Pain and collapse getting worse. No dr. Appt till next week. Help please!

Pain and collapse getting worse. No dr. Appt till next week. Help please!

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spiceyman
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Joined: 10/21/2010 - 4:54pm
Pain and collapse getting worse. No dr. Appt till next week. Help please!

48 yr old male, relatively healthy, happy and somewhat active. 5'10" at 195lbs. 4 weeks ago I took a hard fall directly on my chest/rib cage(arm was outsrtetched with NO support of the fall/landed on rt side and hip) and rolled into the steel piping of the fence. Results, 10 days of rest due to 10%-15% pneumothorax, 2 fractured ribs, scapula and rotator cuff abnormality. Much better there but...... 2.5 weeks ago lower back/right side started hurting mildly, figured I was favoring that side and I slept upright in a chair for 8 days, and then WHAM! One morning burning pain into butt, outside, front and inside of thigh, under kneecap then a circle around kneecap and into shin. Last 7 days it has been all of the above but almost constant to include waking up at night and now, leg collapses approximately 15+ times per day. Depends on how much sitting/standing and walking/stopping. Sometimes knee gives way, sometimes hip and today it felt as though the inside of thigh just buckled. MRI from 10/20/10 results AS written.
FINDINGS:
L1-2, L2-3, L5-S1 disc height loss. Limbus vertabra anterior superior end plate of L3 with adjacent edema and osteophytic change. The conus ends a the thoracolumbar junction and is normal in appearance. No aortic dilatation. No paraspinous mass.
T12-L1 demonstrates no disc herniation, canal stenosis or neuroforaminal narrowing.
L1-2 demonstrates a rt. lateral annular tear and broad based far lateral disc mild protrusion unrelated to central canal or neural exit foramen w/out canal or neuroforaminal narrowing.
L2-3 demonstrates a right lateral annular tear and broad based far lateral disc mild protrusion unrelated to central canal or neural foramen w/out canal or neuroforaminal narrowing. Mild facet synovitis.
L3-4 demonstrates minimal dorsal disc bulge eccentric to the right with a component of annular tear and protrusion within the rt. neural foramen effacing the inferior aspect of the right neural foramen and abutting the exiting right L3 nerve root laterally. There is a broad based lateral protrusion and associated annular tear at this level.
L4-5 demonstrates minimal dorsal disc bulge w/out canal or neuroformal narrowing. There is a dorsal rt. facet synovial cyst unrelated to the central canal or neural foramen.
L5-S1 Demonstrates no disc herniation, canal stenosis, or neuroforaminal narrowing. Transitional lumbosacral anatomy with a left sided L5-S1 assimilation joint.
CONCLUSION:
1. Mild degenerative disc disease with lumbrosacral anatomy at the L5-S1 level with a left sided assimilation joint. Lateral protrusions are present at L1-2, L2-3 that do not abut the exiting nerve root. However, the L3-4 there is a larger broad based and annular tear in the rt. foramen extending laterally abutting the rt. L3 nerve root in the lateral region.
2. Mild facet degeneration amd mild facet synovitis as described above.

Thoughts? suggestions? PCP sent me to Chiro 1.5 weeks ago but NO help and massage twice a week and ultrasound twice a week plus a TENS unit on butt and thigh all day.... NO HELP there!

JulieA
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Welcome to Spine Health

I am suprise your PCP didn't put you on a oral steroid dose pack and sent you to a chiro with a positive mri.

What is the chiro doing? Be very careful.

You may want to get a second opinion from a different PCP & see a specialist. Any time you are loosing the use of your legs it is an emergency in my mind.

The problem with the mri is that when you lay flat those are the results. What happens when you bend/ move? Did the doctor do any flexion/extension x-rays?

I would not feel bad about going to the ER or getting a second opinon- really. Some doctors just don't worry enough about us and it is a shame.

