Re: Herniated Disc

Posted By CCF MD mdf on March 11, 1998 at 13:00:53:

In Reply to: Herniated Disc posted by Tina on March 06, 1998 at 08:53:51:







: Im in general good health except for a back problem.I was diagnosis with this problem in Feb 93. I've suffer two recurrent injuries at the same site. It should be note that inbetween these injuries I was pain free. At first it was thought I had a nuroma at the L4,L5 region because of a foot drop. The M.R.I. certified that it was a herniated disc. Presently I'm off work since my last injury Nov 97. When this last incident happened it felt as if when lifting my shoulder's I would feel relief in the lumbar area.Since my last incident in Feb 95 I have notice a curvature in my lumbar sacral which causes my trunk to fall forward. My S/S are similar to my previous accident. I cannot drive for more than 5 to 10 mins at the time and cannot remain seated for more than 1/2 hr.without feeling increase malaise. I get heavyness in my right thigh and electrical activity in my back radiating mainly at the right tigh and at times to the leg. However there is no burning sensation with this incident but an occassional foot drop for the first month and a half, it now gone.
Treatments to date consist of 34 physio sessions which consisted maily of heat and U/S and some laser which proved ineffective with time. My treatment three wks ago increaed my S/S so I stopped them. The extension exercises were also stopped with the P.T.'s advise and has recommended that I never do these again, it could apparently be the cause of my curvature in the back. I use to do a series of flection and extensions since my last accident. I now walk approx. 1/2 hr per day.
I also have a strong history of osteoporosis in the family. My bone densisty two yrs ago was 80 yrs old. I had than started Fosomax for 6 mos. and stopped with the recommendation of an endocrinologist and now taking H.R.T. along with calcium and Vit D for the past 1 1/2 yrs.
Next wk I'm seeing an orthopedict who specialist in back problems.This is what I need to know.
1  Why are my S/S persisting in my thigh and note returning to my back and finally disappear as previous occassions.
2  Could it be possible the curvature, falling trunk and degenerating vertebracs ( already diagnosed) at this site are a cause of my persisting S/S?? What can I expect??
3  Are there blood works and more test I should ask for?? Vit B12? etc?
4  What does this electrical hyperactivity mean??
5  I have ask my G.P. for a repaet of my bone densisty(last one 1 yrs ago) but he tells me that it has nothing to do with this incident.But I'm not convinced, should I ask the specialist for a follow up???
I feel lost with what to expect, I seem to have lost control of my back and how to best care for it. I've always been so careful but yet this is the third incident.I'm 48 yrs and I was hoping to be able to travel as I would be retiring in about 5 yrs. Is it possible yto return to pain free as in the past incidents or is this only a dream. This incient scares me with regards to my future plans.
Thanks you
Tina
=
Your symptoms are characteristic of a lumbosacral radiculopathy. That is, there is injury or irritation of a nerve root as it exits the spinal cord through the bony structures of the spine.
Typically, pain radiates from the back along the leg, sometimes all the way to the ankle or foot. The specific pattern depends on which nerve root is affected (L4, L5, S1, etc).
Painful symptoms may come and go. This is usually because the space around the nerve root varies in size depending on postural changes such as flexion, extension, torsion, and so forth. After all, that space is not a simple hole in a (vertebra) bone, but rather is made from grooves in the vertebrae above and below. The condition of the disk between the vertebrae affects how much space there is. Further, if disk debris gets lodged into that "hole" (neural foramen) then the root has even less room to work with and is more sensitive to subtle changes in posture or position.
With physical therapy and judicious use of anti-inflammatory medications, the amount of space allowed for the nerve root can increase (reduction of swelling, etc). For this reason, many people experience gradual relief of symptoms. Of course, with re-injury, you are more susceptible at that spot to recurrence of painful symptoms.
I am not certain how to interpret the bone density information.
The electrical sensation is related to the compression and irritation of the nerve root - that is commonly the sensation produced when the brain interprets the signals it gets.
Hope this helps. CCF MD mdf.