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Central disc herniation symptoms? ESI needed?

bucwoodbbucwood Posts: 13
edited 09/12/2013 - 12:23 AM in Lower Back Pain
Hi folks-

I've only posted a couple times but just can't find the answers I'm searching for. I had a work related injury a little over a month ago and have had several back issues as a result. My back, thigh, hips, and butt hurts, and I occasionally have foot pain and tingling. However, it was my left foot at first and now my right foot is acting up. My leg pain isn't that bad, just the weird numbness and tingling at times. The bulk of my pain is in the back and hips.

MRI showed I have a central disc herniation at l3/l4. I've already had a discectomy on a massive extruded fragment on l4/l5 about 2 years ago, so I know sciatic pain very well. This pain is very different. It seems to change constantly and isn't really a leg issue as much as back and hips. Just yesterday my right foot started hurting and I can barely stand on my heels, but I have no pain in the leg at all!! Very weird. My doc prescribed an epidural steroid injection and Celebrex.

I thought ESIs were for leg pain. If my back and hips are giving me the trouble, I'm worried the ESI is unnecessary and just a risk. My doctor only talked to me for like 2 minutes and I've done all my own research since I got very little from him. He wants to avoid surgery if possible.

I read central disc protrusions are harder to deal with, and mine isn't an extruded fragment, just a large protrusion. According to the radiology report, I also have degenerative disc from L3 to S1 and another protrusion at L5-S1, but he the back doc didn't even mention that. What the heck are my options!!

Thanks so much for letting me rant. Any suggestions, help, information, or anything else is much appreciated.



  • bucwoodbbucwood Posts: 13
    edited 09/12/2013 - 12:23 AM
    I really appreciate the effort to put all this together in one place.
  • bucwoodbbucwood Posts: 13
    edited 10/02/2013 - 9:16 AM
    I figured I would write a quick follow up to my ESI procedure. I've read a lot of horror stories concerning this procedure and I can personally say it wasn't that bad for me. I had it this morning and it was over before I knew it. Now the waiting game to see if it helps.
    Thanks again.
  • I hope that you get some relief from the esi.......don't be surprised if it causes the pain to flare for a few days though. It is relatively common after the injections, usually because of the increased fluid in a very tiny space......once the steroids kick in , it settles back down. A central disc herniation can be a bit more difficult than one on the side of the vertebra in that, if it gets too big it can compress the spinal nerves, where a paracentral or lateral can compress the nerve roots......
    As far as the ddd goes, that happens to all of us as we get older than 18. The discs don't have their own hydration system for lack of a better word in place, so they tend to loose some of their hydration over the years and almost everyone will have some finding of ddd if they were imaged......
  • Thanks for the comments. Yeah, the doctor mentioned the same thing about the central herniation. As far as pain or sensation, is there a big difference between the spinal nerves and the nerve roots (i.e., the main dural sack and associated nerves compared to the smaller nerve roots on the sides)? My pain is very dynamic and tends to change and is at times hard to pinpoint. When I had my last herniated disc it was compressing my left nerve root of l4/l5 and I could draw a line from my back to my foot of where it hurt.

    Anyway, you are right. I had a flare up for the past couple days but am starting to feel better.

    Take care and I'll write back with my progress.

  • Yes, there is a huge difference between the spinal nerves in the central canal and those that exit between the vertebre, the nerve roots....the nerve roots can recover from compression although it can take some time, the nerves within the spinal canal if damaged tend to not recover so well.....
    It may be that the reason that you feel the pain move a bit is because if there is compression it may be positional- in other words if you bend or sit a certain way , it may increase but if you move slightly if relieves it.
  • Thank you so much for the information.....Very interesting. I wasn't aware of the central herniation issues. I saw the MRI and it was pretty obvious that the central nerve sack was indented and the side nerve roots were clear. I have a lot of pins and needles and numbness up and down both legs, but especially the left..... I guess it is slightly biased to one side. I didn't realize there was a huge difference, honestly, but I guess it makes perfect sense. Is there any information on Spine Health concerning the differences between central and paracentral/lateral herniations and associated issues ?

    The doctor that administered the injections said there will be a series of 3, and if they don't work I'm looking at another surgery. I guess he didn't like what he saw in the MRI. Not sure if that means another discectomy, a fusion, or what. It gets exhausting thinking about this so often.
  • Thanks. I dug through the link and made a couple searches myself..... it's tough to find information concerning central herniations, dural sac impingement, etc. I will keep looking and also ask my doctor when I have my next ESI (2.5 weeks).

    p.s. It has been 4 days since my ESI and I am still real sore and have funky nerve issues in both legs (pins and needles, foot pain). I'm hoping this is normal this far out. I was kinda hoping I would feel like superman by now, but honestly I feel the same or possibly a little worse since before the ESI. I was in pretty bad shape for a couple days after the injections, but ice and taking it easy made it go by fast enough. Just went for a good walk and starting to feel the typical pins and needles, weekness, etc. and my back is super sore. The joy of back issues.

    Thanks for everything.
  • sandisandi Posts: 6,343
    edited 10/07/2013 - 5:17 AM
    When you try searching, try using thecal sac indentation........sometimes on the MRI instead of using dural sac, they use thecal sac instead.............same thing, just a different name for it.
    The pain post injection can flare up for several days, sometimes even a bit longer, depending on your anatomy and how much fluid is injected. I know when I had them I had the worst flare for over a week and a half. It was horrid so you have my empathy.
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