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Having pain in back, buttock and thigh. MRI shows scatica in the L5/S1. Suggest

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Spine Surgeon
Practicing since : 2002
Answered : 322 Questions
I am experiencing pain from my back, buttock and outer left thigh with occasional weakness in my left leg. I also have knee issues in that leg. This has been a long-term progression over the last 6 plus years. MRI shows scatica in the L5/S1, but not much else. The area is painful to the touch. In the morning it is difficult to get out of bed and moving with minor improvement through out the day. Walking or standing for more than about a half hour makes it worse. I am 51 years old with no chronic illnesses
Posted Fri, 14 Jun 2013 in Back Pain
Answered by Dr. Rahul D Chaudhari 1 hour later
Thanks for writing to us.
L5-S1 disc prolapse can cause leg pain. Can you please upload the report. Is there any nerve compression on MRI? Do you get leg pain in the night? Any specific treatment taken? Any tingling or reduced sensations in the foot? Please get back with above information.
Other reasons which can cause sciatica pain are hip joint pathology or sacroiliac joint issues. Need to be examined by spine specialist to pin point the problem. Have you taken any medicine for fibromyalgia? any relief with it? Thanks.
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Follow-up: Having pain in back, buttock and thigh. MRI shows scatica in the L5/S1. Suggest 22 hours later
The results from the MRI state as follows:
L4-L5 Facet disc height loss with mild broad-based posterior dics heniation. This effaces the ventral thecal sac but does not appear to contact he traversing nerve roots. Facet joint arthropath mildly narrows the neural foramina.
L5-S1 Facet joint arthropathy contributes to mild disc protrusion toward left foraminal zone causes mild narrowing of the left neural foramen. No right neural foraminal steriosis. I also have a report from a chiropratctor from about a year ago that shows the following:
There was tenderness to digital palpation and muscle tension on both sides of the lumber spine. There was muscle hypertonicity present on both sides of the lumbar spine. Edema and swelling is noted on both sides. Lumber spine range of motion severely restricted in all ranges.
Bechterew's Sitting Test: was positive on both sides.
Kemp's Test was positive on both sides.
Valsava's Test positive with onset or increase of pain reported when teh patient was asked to hold their breath and bear down increasing intraspinal pressure.
Lasegue's Test was positive on both sides.
Lasegue's Test was positiove on both sides.
Baggard's Dorsiflexion test was positive on both sides reporducing pain.
Minor's sign was negative on both sides. Patient needs support of weight with arms of chair or hand on healthy side of back
upper and lower extremeities reflexes were found to be 2+ bilaterally.
Lumbar Spine AP-Lateral from 6/15/2012
Severe curve of L spine concave to the left
DDD of L spine most notable of L5/S1
L5 spondylo--- grade 1

At that time the prognosis was fair.

Currently I am not taking specific medications for the fibromyalgia, I never have. but am taking gabapentin 300mg 3 times a day for potential nerve pain caused by the back issue.

As for the level of pain, in the leg and back is usually worse in the morning even though I usually sleep on the right side, (least affected). I have notices mild tingling in the calf areas of both legs occasionally, but usually does not affect the feet.
Answered by Dr. Rahul D Chaudhari 28 hours later
It seems you have degenerative scoliosis with L5S1 listhesis. I wonder you have severe scoliosis but minimal foraminal stenosis. Can you upload your images if possible. Have you tried any pain block in the spine. It may relieve your pain and also helps to establish the diagnosis. You are on quite high dose of gabapentin and it will not cure the problem. Its important to localise the pain generator. I would consider doing facet blocks and nerve root block after studying your images. Thanks.
Above answer was peer-reviewed by
Follow-up: Having pain in back, buttock and thigh. MRI shows scatica in the L5/S1. Suggest 1 hour later
I do not have a copy of the image available, I would have liked to see the images as well. I have not had the option of a pain block in the spine and currently the gabapentin is doing little good as I am noting considerablly more pain generating from the lower lumbar in the last week and weakness to the left leg. I understand this will most likely require additional referals to specialist to obtain a confirmative diagnosis, which currently is unaffordable. I am attempting at this point to determine the least costly method of diagnosis and treatment if possible.
Answered by Dr. Rahul D Chaudhari 9 hours later
I would definitely like to help you but I need to seethe pictures.
You can always ask for the soft copy. Thanks.
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