Good luck,

Julie

spiceyman
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Joined: 10/21/2010 - 4:54pm
Thanks Julie for the

Thanks Julie for the interest. Ok, the PCP has 2 strikes against! Pneumothorax was discovered 5 days after injury because I told doc I was in more pain than he said, I was having a hard time at work, even with meds and right shoulder was 1" lower than left, and my right breast/nipple was 1.5" lower and turned to the right. I looked like a body/landslide. Anyway, back to the lower back and leg, I went to PCP after 7 days of agony and trying to "man-up" with the butt and leg, he checked out some reflexes, I had none in right leg, and some leg lifts etc.. He gave a Toradol shot in the butt and said it was in the "S" region and would be OK with a few weeks of massage and manipulations. He suggested PT or Chiro. I said which would he pick and he said the Chiro.

Chiro ordered the MRI when I told her after 4 visits in 8 days that I was getting worse and leg was not doing as I asked it to do!

I have a follow-up with Pulmonologist sometime next week. He is very professional, empathetic and the head of his dept at Baptist hospital here in Jax. I asked his nurse to relay to him I wanted HIM to assess me and take control by forwarding me to whomever. He sent me for a CT of chest(spine/lungs, etc...) today so he has all he needs. MRI of lumbar and Sacro, Xrays of same region and his CT and rib series.... I should be OK.
Good fortune for me, I have Mayo in town and my insurance is very welcome there.
Thoughts and suggestions are appreciated. I am one who likes to look at ALL angles.

j.howie
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Joined: 06/19/2008 - 7:21pm
Hi spicyman Welcome to S.H.

I agree. Take your MRI to a spinal specialist. A orthopedic or neurosurgeon. A chiro? :jawdrop: he should have referred you! Chances are the specialist will want a discography. :?
Good luck, Jim

Click my name to see my Medical history
You get what you get, not what you deserve......I stole that from Susan (rip)
Today is yours to embrace........ for tomorrow, who knows what might be starring you in the face!

charry
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Hi Spiceyman and Welcome

Sorry to hear of your fall it sounds painful what you're going through. Did this happen at work? If so you need to do a workmans Comp file. My primary Dr. sent me for an EMG/Nerve test on my leg while awaiting an Orthosurgeon and Neurosurgeon consult. My Dr. was concerned about my leg going numb and giving out and had the EMG and was seen by the Neurologist the same day. My Chiropractor wouldn't help me when I had a herniated disc until I was seen by a Orthosurgeon or Neurosurgeon. I hope you get to see a Orthopedic Specialist or Neurologist soon. Take care. Charry

DDD of lumbar spine with sciatica to left hip,leg and foot. L4-L5 posterior disc bulge with prominent facets, L5-S1 prominent facets with a posterior osteocartilaginous bar. Mild bilateral foraminal narrowing c-spine c4-c7 RN

Aviatrix36440
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Chiro!!

Spiceyman,

Welcome to Spine Health!! I have a question, did you have a MRI done with all those results *before* you went to the chiropractor? If so, that PM wouldn't be my PM anymore! Wow!! When my neck started to go south, my chiro sent me for an MRI. When it came back showing a hernia at the C5/6, he immediately stopped manipulating my neck and sent me to a Neurologist for further testing. My chiro won't touch (manipulate that is) a herniated level.

I have protrusions at my L2/3/4 level, so I get the wrap around pain you described, into the knees and the upper calf for me. I haven't collapsed yet, but have had several times when my right leg doesn't come up enough when negotiating stairs and down I go. What you're describing far exceeds that...I would get with a spine specialist (Neurologist or Orthopedist) as soon as you can. If you're losing function as described, that seems more of "emergency" level to me as well. Please let us know how it goes. And please, please be careful! You did a heck of a lot to yourself with that fall! Gentle welcoming *HUG*

Brenda

PCTF C4 - T2, Laminectomies C5, C6 & C7. Severe Palsy left arm/hand.

spiceyman
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Joined: 10/21/2010 - 4:54pm
Wow.... I'm humbled!

To the quick comments.... Thank You. I had no idea the reaction so quickly. However, as I now see, long term pain and disability is rampant and may(I hope not) be something that will not go away so fast. I see why support is so important.
Quick explanations:

9/20/10 Doc started the rib/lung damage then I finished with Pulmo.

