Back Injury

[FireFinder]

I've recently experienced a flareup of sciatic pain down the back of my left leg. Last time I experienced this was in 1999. Periodically from 1987 until 1999, I would experience severe back pain, but nothing that impinged the S1 nerve and caused my leg to spasm and go numb like 1999 and now.

I believe that I am facing surgery, as all the "conservative" therapy hasn't improved my condition, and I am losing strength in my left foot and toes.

I had a MRI on Tuesday, and here are the results:

Findings: The lumbar spine alignment and curavture are normal. No infiltrative marrow lesion or vertebral compression deformity is seen. The distal spinal cord is normal.

There is degenerative disc disease isolated to the L5-S1 level with moderate disc space narrowing. There is a broad based left posterolateral disc protrusion with a superimposted moderate disc extrusion on the left side at this level with disc material descending along the posterior left aspect of the S1 vertebrae. Overall, there is only mild spinal canal compromise, however there is prominent effacement of the left lateral recess anhd left neural foramina at this level.

No other sites of degenerative change are evident.

Conclusion: Degenerative disc disease isolated to the L5-S1 level where there is both a broad based left posterolateral disc protrusion as well as a superimposed focal left disc extrusion of the left lateral recess at this level. The left lateral recess and left neural foramina are prominently compromised as a result.

Here are a couple of pics from the MRI:

Cross section of L5-S1 (the lighter colored area is what I presume to be the "degenerative" parts)



Here is a cross-section of the disc at L5-S1.



I see the doc again on Tuesday and will find out what is in store for me. He says that the injury I suffered in 1987 was the initial herniation which has caused the degenerative condition I have now.

From what I have gathered, either a discectomy or lumbar fusion is what I will be facing.

I've been going to PT, Chiropractor, Deep Tissue Massage, hitting the hot tub at the gym, using ice, heat, painkillers, muscle relaxers, etc. I'm pretty much hitting the end of my rope here, the pins/needles spasms in my foot and sunburn-type feeling on my left calf, ankle wake me up every hour or so. I haven't had more than 4 hours of uninterrupted sleep in almost 3 weeks.

[ChipOnShoulder]

Looks like surgery is what is needed since all other treatments have been exhausted. You probably needed surgery in the past - But the past is the past. My best advise would be to get a second opinion from another doc and have them both talk to each other. After the surgery it is EXTREMELY important to follow all orders to a the letter no more, no less. Don't try to "suck it up" except under the direct supervision of the doctor or physical therapist.

[FireFinder]

Thanks Ranger Doc Cook.

[Ranger Bill]

I have had personal experience with sciatica and MDs don't have all the answers.

About 10 years ago it was so bad I could not drive a car without severe pain down both legs. MRI said I had some stenosis, some bone spurs and a a coupe of mildly bulged discs. MDs told me my options were fusing some discs together or scraping out the insides of some spinal column bones with no gaurantee that it would fix the problem. But before doing that they suggested physical therapy at the hospital. I went three times a week for eight weeks, and got about 10% relief.

I went to a chiropracter for about 10 visits, 2 times a week and got about another 10% relief. But I still couldn't stand up straight and my legs were killing me all the way down to the ankles. I was desparate and started looking at alternatives. I was just about ready to try acupunture, when I was told about Myotherapy and did some research on it. I recommend you do the same. Google Myotherapy and Bonnie Pruden (sp). Bonnie is the one who developed the technique. The web sites will be able to explain it better than me, but basically, in many cases, it's not the bones causing the probelm, it's the muscles that are compressing the sciatic nerve. Myotherapy focuses on the muscles.

When I located a therapist, on my first visit, he told me that if he can't fix my probelm in 3 visits, then he would not be able to fix. And he was right, 3 1-hour visits and I was fixed. I still have some pain, but on a scale of 1 to 10 it's about 0.5. It used to be 8 to 9. It worked for me, not saying it will for you. MDs do two things: drug you or cut you. You may not need either.

[FireFinder]

Ranger Bill thanks for the heads up.

I originally thought I might have Piriformis Syndrome, as nobody had ever diagnosed a disc problem previously. Several visits to Physical Therapy, Chiropractor, and a Deep-Tissue Massage therapist, and the Piriformis isn't the problem. I'll pretty much try anything now, I just want the pain to go away.

