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Is it just a herniated disk?

AnonymousUserAAnonymousUser Posts: 49,671
Hi everyone, I'm new here and looking for info. My sciatica pain started about a yr and a half ago. Sharp stabbing pain in left cheek shooting down to foot.Started after telling MD I had lower back pain for several months.He then had me lie on table, manipulated my legs and had me lie on my stomach and pushed on my spine from bottom to top.Next day the shooting pain began.When I told him he got upset & said "fine then, I'll send you to a doctor to give you shots in your back" I said "fine".That MD is no longer my doc.First shot relieved pain for several months.Then had 2 get a second, again worked several months.This year pain came back as occasional shooting in left cheek and constant burning down left leg.Had 2 more shots.Pain now comes & goes mostly sometimes so bad it wakes me at night & I have 2 sleep on recliner and sometimes my back totally goes out & leaves me flat on my back for a couple days & gradually gets better in about a week.After the last shot I now also have tingling in calve & foot now for short periods with pain that is pretty constant although the level of pain changes.Last years MRI showed nothing really but 3 bulging disks.Last months MRI showed :L3-L4 mild broad based disc bulge.shallow protrusions intaforminally bilaterally.Contact of transitioning L4 nerve roots.Mild to moderate bilateral neural foraminal narrowing.Disk material comes very near the exiting nerves at the level of the neural foramen without definite contact of nerves.mild facet hypertrophic changes.mild central spinal stenosis.
L4-L5:progression of degenerative changes at this level.The broad based disc bulge identified on the prior study now has small central and paracentral left shallow extrusion extending 3.5mm below the superior endplate of L5.Moderate to severe bilateral recess stenosis and mild to moderate cental spinal stenosis.Contact of the transitioning L5 nerve roots and possible affect of the transitoning L5 nerve roots.Contact of the exiting nerves at the level of the neural foramen, right greater than left.mild ligamentum flavum thickening and mild facet hypertrophic changes.There is enhancment of the disc within the right neural foramen and centrally.I also had loss of bladder control last summer after the first steroid shot.Seen urolagist(sp) and had surgery for that which was the incertion of mesh.Now I wonder if that surgery was necessary or if the problem could have been caused by my nerves?? I know this is long, I'm sorry but I have made an appt with a neurosurgeon for the end of the month and was just wondering if anyone could tell me if surgery should be considered.The pain doc said it was an option or I could have another shot.Since the last 2 didn't do much I figured another shot might not be the answer. I'm having a nerve conduction test wednsday ordered by my brand new family doc.


  • Hi, your pain sure sounds like a herniated disc. It doesn't sound like they are large herniations, but obviously large enough to cause severe pain. If you have already had 4 or more shots in the past year I don't know how many more they will give you before they tell you that a microdiscectomy is the next option. I ended up having 4 shots and a selective nerve root block before they told me that there was nothing else they could do. Like you, the 1st couple of shots worked pretty well for me for a few months. My pain level went from a solid 9 down to about a 2. But then after a few months it started to creep back up and the next shots were less effective, and the selective nerve root block didn't do anything. Mine was a huge rupture that they said only had a small chance of healing on it's own without surgery anyway. But, they will usually try to exhaust the non-surgical options first. Good luck, and keep us posted.
  • Hi and welcome! Sorry we have to meet under such conditions, but know you will find needed support here from people that know what you are going through.

    It's good that you are seeing a surgeon about this! Unfortunately I can't read your MRI, but I say, do your homework about your condition. Unless it's an emergency, take what your surgeon says (and ask a lot of questions), then go out on your own and learn more about it. Also, with a huge decision such as surgery (again, unless it's an emergency or pressing!), it's not a bad idea to get more than one opinion until you are satisfied. If it comes down to surgery, you will then be prepared.

    I wish you the best! Let us know how your appointment goes!