10/04/10 The back/leg issue started.(actually now, very limited back issues. All buttocks and below.)

10/11/10 I could not stand the pain or tingling anymore so I went to primary doc. He sent me to chiro. Said x-rays and more would not be needed as it was probably due to me favoring that side and sitting so much. Actually, that makes sense.

10/11, 10/13, 10/15 and 10/18- chiro office gave me two massages, two ultrasounds and some flexes on her table at a VERY limited degree. TENS unit given the last 4 days for buttocks and thigh. Said it work wonders if I would keep it on ALL day.

10/18 I told chiro I could not walk without fear of leg collapsing and pain/burn/numbness was getting worse. She ordered MRI.

10/20 Got MRI.
10/21(today) Got results, did some research with the $5 and $10 words. Got a little fearful so I am here!!!

Aviatrix36440
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Spine specialist time!

Spiceyman,

Does your insurance allow you to go to a specialist without a referral? If not, I would try and get with a spine specialist ASAP. Neurologist or Orthopedist - that specialize in spine issues. I am glad to see the your chiropractor took a conservative route until the MRI came back.

Weakness is a huge flag "warning, warning Will Robinson - danger!" <--- Sorry, trying to make you smile a little. But in all seriousness, "weak" is a big red flag in spine issues, loss of function is another one! If you can't get a referral like now, you might want to consider going to an ER that has a spine specialist on staff, or that can look you over and hook you up with the right doctor for your back. I so hope you're doing better today. Smile

Brenda

PCTF C4 - T2, Laminectomies C5, C6 & C7. Severe Palsy left arm/hand.

spiceyman
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Avia.... I be smilin mon!

Believe it or not. I am somewhat laughing most of the time,.... why?
This all started playing...... tennis!!!! I know , I know..... lame.

Ok, I need no referral and I had no idea the weakness and the loss of function seems so urgent. Don't get me wrong, I am somewhat educated and have common sense, but I have been in sports and active my whole life and I have had MANY sprains, pulls, breaks etc....... and I never thought this could be so serious just 'cause it is my spine.
To be exact, if I get out of the car, stand up from sitting or take first step from standing in one place for awhile, the right leg gets very weak and about 1/4 of the time it falls a bit. If I walk longer than 5 minutes the shin and knee feels like it is gonna explode and now the thigh, inner area, feels like it is "releasing" when I step down or stop quickly.

I have Mayo here in Jacksonville and I do not need a referral for that. I was going to wait to speak with my Pulmonologist next week ONLY 'cause he will know who to recommend and he has seen me since the pneumothorax. I guess I must decide if I am in danger until then and if I should stay away from work for a few days. I spend about 30%-40% walking and the rest at a desk, on the computer. Either way I lose...

Thanks folks....

Aviatrix36440
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Lose?

Spiceyman,

I don't think I would look at it as "Either way I lose..." I look at it that something "not good" is interfering with the nerve signals going to your leg, and you need to find out what, and more important, to what degree.

Tennis? Lame? Here's one for ya, I was yawning when my C6/7 went! <-- Now THAT's lame! (G) Within 15 minutes I lost virtually *all* strength in my arm (triceps, forearm, hand), and then burning pain and numbness. My surgeon had me in his office that day! MRI a few days later, electrical conduction testing, and then surgery! Except for a few weeks I never got a lot of that use back - the nerve was damaged during the herniation!

Now with you, (good stuff I hope coming), yours is coming and going at this stage. I hope that is showing that you don't have permanent damage yet. So going to a spine specialist puts the "8 ball" as called correctly, in the corner (your) pocket!! Smile We're just trying to get you turned towards the right doctor for you. Spine issues can be "more serious" than a heart attack, sorta. *HUGZ*

Brenda

PCTF C4 - T2, Laminectomies C5, C6 & C7. Severe Palsy left arm/hand.

spiceyman
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avia

I meant, whether I sit or stand or walk..... either way it hurts so badly so I lose.

wow, You are attentive and empathetic..... Thanks again and i will keep you updated. Let me know how I can help.....You!

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