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L4-L5 Sacral Spinal root compression - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Very Good Posted in: Brain and Spine
Answered by

General & Family Physician
Practicing since : 2005
Answered : 2408 Questions
User :   free
User :   hello?
Doctor :   Hi
Doctor :   I am Dr AAAAAAA
User :   sorry, it sent me through a confusing screen
User :   nice to 'meet' you Dr. AAAAAAA
User :   so, should I start with a general overview of symptoms?
Doctor :   Please proceed with your query .
User :   kind of long...
User :   For several months, off and on, I've been experiencing random pelvic pain. It was always on the right side, on the inside of my leg and in the pubic bone. Lately, it's gotten a lot worse. It is typically the most painful when I'm sitting, and better when standing or lying down. I've also been feeling pains, which range from dull aches to stabbing sensations in my butt, hip, lower back and the back of my leg. I saw a sports medicine specialist earlier this week and he said my hip muscles are weak and slightly misaligned and inflammation seems to be pinching a nerve, which would make sense. I also took a few bladder infection tests at home to rule that out, because the pressure in that general area makes me think I need to pee sometimes when I do not. It came back negative for nitrates every time, and positive for white blood cells once, though that went away after I started drinking more water. I've had a couple of bladder infections in the past, but this doesn't really feel like one. Also, I saw my gynecologist about three months ago and everything was normal. Now the pain has shifted centrally, directly above my urethra, but it feels close to the surface of my skin rather than deep within. Could this all be referred pain from nerves or should I be concerned about any other potential bladder or gynecological issues? I'm starting physical therapy tomorrow, but I just want to rule out any other issues I should be addressing.
Doctor :   Yes please .
Doctor :   How can I help you ?
Doctor :   Please give me a few minutes to go through your query.
User :   ok
Doctor :   Ok
User :   what do you think
Doctor :   May I ask you A few questions pertaining to your problem ?
User :   absolutely
Doctor :   Do you have fever along with these symptoms ?
User :   not at all
Doctor :   How about tenderness, pain on pressing the affected area ?
User :   not so much direct pain
User :   it's slightly tender above my right pubic bone, and in the back in the outer edge of my butt
Doctor :   Have you been injured in any recent times ?
User :   but nothing significant
Doctor :   Ok
Doctor :   May I know your age please ?
User :   no injuries... I rode bikes a few times last summer with the worst seat ever (sore for days each time after). took three months of boxing training before my wedding
User :   otherwise have been pretty sedentary. i'm a freelance writer
User :   29
Doctor :   Ok
User :   nothing i do now causing pain with movement
User :   the only relief comes in standing up and moving around, or laying down
Doctor :   What was the Gynecologists opinion, did the doctor suspect any PID, Uterin or Vaginal problem ?
Doctor :   Did the Gyned do any ULTRASOUND ?
User :   last time i saw her was in Oct and everything was clear though they didn't do a pap
User :   no
Doctor :   Ok
Doctor :   Ok
User :   i've never had any cysts, anything
User :   i'm on BC and periods are regular
Doctor :   How about any Femoral Hernias ?
User :   that seems highly unlikely
Doctor :   Did the Gynec suspect anything of that sort ?
User :   that would be from lifting heavy objects?
User :   no
Doctor :   Yes , But sometimes even with minimal weights .
User :   would it feel so low, like right above my urethra though?
Doctor :   But let me give my Differential Diagnosis : User :   ok
Doctor :   1. I would at first suspect a L4-L5 to Sacral Spinal root compression.
User :   the sports med doc i visited, pardon the layman's language, said my hip flexor was weat and inflammed and compressing a nerve
Doctor :   I would suggest you to go for an MRI with a Spinal Surgeon or An experienced Orthopedician .
User :   but i found it hard to beleive it would cause stabbing pains right above my urethra though
User :   I'm terrified of having IC
Doctor :   What is IC ?
User :   intersticial cystitus
User :   so you think it just sounds like back/nerve issues?
User :   (I'm sorry, I sound like a hypochondriac though I"m not at all!)
Doctor :   I feel it could be Either Spine or 2.
User :   2?
Doctor :   2. It could be a tear in the Muscular Cuff sorrounding the Hip Joint or the Femoro-Pelvic Joint.
User :   ah
User :   so it doesn't sound like bladder issues or 'lady part' issues... purely nerve/muscle/joint issues, since the feeling moves around so much?
User :   i have physcial therapy schedule tomorrow, so if that's the issue, i'm on the right track
Doctor :   It doesnt seem to be so as UTI are totally different.
User :   yeah i've had those before, different
Doctor :   With pain while urination , fever, etc.
User :   right
User :   ok!
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