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What Does This CT Scan Regarding Difficulty Walking Indicate?
Question: Can you review my ct scan? I will have mri results by XXXXXXX 20. I have quite a bit of improvement since an acute incident at the end of september but remain limited in capacity to sit or walk. I am not able to work. At that time, I didnt have a fall or an accident, just experienced extreme LT lwr back pain and muscle spasm after icing my back. I had had some moderate lwr back discomfort and had seen a massage therapist. Do you expect this will resolve without surgical intervention? Will an epidural by fluoroscopy reduce pain to the point where it is likely that I may overdo it---sit or walk too much? Gabapentin can contribute to insomnia?
Brief Answer:
I need some more information
Detailed Answer:
this is really 2 questions in one:
1) is there anything terrible in my ct scan?
2) what is happening with my back and will it get better?
as far as your ct scan this is a pretty normal scan for someone of your age. it shows some degenerative changes we loosely call "arthritis" but nothing severe
that requires surgery. you have some areas where the arthritis could pinch a nerve which is what is most likely happening to you. in order to help with this I need some more information
along with the back spasm did you have buttock/thigh/calf/foot cramps?
which side is the back pain on?
did you have an emg?
did it start in the back and then move lower on your leg and now improving the same
way it worsened?
any weakness in the leg?
I need some more information
Detailed Answer:
this is really 2 questions in one:
1) is there anything terrible in my ct scan?
2) what is happening with my back and will it get better?
as far as your ct scan this is a pretty normal scan for someone of your age. it shows some degenerative changes we loosely call "arthritis" but nothing severe
that requires surgery. you have some areas where the arthritis could pinch a nerve which is what is most likely happening to you. in order to help with this I need some more information
along with the back spasm did you have buttock/thigh/calf/foot cramps?
which side is the back pain on?
did you have an emg?
did it start in the back and then move lower on your leg and now improving the same
way it worsened?
any weakness in the leg?
Above answer was peer-reviewed by :
Dr. Prasad
I had been experiencing thigh, calf and foot cramps for about 6 months before the pain started but none since it started, 'cramps' have been rare. The cramps were unpredictable and occurred during the day as well as at night. A few times they occurred while walking. All that said, I am sure hip, thigh and back were in spasm all the time. I was taking baclofen 3-4 X per day. The Lt leg is weak. I have a lot of trouble lifting it when getting into the driver's seat. Back pain is LT.sided. Pain had included the hip, thigh and knee. It was burning pain, the worst pain Ive ever felt, worse than childbirth. Pain caused me to lay on my RT side only, until recently. While laying on my Rt side my LT leg had to be straight. It could not be elevated on a pillow. Nothing could put pressure on the inside of my LT knee. There was numbness at the inside of my LT knee for the first 8 wks. No emg. When it started it included all areas from the beginning. I had a lot of difficulty walking even short distances and could not sit for very long either. Was laying down for 90% of the day. The numbness went away about a month ago.
I have had peroneal pain due to posterior tibial dysfunction prior to this back issue.
I have had peroneal pain due to posterior tibial dysfunction prior to this back issue.
Brief Answer:
Sounds pretty certain
Detailed Answer:
At least from the history you gave, that's a pretty convincing story for a pinched nerve. All of the symptoms you mentioned are caused by that one problem.
Epidural steroid injections work really well and you will probably have good relief. Peroneal and posterior tibial dysfunction are a separate problem.
Sounds pretty certain
Detailed Answer:
At least from the history you gave, that's a pretty convincing story for a pinched nerve. All of the symptoms you mentioned are caused by that one problem.
Epidural steroid injections work really well and you will probably have good relief. Peroneal and posterior tibial dysfunction are a separate problem.
Above answer was peer-reviewed by :
Dr. Ashwin Bhandari
Original question: Will an epidural by fluoroscopy reduce pain to the point where it is likely that I may overdo it---sit or walk too much?
The CT scan states that there isn't any nerve compression....will a pinched nerve show up on a mri?
I now have a problem with restless legs and insomnia, that did not exist before all this...what have you found to be most often effective?
Most of the pain is at L5-S1. Last night I am starting to get sharp pains at the top of my Lt foot. Is this unrelated to the back?
The CT scan states that there isn't any nerve compression....will a pinched nerve show up on a mri?
I now have a problem with restless legs and insomnia, that did not exist before all this...what have you found to be most often effective?
Most of the pain is at L5-S1. Last night I am starting to get sharp pains at the top of my Lt foot. Is this unrelated to the back?
Brief Answer:
No, no, and yea
Detailed Answer:
epidurals work well for pain control of the symptoms going down your leg but the underlying problem that caused it is still there. if you overdo the pain will come back. your arthritis isn't that bad though so there isn't really anything that will happen if you overdo it except more pain.
the MRI will show the nerve and discs better but there will probably be little in the way of severe disease. your MRI will probably be read by radiology as mild. lots of times the pinched nerve will show up on the emg but not MRI, sometimes at sites where the arthritis isn't that bad. depends on where the irritation is.
most likely any symptoms you have currently are from the bad except restless legs which is its own disease.sometimes epidurals help restless legs though if the sensations you're having aren't actually a brain problem
No, no, and yea
Detailed Answer:
epidurals work well for pain control of the symptoms going down your leg but the underlying problem that caused it is still there. if you overdo the pain will come back. your arthritis isn't that bad though so there isn't really anything that will happen if you overdo it except more pain.
the MRI will show the nerve and discs better but there will probably be little in the way of severe disease. your MRI will probably be read by radiology as mild. lots of times the pinched nerve will show up on the emg but not MRI, sometimes at sites where the arthritis isn't that bad. depends on where the irritation is.
most likely any symptoms you have currently are from the bad except restless legs which is its own disease.sometimes epidurals help restless legs though if the sensations you're having aren't actually a brain problem
Above answer was peer-reviewed by :
Dr. Yogesh D
typo? "from the bad" ?
