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32yoa Male w/ Extrusion Diagnosis & Consult

bigbrianaustinbbigbrianaustin Posts: 3
edited 12/22/2015 - 7:00 AM in Back Surgery and Neck Surgery
My Story:

Mid-August of this year, laid down in bed and rolled awkwardly towards my gf, and immediately felt my left quad tense up and feel like I strained it. Felt similar to a hamstring pull which I had plenty of in HS sports, etc. Used a foam roller and tried to work it out, but got nowhere with it. Took NSAIDs and got a little relief, but nothing long term. Went to a friend who does massage at a Chiropractic/Massage clinic and had her work some stuff out. Felt a lot better, but still not 100%. The pain then seemed to shift to my left glute, and was a very deep pain. I woke up several days in a row with extremely tight, painful muscles, and any time I sat for more than about 10 minutes, when I stood up, nearly all the muscles in my hip flexor region would spasm for about 10 seconds, nearly doubling me over in pain, and then slowly let up. Decided to see the chiropractor and he felt that my pelvis was out of alignment, and so he did an adjustment, then recommended I come back for PT. Did 8 sessions of PT over 4 weeks, which consisted of ultrasound, soft tissue massage, E-Stim, and at-home exercises. Felt decent for about 2 hours after each appt, but never 100%.

Finally decided to go to PCP in October, but had to see his NP instead. She did a few mobility tests, said it wasn't a disc issue, and said to continue PT for at least 2-3 weeks but gave me an rX for Vicodin, Zanaflex and Diclofenac as an anti-inflammatory. I started taking the Vicodin at night, due to driving for work, and after the first night, I woke up and had no pain whatsoever, full range of mobility, and was elated to be done with the pain. I then went on a 5 day hunting trip and did 10+ miles a day, and the only time I experienced pain was a slight twinge in my lower back when I was standing still. Came back and continued the meds and did PT 2 more times, but I then ran out of the Vicodin and during this timeframe the pain then came back full force and started moving down my left leg as well as in the glute still.

I did a bunch of my own research and found that I was likely dealing with a nerve issue in the L5 area. After continued PT with no improvement and some more movement all the way down to the ankle area, I went back to my PCP's NP and she said he still didn't think it was a disc issue, so she gave me an rX for Tramadol (as she didn't want to keep me on an opiate for too long) and sent me on my way. Tramadol once again made me feel like I had conquered the problem, but alas, 15 days later I once again ran out and was back to regular pain levels.

I finally had an appt with my actual PCP and after discussing the specific locations of the pain, the type of pain, and the fact I had already been seen for some Degenerative Disc Disease approximately 4 years ago, he finally discussed an MRI. He did do one corticosteroid injection because he felt there was some bursitis on my hip which may be pressing on the nerve as well, but told me that after 4-5 days, if I didn't feel a difference, that I needed the MRI. No change, so MRI happened last week.

I just got the call today from my PCP's nurse that he evaluated my MRI and found an extrusion in L5 that is impinging on the nerve root, and that they wanted to schedule me for a surgery consult. I agreed, and will talk to the surgeon, but I am really hoping to get more information regarding the potential for alternative treatments, such as actual epidural injections that are targeted to this specific nerve and area. I have actually had 4-5 days of feeling very good lately with very little pain other than when I wake up, and would like to avoid surgery if possible, but don't want to risk prolonged or permanent nerve damage. Unfortunately, I just recently signed up for Short-term disability through work as well, so it will not cover a pre-existing condition for 1 year. I would like to hear any experiences with the epidurals working. I think if I could do 3-4 of those over the next year, and then plan for surgery, it would be a much better situation for me physically and financially.

Thanks for any and all help. I have been reading quite a few of the stories and progress reports on here, and so many are very encouraging, but there are also a few that have me worried. I work as an Animal Control Officer for our local police department, which is a somewhat physical job that requires lifting regularly, so it is really a fine line at this point for me. Never had any surgeries before, so it's overwhelming to say the least. Thanks again!

Welcome to Spine-Health

While you may have provided us with some information, there is always more to provide.

