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Lower leg pain for 6+ year and no one could tell me what is wrong with me...HELP!!!

AnonymousUserAAnonymousUser Posts: 49,671
edited 06/11/2012 - 8:34 AM in Chronic Pain
I was in a car accident back in Feb 2000. I only had some back problems which ended up going away with acupunture treatments. After a few years went by I began to develop knee pain in both knees. The doctor did x-rays and nothing really came up and gave me Ultracet to relieve the pain. I then developed pain in both my legs starting from my feet/ankles to my knees. It was excrusiating pain expecially at night. I wouldn't be able to sleep for more than just an hour or so. Then gradually the pain became more consistant throughout the day and that is where I am now. I am starting to gain weight and I have never had this much fat on my body that sometimes its hard to exercise or just walk because of the pain I'm in. I also occasionally have pain in my upper and lower back, numbness in my legs when I sit for too long, and lately I have swelling on my left ankle and bulging on my right foot. My medical history contains of: Rynaulds disease, mitral valve prolapse, low bp, and a heart murmer.
These are the medications I have tried: Ultracet, Ultram, Tramadol, Darvocet, Seroquil, Neurotin, Cymbalta, Lyrica, Vicoden, Percocet, Kadian, Mobic, Elavil, and regular over the counter medication. I am currently on Kadian 20mg which I take once daily, Elavil 25mg to help me sleep, and just started taking Percocet 5mg/325mg during the day to help the pain go away. I don't always have pain during the day, just occasionally. I have tried Orthopedic, no help. Have gotten extensive blood work and they didn't find anything. I went to a Neurologist and had that painful nerve testing done with those pins and all they found was slight perferal neuropathy. I see a pain management doctor every 3 weeks who subscribes me these medications. He sent me for an MRI and the results came back:
L5-S1:There is mild facet arthropathy with an associated broad-based disc protrusion resulting in mild narrowing of the lateral recesses and mild narrowing of the right neural foramen.
Can anyone tell me what this means? Can anyone help me figure out why I have this pain? What my next steps should be on how to treat it or get in control of it? Because it has been controlling me for over 6 or so years and it might only get worse.


  • Welcome to Spine-Health. As I was reading I was hoping that you had or were going to have an MRI and then it popped up at the bottom.

    I have to disagree a little with Straker on this one. The facet arthropathy (facet arthritis) can be treated conservatively with injections or rhizotomy (burning the nerve). Neither of those treatments are too painful and the success depends on if they lessen or end the symptoms. If your symptoms do decline, then it's a matter of for how long.

    The disc protrusion could be pressing on nerves that are causing symptoms also and one of the conservative treatments for that is an ESI. There have been many successes with ESIs for discs that are not herniated.

    Please keep in mind that I'm not a doctor and these are my unprofessional opinions. It will ultimately come down to the doctor (or preferrably a fellowship-trained spine surgeon) to interpret your MRI and suggest a course of action. My point is that surgery at this point is not a foregone conclusion and that there are conservative measures that can be tried.

