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Please give me some advice..I'm so worried about having CES

AnonymousUserAAnonymousUser Posts: 49,671
Hi everybody!

I have had the herniated disc for 4 months. I guess i got this injury due to workout, I usually did4 squat and calf raises which put lot of pressure on the spine. Initially, the pain started at the back , and then it radiated down to the buttock , thigh , calf, and ankle on my left leg. For the first two months of injury, I had excruciating pain that i could barely walk (pain is 8 out 10). I refused to see the doctor because i thought i was simply having some sorts of muscular pains, tendons. Eventually, i no longer suffered from its awful pain; I went to see the doctor. They send me for an MRI, and the result states:

L1-2 through L3-4 demonstrates no evidence of disc bulge or protrusion. Central canal and neural foramina are patent.

L4-5 shows a minimal disc bulge flattening the thecal sac anteriorly. Central canal and foramina are patent.

L5-S1 is significant for presence of large disc extrusion which is eccentric to the left measuring 1cm in AP dimension. This is associated with an annular tear about its posterolateral margin to the left. A small component of disc extends slightly caudal to the interspace. This extends into the left lateral recess contacting and deflecting the left S1 nerve root. The right S1 is crowded however not deflected. The central canal remains patent. There is mild narrowing of the left neural foramina.

IMPRESSION: Large L5-S1 disc protrusion effacing the left S1 nerve root within a lateral recess

After doctor looked at my result , he said "this is very bad" , then he started asking me some questions regarding any problem with my bowel and bladder, and saddle numbness, I basically did not have any problem with that . The only problem i had was extremely excruciating pain. Then , he prescribed "Prednisone" for 2 weeks term, he said if " I don’t see any improvement after 2weeks of taking this medicine , he will transfer me to the specialist of pain management for the injection . A day after taking prednisone, I began to have constipation and diarrhea, but constipation is most of the time. I was not sure, could the prednisone cause constipation? (I m scared of having cauda equina) I ran to the doctor, and tried to see him. Unfortunately, he was out for vacation and not come back after two weeks. I came back 2 weeks later when i finished the Prednisone. I asked him "Do I have cauda equina?" because I am having the difficult bowel movement .He said "he does not think my constipation and diarrhea related to my back”. He also did some physical examinations; he tested my ankle reflexes and anal sphincter (he said they were fine).He gave me some the Lyrica. But i actually still worry about CES, i think about it all the time. I would not worry that much if I don’t have constipation and diarrhea. I have searched so many information online that herniated disc can cause "Cauda equina Syndrome" .The most common cause is large disc herniation and central compression on the cauda equina nerve roots, and its symptoms associate with bladder / bowel disturbances(retention and/or incontinence), saddle anesthesia, perianal numbness, foot drop..etc... .My disc protrusion is large (1cm).However, i know I don't have problem with my bladder; I am able to urine when I need. There is no numbness around my anus, but I feel uncomfortable due to hard and dry stool that make my anal skin becomes sensitive....there is no saddle numbness, but i had some weird sensation ( i don't know how to describe it, it just like "cool sensation"..It never stays long;it come suddenly and gone). I do have some tingling on the left calf down to feet when I have awkward posture (lean my back against the wall and put the right feet on the wall, the left leg will tingle). I can walk on my toe and heel...

The pain is getting better, the current pain is about 1 out of 10. I think i can run now; however, there is just only 1 problem that really frightens me is the "irregular bowel movement". I have suffered alternating between constipation and diarrhea for more than 1 month (right after the day I took prednisone).

My MRI shows no evidence of central compression on the nerve root...My question is "Does the disc likely to move and compress on the cauda equina nerve root? (I m sorry if this question sounds idiot...I 'm too depressed about CES)--- my MRI has been done two months ago; i asked Dr for another set of MRI, but he said it is not necessary.(he does not think i have it)


  • As long as your in close contact with the Dr on your symptoms as you are now is good. That's great your pain level is down also. I think a second opinion would help you feel more at ease. I'm not sure prednisone causes constipation but it can do alot of changes in your system so it could be that. Are you taking any other meds for your pain? I think there are people here who had CES and give some support but if you ever have urinary retention or weakness or loose stools and a relaxed anus and saddle numbness that would certainly be cause for concern and you would go to ER. I hope that you will be okay though. Take care. Charry
    DDD of lumbar spine with sciatica to left hip,leg and foot. L4-L5 posterior disc bulge with prominent facets, L5-S1 prominent facets with a posterior osteocartilaginous bar. Mild bilateral foraminal narrowing c-spine c4-c7 RN
  • Hi Charyy,Greatly thanks for your input.

    I stopped taking any Prednisone month ago, but now i have currently been taking 100mg Lyrica every night for a month (DR said Lyrica is good for the nerve, and i think it works). Well, i know i don't have urinary retention, but constipation and "cool sensation" at the inner thigh and butt have got me worried.Like i described above, those sensation come suddenly like a "flash" and then gone , they never stay too long.

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