  • HI I'M PETE and i too suffer from pain.
    i cant say i fully understand what was done in your last surgery. this new mri certainly shows some problems that need attention like stenosis and foramin narrowing. get a few opinions and keep us posted as to what plan they come up with
    best of luck
  • Hi,I can have 1 more shot if I want,it's been a yr and a half since my first one. I'm just afraid because after the last one I began having tingling from the knee down thru my foot upon standing a few seconds then it goes away after a few minutes.It also happens rarely while laying down.I'm afraid if I have another it will get worse or just end up constintly numb. Also because it didn't help much with the pain.
    I do believe the rupture seems small, I just wonder if the other stuff in the MRI report are adding to the problem and I fear that the bladder control problem I had last summer which came on so abruptly might have actually been caused by nerve damage.I have a check up with the urologist 2day and I will ask him. I didn't mention it to him last yr b4 the surgery because the pain doc said my MRI really didn't look too bad & I wasn't having pain at the time because the shot I had was still working.And I didn't know sciatica pain could cause a bladder problem.
    I am 44 yrs old and also have COPD. Showering alone causes breathlessness, I don't know how well I'd do at regular exercise.I just know I have a bucket list of things I want to do while I still can and this pain is so unpredictable that I can't make any plans. Like everyone here I'm sure, I'm tired of the pain & laying around the house. The Nsaids don't seem to help & the pain doc says that I just have to deal with it,have another shot & see what happens or look at surgery.
    Did you have the surgery? Did it help?
  • For your support. I'm researching everything I can. My MD told me to stay away from Chiropractor with my spine the way it is and I tend to believe him seeing my first doc manipulated my spine and now I have dibilitating pain opposed to the back ache I had had when I walked in his office. He was a D.O. not an M.D.
    Your surgery and or meds must have helped some if you are retuning to school. Congratulations! Working for the public schools is a nobel career choice.I won't even go to the grocery store anymore because the more I walk the more pain I end up with.
  • I haven't had surgery yet but I am going to a neurosurgeon for an opinion. They have a Neurosugery Center at a great hospital here and both my pain doc & MD said they are very good.
    I will keep you posted.
  • Hi, yes I had an L5-S1 microdiscectomy last October. My surgeon said that it went almost perfectly. My hip/hamstring/calf pain was mostly gone immediately when I woke up from the surgery and the million needles feeling in my foot was completely gone. I was supposed to walk for 45 minutes a day starting immediately. Most surgeons now say that walking is the most important exercise to do for recovery, and hopefully prevention of scar tissue build up. I walked every day just like they said and then almost overnight my hip/hamstring/calf pain came back to a 5 level after 7 weeks. I freaked out, thinking that it had re-ruptured, and demanded a new MRI. It showed huge scar tissue. They said that scar tissue scrinks easily with a cortizone/steriod so they did another selective nerve root block shot up against the S1 nerve that was being crushed again. This shot was excrutiating pain for the 10 minutes that the needle was in, but 3 days later it started to work. It has been almost 6 months since this shot and my pain level is around 1 to 1.5. Easily bearable with no pain medication and not showing any signs of getting worse yet. I am starting to get my old life back. I am now walking 55 minutes a day and surgeon reluctently gave me permission to start a little light eliptical and jogging. I realize that my back and my life will never be the same, but I am happy with the results of the surgery so far. Good luck.
  • Sorry i missed the fact that the procedure you had was a urological procedure with mesh. i thought it was a fusion! did that help. are you still having bladder trouble?
    if in fact the pressure on the nerves is causing bladder problems most dr.s would recommend surgery. we'll see what ns says....pete

  • I just want to point out something here: the differences between a D.O. and an M.D. are not so notable anymore. Since one of the major differences stems mostly from the teaching style in school (D.O.'s are trained to treat the whole, rather than the part), but that difference is becoming less and less defined as M.D.'s are starting to get some of that same training.

    The other difference is they are trained in manipulation (which caused you pain), which works well for many people. They are much better at this than Chiropractors, in my opinion. It's just unfortunate and I'm sure distressing that this doctor actually caused pain rather than helping it.

    I hope you are doing well today!
  • Hi ev1,well I went for the nerve conduction test 2day.I didn't take any anti-inflamatory meds for the last several days. I showed the Doc the MRI report. She seemed puzzled that my pain was down my left side instead of my right because the MRI indicated more damage on the right side.Apparently the NCV test didn't come out like expected and they decided to go ahead with the EMG. She said I definately had a pinched nerve on the left but was baffled because the right side showed nerve damage. She said it may be just that it was old damage and the nerves just kinda fizzled away?? She said she was going to go over the results in more detail & send them to my doc. So...who knows. It's a waiting game.
  • I am really amazed that no one connected your bladder control problems to your back problems. I will be interested to hear what the urologist has to say when you see him again. I trust you have read all about cauda equina syndrome and understand the relationship between the lower lumbar spinal nerves, and the bladder and bowels.

    I had a similar experience with my nerve conduction study and EMG. I had told the neurologist what my symptoms were and what my fusion was supposed to correct. As he was doing the testing, I could see something was confusing him and he repeated parts of the tests several times. The simplified version is that he was finding my left L5 nerve was most affected, but my pain was in my right leg. I have no explanation for this, but it apparently happens fairly often.

    Let us know what happens with your neurosurgeon.

    xx Gwennie
  • I seen him day b4 the nerve test for a check up. I asked if my back problem might have caused the sudden bladder problem I had. He said even tho I had 2 different bladder control problems one of which is associated with the cauda equina symtoms he didn't think that was the problem. When I asked him he looked suprised. I wonder if he just don't want to be accused of failing to do the proper tests b4 surgery for my bladder problem. It would not really be his fault as I didn't mention my back problem to him as I had had my 1st steroid injection a few months prior to my bladder problem and was feeling fine thinking my back problem was cured. I will just have to wait & talk to the surgeon.
  • i'm sure the surgeon will ask you about bladder control. that is one of their first concerns....anyway good luck with it and keep us posted. by the way i too had bladder control problems which were cured by lumbar surgery... so think positive....pete
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