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Back Problems Message Board

Back Problems Board Index

Re: Dr's stumped
May 16, 2011
Welcome to the board.

As you surmised from what the doctors have already told you, nothing pops out on the radiology report that makes one go " Oh...that's what is causing the symptoms he has described...."

Have you had an X-ray of the lumbar and sacral spine? Also did they do anything on your cervical spine when you had your head split open? Most often, leg pain is the result of a lumbar spine nerve compression, but sometimes cervical nerve compression can cause leg pain as well. The reason for the X-ray would be to look for spondylolisthesis, which is a situation where one vertebra slips over the top of the adjoining vertebra. This can also cause an instability which often leads to nerve compression. It is more easily seen on X-ray than MRI.

The symptoms you describe could be coming from that L5-S1 segment where there is a small disc herniation, and where there is some stenosis in the foraminal opening where the spinal nerve exits the spine.

Also the extra vertebra could conceivably be a source of pain...but usually is not in and of itself. The MRI mentions: [B]Degenerative changes are noted along the sacroiliac joints. [/B] This could be a source of your pain. SI joint problems often have the same symptoms of a lumbar disc herniation, such as the leg, hip pain etc. and it could explain why you have weakness in both legs or that it switched from side to side. I will warn you that "some" spine specialists are not keen on assigning any pain symptoms to a SI joint dysfunction. Some will just shrug when you try to bring it up as the pain generator. This might be something to ask of a good PT or someone who does body work.

I would suggest you consult with another spine specialist, perhaps an orthopedic spine surgeon this time, since you saw a neurosurgeon previously. As you might want to look for a physiatrist (Doctor of Physican Medicine and Rehabilitation) who specializes in orthopedic cases. This specialty works to get a patient back to a functioning level using a variety of conservative methods, but not surgery.

When it is not obvious what is causing the pain, sometimes a patient has to do a lot of research and keep consulting with a variety of specialists to find the answers. It can be very frustrating, but sometimes it is necessary to keep looking and to not give up.

I've kind of lost track of how many specialists I saw...but it was 16 or 17 over a two-year period....You may need to travel out of your immediate area to find someone who will listen and be willing to take on your case.

Regarding the MRI, you can have a "positional" MRI, which may or may not provide some new information. Again, this is not available in all areas, but you can look online to see what might be close to your location. I would think with the type of compression injury you sustained, it would make sense that the force of that trailor "buckling you to the ground" could have damaged the lumbar and sacral joints might be worth pursuing a positional MRI on the slight chance that it might reveal something that is not shown on the prone MRI....

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