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Weird Chronic Pain
I'm having unilateral left side pain in my body. I have pain in my left palm and fingers, and then pain behind the left groin and the nerves behind the left testicles, and then left feet. These pains seem to be disconnected and not running continuous. I have seen several special neurologists, spine specialists, urologists, orthopedics and chiropractors.
None of the test shows any infections or abnormalities, other than L5-S1 disc bulge in my MRI. I can visibly feel this bulge by touching on the left side of my lower spinal. The MRI also revealed very mild curve in my spine.
These pain worsens when the temperature drops, and feels better when it is sunny and hot. The pain also worsens and radiates when I try to lie down on a flat hard surface.
Can somebody say whether L5-S1 can cause pain in the genital region and perineum? Some neurolgists are saying it can, and some other are saying it can't and only the T12 causes the genital pain. Which is true?
Can somebody shed some light on this issue and let me know what am I undergoing?
I'm suffering with this pain for nearly a year now, and it has become chronic.
None of the test shows any infections or abnormalities, other than L5-S1 disc bulge in my MRI. I can visibly feel this bulge by touching on the left side of my lower spinal. The MRI also revealed very mild curve in my spine.
These pain worsens when the temperature drops, and feels better when it is sunny and hot. The pain also worsens and radiates when I try to lie down on a flat hard surface.
Can somebody say whether L5-S1 can cause pain in the genital region and perineum? Some neurolgists are saying it can, and some other are saying it can't and only the T12 causes the genital pain. Which is true?
Can somebody shed some light on this issue and let me know what am I undergoing?
I'm suffering with this pain for nearly a year now, and it has become chronic.
Hi bostongeek,
Hope you are doing good. I read you post and wanted to check if your problem is resolved? Actually, I have started to have similar pain and was looking for answers. Please suggest if you get read this mail.
Thanks in Advance
AABYY
Hope you are doing good. I read you post and wanted to check if your problem is resolved? Actually, I have started to have similar pain and was looking for answers. Please suggest if you get read this mail.
Thanks in Advance
AABYY
Thank you Tuck. The Spinal Stenosis is in Lumbar region. It was visible in ordinary x-ray, and my orthopedic asked me to wear a belt for 6 months continuously to fix it. Though I purchased the belt for my back, I did not wear it seriously. Can you please tell me whether wearing such belts help keep the spine intact and bring back to their original shape?
My orthopedic also referred me to the neurosurgeon, who in the MRI did notice the spinal stenosis, telling me it is mild and there is no need of surgery for my age.
Now the pain is moderate on my back, left buttocks and left groin now, and the pain is mild in left feet. I do see numbness sometimes in my groin. Interestingly there is no pain in my left palm and fingers.
My orthopedic also referred me to the neurosurgeon, who in the MRI did notice the spinal stenosis, telling me it is mild and there is no need of surgery for my age.
Now the pain is moderate on my back, left buttocks and left groin now, and the pain is mild in left feet. I do see numbness sometimes in my groin. Interestingly there is no pain in my left palm and fingers.
Thanks for the update. It's good to hear from you. I've been wondering how you were doing. Sorry to hear about your returning and increased pain! My heart truly goes out to you!
You left out an important diagnosis in your initial posts. What type of Spinal Stenosis do you have, Lumbar or Cervical Spinal Stenosis? I am assuming, based on your pain that you have Lumbar Stenosis which accounts for 75% of all Spinal Stenosis.
When a person has lumbar stenosis it means the spine has narrowed and to one degree or another this narrowing causes compression of the spinal nerve roots. In Lumbar Stenosis this compression effects the nerves (roots) in the lower back. This can produce multiple symptoms that include sciatica, often weakness, tingling and sometimes numbness. These symptoms can radiate from the lumbar (low back), into the buttocks and legs, on occasion even into the groin and/or testes. Symptoms commonly increase with activity. However even though activity produces or increases the pain it is extremely important that one keeps moving.
In my opinion this explains many of your painful symptoms. Spinal Stenosis is often associated with degeneration of the spine..... and can be more prominent in ppl with scoliosis.
In mild to moderate stenosis one is usually encouraged to exercise, take NSAIDS, sometimes steroid injections help ease pain and often activity modification is implemented. If the stenosis becomes more then mild to moderate or pain becomes unbearable the next or last approach is usually surgical. A skilled neurosurgeon opens the lumen of the spine.