[AbnRgr289]

I was diagnosed with degenerative disk disease back in '94. It's between the L3-L4 and the L5-S1. The L5-S1 bulges on my spinal cord and causes a numbness sometimes. there is always pain to some extent. I was told years ago to make sure I kept my hamstrings stretched out real good because if not it will cause them to pull down on the top of your hips and cause more pain. When ever I have problems I'll stretch them out and it damn sure feels better afterwords.

Just something that might help you out between now and when ever.

[Ranger Bill]

That's the whole point. 9 times out of 10 it's muscle spasm that's causing the sciatica. I read somewhere when I did my research, that over half of the U.S. Olympic Gymnasitc Team had bulged lumbar discs, but they had no pain. My myotherapist told me that about three-fourths of his patients were those that have had surgery. By the way, I'm not a therapist, don't own a clinic, and don't get kickbacks.

[Black 6]

L5-S1 BABY YA!


three compressed disk fractured vert. spinal fusion at L5-S1. i did not have a choice on hitting the slab. i also have the degenerative thing too. i can not speak on your specific problems as mine was the result of a jump. what i can tell you is the pain was great. and even after the surgery, i live with it every day. if the knife is mandatory, do not expect it to relive every thing. i think my entire situation was mishandled possiably even screwed up................

sorry to seem so down, but you need to be aware of the fact that going though it may not compleatly get rid of all the pain.

[JMK SF G-2]

I have "compressed disks" at L4/L5 and L5/S1. It occasionally causes sciatica, and can hurt like a motherfucker. After having had X-rays, a CAT scan and an MRI, all they (the doctors) can tell me is that "Yeah, it'll hurt sometimes". I do the physical therapy, and take the meds when I need them, BUT it still hurts. I just deal with it, because apparently it ain't going away. If you get the surgery, I think it'll help. Best of luck to you, bro.

[RGRPA]

Fire Finder

Sorry about the back. Your MRI does show there is a "Bony" component to the possible impingement of your sciatic nerve. There is a good chance you are part of the small percentage of people who will not get relief from addressing only the muscle component of the problem.

Once it becomes a quality of life issue, then you have to do something. Good Spine Specialist always address surgery as a last result and they are more reluctant to cut these days than they have been in the past.
If surgery becomes your choice of treatment get a second, third, fourth.....opinion from Surgeons who specialize not only in Spine Surgery, but specifically in lower spine surgery.

Doc Cook could not have said it better, a large majority of the bad outcomes patients have is the result of the patient getting too Froggy too Fast after surgery and pushing too hard trying catch up once they start to feel relief.

Sorry to be so long winded, but the decision to have lower spine surgery is a tough one that should only be looked made after careful consideration of all of the reasonable course of action.

Take care

[FireFinder]

Looks like I'll be having a laparoscopic lumbar discectomy on April 18th, with an overnight stay in the hospital, followed by a week or so off from work, and rehab.

I opted to not try the cortisone shots. My doc said some docs might want to fuse L5-S1, but he didn't think that was necessary.

[AbnRgr289]

Looks like I'll be having a laparoscopic lumbar discectomy on April 18th, with an overnight stay in the hospital, followed by a week or so off from work, and rehab.

I opted to not try the cortisone shots. My doc said some docs might want to fuse L5-S1, but he didn't think that was necessary.

They wanted to fuse mine back in '94 and I said no. If it got worse and there was no other option I would, but I'm still sucking it up and driving on.

[FireFinder]

Ranger AbnRgr289, I understand that. My doc said he had a similar disc injury, and tried the cortisone shots first, then had the same procedure I am opting for with no problems.

I'm all for getting those chunks of disc off my nerve root.

[AbnRgr289]

Ranger AbnRgr289, I understand that. My doc said he had a similar disc injury, and tried the cortisone shots first, then had the same procedure I am opting for with no problems.

I'm all for getting those chunks of disc off my nerve root.

They have allot more to offer now then they did back then, especially compared to the Army. Uncle Sam will always be the last one to start doing something new. I'm interested in how it comes out, my 6 has done some research about it and it sounds pretty good. Good luck and take care of it like the Doc says afterwords.