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Back Problems Message Board

Back Problems Board Index

Hi everyone. Thank god for this board! I was wondering if I could get some advice. I have degenerative disk disease at L4-L5 and a bulge at L5-S1 with very little spacing at the L4-L5 level and some space compromise at L5-S1. (I used to be 6'3" now am 6' 1 and 3/4"...) I have had this condition for years (tenpin bowled semi professionally). I first had problems at 26 (herniation at L4-L5) and am now 40. I had just gotten to the point after lots of pain that my back became managable (last 6 or so years before recent incidents). I had pains in the morning and stiff getting out of chairs but was mostly ok (Ibuprofen). I refused to think about surgery even after the first incidents left me bedridden for months. I had even gotten back to league bowling on Friday - stiff and sore on Saturday but accepted that.

So, about 1 and 1/2 years ago I was having an unusually bad back day and bent over to pick something up and my right knee bent backward and I felt something "go" in my knee. I tried to compensate too much for my back and somehow my right knee sort of gave out. I was thinking right after that happened "damn, thats going to come back and bite you". After that day my knee always had a somewhat unstable feeling like it was going to "give way" but never any swelling and never have I had any trauma or impact to my knees hip or back (besides the rigorous bowling). I went along like that for a year and a half.

Well, about one month ago on Christmas eve everything was fine (knee still feeling unstable but able to do things) went to the gym got on the elliptical and did 30 mins. (trying to loose weight I am 255 lbs.) Finished up got in the car to shop and when I got out at the mall 1 hour later I started limping. Pain in my right groin area causing me to limp on my right leg. It got really bad to the point that on Christmas day I was looking really bad barely able to walk without pain. Trying to put a sock on that right leg was really a struggle and painful for about a week. The pain was in the groin and my back was in play too, with my back spasaming when trying to lean forward to get the sock on. It has gotten somewhat better since then but as it did my knee came into play and now there is a pain from my hip/groin all the way down the thigh to the inside of my knee. I made an appointment with the Ortho who did the reflex tests with the triangle thingy (all good there) and took an xray of my back and hip. The hip looked fine but Doc scheduled me for an MRI on the hip this coming Saturday 1/22/11 and a follow up with him on the 25th. My back had obvious issues on xray but he said we would address that later and for now address the hip pain. He did not seem too concerned with the knee though. My knee situation is scary because again no trauma such as a car accident etc. but now knee feels like its burning even when resting. This post seems to be about knee/hip but really I think its my back perpetuating all of this hence posting here.

Can anyone suggest what I could have possibly done to my right knee when bending over that one time?

Can anyone suggest what might be going on re the elliptical incident and my hip/groin? I mean this came out of nowhere and at no point during the exersice did my body give any indications, I was feeling great actually.

What should I ask from my Ortho Doc on my next visit?

Thanks for reading and any advice anyone can give! (I know it was quite long)

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.
Hi everyone. Hope everyone is doing well, just wanted to update. Went back to the ortho on Friday and he explained the results of my hip MRI. He said there was nothing he could find that was outstanding except early onset of arthritis and that there was a small divot in the bone on ball of the hip joint. Spacing of joint, muscles etc. were all in alignment and he said that there were no cysts or growths but did mention the early onset of arthritis which he said about 30% of the 40 year olds will have on average. He did not believe my initial hip and knee pain was coming from my hip or knee but referred from my back. He offered physical therapy or a lumbar MRI and I went for the MRI, its been awhile anyway. In the meantime I am cleared to exercise but when I do I can't say I feel better. Still back pain with my putting on a sock with my right leg still feeling tense and that leg down to the knee on the inner thigh really not feeling good. Tried bike and elliptical and both make me feel tense in the right leg during and after. This is really new and weird to me and the most scared I have been because it affects my walking directly. I limp slightly on my right leg. Almost as if it is shorter than the other... So anyone so kind enough to answer, should I keep exercising or just try to wait this thing out a few weeks, lumbar MRI etc.? Not sure what to do here because I don't want to further any damage if I am actually trying to heal but want to loose weight as a tool against my back woes you know?

Thanks everyone.

Hi everyone,

Well I had my lumbar MRI and it shows "marked loss of height and dessication at L4-L5" and a pressing of the thecal sac with no nerve impingement. There was nothing else remarkable on the MRI. My hip and knee are almost back to normal (95%) but my back seems worse. Now regular activities are much harder since my last incident. Any sports activities are out of the question based on how I feel (I was able to bowl and play baseball/basketball with little/some pain until recent incident on Christmas eve). I did loose about 8 pounds over the last month with no difference in pain. I am 40 years old and feeling that life is really heading towards a downward spiral for me. I can't play baseball at 40? Really? Well my doc wants physical therapy and then shots before he will consider sending me to an Ortho (I found out my current doc is more of a general sports medicine type of doctor). I am now open to surgery when before I was so against it. The way I feel and the 1 and 1/2 inches of lost height are making me consider this. Physical therapy/chiro never worked for me and the shots kind of seem like a temporary fix. I have good insurance until September but this is COBRA. If I dont find a job by then I am in the deep you know what... Private insurance at that point is swingable but may not be supported by many offices etc. What in your opinions should be my next moves?

Thanks for any help!

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