Again surgery is the last resort and saved only when other approaches/treatments are not effective. Surprisingly it generally "cures" the condition stopping the compression of the nerve roots. My mother had this surgery around the age of 63-64 with excellent results. However it didn't stop the degeneration of her spine and she is again experiencing low lumbar pain but not with many of the symptoms that she had with the stenosis.
I wish you well and hope you'll continue to keep us updated. I'm wondering if you have consulted a Neurosurgeon? I am not suggesting surgery but you may obtain better answers with a consult from a true expert in stenosis.
Peace,
~Tuck
You left out an important diagnosis in your initial posts. What type of Spinal Stenosis do you have, Lumbar or Cervical Spinal Stenosis? I am assuming, based on your pain that you have Lumbar Stenosis which accounts for 75% of all Spinal Stenosis.
When a person has lumbar stenosis it means the spine has narrowed and to one degree or another this narrowing causes compression of the spinal nerve roots. In Lumbar Stenosis this compression effects the nerves (roots) in the lower back. This can produce multiple symptoms that include sciatica, often weakness, tingling and sometimes numbness. These symptoms can radiate from the lumbar (low back), into the buttocks and legs, on occasion even into the groin and/or testes. Symptoms commonly increase with activity. However even though activity produces or increases the pain it is extremely important that one keeps moving.
In my opinion this explains many of your painful symptoms. Spinal Stenosis is often associated with degeneration of the spine..... and can be more prominent in ppl with scoliosis.
In mild to moderate stenosis one is usually encouraged to exercise, take NSAIDS, sometimes steroid injections help ease pain and often activity modification is implemented. If the stenosis becomes more then mild to moderate or pain becomes unbearable the next or last approach is usually surgical. A skilled neurosurgeon opens the lumen of the spine.
Again surgery is the last resort and saved only when other approaches/treatments are not effective. Surprisingly it generally "cures" the condition stopping the compression of the nerve roots. My mother had this surgery around the age of 63-64 with excellent results. However it didn't stop the degeneration of her spine and she is again experiencing low lumbar pain but not with many of the symptoms that she had with the stenosis.
I wish you well and hope you'll continue to keep us updated. I'm wondering if you have consulted a Neurosurgeon? I am not suggesting surgery but you may obtain better answers with a consult from a true expert in stenosis.
Peace,
~Tuck
Tuck, NurseAudrea,
Here is an update. After several months of rest and minimal activities, I tried some brisk walking in treadmill for approximately for 30-40 minutes for a week now. The pain returned severely on my left back (exactly on L5-S1) accompanied by pain in left feet, left knee and left groin.
I forgot to tell you - my MRI revealed narrowed spinal columns (spinal stenosis). Can this be the cause of my pains?
I am really unable to distinguish clearly the type of pain I have in the nerves behind my left testicle. Sometimes it appears as a constant dull pain throughout day and night, and sometimes it appears as a pain due to inflammation. Can referred pains mimic like pain due to inflammation?
Here is an update. After several months of rest and minimal activities, I tried some brisk walking in treadmill for approximately for 30-40 minutes for a week now. The pain returned severely on my left back (exactly on L5-S1) accompanied by pain in left feet, left knee and left groin.
I forgot to tell you - my MRI revealed narrowed spinal columns (spinal stenosis). Can this be the cause of my pains?
I am really unable to distinguish clearly the type of pain I have in the nerves behind my left testicle. Sometimes it appears as a constant dull pain throughout day and night, and sometimes it appears as a pain due to inflammation. Can referred pains mimic like pain due to inflammation?
Yes, took MRI of spine and brain, and it is normal. My neurologist ruled out any demyelination, MS, etc.
Pain that presents on one side of the body can indicate MS. Has anyone taken an MRI of your cervical spine and brain>
Well I am glad Tuck answered the question for you. She is correct. Surgery should be the very last option. Too many people rush into it and then have complications and sometimes more pain than what they went in with. Surgery can do wonders, but at the same time, it too has it's risks.
Also wanted to mention, I have a slight curve also (Scoliosis) very mild, and it never caused me any pain. If you get an EMG they will be able to tell if you have a nerve entrapment causing the pain in your legs and perineum. That would be called a Radiculopathy. I am also in my mid 30's and have been dealing with these kind of issues since I was 22. I understand how it feels to have these kind of problems before the prime of your life.
