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Back Problems Message Board


Back Problems Board Index


I have been lurking for a while and am quite depressed about this whole thing. I used to be a very active person. Runner long distance road biker heated yoga downhill skier. I have had constant 24 hours per day lower back sacral pain. I have seen chiropractors, DO, board certified psychiatrist and rheumatology. No has a diagnosis for me. Had 4 facet blocks lumbar sacral with no help. Spine MD then asked ME where I wanted to try next. ESI or sacral injection to find the source of my pain. I did not go back. I have also gone to a myofascial pain clinic and he feels I need pelvic floor PT. Called them 4 month wait. The pain is an intense burning in my sacrum and the last 4 weeks has moved to my privates (vaginal area). I cannot sit at all. Pain so bad this week can barely sleep.
MRI done June 2013 diffuse lumbar spondylosis, left foraminal disk protrusion at l4-l5 touching the l4 nerve root. Lumbar facet arthritis.
Pelvic ct sacral iliac widening.
Oh did PT for 10 sessions with no help. On Celebrex now and barely touches this pain.
I'm trying to get into a pain clinic but if they cannot help I don't know how I will live the rest of my life in this pain. It came out of the no where. sorry for the post....
Was this from your MRI?

[B]MRI done June 2013 -- diffuse lumbar spondylosis, left foraminal disk protrusion at l4-l5 touching the l4 nerve root. Lumbar facet arthritis. [/B]
I would imagine that whoever told you your discs were "fine" was speaking generally and not perfectly factually. He may have meant that the discs were not bad enough to require specific treatment, but the MRI indicates they are not perfectly healthy.

Lumbar Spondylosis is a generalized term that means degeneration of the spine. It often goes hand in hand with the aging process (and the human spine begins its aging process in our 20s). It can include facet arthritis, disc disease and degeneration and stenosis. The report indicates you have this disc disease, facet joint arthritis and "left foraminal disk protrusion at l4-l5 touching the l4 nerve root."" There is a protruding disc at L4-L5 that is coming out beyond the disc space and is pushing into the left foraminal opening, and coming in contact with the L4 nerve The foramen are openings located at each vertebral level through which the spinal nerves exit the spine out to the limbs and rest of body.

So we know from this report that there is a specific problem at L4-L5, pushing into the L4 nerve, and more generalized deterioration throughout the rest of the lumbar spine. We just don't know to what degree as the report doesn't say.

Generally when a spinal nerve is in any way impacted or irritated, it tends to cause pain, numbness or tingling that can occur any place along the length of that particular spinal nerve. For example, the dermatome for the L4 nerve comes out the sciatic notch and runs down the lateral side of the thigh, wraps around the front of the lower thigh and across the knee cap and down the inside of the thigh and into the big toe. You could feel pain or other weird sensations along this route.

If you have done lots of cycling through the years, I would think you might have a combination of this L4 nerve problem and then something like the pudendal nerve entrapment or maybe it's just an irritation. You may be able to resolve the pain with a PT who is really experienced in pelvic floor and pudendal nerve, levator ani, etc. You'll want to keep an eye on that L4 problem though because it may continue to deteriorate as you age.





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