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Back Problems Message Board


Back Problems Board Index


Thank you for all of that information.
I don't or have ever had pain down my legs though, so does that make it less likely to be stenosis? The pain is only ever in my lower back and buttocks, and occasionally up higher in my back when the muscles get tired of trying to compensate.
While my MRIs do show a bulge at L4 L5, they also state that the bulge "extends into the right IV foramen but the right L4 nerve root does not appear displaced or swollen."
For this reason, I have never been referred to a neurologist, but yesterday I just called one myself and got an appointment for a few weeks time.
I also have small focal right sided T11 T12 disc protrusion which is minimally indenting the thecal sac. I have struggled to find much information of this online, could the be causing nerve related pain?

I also have a torn ligament in my wrist, and earlier this year I was told that both problems are due to hypermobility and that very little could be done about it. I'm not convinced though. I wonder if they could be related anyway though? I've had my wrist strapped up for over a year now and tried various treatments, none of which have worked. I'm a pianist. :(

As for not knowing who to see here in Ireland, I have been to most specialists already bar a neurologist and a surgeon. I'm running out of ideas!

Maeve
I guess I misunderstood. I thought you had pain further down in your leg. It could still be stenosis...and it may just not have progressed to the point where the nerve pain is into the leg. (Yet?)

[B]small focal right sided T11 T12 disc protrusion which is minimally indenting the thecal sac.[/B] The thecal sac is the membrane that surrounds the spinal cord and spinal nerves. A slight indentation could be putting some pressure on the spinal nerves. The word "minimally" indicates that this is probably not causing pain. It indicates that the bulge is sufficiently large that it is pressing on the sac, and thus, it must be mentioned in the report..if there were a sliding scale from 1-5, "minimal" would be a 1...but is likely not causing any pain or problems. If it enlarges and moves up the scale from minimal, then it would be more problematic.

It is important to remember that a MRI is just one piece of the diagnostic puzzle. The doctor uses the physical exam, a basic neurological exam, an oral history and description of symptoms and correlates that information to that found on the MRI to make a diagnosis. Also, there is not always a correlation between the size of a disc bulge and the amount of pain it causes. Something that appears inconsequential on the imaging can be responsible for a great deal of pain. And, conversely a patient can see a report of her spine stating disc herniations that look bad, and have no pain at all. Most of us would should signs of disc degeneration on MRI, but in only a few would this degeneration be causing pain.

I hope the neurologist will be able to figure out what is causing your pain. Be sure to ask him about the possibility of stenosis. Be sure to tell him what makes your pain greater. I found it useful to keep a pain journal, writing down when it was worse or better, what position caused it to be worse or better, what activity caused it to be worse or better, etc. In my case, I got so I couldn't stand for more than a couple minutes before the pain became intolerable. I kept a stool in the kitchen and would sit down for a few minutes, then stand back up to finish chopping the onion, or whatever I was doing. The pain would be relieved by getting off my feet.

You can show the journal to the doctor, or refer to it when talking to him/her. It will help the doctor to see patterns that will help him/her to understand what is causing your pain. Due to your age, the doctor will not be expecting to find stenosis, so I would bring it up if he doesn't mention it.

Take some time and do some research on the internet. Look for "causes of lower back pain" or something similar and see if anything describes how you are feeling. Also look at simple spinal anatomy so you will be able to understand what the doctor is telling you....so you'll know exactly where the T11-T12 disc falls on your body...you'll know what a disc protrusion is...as opposed to a disc herniation, disc rupture, etc.





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