Lumbar MRI Results

[massphatness]

I figure someone here has gone through this, so I thought I'd find out what I'm in for - maybe get some tips, etc.

Been experiencing what I thought was hip pain since about January; infrequently at first but increasing in intensity since mid summer. Stays were negative and ortho decided to treat conservatively with PT. Pain increased in both intensity and frequency radiating down my leg and into my toes. MRI was ordered. Results:


Lumbar spine at L4 & L5 shows a protruding disc leaning on the left nerve root

Also at L5 & S1 second protruding disc leaning on left nerve root

The above is consistent with the pain I’m feeling down my left leg and into my toes.

See this link for map of the spinal column:* http://www.makoa.org/scimap.htm
The impacted segments are toward the lower end of the spine.

The orthopedist wants me to see a neurosurgeon and says they will likely treat via a series of epidural steroidal injections.

So what am I in for? Anyone go through these injections? How tight do I clench my teeth when the needles go in? Alternatives? Potential issues? Tips on recuperation?

:tu

[Commander Quan]

I had the same issue, and I let it go on for way too long self medicating with 9-12 Advil a day for about 6 months. Finally after it got so bad that I could barely get a sock on or push in the clutch on my car I went to see a doctor. The Neurologist prescribed a Prednisone pack and physical therapy. The drugs where fantastic to take the inflammation out, but the therapy center that was affiliated with that group of doctors was a joke, so I quite going and did my own therapy at home 10 sets a day mostly back bends like the upward dog possession to get the anterior space between the vertebrae to open back up and get the disks pushed back in. It's been about a year now and I still to a couple sets of back bends a day, and as long as I don't sit for hours on end it feels good.

Sorry I don't know what you'll be going through with the shots, if that is what he prescribes, but expect a couple months of recovery, and then start strengthening the core mussels to take stress off the disks. Good Luck.

[MajorCaptSilly]

I went through a series of 3 shots for L3 and L4 about 15 years ago. The first shot helped but not much. The second shot (about 3 months later) made everything perfect. No pain no numbness in my leg. I only did the 3rd shot because the doctor said it would be best. I now have some times of pain and sciatica when I do stuff that involves pulling heavy stuff. I also have some pretty nasty arthritis for my age from the injury. With that said, the shots were pretty easy and painless and gave me a lot of relief.

Good luck!


MCS

[Resipsa]

Vin, not only have I been through this, I'm still going through it now as a result of my accident last summer.

I'm curious as to your symptoms, the pain is down the front or the back of your leg? Any pain in your groin? Have you been to see a spinal specialist or just an orthopedist?

Reason I ask is pain in the hip, and correspondingly in the groin, is symptomatic of a problem at L1, not as I understand it at L5. I only know this because that's where my problem is.

As to the injections themselves, I had a series of 3 last year. The amount of relief you get is contingent to a certain extent on the size and nature of the protrusion. Is it just a bulge, or has the disc ruptured?

What the injections are doing is putting the steroids right at the site of the inflammation and swelling to reduce it as much as possible. So how effective they are depends on the amount of the damage done.

For example they worked well for me, and I'm much better than I was, but still have quite a bit of pain being treated with pain killers.

Thats primarily because my spinal doc and the neurosurgeon both told me the same thing. My disc is ruptured, in essence the jelly is out of the doughnut. They told me they consider a large rupture to be .8 mm. Mine is 1.6 cm, so it's about twice the size of what they would consider a large rupture. So the relief you get may be total, depending on how bad the problem is.

The injections themselves are quick, but the pain is sort of intense. Not a very pleasant experience when they actually do it, but it my opinion they work.

[shilala]

I did the shots, Vin. They didn't help, but it wasn't anticipated they would, it was just a stop in the course of conservative measures. I'm not sure if mine were the same as usual, they were powdered corticosteroids delivered under xray and I had about 30 shots in each side, but that was because of all the injury I had in there. I only had two courses because the second one just about did me in. I ended up in the emergency room over it.
Scott (sofaman) just did the shots and they completely fixed him. He had no troubles at all. As soon as he felt better he started working out like a madman and made a complete transformation. Being in shape has kept the problem fixed.
I have a couple wrecked discs at T1 and T2 that I'll probably have to get attended to someday, but for now I'm pretty used to it.