I have recently stopped tramadol and am having severe insomnia,...from reading online, it appears that restless legs could be related to tramadol withdrawal as well as the insomnia. I guess it is something I will just have to put up with, because nothing is working.........benadryl or gravol or tylenol and naproxen, or chamomile tea or muscle relaxant. and I use a cpap for sleep apnea....so enough of trying to find an insomnia remedy. Have been to the public pool and hot tub, 2 nights in a row with no improvement either.
if the pain is/was due to a nerve that is pinched or compressed, it is important not to contribute to further compression. my job entails a lot of sitting...if the epidural controls the pain and I go back to work and sit a lot......it will hinder any long term progress. However on the other hand if the epidural contains a corticosteroid ? it may reduce inflammation and compression?
because the pain came on acutely,....I tend to think of it as something that can be resolved, rather than chronic arthritis.
severe lower leg muscle spasms preceded all this, are muscle spasms related to nerve compression?
I have recently stopped tramadol and am having severe insomnia,...from reading online, it appears that restless legs could be related to tramadol withdrawal as well as the insomnia. I guess it is something I will just have to put up with, because nothing is working.........benadryl or gravol or tylenol and naproxen, or chamomile tea or muscle relaxant. and I use a cpap for sleep apnea....so enough of trying to find an insomnia remedy. Have been to the public pool and hot tub, 2 nights in a row with no improvement either.
if the pain is/was due to a nerve that is pinched or compressed, it is important not to contribute to further compression. my job entails a lot of sitting...if the epidural controls the pain and I go back to work and sit a lot......it will hinder any long term progress. However on the other hand if the epidural contains a corticosteroid ? it may reduce inflammation and compression?
because the pain came on acutely,....I tend to think of it as something that can be resolved, rather than chronic arthritis.
severe lower leg muscle spasms preceded all this, are muscle spasms related to nerve compression?
Brief Answer:
Yes,
Detailed Answer:
Hi,
Thanks for writing back.
Sorry that was supposed to be "from the back". Cramps are very common. If you truly have restless legs none of the treatments you mentioned are indicated for it. Most of what you mentioned are treatments for sciatica/back pain/cramping. Treatment with Te injections will actually help you sit longer and the job you do has nothing to do with the long term outcome other than put you at risk for progression of your lumbar arthritis if you don't use proper ergonomics and posture,
Regards,
Yes,
Detailed Answer:
Hi,
Thanks for writing back.
Sorry that was supposed to be "from the back". Cramps are very common. If you truly have restless legs none of the treatments you mentioned are indicated for it. Most of what you mentioned are treatments for sciatica/back pain/cramping. Treatment with Te injections will actually help you sit longer and the job you do has nothing to do with the long term outcome other than put you at risk for progression of your lumbar arthritis if you don't use proper ergonomics and posture,
Regards,
Above answer was peer-reviewed by :
Dr. Raju A.T
Your previous response was that if I overdue it, the pain will come back.
Right now, there are several ways that I can overdue it: sitting too long, walking too much, and as you mention improper ergonomics( eg moving too quickly and/or in the wrong way).
My job entails sitting for very long periods. eg most of the day.
Without the epidural, I can not sit for more than 2-3 hrs per day. that is, here at home.
With the epidural I guess, due to the absence of pain, I could sit for 8 hrs / day.
It makes sense to me, that if I were to choose to sit for 8 hrs/ day with the epidural, that it would be a step backwards rather than forwards. My understanding from my physiotherapist, is that I will not be able to sit for 8 hrs/day as I have previously.
Restless legs must have been part of withdrawing from use of tramadol. Gone now.
I am choosing to put up with the pain and limitations associated with the pain, rather than use the tramadol, because of side effects. Slept fine with 1/2 tab gravol. Wake up with some pain, but bearable,...since I am not at work.
I live in Abbotsford, BC, Canada, and work as a nurse case manager for community health.
Right now, there are several ways that I can overdue it: sitting too long, walking too much, and as you mention improper ergonomics( eg moving too quickly and/or in the wrong way).
My job entails sitting for very long periods. eg most of the day.
Without the epidural, I can not sit for more than 2-3 hrs per day. that is, here at home.
With the epidural I guess, due to the absence of pain, I could sit for 8 hrs / day.
It makes sense to me, that if I were to choose to sit for 8 hrs/ day with the epidural, that it would be a step backwards rather than forwards. My understanding from my physiotherapist, is that I will not be able to sit for 8 hrs/day as I have previously.
Restless legs must have been part of withdrawing from use of tramadol. Gone now.
I am choosing to put up with the pain and limitations associated with the pain, rather than use the tramadol, because of side effects. Slept fine with 1/2 tab gravol. Wake up with some pain, but bearable,...since I am not at work.
I live in Abbotsford, BC, Canada, and work as a nurse case manager for community health.
Brief Answer:
Sort of
Detailed Answer:
sitting isn't really a step back and neither is standing. your problem is likely to completely resolve with the injection and allow you to sit much longer. you can expect that your pain will return at some time but there isn't much you can do to provoke it intentionally besides incorrect lifting techniques. day to day activities are unlikely to provoke the pain
Sort of
Detailed Answer:
sitting isn't really a step back and neither is standing. your problem is likely to completely resolve with the injection and allow you to sit much longer. you can expect that your pain will return at some time but there isn't much you can do to provoke it intentionally besides incorrect lifting techniques. day to day activities are unlikely to provoke the pain
Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.
Above answer was peer-reviewed by :
Dr. Bhagyalaxmi Nalaparaju
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