Back and leg pain

@pljauthor
Not having discs cushion your vertebrae and if any disc material compresses your spinal cord/nerves will not improve without surgery. Injections will be a temporary way to delay surgery (what I was doing) but injections do not work for everyone. I am a 55 year old female and single parent of a teen son. My quality of life was getting so bad that I didn’t want to delay surgery anymore. My neurologist suggested getting surgery while younger to not only improve quality of life but also make recovery easier. I am glad I did not delay surgery until I was older. The surgery was extremely painful and getting around the first week was extremely difficult but got a little better 2nd week. When I went for my post op appointment (yesterday 8/15/2024), I was told I am doing really well, incision healed well, and I am off narcotics (after 1st week). He said I was the best post op appointment he ever had because I am doing so well at 2 weeks post surgery! 🙂

See attached pictures of my L3-L5 decompression/fusion.

@pljauthor
Not having discs cushion your vertebrae and if any disc material compresses your spinal cord/nerves will not improve without surgery. Injections will be a temporary way to delay surgery (what I was doing) but injections do not work for everyone. I am a 55 year old female and single parent of a teen son. My quality of life was getting so bad that I didn’t want to delay surgery anymore. My neurologist suggested getting surgery while younger to not only improve quality of life but also make recovery easier. I am glad I did not delay surgery until I was older. The surgery was extremely painful and getting around the first week was extremely difficult but got a little better 2nd week. When I went for my post op appointment (yesterday 8/15/2024), I was told I am doing really well, incision healed well, and I am off narcotics (after 1st week). He said I was the best post op appointment he ever had because I am doing so well at 2 weeks post surgery! 🙂

See attached pictures of my L3-L5 decompression/fusion.

I have had numerous MRIs over the past eight years. Looking to pinpoint the reason for the continuing pain im buttocks and lower back(caused by a hard ski fall on my lower back and buttocks) . Each time the interpretation says "nothing remarkable' normal degenerative changes. Has anyone out there in Commenters Land had a second, even third interpretation of their MRI? And had something discovered thet was missed.
Thank you in advance.

@heisenberg34
Did you have MRIs of both lumbar and hips/pelvis recently and do you review the report details and not just the summary? Have you had functional MRI to see if you get symptoms/changes in joints with different movements? Have you had X-rays where you are not just standing facing/sideways but also bending forward and leaning backwards?

Have you had EMGs/nerve conduction studies done by a neurologist to check lower limb nerve health? Have you ever had a myelogram done to test nerve health in your spine/pelvis?

It sounds like the fall may have injured nerves/blood vessels/blood flow that may/may not show on the MRIs or the radiologists were mainly focused on spine/joints.

I had doctors miss things noted in my MRIs (like my neurologist and a separate spine/pain center doctor missed my 2019 cervical MRI showing spinal cord flattening…neither of them said a thing about the fact my spinal cord was being injured and required urgent surgery to prevent further damage). I question if some doctors actually look at the MRIs/reports/images.

Reading the details of the reports and comparing changes over the years might be helpful. Did you have MRIs all done at the same place? I had them done at different places over the years.

Have you been working with an orthopedic spine specialist? I saw a neurosurgeon who was not really helpful.

@pljauthor I think you need some more information on if your symptoms are, or are not related to your spine. Compression of the spinal cord can cause incontinence and problems with bladder or bowel control. Sciatic pain can be generated by a spine problem, or if can be a pelvic alignment problem causing muscles to compress nerves that go to the legs. Before anyone offers to do surgery, you need this figured out.

I would recommend getting second opinions from a spine specialist and a urologist, and even a physical therapist may be helpful with an evaluation.

Here is some information about lumbar plexus compression syndrome which mimics a spine problem and causes sciatic pain.

MSK Neurology - "How to identify and treat lumbar plexus compression syndrome (LPCS)"
Posted on March 30, 2017 by Kjetil Larsen
https://mskneurology.com/identify-treat-lumbar-plexus-compression-syndrome-lpcs/

Wow! So many questions. I don't know where to begin. I had an MRI on my lumbar spine in June. It ws sent to my Primary, Pain specialist here in Dover, and my new pain specialist. I had an EMG ordered by the new pain doc, reviewed by the neurologist who performed it. He is part of the team that my new pain doc runs. Nobody mentioned anything out of whack. I have had x-rays within the last year or two. Front. back, side, etc.

I don't know how closely any of them actually study the tests. I'm not a doctor (and I didn't stay at a Holiday Inn Express last night). I had multiple MRIs over the past eight years as I mentioned. I think you have hit upon a key problem. These doctors don't seem to really know what they should order. Seems like I am frequently suggesting frugs or tests. Unfortunately, I don't know how to find a doc that will do a full-blown study on me to get to the bottom of my issues. The new pain doc seems to be on top of things. He gave me more information and hope than my pain doc in Dover. It is so frustrating! I feel as if I am just getting passed around from one to another. Anyway, I appreciate your feedback. I will look into this "functional MRI". Not familiar with it.

Thank you for all of the information! I have had an MRI and am missing discs at L4 and L5 due to degeneration. Everyone says to avoid surgery, so I am moving slowly. Pain relief is high on the agenda, but long term, I may have to have the surgery.

The problems you are having sound a lot like mine except I did have surgery. If I had to do over I would have tried some of the procedures mentioned first. It may have given me relief without surgery. Since my surgeries in which my L1 was compressed with spinal stenosis and degenerative arthritis I have had the ablation which didn't work, nerve blocks. They feel the pain I am having again in my leg is from a pinched nerve. Six weeks ago I had a spinal stimulator implanted. It is finally starting to give me relief but I still had groin and buttock pain so I just had an injection in my iliac joint (I think that's what it is called). It is the most relief I have had in over a year. I can stand without pain. I know it is only temporary but it is wonderful. The final decision is yours. Just don't go in like I did with very little knowledge. Read, discuss with others and get a second opinion. Best of luck to you.

@heisenberg34
Don’t give up and keep pressing for answers and advocate for yourself. Doctors aren’t perfect and make mistakes. I read through all medical reports and looked up medical terms so I fully understood what my MRIs showed. I would then ask a lot of questions. Doctors should not just be relying on tests but also physical exam and fully listening to all of your symptoms and how they are affecting your quality of life.

What I recently learned from my spine specialist is EMGs should not be relied upon to explain pain/numbness/weakness radiating from spine/lower back to hips/buttocks and legs.

Demand you get answers or referrals to get to the bottom of what may be causing your spine/hip/buttock pain. You can’t treat pain if you do not know the real source of it. Injections, pain pumps/stimulators, medications, etc. won’t really work if you don’t know if it is spine/joint or soft tissue/tendon/muscle pain.