[bobarian]

Shots help some people and not others. But its the least intrusive solution. If it doesnt work, then other treatments may be necessary. Some may say differently but I would advise you to stay away from chiropractors at this stage. Look towards a long term solution rather than short term relief. :2

[mosesbotbol]

Been there, done that with the shots. They suck, are painful, not a cure, and damage the bone if done more than 3x.

They do offer some relief which paired with chiropractic and PT may allow for some length, and straightening of the spine (which is the cure). Muscle tension often causes the spine to pull one way or another, pushing the disk.

Not sure how heavy you are, but losing weight and strengthening your core will help a lot. Do a lot of walking too.

[Savor the Stick]

Vin Buddy,
Sorry to hear you are experiencing pain.

Injections did not help me...made me worse. If I knew what I know now...and it were available--I would go spinal decompression (Google it) and they have a treatment to deal with inflammation using lasers now--don't know too much about it.

Spinal decompression has been gaining favor and usually the first treatment is free and some relief from pain is immediate.

I'll be praying for you!

K:)

[IBQTEE1]

Hey Vin sorry that you are going through this. Thoughts and prayers sent your way.

[sofaman]

Vin, I had the exact same issue last year L4 and L5 at first we tried meds and PT and it didnt work at all then we tried injections with PT and still no relief so my DR sent me down to Pittsburgh to get the Epidural Injection and it realy worked for me. It is not a very pleasent procedure but it was worth it for me after the first injection i felt much better and once I had the 2nd injection my pain was totaly gone and I havent needed another one since then, that was last August.

[mash]

As you can see from the answers above, the results are mixed. But in the right hands they are safe and if you have radicular symptoms (nerve root irritation and pain down your legs) they are worth it. The vast majority of people with your symptoms don't need surgery. Stay active, backs need to move.

[billybarue]

My wife is an interventionalist Pain MD. She did her fellowship in your "neck of the woods" in downtown Boston at Beth Israel. Neuro consult standard for spine. Hopefully the Neuro group has a Fellowship trained board certified Pain doc (most likely a trained anaesthesiologist like my wife). Epidurals for pain intervention are right in the wheel house for a Pain Doc with anaesthesia background. Neuro guys do them but you might consider getting it from a Pain doc.

She cringes everytime I lift stuff. She refused to watch me pack the trucks of household goods for our recent move. She sees destroyed backs everyday.

[shilala]

I had the epidurals, not the injection Scott mentioned that he got first. I'm not sure what they do there. Like he said, the epidurals are pretty unpleasant. If they're done in a good facility with the right machines by good doctors, they aren't too tough. If they're done by mad doctors in dungeons with antiquated equipment, they send guys to the emergency room. It's my bad, I should have walked when I saw what I was in for. *shivers*

[mosesbotbol]

Look for an inversion table like you see on TV. You'll get some relief from that for sure. Buy it from a place with an easy return policy just in case.

[massphatness]

I'm on deck for my first epidural on Thursday.

Fun times.

[markem]

Sorry Vin, this is the first I've seen of this thread.

Hope that the injection is painless and the treatments do exactly what they are supposed to do for you. You are in my thoughts and prayers, brother.

[Savor the Stick]

Great to hear Vin. You will be in my prayers and thoughts for a successful treatment.

:gl

[mosesbotbol]

I'm on deck for my first epidural on Thursday.

Fun times.

;s

Not a fun time. Make use of the relief to really help your spine out.

[bobarian]

Good luck, Vin. Hope it brings you relief.
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[icehog3]

Hope this improves your quality of life, My Friend.