One of the most important things that members can do is to provide the rest of the community with as much information about themselves as possible. It is so very difficult for anyone to respond when we do not have enough information to go on. This is not meant to indicate that you are doing anything wrong or violated any rule, we are just trying to be pro-active and get the information upfront so that people can start responding and your thread is more effective.

So many times we read about members who have different tests and they all come back negative. The more clues and information you provide, the better chances in finding out what is wrong, The fact that your test results are negative does not mean that you are fine and without any concerns. Many times it takes several diagnostic tests and procedures to isolate a specific condition.

Here are some questions that you should answer:

  • - When did this first start?

    . Year, Your age, etc
- Was it the result of an accident or trauma?
- Are there others in your family with similar medication conditions?
- What doctors have you seen? (Orthopedic, Neurosurgeon, Spine Specialist, etc)

  • . Which doctor did you start with? Ie Primary Care Physician
    . Who are you currently seeing?
- What Conservative treatments have you had? Which ones?

  • . Physical Therapy
    . Ultrasound / Tens unit
    . Spinal Injections
    . Acupuncture
    . Massage Therapy
- What diagnostic tests have you had? And their results (MRI, CTScan, XRay, EMG, etc)

  • . Summarize the results, please do not post all details, we cannot analyze them
    . How many different tests have you had over the years? Similar results?
- What medications are you currently using? (details, dosage, frequency, etc)

  • . Name of Medication
    . How long have you been using this?
    . Results
- Has surgery been discussed as an option? (If so, what kind)
- Is there any nerve pain/damage associated?
- What is your doctor’s action plan for treating you?

Providing answers to questions like this will give the member community here a better understanding
of your situation and make it easier to respond.

Please take a look at our forum rules: Forum Rules

I also strongly suggest that you take a look at our FAQ (Frequently Asked Questions) which can be found at the top of the forum menu tab or by going to FAQ There you will find much information that will

  • - Help you better utilize the Spine-Health system
    - Provide pointers on how to make your threads / posts
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    - General pieces of valuable information

Please remember that no one at Spine-Health is a formally trained medical professional.
Everything that is posted here is based on personal experiences and perhaps additional research.
As such, no member is permitted to provide

  • - Analysis or interpretation of any diagnostic test (ie MRI, CTscan, Xray, etc)
    - Medical advice of any kind
    - Recommendations in terms of Medications, Treatments, Exercises, etc

What could be good for someone could spell disaster for another.
You should also consult your doctor to better understand your condition and the do’s and don’t’s.

It is very important that new members (or even seasoned members) provide others with details about their condition(s). It is virtually impossible to help another member when all the details we have are

I’ve had this for years, it hurts, I cant move my shoulder – what could this be, what treatment should I get?

Diagnosing spinal problems can be very difficult. In many ways it’s like a game of clue. Especially, when the diagnostic tests come back negative – no trouble found! Then it’s up to the patient and the doctor to start digging deeper. The doctor is like a detective. They need clues to help them move along. So, you as the patient need to provide the doctor with all sorts of clues. That is like it is here. Without having information about a condition, its impossible for anyone here to try to help.

Specific comments :

Personal Opinion, not medical advice :

--- Ron DiLauro, Spine-Health System Moderator : 12/22/15 12:12 est



  • hvillshhvills Suzhou, ChinaPosts: 722
    edited 12/21/2015 - 8:49 PM
    The pain meds will only hide the problem... not fix it. If you want to truly confirm if you have a pinched nerve at L5 you need to get an MRI. This imaging will tell your doctor what is or is not the problem with your spinal column. If you don't want to get an MRI then at least start with an X-ray so your doctor can at least see the basic condition of your spine.
    Harry - 63 year old male...
    PLIF L4-L5-S1 due to disc degeneration... May 23, 2013
    PLIF L5-S1 due to failed fusion and broken screw... Jan 19, 2015
    Microdiscectomy, decompression L3-L4 due to herniated disc... Jan 19, 2015
  • RunnerHKTRRunnerHKT Posts: 231
    edited 12/22/2015 - 12:39 AM
    I don't see that you have a diagnosis of a disc extrusion. You would need an MRI for that. I think honestly you do need an MRI. It's a bit irresponsible of the NP t o continue to prescribe pain medicine without doing any diagnostics to ascertain the underlying cause. Good Luck hopefully it is just a bulge and it can get better...
  • It looks like my post got cut in half by the added content from the moderator. I did have an MRI and there is an extrusion. Not sure why it posted that way...
  • LizLiz Posts: 7,832
    Sorry about your post I have edited it and it now reads as it should