    Take care and please keep us posted.
  • looking at your symptoms i would say that you have some nerve impingement on the L5/S1 nerve route and this coupled with the facet joint syndrome .will be giving you hell .{in my opinion there is nothing that can be done for the facet joint problem that wont cause any more problems in there own treatment .any procedure performed on facet joints tends to be temporary and can cause even more pain i am only giving the uk line there .my anesthetist told me that facet joint problems don't respond well to any treatment.some may get a very small amount of relief there may be different procedures in other parts of the world where the out look is more favorable };Thanks cath] ,But if the nerve problem is giving you problems with your sleep etc there is no option other than to open you up and do a laminectomy or/and discectomy ..this is about as good as it gets BUT as i keep telling everyone back surgery is the last resort because its far from a perfect solution.the reason for this is so..once you are operated on your back will never be the same .you will always have some degree of back ache and is more than likely that you will require top up surgery as the years go by .the reason for this is epidural fibrosis {scar tissue} to you and me! .what is going on with your medical people next? you have your MRI result and normally there would be a follow up and referral? i take it that's your next move? .if not you need to see about your back ..don't leave it because it will go worse ..i feel for you as i have had surgery x2 and i am still in pain and don't sleep too well {about 3 hours max} try ice pack on your back make sure that when you do sleep that you sleep with a pillow in between you legs at the knee lay on your side and slightly bend your knees up towards your chest you should find this a bit comfier .in the day i have found a recliner is the best thing to sit in..but if you have not got one .lay on your settee again with your knees bent and place a pillow under them don't have a straight back and legs this will pull on the lower back and hurt even more.make sure you have a suitable supply of prescription pain killers and take them as per order.i hope that i have been of some use to you and wish you good luck with your back{EDITED FOR CLARIFICATION}
  • Your problem is what the Neurologist told you. It's Neuropathy. Neuropathy is a very painful condition and we sometimes never know what brings it on.
    The pain is worse at night, just as you said.
    As you already know it's very painful and difficult to treat except with narcotics. Over the counter meds are of no help as you have found out.
    Type Neuropathy in a search box and it will bring up pages of information on this very painful condition. The percocet you are on on just is not strong enough to really help your pain. There is no cure for this condition....except pain management.
    I am so sorry that I can't offer much hope for a cure but the pain can be managed and I could always be wrong.
    The Neurologist has already diagnosed what is causing your pain. Believe me I am no Doctor....just someone with the same condition.
    Talk to your Pain management Doctor about how he/she treats Neutopathy. I know yout pain can be better managed....perhaps a long acting narcotic is needed, Something you take every 12 hours. They will need to keep adjusting your meds until you find the right dosage.
    Best of luck to you. I do hope you find some relief.
    Patsy W
  • I would concur with others that it sounds like you have problems stemming from some problems at the base of your spine, the lumbar 5-sacral 1 (L5-S1) area. Chances are the S1 nerve is being compressed by the structural problems you have going on in that area.

    Facet arthropathy is a type of arthritic change that often develops in a facet joint. Unfortunately one of the fairly common side effect of being in an impact accident (fall, car crash, etc) is that one develops arthritis as one ages. This could be the cause of your arthropathy, but it can also develop due to other reasons.

    This is coupled with a broad-based disc protrusion that is pushing into what should be an exit root for the nerves as they leave the spine. The right neural foramen is an opening (foramina are on both the right and left sides of the central canal) that exists for the spinal nerves to pass through freely. When there are arthritic changes that rough up the edge of the "hole" and a disc that is bulging outward, taking up space, it often results in nerve pain. The spinal nerves innervate a particular part of the limbs...a pinched or compressed nerve will result in a fairly predictable pattern. You can search for "dermatome map or chart" to see the area that is affected by the L5-S1 nerve.

    There may be a way to decompress the nerve so that you will have relief from the pain, as Cath mentioned. There are facet nerve blocks that can be administered to determine if a particular area is causing the problem. Steroid injections can help reduce inflammation and hopefully, reduce the pain. I recently had fluid withdrawn from a facet which can also cause pain. Has your pain management doctor viewed your new MRI and suggested any of these treatments?

    If you have osteophytes growing as a result of the arthropathy, and also to open up the foraminal openings, a fairly simple surgery can be performed where these bony overgrowths are scraped away....The surgery is performed to make more room for the nerve to pass freely.

    Since the EMG did not indicate nerve damage with the S1 nerve, surgery would only be done for pain management. Otherwise, the surgery would not be necessary.

    Obviously as you can see by all the opinions you are getting, none of us have medical training!! If possible, I hope you can consult with a spinal specialist to get a proper diagnosis and treatment plan.
  • I just want to offer some hope here because two and a half weeks ago I received bilateral ESI and bilateral Facet Joint injections in my L4/5 and have been relatively pain-free ever since. I've posted my MRI result from before the injections and I have some pretty severe problems in that area.

    This is not to say it will work for everyone and I don't know how long this result will last, but it IS possible to receive relief from conservative measures. That being said, everyone is different and results vary.

    L4-5: Diffuse disc bulge and moderate degenerative changes involving the facets bilaterally with associated ligamentum flavum hypertrophy. Moderate to severe spinal canal and bilateral lateral recess stenosis at this level. Impingement of any of the traversing lumbosacral nerve roots is possible. There is mild narrowing of the neural foramina bilaterally without definable nerve impingement.

    Impression: Multilevel degenerative disc disease and facet osteoarthropathy changes of the lumbar spine as described in detail above. Moderate to severe spinal canal and bilateral lateral recess stenosis at L4-L5 could impinge any of the traversing lumbosacral nerve roots at this level.

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