Audrea
Also wanted to mention, I have a slight curve also (Scoliosis) very mild, and it never caused me any pain. If you get an EMG they will be able to tell if you have a nerve entrapment causing the pain in your legs and perineum. That would be called a Radiculopathy. I am also in my mid 30's and have been dealing with these kind of issues since I was 22. I understand how it feels to have these kind of problems before the prime of your life.
Audrea
Thanks Tuck. Forgot to mention, I'm in my mid 30s and not that old. And yes you are right, chronic pain is life changing. I feel everything in shambles now. I will try checking with my doctor again on EMG.
Rheumatologists treat more then arthritis but I van understand your reluctance to consult with one. They may not have answers for you either.
In simple terms, without going into medical explanation an EMG measures the electrical impulses that the nerves produce. The test can determine such things as nerve entrapment.
A mild scoliosis should not produce your symptoms. Dermatome patterns from the L5-S1 do innervate the Perineum .... again in more simple terms the disc bulge can produce your symptoms... If that is the causation is something that only your physicians can determine. It's my opinion it's very likely. As said above a bulging disc often heals with conservative measures and time. And yes resting on your back will often place pressure on these nerves and increase your pain.
However it's been a year and you may benefit from additional treatment. Surgery should be your very last resort.... as any goods surgeon will tell you. A PMP may offer additional treatment and in my opinion it's worth a try. What do you have to lose at this point. You sound like this condition is terribly uncomfortable for you.
My heart goes out to you.... Chronic Pain can be life changing.
In simple terms, without going into medical explanation an EMG measures the electrical impulses that the nerves produce. The test can determine such things as nerve entrapment.
A mild scoliosis should not produce your symptoms. Dermatome patterns from the L5-S1 do innervate the Perineum .... again in more simple terms the disc bulge can produce your symptoms... If that is the causation is something that only your physicians can determine. It's my opinion it's very likely. As said above a bulging disc often heals with conservative measures and time. And yes resting on your back will often place pressure on these nerves and increase your pain.
However it's been a year and you may benefit from additional treatment. Surgery should be your very last resort.... as any goods surgeon will tell you. A PMP may offer additional treatment and in my opinion it's worth a try. What do you have to lose at this point. You sound like this condition is terribly uncomfortable for you.
My heart goes out to you.... Chronic Pain can be life changing.
nurseaudrea,
I took MRI 2 times on my spine and brain, the neurologists had told me EMG is not required. Can you tell me how EMG is different from MRI?
The pain is dull in left feet and left hand with some numbness, but the pain increases whenever there is drop in temperature.
Though I have the pain and bulge in the disc, the pain is not only in the perineum, it is in the complex place where the perineum meets the back of the testicles and where the penis originates. Then the pain continues on the left inguinal (groin) region, and then goes to leg. I did consulted urologists who clearly told it doesn't seem to be a urological issue after conducting several tests.
I took MRI 2 times on my spine and brain, the neurologists had told me EMG is not required. Can you tell me how EMG is different from MRI?
The pain is dull in left feet and left hand with some numbness, but the pain increases whenever there is drop in temperature.
Though I have the pain and bulge in the disc, the pain is not only in the perineum, it is in the complex place where the perineum meets the back of the testicles and where the penis originates. Then the pain continues on the left inguinal (groin) region, and then goes to leg. I did consulted urologists who clearly told it doesn't seem to be a urological issue after conducting several tests.
Tuck, I had seen couple of big specialists in my city, one is specialized in neurology and one spine specialist. The neurologist was going with the books saying only the T12 can cause pain radiating into the groin and to the genitals, and asking me to consult a doctor who is specialized in pain management. However I'm bit skeptical.
I haven't consulted a rheumatologist yet. I don't have arthritis, the report came back negative.
The doctors say it can't be any infection as well, which can't continue with a constant pain like this, rather it will manifest. I don't see any manifestation of pain in this one year.
Can disc bulge cause disconnected pain as I mentioned. The pain is not running continuously for me. Though while sleeping on supine position, sometimes I can feel the pain continuously running from my left back, left groin all the way down to my left toes and feet.
It is really weird to see the pain in my left palm and fingers. I do see my MRI showing my spine with a very slight curve, though the report din't have any observation on it, can this be scoliosis which is causing this pain?
I haven't consulted a rheumatologist yet. I don't have arthritis, the report came back negative.
The doctors say it can't be any infection as well, which can't continue with a constant pain like this, rather it will manifest. I don't see any manifestation of pain in this one year.
