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Neurology and Neurosurgery Forum have been answered by doctors from The Cleveland Clinic Foundation.
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Subject: Re: butt & leg pain Siatica I've been in pain since 4/23/98 I have had 3 epidurals, 1 facet block, all did nothing to help with the pain. MRI: results 5/19/98 Lumbar Myelogram results: 9/8/98 L4-5 Mild diffuse ventral impression extending apporx. 4 mm. posterior to the vertebral body margin. L5-S1 There is a central fairly focal protrusion which indents the central aspect of the sac but is mostly involving the epidural fat. My question is this, I've been through P/T since late April for pain management and am now using a TENs unit, which only helps a little. Since the last test of the myelogram my doctor says that he feels my pain is caused by soft tissue. What I want to know is how this is possable, I can feel as though a nerve is being pinched some how. I still have great pain in my left butt and leg, going all the way down to my foot. At times, my foot feels as if it is on fire. I can only walk for a short period before the pain get so intense that I must lay down, and standing for more than 15 minutes is even worse. COULD THIS DOCTOR HAVE MISSED SOMETHING!!!!!!! Thank you
Thanks for your question. The symptoms described in your message are fairly typical of "spinal claudication". Although the exact mechanism of action is still not well established, spinal claudication is described as a positional dependent pain/discomfort in the lower-back/gluteal region that may or may not propagate further down the legs. Many times, the simple act of standing up (without moving/walking around) triggers the symptoms. Therefore, patients often complain about not being able to stand up for a prolonged period of time - sometimes even brushing the teeth in front of the basin is enough to trigger the pain. Spinal claudication most often is associated with stenosis of the spinal canal (such as your case). You did not mention an Electromyography (EMG) in your posting. It is a test that would help evaluate objectively any degree of nerve damage either intra-canal, or as the nerves exit the vertebral column. If you would like a second opinion, I suggest a consultation/referral to If you live in the Cleveland area, the Department of Neurology at the Cleveland If you wish an appointment at the Department of Neurology at the Cleveland I hope this information is helpful. Best of luck. This information is provided for general medical education purposes only. | |
