Posted By CCF Neuro MD on October 15, 1997 at 15:42:10:
In Reply to: lower back pain,back and legs burning posted by Garry Paul on September 28, 1997 at 22:23:53:
: I have a lower back problem that seems to be atypical and I am looking for some guidance. In October of 1996 I started noticing soreness in the area where the hamstrings attach near the perineal area brought on by sitting. The first sign was during a cross-country trip the day after 3 volleyball games. Over the past year it has progressed so that any sitting causes discomfort in the lower back (near L4-L5-S1), the base of the ishial tuberosity and the hamstring attachment area. At this point standing in one place causes lower back discomfort also. Interestingly, I have no problem when walking. As my condition progressed I was getting burning radiating up my back and down the back of both legs. When I lay on my back the burning starts up my back. When I lay on either side, my hips get sore and burning occurs up my back. When I sit or stand in one place, burning occurs down the back of both legs. The burning seems to originate ultimately in the lower lumbar-upper sacral area. I have taken a variety of anti-inflammatory drugs which all seem to help limit the burning as long as I severely limit my activities. I have had xrays, a bone scan, an EMR, a muscle test, a pelvic MRI, and prostate biopsy and all were unremarkable. I had a lower back MRI which shows some narrowing between L4-L5 and L5-S1and some disk bulging. I have been told this was normal degeneration for my age (53) but that sometimes there are those that have symptoms with relatively mild degeneration and maybe I am one of them. I have had 2 steroid injections. The first he called a sacral bath and the other into the tailbone possibly to deal with the hamstring entry points and ishial tuberosity soreness. The first injection may have had some temporary relief. The second had none. I also have extremely tight hamstrings and have had physiotherapy to stretch my hamstrings and groin muscles, to strengthem my lower back and stomach muscles and stabliization exercises to instill proper walking and bending postures. I feel that the exercises have served to aggravate my problem especially the knee to chest exercises that seem to stretch the back. This has increased my lower back discomfort while standing and sitting and has accelerated my burning. A hot tub or heating pad masks my problems for awhile but the burning is driving me crazy. It is now being recommended that I have a discogram with a possible eye toward surgery. Is this reasonable? What are my alternatives.? Doesn't the Cleveland Clinic have a non-invasive procedure that puts you in a device that allows negative disc pressure allowing them to heal? One final point - in the past 5 months I have lost 11 pounds from 174 to 163 lbs. This may be because I move around a lot as this is when I am most comfortable and because I now stay home mostly and eat 3 fairly healthy meals. Would a small tumor show up in MRI's in March of 1997 - 5 1/2 months after my problem started but before it progressed to today's severity?
Dear Mr. Paul,
Hello, well it sounds as though you have thoroughly described a frustrating time!
I hope that this settles down soon. To answer some of your questions....
We do have a Spine Center here at the Cleveland Clinic and it is impossible for me to tell you what they would recommend without seeing you and examining you first. The alternatives to a discectomy are conservative treatment
such as that which you have had- PT, antiinflammatory medications, muscle relaxors and waiting. A small tumor would most probably show up on the MRI
as this gives a nice image of the bones and the spinal cord but it is not
100%, sometimes things are more obvious after the symptoms have been present for a while.
Some medications such as antidepressants work on nerve disconfort and may be an option ofr you, you should ask you doctor about this.
Well good luck!
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