Can disc bulge cause disconnected pain as I mentioned. The pain is not running continuously for me. Though while sleeping on supine position, sometimes I can feel the pain continuously running from my left back, left groin all the way down to my left toes and feet.
It is really weird to see the pain in my left palm and fingers. I do see my MRI showing my spine with a very slight curve, though the report din't have any observation on it, can this be scoliosis which is causing this pain?
If you look up dermatome patterns on the internet you will see how the nerve patterns run. If I remember correctly I believe the S1 and below can innervate the Perineum. And I also wanted to add that laying supine adds extra pressure on these nerves and it makes sense that you would experience more pain in that position. This also happens to me. I have a nerve in my leg that goes numb when I lay supine everytime. I have to put a pillow under my knees so it does not happen or lay on my side.
Have you had an EMG to see if you have a radiculopathy from the disc bulge? Many times a bulge will heal itself and many people have them and do not even know it. When it herniates and the material leaks out is when it can become much more painful and could require surgery to fix. What other symptoms are you having? What are the qualities of your pain? Is it shooting, dull, aching, stabbing, electric, sharp? If you can describle what type of pain it is your doctor would be much more able to diagnose what is wrong and may even order different tests based on symptomatology.
Hope that helps.
Audrea.
Have you had an EMG to see if you have a radiculopathy from the disc bulge? Many times a bulge will heal itself and many people have them and do not even know it. When it herniates and the material leaks out is when it can become much more painful and could require surgery to fix. What other symptoms are you having? What are the qualities of your pain? Is it shooting, dull, aching, stabbing, electric, sharp? If you can describle what type of pain it is your doctor would be much more able to diagnose what is wrong and may even order different tests based on symptomatology.
Hope that helps.
Audrea.
Hello and Welcome o the Pain Management Forum. As you know there are no physicians or "Experts" in our community.
I am so sorry to hear about your continued undiagnosed chronic pain. We can relate. According to what I have read and my understanding it is not uncommon for pain to radiate from an abnormality in the L5--S1 into the genital and perineum region.
The L5-S1 is the most common area of the spine to suffer injury or deterioration. It's the area that receives the most impact/stress, even with normal activity. I can't explain the opinion of the physicians that claim is will not cause radiculopathy. They may feel that your condition is not extreme enough to produce these symptoms. I'm guessing here.
The worsening of symptoms you describe when you are supine or the weather changes are typical of structural issues of the spine. Resting supine often produces increased pain when the low spine is affected.
I always suggest second or even third opinions. Sometimes the problem with that is the physicians don't agree... and then you are left to determine which one is correct. I assume that is the position you now find yourself facing.
Have you consulted a PMP or a rheumatologist?
Sometimes you have to just decide which physician we are most comfortable with, which one makes the most sense and offers acceptable solutions to our pain. I hope one of the specialist you have consulted are associated with a large teaching facility. If not I would make an appt for one final consult with a "Big Dog" specialist.
Another important factor, in my opinion, it that your pain is being treated. You deserve to be comfortable regardless of the reason for your pain. Please feel free to offer additional information and do keep in touch. I will look forward to hearing from you soon.
I wish you the very best.
Take Care,
~Tuck
I am so sorry to hear about your continued undiagnosed chronic pain. We can relate. According to what I have read and my understanding it is not uncommon for pain to radiate from an abnormality in the L5--S1 into the genital and perineum region.
The L5-S1 is the most common area of the spine to suffer injury or deterioration. It's the area that receives the most impact/stress, even with normal activity. I can't explain the opinion of the physicians that claim is will not cause radiculopathy. They may feel that your condition is not extreme enough to produce these symptoms. I'm guessing here.
The worsening of symptoms you describe when you are supine or the weather changes are typical of structural issues of the spine. Resting supine often produces increased pain when the low spine is affected.
I always suggest second or even third opinions. Sometimes the problem with that is the physicians don't agree... and then you are left to determine which one is correct. I assume that is the position you now find yourself facing.
Have you consulted a PMP or a rheumatologist?
Sometimes you have to just decide which physician we are most comfortable with, which one makes the most sense and offers acceptable solutions to our pain. I hope one of the specialist you have consulted are associated with a large teaching facility. If not I would make an appt for one final consult with a "Big Dog" specialist.
Another important factor, in my opinion, it that your pain is being treated. You deserve to be comfortable regardless of the reason for your pain. Please feel free to offer additional information and do keep in touch. I will look forward to hearing from you soon.
I wish you the very best.
Take Care,
~Tuck
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