SEVERE LOWER BACK PAIN AND TINGLING DOWN LEG

[melbrock]

I HAVE SEVERE LOWER BACK PAIN AND TINGINLING DOWN MY LEFT LEG FOR A MONTH NOW HAD MRI SHOWS DEGENERATIVE DISC DISEASE L2-3 TO L-4-5 L5 IS TRANSITIONAL. THRE IS PROMINENCE OF THE LUMBAR LORDOSIS. SAW A NEUROLOGIST YESTERDAY AN DHE SAID SOMETING ABOUT FACET JOINTS AND INFLAMATION.  NOT SURE WHAT IS WRONG WITH MY BACK AN DWHAT CAN I DO ABOUT IT. HE IS SUGGESTING POSSIBLY SHOTS AND HAVE EMG SCHEDULED

[melbrock]

i am in excrutiating pain and i apologize to this community . i would like an answer in simple english lay english pretend you are talking to a child. i have mental illenss and need to know what is going on with my back. i cannot sleep or sit or move. please respond to my question

[melbrock]

i apologize. i am in excrutiaing pain and i have severe mental disorders and need things explained in simple terms.  the mri did not say anything about a disc problem only what i said in my question. the neurologist said i think that it had something to do with my transitional vertebrae and inflammation in the facet joint and possible injections., the whole thing has me terrified.

please explain this in simple english

the mri impression reads prominence of the lubar lordosis and mild degenerative disc disease from l2-3 to l4-5 with transitional body of l5. MInimal retrolishesis of l4 on l5 with a bulging disc not compromising the roots of the sac. there is no disc herniation or stenosis. what does this mean in simple english. thank you for your reponse

[Christopher R Newey, DO]

Thanks for using the forum. I am happy to address your questions, and my answer will be based on the information you provided here. Please make sure you recognize that this forum is for educational purposes only, and it does not substitute for a formal office visit with a doctor.

Without the ability to examine and obtain a history, I can not tell you what the exact cause of the symptoms is. However I will try to provide you with some useful information.

The description you provide is a radiculopathy (i.e., nerve root compression which will be described later). The exact location cannot be commented on based on the description (i.e., is it an L4/5 problem, L2/3 problem, etc). A specific pattern of sensory changes and perhaps motor changes is usually presented in the various radiculopathies.

The spinal cord is encased by bones called vertebra. Nerves come off the spinal cord and exit through holes formed between the vertebra. If a nerve is compressed as it exits through these holes, particularly in an area called the nerve root, a radiculopathy results. The compression could be due to arthritis of the spine or due to a herniated disc or other lesions. (Did the MRI mention anything about a herniated disc?) The symptoms include pain at the level of the problem (i.e. back) and pain that may radiate down the leg (depending on where the problem is – L2/3, L4/5, L5/S1, etc). In more advanced cases, muscle weakness or sensory symptoms such as tingling or numbness may occur. A radiculopathy is often diagnosed based on history, physical examination, and MRI of the spine. An EMG/NCS will allow your physician to understand better the extent of nerve damage and source of nerve damage causing your symptoms.

If the pain does not spontaneously resolve, a minority of patients may require surgery.  Indications for surgery, though, can be emergent. These include muscle weakness, loss of bowel or bladder control, loss of sensation particularly in the pelvis, and severe and progressive pain. (Please discuss this with your physician if any of these symptoms are present). However, if none of the emergent symptoms are present, nonsurgical measures should be tried first. These include physical therapy, NSAIDs, etc. Additionally, patients may be referred to a pain specialist. These physicians are usually trained anesthesiologists or physiatrists who perform various types of injections to relieve the pain. The injections are performed in a series. Your neurologist is likely wanting you to have what is called facet injections. These are injections in the back at the location near where the nerves exit the spinal cord.

I agree that you should follow up to have the EMG/NCS. If your pain is severe enough, the facet injections are an option. I would also recommend that you obtain physical therapy. Continue following up with your neurologist regarding your symptoms.  

Thank you for this opportunity to answer your questions, I hope you find the information I have provided useful, good luck.