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Tingling in the soles of both feet, pain in L5/S1 disc. Normal MRI. Reason for back pain?

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Practicing since : 2000
Answered : 634 Questions
Hello Dr. Grief. First things first, thank you for taking the time to speaking with me. Having said that, you will find me to be somewhat of an anomaly. I've had lower back back for the past 6.5 years ... I realize this is a general statement so let me elaborate. 6.5 years ago I carried about 15 loads of gravel and the very first symptons started that night which included tingling in the soles of both feet, significant pain in what appears to be the L5/S1 Disc. I've been on pain medications since then with multiple MRI's performed and no evidence of a bulging or herniated disc (or so I'm told). Pain is made excruciatingly worse when sitting which is why I've had to use a lumbar cushion for the longest time. Finally, I had a discogram performed several week ago which showed no tears in the annulus fibrosis however; the pain from the procedure was obviously worse and has still yet to subside. Multiple neurosurgeons have said that the disc height and anatomical structure is fine along with the spine being stable. They are recommending either an IDET procedure, a neurotransmitter implant or as an absolute last resort a fusion.

In addition, the disogram on the L5/S1 disc showed an opening PSI of 30 and inflated to 70 PSI at which point the pain was "concordant". The L4/L5 was the control disc and that also revealed an initial PSI of 30 and also inflated to 70 PSI however; no pain was evident from this area. I have the MRI CD's but am unsure how to copy an image (saggital or axial) and then upload.

Can the neurotransmitter therapy help to isolate the pain causation area more definitively or is it strictly non-diagnostic in nature?
Posted Wed, 20 Mar 2013 in Back Pain
Answered by Dr. Payman Hajiazim 2 hours later
hi XXXXXXX thanks for asking. Neurotransmitters regulate the perception of the pain. Some medications which regulate the serotonin system can alleviate the pain. You can ask your doctor about a medication from the class of serotonin re-uptake inhibitors.
Endorphin is another neurotransmitter which can regulate the pain. Having a regular exercise can help for better secretion of endorphin and also acupuncture help in that aspect.
Emotional tone which is regulated in amygdala can also help for better control of pain. Some medications can do it or even talk sessions for emotional regulation can be useful.
I hope this information helps.
I wish you a good health.
Above answer was peer-reviewed by
Follow-up: Tingling in the soles of both feet, pain in L5/S1 disc. Normal MRI. Reason for back pain? 38 minutes later
Thank you Dr. Hajiazim for the response however it doesn't really answer my question on if a Medtronic Neurotransmitter would be able to better pinpoint the source of the pain of the low back pain. Thanks Anyway.
Answered by Dr. Payman Hajiazim 1 hour later
Hello XXXXXXX Thanks for mentioning. There is no Medtronic Neurotransmitter devise to pinpoint the pain, however, the pain could be managed well with intra-spinal (inside the spine) injection. You can ask your doctor to introduce you to an anesthesiologist who does it.
I wish I have answered you properly.
Above answer was peer-reviewed by
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