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leg- sciatica issues but not showing up on MRI- anyone else???

My back has been going down hill since August.
I have weakness in both legs in the foot and thigh , cramping at L5/S1 (calf and foot) and the ESI I had last week made me worse. My legs really started cramping after the shot and I
have never had that before (the shots have never made me worse). My legs have been cramping for a couple of weeks now
(before the shot) but the ESI made it much worse.
The surgeon and PM Dr. say my MRI and EMG shows no nerves being pinched despite all the other issues (DDD, spondy, fracture etc). How is this possible?

Has anyone else had this issue?

I feel like I'm going to battle with the Dr.'s, it just seems illogical that my legs would be this bad just from my disk/ DDD and not from nerve root impingement. The surgeon said no to surgery because the MRI shows no nerve root impingement.Luckly the PM Dr. doesn't agree and thinks I need the surgery.

I'm having a discogram this week, maybe the CT afterwards will tell a different story?
99/00 L4/5 & L5/S1 herniation
2001 L5/S1 microdisectomy age 25
severe DDD at surgery level
2011 pars
2012 RFA L/3/4/5
7-02-13 L4/5 l5/S1 360 fusion ALIF PLIF
DX spondylitis , DDD, scoliosis, and slight kyphosis


  • Indeed it is not uncommon for an MRI to show nothing but the patient to still have issues.
    Likewise, it is not uncommon for a random MRI to show a lot, but the patient has very little symptoms if any.

    The MRI is one tool to use to diagnose. The discogram can indeed help along with your symptoms.
    Good luck.

    The doctor is saying no surgery because he is being responsible. If he were to say yes, I'll operate, it would be exploratory and 'guestimate' on which level to look at based on symptoms alone. So while he is saying no, he is doing so because he would be setting both of you up for failure if he said yes before figuring out just where the issue is.

    It stinks because it will take longer but hopefully the disco-gram will help.
  • Have you had a CT scan yet? i ask because one of my biggest problems doesn't show on the MRI, but showed on a CT scan.

    i had a herniated disc at L5-S1. 2 microdisectomies with hemi-laminectomies, and herniated for a 3rd time. MRI shows the compression on 2 nerves, which hadn't changed in a while. But what it didn't show was the 1/2 in long bone spur pressing into one of those nerve roots. And that was the biggest reason for needing the fusion ultimately.

    my insurance looked at the MRI and said they would approve the laminectomy (even though i had 2 already paid for by the same company.) but that i didn't need a fusion, meanwhile, the MRI doesn't mention the bone spur. and the only way to get rid of it, was to do the fusion.

    its posible not to see everythhing thats going on with just an MRI. the CT scan can give detail on the bones better, and its possible there is a problem there, and not with just the disc.
    Microdisectomy / hemi-laminectomy 6/2010 and revision 10/2010
    Cervical fusion C4-5 and C5-6 9/2011
    Lumbar Fusion L5-S1 6/2012
  • Yep, no change since surgery but MRI looks good.....discouraging. Good luck!
  • Good to know. I'll stress to the pain management dr to look at the CT
    For something to explain my leg issues. He said ill have one after the discogram.
    99/00 L4/5 & L5/S1 herniation
    2001 L5/S1 microdisectomy age 25
    severe DDD at surgery level
    2011 pars
    2012 RFA L/3/4/5
    7-02-13 L4/5 l5/S1 360 fusion ALIF PLIF
    DX spondylitis , DDD, scoliosis, and slight kyphosis
  • I went and saw a NS, who is suggesting sciatica, and even my herniated disc was secondary to something else. He thinks hip......I've done some internet research and think piriformis. That being said, perhaps you have something else impinging on your sciatic nerve?
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