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When to go gangbusters and when to stay conservative?



  • I really hope this is the answer for you to get back some back...I am really pulling for you that this all works out.
  • Can i ask what your symptoms are?

    I also suffer with a feeling in my hamstring that i often think feels like a pull or a tendon, it gets sore and tight and is sometimes really sore right in the bum crease. It comes and goes depending on activity level and i also get soreness in my glute muscles on the left side. I also remember you saying that if you sat on your foot it helped relive the symptoms which is the same as me!

    I've been treating my symptoms as stemming from an L5/S1 mild prolapse and also the disc is mildly degerated. The MRI showed the disc is not pressing on the nerve root and there is only minimal loss of disc space. Also had an EMG which came back as normal so sometimes i do question the diagnosis and wonder if it is musculoskeletal, well what i mean is, could it be musculoskeltal NOW as i guess things have changed in 2.5 years!.

    So anyway, this is a little waffling but i'd be really interested to hear your symptoms and see if they are anything like mine.

    P.S If it were me, i'd get the MRI
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  • I tend to want to know what exactly is happening, so tests are not something I am usually conservative with unless they are risky (MRI is not a very risky test, it's not like you're being bombarded with radiation. And since I'm already guaranteed cancer from all the x-rays I got on my shoulder, I give up anyway).

    And, yes, lifetime caps are going away. Anyway, usually you re-earn them every year- for as bad as my health is, I've barely dented mine.
  • So, I finally have all my test results...

    As expected the MRI showed tendonosis in one of the tendons of my hamstring. The tendon itself is not torn, but there is collection of edema around it. With that, my orthopedist said it's best to hold on the PRP. The PRP strengthens the tendon because the needle stick partially tears it, and without a partial tear already there he is hesitant to want to stick it. So, we wait and if another couple months of conservative care don't have me improving (ahhh, as if 7 months weren't enough already) then we'll re-visit the PRP. But, I'm glad that the tendon is not torn and that he isn't jumping on sticking a not torn tendon even if it is chronically inflamed.

    So, with that I did go ahead and have my PM doc do some trigger point injections into the hamstring muscle that has the tendon issue. He found a *huge* one and got it really good, and it did surprisingly relieve some of the pain around the tendon and so far the spasms have reduced. Not sure how long it will last, but hopefully the trigger point injections will help lengthen the muscle and pull some tension off the tendon. My PM doc was skeptical, but I think when he finished he was more confident that it may help. I was a little surprised too because I see an awesome manual therapist who beats me up pretty good pressing out trigger points, but clearly this was one that needed to be needled.

    All in all, I'm glad I did the MRI because it feels *really* good to know exactly what is wrong and exactly where the problem is. Chances are the edema is causing aggravation of the sciatic nerve rather than this being a true neurological problem. We also know exactly where the tendonitis is now, so that will help direct future PT, injections, etc...There were a couple replies with similar "mystery" leg symptoms, and I guess my experience just goes to show that even when the diagnosis is assumed (we assumed neurological because I am an L-spiney) there is room to question when things aren't adding up. I'm just glad I had a thorough enough team of doctors to not just dismiss this as neurological, because knowing it is a muscular injury impacts the way it is treated.
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