[Spine Journey]

QUOTE=laid up doc;90287]SJ - i have a few questions that might guide your analysis of your symptoms:
1. did the steroid injections resolve all/most of your symptoms?
2. were they epidural or facet injections?
3. do you have a lot of pain w/sitting/coughing? those 2 things are fairly specific for discogenic pain. facet pain is usually more constant, worse w/ lumbar spine extension (leaning back).
4. if you had facet changes in '03, they probably are at least as bad now. did they comment on your facets in your more recent MRI?

Doc, to answer your above questions:

1.Nov 2010: I was having an episode of low back pain w/right side sciatic pain down the back of my right leg, with sharpe pain in the right buttock. 11/2010 MRI results: DDD L5/S1, 3.5mm left paracentral and lateral recess disc protru. L4/L5 mild disc buldging no canal or foraminal stenosis. Nov Injection: transforaminal eidural steroid injection L5/S1. left side. Got relief from the sciatic pain, but back pain remained.

Jan 2011: had another episode of severe concentrated low back pain where I could not get myself out of bed for a few days. There was not has much referred pain, it was concentrated to the low back. This time the pain was caused by breathing, coughing, sneezing... Got in to see an Ortho, b/c of my appearence at that time, he felt I may have rupture my disc since that last injection/ MRI so he ordered another MRI immediately. New MRI: L4/L5 Bilateral Facet hypertropy. Right foraminal disc protrusion, not contacting existing nerve root. No significant stenosis. L5/S1 left paracentral and left foraminal disc protrusion, mildly encroaching upon the under surface of the left neural foramen. No significant central or foraminal stenosis. Dr suggested select nerve block, procedure volume caudal deposition epidural steriod. Provided moderate relief for a few days, but had trouble bending forward. bending backwards was less pain

5/2011: Had another episode of low back concentrated pain, back of the leg pain had subsided by this time. This felt like discogenic low back pain. Procedure: Paravertebral facet block L4/L5 and volume Caudal. No relief to low back pain at all.

June 2011: leg pain started. Now leg pain is side and front of the thigh, not specifically pain in the back of my legs. All pain is side to front of thigh to the point of difficulty walking/ standing more than 1hr.

No, I do not have pain when coughing. Now, I can sit for a longer period of time before needing to stand and stretch.
According to the Lumbar Dermatomes it appears that L4-S1 can cause leg pain, I just want to make sure that my leg trigger is the DDD at L5/S1.

Thank you,
SB