[ktblunden]

I know exactly what you're going through. My pain started in what I thought was my left knee, but I couldn't pinpoint exactly where or how it hurt. As time went on it became a sharp radiating pain from my hip all the way to my foot and my toes were numb most of the time. I fought with crappy insurance for a while (Kaiser is really good at preventive stuff, really bad at actually providing treatment) then switched to my wife's much better insurance. I found a good, well recommended spinal specialist (this is key, find someone who actually specializes in the area and ask around about their reputation). I had a massive herniation at L4-L5 and a smaller one at L5-S1, both were pressing on the left sciatic nerve root.

I had a couple epidurals, the second of which relieved my pain completely for about two and a half months (the first was done by Kaiser and they missed the nerve). The pain came back after that, and ended up a little worse than before. I made the hard decision and on July 28 of this year I had a microdiscectomy surgery. He went in and removed the herniated disc material and freed up as much room around the nerve as possible. This was a pretty routine, not too severe surgery (other choice was a fusion, which is basically a last resort). I have been completely pain free in my leg since the 3rd week of recovery and I'm just about completely rehabbed as far as my back muscles. I was out of work for 2 months.

So there you have it. Pain coming from back problems is horrible, and it can affect quality of life severely. I hope everything gets all squared away for you. Will you be sedated during the epidural? I've done awake and sedated and I would definitely recommend sedated. Awake isn't bad, but it is really uncomfortable and obviously much more stressful. You'll get through it fine, it's one of the most performed back procedures and I think my last one took about 7 minutes total, including local anesthetic injections.

[jesseboston81]

Good luck tomorrow Vin. I hope you get relief quickly!

[IBQTEE1]

Good luck Vin!!

[shilala]

Prayers, Vin. :tu
I bet you'll be glad you did this. Be patient and give it time to work.

[RevSmoke]

I haven't been around here much lately, so this is the first I've seen of this.

You are, and will remain in my prayers.

Peace of the Lord be with you.

[hotreds]

Yupper, Vin. Had this, worst part was having to lay flat on my stomach while they gave me the shot and looked for the correct spot. Did help me quite a bit, tho. I was told that I would likely need to go under the knife at some point. I think I'll pass, frankly. I am once again always in some pain/discomfort, but have learned to live with it. Doesn't go down into my legs too often, however.

So, I think you'll be helped, dear brother. I pray that you will and that all goes swimingly for ya!

[14holestogie]

Praying that all goes well and you get the relief you seek, buddy.

[TonySmith]

Hope you find some relief from the pain. You are in my thoughts, Vin

[massphatness]

Well that wasn't so bad. The injection was relatively painless. Doc said to expect some increased soreness the next couple days because he's basically irritated the area, but by the end of the weekend I should start to feel some relief.

Thanks for all the well wishes.

[kaisersozei]

Good news, Vin :tu

[hotreds]

Like to hear!

[guado]

Been there done that. Find an awesome neurosurgeon in your area. Have the surgery. If it isnt too bad there is no fusion just a disk cleanup. Laminotomy/diskectomy. I had it done about 3 years ago. Which I hadnt waited so long. Now I have some permanent nerve damage that would not have been there had I dont the surgery ASAP/ Most of the treatments numb it or just bandaid it but never FIX the problem. Lots of PT lots of stretching etc will help you out but ultimately will need to be fixed.

[shilala]

Now you should get all p90x'd up, Vin. That'll fix it for good, plus you'll even be more incredibly buff, if that's possible. :tu

[sofaman]

Good luck Vin I hope you are fealing better now:tu If you are not dont be discuraged I know for me the magic happend with the 2nd injection:)

[massphatness]

Just some general soreness at the injection site today - the leg actually feels pretty good although the doc did say it would take 2-10 days for the steroids to really kick in.

Cautiously optimistic at this point.

[icehog3]

Glad to hear it, Vin. :)

[markem]

:wo glad to hear that the leg is feeling better already, Vin.

[bobarian]

Good to hear, Vin! Hope things feel better each day. :banger

[Stogeyfish]

Good news, Vin! Good luck with the pt!