues.... Herniated and stuff.... Some days I dont feel it and somedays its hard to walk.. Like last nifht SUCCKKKS
Posted on 10/30/14 at 8:01 am to Tigermite
quote:
Microdiscectomy brah. Takes about 2 hrs. And you'll wake up pain free
That's what I had in 2000 and it was AWESOME. But...... I had a clear rupture(piece disc hanging out in spinal canal). Wouldn't recommend surgery for a herniation unless last resort.
Posted on 10/30/14 at 8:38 am to mikelbr
I have a herniated L5-S1 and the MRI clearly show the disc jamming into my nerve root. Have massive sciatica and have troubles with bladder.
Posted on 10/30/14 at 8:50 am to mikelbr
.
This post was edited on 1/12/15 at 12:28 pm
Posted on 10/30/14 at 9:10 am to SomethingLikeA
Have you had surgery?
At 32 I had exactly the same thing. Listhesis at L5-S1 plus the other things.
I was in the medical field and had a lot of people tell me not to have surgery. I finally thought that I could not take it any more and had the fusion. Pain is relative. What you think is a 10/10 today may be a 6/10 in 6 months.
If I could go back and redo one thing in my life, it would be not having that surgery.
Ten years later I continue to have trouble every day. The first surgery failed to fuse, had a revision done from the front to L5 S1.
I have had the discs at the two levels above the fusion herniate and rupture, requiring 2 more surgeries.
Oddly enough, the only thing that keeps that pain bearable at this point is exercise. If I miss a day, I know it. I ride a bike daily.
My advice is find a book called "Heal your own back" or the McKenzie Method and follow it religiously. This includes all manner of posture, forget about what sitting in a recliner feels like.Exercise daily and strengthen your core muscles.
Just my two cents from someone who has been there
At 32 I had exactly the same thing. Listhesis at L5-S1 plus the other things.
I was in the medical field and had a lot of people tell me not to have surgery. I finally thought that I could not take it any more and had the fusion. Pain is relative. What you think is a 10/10 today may be a 6/10 in 6 months.
If I could go back and redo one thing in my life, it would be not having that surgery.
Ten years later I continue to have trouble every day. The first surgery failed to fuse, had a revision done from the front to L5 S1.
I have had the discs at the two levels above the fusion herniate and rupture, requiring 2 more surgeries.
Oddly enough, the only thing that keeps that pain bearable at this point is exercise. If I miss a day, I know it. I ride a bike daily.
My advice is find a book called "Heal your own back" or the McKenzie Method and follow it religiously. This includes all manner of posture, forget about what sitting in a recliner feels like.Exercise daily and strengthen your core muscles.
Just my two cents from someone who has been there
Posted on 10/30/14 at 9:37 am to jaggedlp
At this point he says there will be no fusion. He will go in and remove the herniated disc and shags a portion of the bone. He believes this will release the pressure on the nerve and stop the sciatica pain. I do have a bulge on l3-l4 but he believes if I get the extra weight off it may not require surgery for a long time.
Posted on 10/30/14 at 9:52 am to DieSmilen
quote:
and have troubles with bladder.
This is VERY important, up until reading this I was not sure surgery was right for you (not that what I think matters) but having issues with bladder is one of my 2 criteria for having back surgery, hope all goes well for you and wish a speedy recovery
This post was edited on 10/30/14 at 9:53 am
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