Does this sound familiar?

mdesmond · #1 02-28-2012, 11:38 PM

I have been diagnosed with a central disc protrusion at L5 S1 (described as mild or moderate depending on the MRI report you choose) along with hypertrophic facets at L5 S1 and L4 L5. I also have a slight scoliosis. The protrusion is touching the S1 nerve roots bilaterally and the L5 S1 displays a degenerative signal and some disc height loss.

My back never bothered me until a fall last year, in fact I was a semi-athlete considering the NY marathon, running 30-40 miles per week. The pain began in my right hip, then right upper butt (piriformis area), then gradually went from being a sharp localized pain to a intense agonizing radiating sensation throughout both legs into my feet (in a non dermatonal pattern). At this stage, a year on, I experience severe lower back pain, and stinging burning sensations throughout my legs. The pain is exacerbated by clothing. The soles of my feet and anterior thighs are the worst, followed by my inner thighs. The pain has a stinging buzzing texture to it. I cannot exercise, doing something as simple as laundry is a massive ordeal.

I had an emg that came back negative for nerve damage. I suspect internal disc disruption at L5S1 with pain referred via the sinuvertebral nerves into the L2 dermatome. And radiculitis at the S1 level. However my doctor seems confused about the whole thing. I went to a surgeon in Manhattan and he dismissed disc disruption, telling me that there was nothing operate on.

So I was just wondering, for those who have experienced this nightmare, does this sound familar? Is this what an internally disrupted disc feels like? Should i push for a discogram? Im planning to contact Dr Boeree in the UK and set up an appointment, Im getting nowhere at the moment with this and its having a horrific toll on my life.

Thanks!

laid up doc · #2 02-29-2012, 12:40 AM

not all surgeons believe in disc disruption - they think if the MRI doesn't look "bad enough" then surgery won't help. i was told this by one US surgeon even with TWO ridiculously positive discograms.

if you have facet issues,, then ADR may not be your best bet. either way though, if there's a question as to whether that disc is your pain generator, then a discogram may help clarify things.

Harrison · #3 03-01-2012, 10:40 PM

M, any progress in the past few days? Any news? Can you tell us a little more about your facet issues? Is it your understanding that your facet hypertrophy is a compensatory mechanism to adapt to the DDD?

Hope we can help you in your journey. A "journey" it is...

mdesmond · #4 03-02-2012, 03:45 PM

Hey doc/Harrison,

My first MRI, six months after my fall, showed hypertrophic facet joints. However I have a long history of athletic living, so its difficult to know if my facets were just worn in general, and not related to the disc problem, or wither they started to expand due to the disc injury itself. I don't have classic signs of facet problems though, my issues are predominantly nerve type pain (tingling, stinging, allodynia) in the lower back, thighs and feet. Exacerbated by movement and weight bearing.

So far my physiatrist (4th doctor) and this surgeon I talked to seem to think that the herniation is too minor to be causing such debilitating pain. I did 5 months of PT (core work mostly, stretching, tens, mckenzie etc), 1 caudal epidural (provided 2 days of minor improvement), and a diagnostic steroid injection into my hip after an MRI indicated i had a small labral tear (had zero effect). I also did some massage and chiro but to no avail.

I have been referred to a neurologist in the meantime for a consult, Im not sure how she is going to help. I guess my biggest issue is all the confusion surrounding this problem. Initially I was diagnosed with a lumbar sprain, then sacroiliitis, then it was L5S1, but now we arent sure about that because the pain spread throughout both legs. It seems like internal disc disruption or maybe mild cauda equina syndrome are the only things that makes sense. But my MRI doesn't indicate much compression.

I guess Im really trying to figure out if this sounds like something that could be fixed with ADR or if I am way off and just clutching at strings.

Thanks for the replies!

laid up doc · #5 03-02-2012, 07:31 PM

sounds like a discogram may be in your future... i was diagnosed first w/ SI joint dysfunction for quite a while, til i saw a new doc who thought my pain sounded more discogenic - my MRI showed very mild degeneration really -- and voila.... overwhelmingly positive discogram.

then biacuplasty worked til a car accident, and i'm doing as well as can be now 4.5 mo after my ADR at that level. i didn't have any facet issues at all though, and no other apparent pain generator other than muscle spasms.

it's a fairly miserable procedure and you can't do anything for a few days after. but, until some new type of MRI or other test is developed, a discogram the only way to tell for sure if a disc is causing your pain.

srajan0929 · #6 03-02-2012, 07:54 PM

hey have you ever had any facet joint injections? the epidural you had i am assuming was in the disc space correct?

see if you can get facet joint injections to rule out facet issues. if they work, then great...you have pinpointed your pain. if they don't, then perhaps its the discs causing you pain? how are you SI joints?

raj