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L5 S1 bilateral foraminal stenosis

oceanman58ooceanman58 Posts: 5
edited 06/11/2012 - 8:55 AM in Spinal Stenosis
I wanted to ask if anybody has had pain from lumbar spinal stenosis primarily in the calves and ankles? The surgeon is hesitant to recommend surgery for me because I don't have the other symptoms associated with bilateral foraminal stenosis. This horrible pain has been going on for nearly two years and I won't bore you all with everything I've tried for relief.

Also, has anybody had surgery for bilateral foraminal stenosis and has a success story to share?

Thank you all.

Andrew in Southern California


  • Hi Andrew in SoCal! Have you tried a pain clinic??

    Jennifer in Iowa
  • Andrew,

    Howdy and Welcome to Spine Health!! I have stenosis at the L5/S1 level thanks to what is called Spinal Epidural Lipomastosis (SEL) which is where a fatty tumor surrounds the Cauda tail, and compresses it.

    On mine there is no "conservative" treatment due to how it formed. 99% they are going to have to conduct a Laminectomy to get that crap out of there. As for symptoms, presently associated with it I get lower back pain that intensifies when sitting in various positions, standing, walking, pain in the outer buttocks and down the sides of my thighs, outer part of my knees, mid point on my shins, and the tops and bottoms of my feet and toes - the feet and toes go numb when sitting or standing still.

    You didn't mention what your doctor feels is the threshold for surgery? I am also told to be on the watch for bladder and bowel issues (which I have intermittently). Between the L5/S1 and my upper lumbar issues, leg weakness is daily now.

    Stenosis as you probably know is a narrowing causing nerve irritation or entrapment of either exit nerves or the cord (or down that low, the Cauda). From what I've been able to learn, it all depends on what is causing the stenosis, how fast it is progressing, and what affects you are having (weakness is the biggie); weakness, pain, function, etc.

    If you look at a Dermatome map, 'calf's' are the S1/S2 nerves, whereas the L5 nerves are the outer half of the shins down to the tops and bottoms of the feet and 3 middle toes. I too am bilateral. I hope you have answers soon. I know the pain sucks. *HUG*

    PCTF C4 - T2, Laminectomies C5, C6 & C7. Severe Palsy left arm/hand.
  • Thank you for your reply and I am sorry that you have to go through all that pain. I pray that surgery just miraculously takes away all the suffering you're going through. I've developed a renewed empathy for people suffering with it. I actually want to get better so that I can help others get through their pain.

    I don't have very much weakness or tingling, however, if I do have tingling it's when the pain is at its worst during the evening after the day's activity. I go for my third epidural shot in a couple of weeks. I believe that will help at least a little to cut it down. Someone told me about accupuncture helping which I've tried before so I am going to try that again soon. The last time it relieved the pain for a day and then it was back. Anyway, thank you for your info. It helped a lot

  • Hi Jennifer, I have tried a pain clinic. They are swamped within the HMO I'm in. Good HMO, just swamped with pain sufferers. They do help. I'm doing all the steps that you take including exercise etc, but in the long range I want to roll the dice with microdiscectomy. I believe it will help. I need to consult with another neurosurgeon and ask him or her if they have seen pain only in the calves and ankles before. Why do I picture this one "oseophyte" laying on a nerve that's causing all the problems? LOL Could it be that simple. Anyway, thank you and good feelings and no pain to you.

    Andrew in So Cal.
  • My main area of stenosis is at L4-L5. My L5-S1 disc is herniated also though, towards the spinal canal. This is from an annular Tear. The disc above is at advanced ddd, herniated and pretty much flat as a pancake. This has been going on for a number of years now so the ligament in there, the facet joints, etc have swelled from handling the extra load not carried by my flat disc. The bottom of this is the vertebra that is the top of L5-S1. That disc in me also still has some height etc and could press on stuff, but my MRI doesn't show bilateral stenosis at this level. Just what comes from the disc itself. I have pain that is in my backside (butt actually) on both sides and goes into the top of my thighs. Then it skips down to the outside of my calves and runs down the outside of my legs and around the ankle bone on the outside of both legs. It gets pretty intense at times. From what I can tell a branch of the sciatic nerve runs right to that area. My pain skips my knee area and goes to the outside rather than the inside of the leg. So I would say stenosis in those bottom discs are known for sciatica, and the pain can vary for sure.
  • Thank you for your reply. You know, knowing that there are other people that understand why a person doesn't want to socialize anymore due to pain. It's amazing I'm in this place where walking the dog sometimes is daunting. I was always the step aerobics every other day person for twenty five years. Anyway, I wish everybody reading this or replying a speedy recovery with 95 to 100 percent of the pain gone. I'll take those figures myself. I'll keep you updated after the third epidural on Thursday.
  • Hi all , went for my third lumbar epidural yesterday. Pain has lessened today just like the last epidural. I see a neurosurgeon for a second opinion in 3 weeks and I pray the doctor will recommend surgery. I know for some of you surgery didn't work, however I have tried every other treatment known to spinal stenosis sufferers and pain is still here. I really believe whatever surgery they opt for is going to help. Everything I've read on this site regarding stenosis patients who only suffer leg pain, when they get the surgery, it usually lessens the leg pain. And to me less sounds better than the same old kind of day. So I wish you all the best and I'll keep you informed after that appointment. I guess for me it's trusting in God and playing the game.
  • I have the pain in the calves and ankle due to L5 bilateral foraminal stenosis. I've had two opinions by neurosurgeons and one said wait it out it's been 4 weeks and the 2nd said I need to have a Laminectomy to free up space for the nerve roots. I'm in constant pain and have to lay down most of the day only able to walk 2-3 minutes then the pain shoots so hard I need to lay down quickly. I have a 3rd opinion on Tuesday. Hope all goes well for me because I have 3 children that need me. Best of luck to you!
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