Posted By Mark Cors on April 26, 1999 at 10:30:09
Hello, I am 39 years old with excrutiating feet pain and burning. I had an MRI which showed a smll bulging disc at L5/S1 level. I also had an EMG which showed nerve involvement at this level...but no peripheral neuropathy. I have heard that an EMG can only show large, not small nerve involvement with PN.
The pain feels just like they describe on all of the neuropathy pages. I have pins and needles, numbness, burning sensation, problems walking, intense pain and spasms. How can this not show up on the EMG?
Can this be from the small disc bulge? I am seeing a neurosurgeon who is stumped. I also found something called RSD. Could that be it?
They are putting me on Neurontin and Tylenol With codeine #3, but do I not need to try to find the cause of the problem and try to fix it? If this is PN can it get worse and cause even more serious problems? I can not walk any kind of distance now...even the grocery store is too much. Standing any length of time is impossible also. I am scared of eventualy being in a wheel chair.
Is it possible to have pain blocks for this area? Again, though, I wonder if blocking the pain,as in meds, or blocks, will hurt me in the long run?
Thank you for your time and consideration in this matter...I am sure that it is not easy to answer questions like this without seeing the patient.
Scared and in tremendous pain, Mark Cors
Posted By Judy on April 26, 1999 at 17:04:55
Your symtoms are exactly what I was going through in July of last year. I have yet heard anyone describe them exactly like mine, until your post. I was either going to go to the grocery store in a wheelchair or not go. I had had numbness i my feet for about 2 yrs off and on and then when it went to my calves I finally went to neuoroligist. They put me on trazadone and I was fine until the pain started in July and my GP took lumbar xrays and sent me on to an orthopedic surgeon who sent me for an MRI and bloodwork. He said it was pretty strait forward nerve compression of L4-L5 and he advised epideral injection to see if that would give me any releif....No releif after 3 different injections (but I'm glad we tried.) By then it was mid Sept and I was in such pain and so depressed (after having to cancel vacation plans twice) and doing excercies, injections and such we scheduled surgery for Oct 1. They grafted bone, put in plates and screws (dont know the technical terms) But the pain was so much better, it's not gone but I am walking about 2miles a day and am looking forward to tomorrow. I still have alot of pain, but I know I can live with it. I had to get off the codein (messed with my head) but take Advil/tylenol during the day and when the pain gets bad I take an ULTRAM. Still take Trazadone at night, and I want to try the Neurontin..I wish I had this computer earlier to talk to people that had been through this...The doctor says the nerves were damaged but I could possibly see improvement up to a year. At least I know I can live with this much pain if I have to. Still looking for improvement though and any suggestions.... Good luck to you!!!
Posted By Judy--Disc involvement--Thank you--Mark on April 26, 1999 at 19:44:32
Thank you very much for your response!! Did your doctors' say that you had a herniated disc? Mine is only minimally bulging...that is why I am so confused. Neurontin does seem to take the edge off of the pain. I too have numbness in the tops of my feet.
I too can not imagine a vacation like this. I am in too much pain. If I skip one dose....YOW!!!!
I am trying an Epidural Wednesday afternoon. Are they painful? Are your feet numb afterwards? How can you walk then?
Should I plan on laying down afterwards? I am sorry it didn't work for you. Yes, I am glad that I am trying it though.
Well....thank you again!! Good luck to your progression. I did hear that if the damage wasn't there too long....regeneration can happen for upwards of a year!!
Posted By Judy on April 27, 1999 at 11:13:58
I dont know the technical terms for what was wrong--I do remember the surgeon saying I had slight Spondi-something/Luxation??? I'm not sure but what basically it meant was L4 was laying on L5 slightly and compressing those nerves...As you can see I'm not much on Medical terminology....As far as the epideral was concerned I can say it was not all that bad..Not easy but the chances of a little relief is worth it. I didn't have any more numbness than normal after mine and I did seem to have a bit of releif on the 2nd or 3rd day..But I will pray that yours will work for you..everyone is so different..Judy...
Posted By CCF MD mdf on April 29, 1999 at 21:57:08
The symptoms of pain, numbness, burning, and tingling can result from unhappy neural tissue anywhere - it is not just from neuropathy, it can be from radiculopathy, or myelopathy.
Now let me define these terms.
Neuropathy is something wrong with nerve(s).
Radiculopathy is something wrong with nerve root(s) at the spine.
Myelopathy is something wrong with the spinal cord itself.
Note: these terms are not specific to what could be causing the problem, they just indicate where the problem is. That is in fact what your doctor(s) should be doing in making a diagnosis.
An EMG and nerve conduction study can study the nerves, and to a limited extent the nerve roots, but does little or nothing to study the spinal cord. If the EMG says there is neuropathy, that's the best test.
An MRI of the lumbosacral spine can reveal wear and tear, that is, degenerative changes such as your bulging disc. I would be very surprised if the bulging disc resulted in nerve root damage per se. However, I am NOT surprised that a relatively mild pattern of abnormality on MRI (such as bulging) can be associated with a LOT of pain (I see this all the time).
If your doctor has not already thought about it, ask him about the possibility that the problem might lie in the cervical spine. The fact that both feet are burning suggests that L5 radiculopathy is not really the prime suspect, and if your EMG/NCS did not reveal a neuropathy, then this is the next place to look. The "problems walking" and "spasms" also make me wonder about this.
If you desire a second opinion, you may call 800 223-2273 and ask for neurology appointments at extension 4-5559. Of course, this forum can't substitute for actual medical advice.
I hope this helps. CCF MD mdf.
Posted By CINDY on May 03, 1999 at 14:36:56
MARK, YOU HAVE MY COMPASION AND UNDERSTANDING. I SUFFER AS YOU DO. WHILE I AM NOT CURRENTLY IN A CHAIR, I DO USE ARM CUFF CRUTCHES WHEN I GO FOR A WALK OR GO TO THE GROCERY. YES AND LOTS OF PAIN TOO, AND MEDS DO VERY LITTLE TO HELP. I HAVE SPENT SEVERAL YEARS AT A TIME IN A CHAIR, AND I HAVE TO SAY IT DID REDUCE MY PHYSICAL SUFFERING, ALTHOUGH, UNTIL I ACCEPTED IT, THE CHAIR UPPED MY EMOOTIONAL SUFFERING. WHAT I HAVE TURNED TO THESE DAYS IS ACUPUNCTURE. I HAVE GREATLY REDUCED MY PAIN. HE GAVE ME ACUPRESSURE POINTS FOR THE PAIN. IT DOESN'T SOLVE THE PROBLEM, BUT THE LEG PAIN AND HEADACHES ARE GREATLY REDUCED. I'M GOING BACK AGAIN SOON. I RECEIVED RESULTS OF MY MRI. 3 BULGING CERVICAL DISKS AND 2 BULGING THORACIC DISKS. HOPEFULLY THE ACUPUNCURIST WILL GIVE ME MORE ACUPRESSURE POINTS. BUT HEH...TRULY.....GETTING OFF MY FEET HELPS THE MOST, AND NOT CARRYING ANYTHING. WHEN ON MY OWN, I WOULD PUT MY GROCERIES IN MY SON'S WAGON AND PULL THEM UP THE RAMP, NOT EASY, BUT NOT WEIGHT BEARING. GOOD LUCK TO YOU. I HOPE THIS MESSAGE GETS TO YOU . I SENT ANOTHER AND DO NOT SEE IT POSTED. CINDY
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