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L5S1 Radiculopathy in left foot
Spine Health | Last Active: Dec 24, 2022 | Replies (18)Comment receiving replies
@jenniferhunter following up on your comment here. We went up to Mayo and neither person I met with saw anything in my mri where they would offer surgery. So they referred me to neurology. So waited a week and came back up to get the suggestion it might be plantar fasciitis…. I saw my podiatrist the next day and she could not believe that was even suggested…. It’s not. It’s nerve pain and follows the L5S1 nerve root. I let the Nero know and they referred me back to surgery. Surgery in our meeting said no need to try injections again as they didn’t believe it was back related pain. Now they say to shoot the nerves again apparently. Met the injection doc today and he can’t believe this was mayo’s response either.
While I’m glad it’s not something like a neurological disorder, I know what I’m feeling and I know the answer is not to pump me full of gabapentin and hope it goes away (as the Mayo surgeon suggested sometimes these just go away) but no idea if in a year or two or tomorrow….
I went to NE Spine as it is the group my alma mater uses and they really couldn’t believe the Mayo response either. Yes my mri isn’t horrible, but it’s not great either. There’s also more to looking at a picture. My symptoms largely go away when I lay down on my back. Mri was taken from on my back. It fires up when I stand and when I sit (when my foramen are under pressure) and I have significant weakness in my leg with a lot of muscle mass lost and stretching my legs can cause serious shooting pain. They suggested it’s foramen narrowing. Suggested an ALIF L5S1. A doc in iowa and in Nebraska suggested Mayo won’t operate if they don’t see it as textbook in the imaging. So now, based on my experience, why they even accepted me up there in the first place?
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@jorgy20 Thank you for following up here. Did anyone suggest a standing or seated MRI? There are places that do those. Sometimes a full spine standing X-ray is done. Was there any comparison on imaging like an X ray in different positions looking for slipping of vertebrae that may only happen in the positions that gives you the pain? When you stand, what is your posture like? Are you stooped over? Have you tried any physical therapy? I remember, you were seeing a 6th year neurosurgery resident at Mayo. Those clues about how your pain changes with your posture and body position are very important to communicate to the doctor.
Mayo does have an Office of Patient Experience that you can contact and it does result in a review of the records if you feel the visit was unsatisfactory. They may assign a different doctor at Mayo.
There was also this document about how other problems can mimic a spine problem. I don't understand this well enough to comment on that, but you could show this to your doctors, or even the doctor at Mayo and ask if your issues are similar to what is explained in this document. You could do that on the portal.
"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/
The author, Kjetil Larsen, is also on facebook and posts this regularly about patients he sees. You could ask him a question and see if he comments. Obviously no one can diagnose over the internet, but you can learn how problems like this occur.
Surgeons do have to figure out exactly where the pain is coming from, because, otherwise, if they operate, it might not solve anything, and they wouldn't want to put your through unnecessary surgery.
I know this is frustrating. I went through stuff like this because surgeons kept missing my diagnosis and coming to Mayo made all the difference for me. There were 5 surgeons before Mayo who all got it wrong and wouldn't help me. Get as many opinions as you need from expert surgeons. My Mayo surgeon was Jeremy Fogelson who was trained at Mayo and teaches in the neurosurgery program. He is a deformity specialist and does some big surgeries and simpler ones like my cervical fusion. Will you be asking your current specialists about the changes in your symptoms with standing and sitting?