Stenosis ++

Have they tried any type of nerve block to see if that helps? I have a neck that has had both a 2 level surgical fusion and has been autofused for many years. Stenosis. I get some whopper muscle spasms. About every 12 weeks I get a neck nerve block (bilaterally) using ultrasound guidance. Some corticosteroids and bupivicaine. Not perfect but definitely helps. However similar didn’t help my back problem, which gives me sciatic pain. That consists of a previous multilevel fusion with “moderate to severe stenosis”. I refused another fusion surgery and eventually got (in January) a Spinal Cord Stimulator. The trial was successful so I went ahead and am glad I did it.

I have severe stenosis L4-S1, and experiencing pain in my lower back, pelvis, legs, and rectum, along with Tenesmus (a constant strong urgency to move my bowels). Sitting or lying down relaxes the pain and urgency. Has anyone experienced the same symptoms, or had any type of GI problems directly caused by stenosis?

@mmalone1804 - Good morning. I'm sorry to hear of your severe stenosis. I understand the discomfort along with your very real quandary as to what to do next. My neurosurgeon (who I grew to be close to and who was very willing to talk straight with me) described my spine as "a mess". In 2023 I did a 4-level job on both cervical and lumbar regions. One year+ post surgeries - I'm happy to report that 99% of pre-surgical symptoms are gone. But recovery is still progressing.

I had all the symptoms you mentioned including rectal pain (at times almost unbearable) and GI problems. Now? All of those discomforts and inconveniences are totally gone! And I don't miss them. Folks who've never experienced "sudden and surprising onset of a bowel movement" may not appreciate how much your life can be impacted!

Where are you in the diagnostic process? Do you have a strategy in place? Mayo Connect is a great place to ask questions, share feelings, and gain new knowledge.

Thank you so much for your reply. I’m into the third year of this nightmare. Starting with GI and colorectal doctors finding nothing. Then urogynecology and vascular, again unable to find anything wrong. Finally, a lumbar MRI shows severe stenosis, a possible culprit. We’re starting with an epidural injection into the caudal space to see if I get improvement and a surgical referral. What levels did you have your surgery performed on? I am happy you have gotten relief, and you have given me hope that I am finally on the right track.

has anybody ever heard of Medial Branch Block (MBB)? or had it done on them?

@mmalone1804 - Great job of never giving up! So much of your medical journey is related to how hard you work to be your own "best advocate". Keep pushing until you feel like you have the right answer.

I had L2-5 laminectomy (though not called that exactly) and fusion. My investigations showed reasonable causation between severe stenosis and GI type problems.

The process you're now experiencing is the typical diagnostic path. Because nerve-related problems can be very hard to pinpoint, steps such as epidurals can help the docs sort out (often through the process of elimination) the ultimate cause.

Hang-in there! Maintain a positive attitude. Keep driving until YOU are satisfied with the diagnosis and subsequent treatment strategy. Check-in with MCC (Mayo Clinic Connect) now and then to update us all. We care about your well being.

I am looking into a Medial Branch ablation and rhizotomy for pain. Just learned of a new procedure to remove the medial nerve if the ablation is successful, might be something I look into. This alone will not resolve other issues with my spine, but.....

I had a diagnostic block on S1/L5 and L4/L5 recently and it did help with pain for a few hours. I do not tolerate steroids, so I knew my block was going to be strictly diagnostic. However, I have friends that have found relief with blocks and epidurals.

Thank you so much for your encouragement. I am truly grateful for your advice. I’ll keep you posted…

Hi again,
I’m just reviewing the posts from last month. I have since had the caudal injection and my back pain has improved about 50-60%. I’m grateful for that. The surgeon has mapped out a plan, but does not think that the surgery will relieve any of the rectal pressure and urgency. As soon as I’m upright, I feel the strong need to eliminate, but nothing is there, aka Tenesmus. It goes away when I’m sitting or lying down, but that’s no way to live.
You mentioned that your stenosis caused rectal issues. Can you be more specific, and did your surgery correct the problem?

@mmalone1804 - I did have rectal issues but nothing like what you're experiencing. Sorry. Surgery made all those bladder/rectal challenges go away.