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Back Problems Message Board

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I can help explain a couple things to you. The reason why you are more comfortable when not standing on your feet is due to the central canal stenosis.

Before going into more detail we need to clarify a couple things about the spinal nerves. Obviously I have no formal medical training and I am not going to go into a great deal of detail, but a basic understanding of the nerves is helpful when dealing with back issues.

There are 31 pairs of spinal nerves that connect with the spinal cord through nerve roots and travel to specific parts of the body. These are broken down into the cervical, thoracic, lumbar and sacral areas. Each pair of nerves innervates a particular part of the body. The cervical nerves tend to innervate the arms and upper body while the lumbar and sacral nerves innervate the lower limbs and some of the big muscles of the "core."

For example if your big toe is numb, your doctor will know to begin looking at a problem with the L4 spinal nerve. This is because each pair of nerves is responsible for innervating a particular part of the body. This (the area that is innervated) is called a dermatome and you can look for a dermatome map online to see which spinal nerves innervate which area of the body.

It is important to note that you do not need to have a single bit of back pain to have spinal nerve compression. The nerve can be compressed, irritated or "pinched" as it exits the spine and you can feel pain at any point along the nerve. For example, sometimes people have tingling in their toes first, before they have any idea they have herniated a lower lumbar disk.

[B]Multilevel lumbar degeneration, including a right paracentral disc protrusion at L5-S1, which produces mild to moderate acquired central canal stenosis, and abuts and dorsally displaces the traversing right S1 nerve root in the lateral recess.

This indicates that there are changes of a degenerative nature at several of your lumbar segments. The one that seems to be the worst is a disc located between the L5 and S1 vertebra which is protruding, and is causing mild to moderate narrowing in the central canal. This disc bulge is taking up room that is needed by the S1 nerve, which results in the S1 nerve being pushed aside (displaced) by the disc protrusion in the lateral recess (think of the lateral recess as the exiting door for the nerve as it goes from the spine out into the body).

So, these sentences indicate that there are two potential areas where that S1 nerve is being compressed and/or irritated: in the central canal due to the stenosis (narrowing) and in the lateral recess.

Often when the S1 nerve is compressed, the pain radiates down the buttock and down the back of the leg. It can result in pain in the large muscle of the calf and can run down into the outside edge of the foot, into the little toe.

I had stenosis that affected my lower lumbar nerves, including S1. Prior to having surgery (and I put it off as long as I could), I was only able to stand for about a minute or two and I could only walk a very short distance before the pain became intolerable. I was driving down my driveway to the mailbox to get my mail. I couldn't stand to take a complete shower, etc. This is stenosis. Luckily, in my case, as soon as I sat down or lay down, the pain mostly went away...but, I was turning into a hermit.

It may be that your disc protrusion is such that it can heal on its own without surgical intervention. I hope that will be the case for you.

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