    Liz, Spine-health Moderator

    Spinal stenosis since 1995
    Lumber decompression surgery S1 L5-L3[1996]
    Cervical stenosis, so far avoided surgery
  • Liz53Liz53 MissouriPosts: 142
    I experienced a missed extruded disc fragment on my L4 nerve root that caused intense leg pain about 2 1:2 yrs ago. It took 5 months of meds, pt and finally a neurosurgeon found it on the MRI. I had a surgery to remove the fragments and they left the disc alone. Fast forward 2 1/2 yrs and I now have a new herniation at the same level compressing the same nerve root! I have had two opinions and they both say wait 6-8 weeks to see if it heals and if it doesn't then more surgery.
  • hvillshhvills Suzhou, ChinaPosts: 722

    Sometimes epidurals work and sometimes they don't.... even if they do work it is usually only temporary. They are kinda like the pain meds with just hiding the problem and not really fixing it. The londer you go on with the nerve root pinched... the more your chances of permanent nerve damage. The best thing is to consult with your doctor on your game plan of putting off the surgery.
    Harry - 63 year old male...
    PLIF L4-L5-S1 due to disc degeneration... May 23, 2013
    PLIF L5-S1 due to failed fusion and broken screw... Jan 19, 2015
    Microdiscectomy, decompression L3-L4 due to herniated disc... Jan 19, 2015
  • RunnerHKTRRunnerHKT Posts: 231
    edited 12/22/2015 - 1:34 PM
    I was reading and looking and thinking, wow this guy has done all the things with no MRI! If you have a disc extrusion I'd bet money that your pain is coming from the disc. I would make an appointment with a neurosurgeon for an eval. you could go to an Orthopedic guy as well, I just have a preference for a Neurosurgeon.

    I would encourage you, if you need surgery to not go the epidural and wait route. I did this, and both my surgeon and I agree that my outcome is less optimal because I waited. Every day that there is pressure on the nerve is another day of damage that the nerve has to heal... The epidurals helped me quite a bit, but honestly, if I had to do it all over again, I would have done all of the stuff in one surgery, rather than All of the medications/epidurals/pt.... But... that's just my opinion. I was in a difficult spot when my disc finally herniated and I felt I needed to wait...but truthfully, I do regret it, because I have a lot of permanent damage...
  • Liz53Liz53 MissouriPosts: 142
    edited 12/22/2015 - 1:39 PM
    permanent damage where? I am in the same boat not knowing how much damage I will incur and am trying the epidural route but the first one did nothing! Lots of pain and having been through this before I am not looking forward to another surgery.
  • dilaurodilauro ConnecticutPosts: 9,837
    an ESI should not cause any pain.

    Will it always be successful? No, seems hat its almost a 50-50 chance based on our member's experiences.

    The times when I have read about painful ESI is when the doctor tries it blndly without the aid of a fluoroscope or x-ray type of device.

    Read up on ESI here All about Epidural Steroid Injections
    Ron DiLauro Spine-Health System Administrator
    I am not a medical professional. I comment on personal experiences
    You can email me at: rdilauro@veritashealth.com
  • Liz53 said:
    permanent damage where? I am in the same boat not knowing how much damage I will incur and am trying the epidural route but the first one did nothing! Lots of pain and having been through this before I am not looking forward to another surgery.
    My L5 nerve is permanently damaged, I have continual numbness/tingling sensation in my R calf and my first 3 toes generally feel as if something is pushed up against them. It may improve some more but even my neurosurgeon thinks the toes especially will always have those sensations...
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