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S1 nerve root irritation with a clean lumbar MRI?

Hi everyone,

I've written in this forum a couple of times about my agonizing months of worsening sciatic pain on my right side. Started last summer after running a lot and has continued to get worse since then (and yes, I stopped running since and doing most exercise, other than PT). At first I just felt low back pain, then it moved down to my butt and hip, now its down my leg and into my foot. The pain is by far the worst in my butt area, which is why doctors previously thought it was piriformis syndrome, but after two piriformis injections providing no relief, they have been looking at my spine again. I had a lumbar MRI done last October that came back normal, so my doctor recently decided to send me to have a nerve conduction study to see whether it would pick up on anything in the spine. The study showed irritation at my S1 nerve root. The neurologist who conducted the study sent me for another MRI of my low back to see if it would show what was irritating the nerve root (disc herniation, bone spur, etc.) but the MRI I had yesterday came back completely clean AGAIN! At this point I feel like I'm going crazy! Can a spinal nerve root be irritated with no apparent cause? Is there something the MRI can't show? I've been tested for rheumatological disorders also which came back clean, so I can't think of other reasons why that nerve root would be so irritated! Anyone else experience something like this?
1 1/2 years chronic pain in butt, hip, and sometimes low back. 7 steroid injections (piriformis, s1, si joint, hip joint). Hip labral repair arthroscopic surgery 12/2015. Sciatic neurolysis 12/2015.


  • SavageSavage United StatesPosts: 5,476
    I don't think there is a test out there that is 100% guarantee for answers.
    That's why many tests are done on some people for doctor to even get into the ballpark.

    And I've heard more than once about doctor getting in there with surgery and seeing yet something else.

    You asked if nerve pain can be without "apparent cause."
    Personally, I would think yes. I think pain indicates something wrong.....and not just the spine.

    Doctors often work with symptoms and document .....cause unknown.

    For ex I had right lower abdominal burning..double over pain ..for years in the 80's. Test after test..revealed nothing. And aspirin my only med and did little to nothing in relieving the pain.
    During ultrasound of my gall bladder, they discovered my right kidney only had 5% function and shortly thereafter, I had kidney removed.
    That pain has never returned.

    It seems good you had nerve conduction study. That gives doctor an area to treat and hopefully relieve or reduce your pain.
    Your doc seems to have good attitude in searching for how to best treat you. Trial and......try again.
    Best of luck to you
    Spine-Health Moderator
    Please read my medical history at: Medical History

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