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Back Problems Message Board

Back Problems Board Index

As the other posters implied, none of us has medical training, so at best, you are getting your fellow spineys' impressions of your MRI based on what we've learned from our own experiences. If you can manage it, it would be a good idea to see a spinal specialist as Carol mentioned for an accurate diagnosis.

If you enjoy doing some research, run a search for a dermatome map. The dermatomes provide a "road map" to help medical professionals determine which area of the spine may be damaged and thus, causing pain. Each spinal nerve provides sensation (including pain) to a particular area of the skin -- the lumbar spinal nerves innervate the area below the waist.

For example, the S1 nerve root, in most people, starts high up in the buttock, runs down the back of the leg, down the outside of the calf and into the little toe. L5 runs next to S1 but on the outside of it, going down the side of the buttock (hip), down the side of the leg and then at the knee, it ventures more toward the front-side of the calf, down the top of the foot and into the 3 middle toes. And L4 runs into the big toe.

Obviously none of our bodies are as clearly divided up as the chart indicates, but in general, when you have pain running down the back of the leg and into the outside of the calf and foot, a good place to start looking for problems is at the disc located between your lumbar 5 and sacral 1 vertebrae.

Your MRI confirms that the bulging disc is irritating the S1 spinal your doctor will pay particular attention to this segment when he examines you and talks with you. The nerve is not being badly compressed, at this point, as the MRI indicates that the S1 nerve is not being displaced.

Regarding stenosis, it is readily seen on MRI imaging. Stenosis is a narrowing, and it can be clearly seen in two main areas: the central spinal canal and the foramina (which are "openings" at each pair of vertebrae where the spinal nerves exit the spine). Your MRI report indicates that there is no sign of stenosis at these areas. It states "The central canal is preserved." It also says "The foramina are patent bilaterally." If this were not the case, it would be noticeable and reported on the radiology report.

In all likelihood, it is not necessarily the disc herniation that is causing your pain, but the irritation of the S1 nerve, which is caused by the disc herniation. The spinal nerves are VERY sensitive. Pain results when the nerve is either compressed (pinched) or irritated. The nerve remains irritated as long as there is disc material touching it, or in the case of a ruptured disc, there can be a chemical irritation as well. When the problem with the disc is resolved either through conservative methods or through surgery, the nerve usually recovers and the leg pain resolves.

This is a simplistic explanation, but I hope it gives you some idea why there is a problem in your lower lumbar spine, but you have pain in your leg/foot/hip areas. I hope you can get some medical care and that your pain will be resolved for you soon.

Please let us know how you are doing.

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