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Back Problems Message Board

Back Problems Board Index

Welcome to the board. I'm not quite sure how to begin to try to answer some of your questions....but I would like to mention that since you already know that you have degenerative disc disease at L4-5, and you have lost that much height, and since "hip" pain often turns out to be an issue with either the L4-5 segment or the segment below, L5-S1, I would encourage you to get a lumbar MRI in addition to a MRI of the hip. I think chances are good that you have something going on with that level that is impinging on the L5 spinal nerve root. As you know, none of us has professional medical training, so at best, I am just giving you some thoughts based on my own experiences with L4-S1 problems.

It sounds to me like the problems you mention, like the elliptical trainer episode, may be coming from a nerve compression at the L5-S1 level. Those nerves run down through the buttocks, exiting the pelvis at the sciatic notch, and then run down the back and side of the thigh. Pain can continue down the calf and into the foot, but can stop at the knee, or hurt anywhere along this route. The top of the knee is usually L4 you can see why I would suspect your issues that you mention having at L4-5 and L5-S1.

If you enjoy reading on the internet, search for a "dermatome map." The dermatomes are like a map that indicates which spinal nerve innervates a particular area of skin, and provide a very basic clue as to where the doctor should begin looking for possible issues. For example if a patient complains that his big toe is numb, the doctor will suspect an issue, like a herniated disc, at the L4-5 level, because it is the L4 spinal nerve that innervates that part of the foot. It gives the doctor a general idea where to start looking.

Regarding the hip....of course there is a possibility that you have an additional issue with your hip. But I would definitely check out the lower lumbar vertebrae too. A brief example: my MIL kept complaining of hip pain that made it very difficult to walk. She had several injections into the bursa, etc. Eventually she had a MRI of the lumbar area and discovered that she had an instability at L4-5 and spinal stenosis, and DDD at that level. She had a one level fusion, and after recovery, is walking without pain.

In your case it may be that you have mechanical hip and knee problems, but it won't hurt to have your lumbar area checked out. DDD is not something that improves with the aging process, so things may have changed since your last lumbar imaging.

Please keep us posted on how you are getting along. I hope you can find some solutions to your pain soon.

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