Those with lumbar issues ~ back symptoms vs MS symptoms?

[6-paq]

I need some input with those of you that have lumbar back problems as well as possible, or definite MS.    I'm having trouble determining if my symptoms are due to my back or MS stuff.   Problems areas are moderate central canal stenosis in L4-L5 and mild stenosis in L5-S1.  Also SI joint instability and hip arthritis.   I am currently un-Dx'd.

I'm assuming if I get certain symptoms when I sit and they worsen with prolonged sitting, that would be due to my back issues, especially if tends to follow a dermatome?   That happens on my right side/leg.  Outer part of leg gets an achy "cold" feeling that extends down the side of my calf and around the bottom outside of the foot and heel.

My left side gets different parasthesias that occur more when I tend to walk for exercise or do certain exercises.  More of a tingling that also follow some of a dermatome, but also are in other areas from the right side.   The tingling has been in the same spots.  

I also have bilateral parathesias in the bottom of my foot and the bottom of the middle three toes that occur when walking or standing.   I do have to say that my leg/foot issues started off as bilateral and have evolved to a difference between left and right over time.  I think that I've read it here that MS starts typically starts off asymmetrical and evolves to bilateral over time????

My physical therapist at the time said that since the parasthesias followed a "line", and if she was able to replicate the sensation when she worked on a disc area (which she did), that indicated more of a disc issue.   She actually did wonders for me, but I haven't seen her since January.

Neuro said my back issue, as shown in my l-spine MRI, have nothing to so with what is going on in my legs and feet, and only ordered PT when I flat out asked him for it.  

I'm bringing this up now as I have started an exercise routine within the past week and have been much more physical than I have in the past 1.5 years.   The parasthesias have just started to worsen.  Most specifically is the right side stuff which is beginning to bug me when driving.  

I know that you can have a pseudo-exacerbation and a worsening of symptoms when over-heated, but how can you tell what is from a disc issue vs. MS?  

I have a follow-up appt with my neuro on the 16th.  I really don't expect anything from him regarding my disc stuff, as he doesn't think it's a source of my parathesias.  I'm wondering if he's right?    

I read so many of you have similar symptoms, but then I read about those with back issues (and no MS) that have the same symptoms.    How do you sort this all out?   Should I see someone else about my back, just to rule it out as a source of my leg/foot parathesias, which would then lead to an MS cause?

[young at heart]

PAT,

ITS QUITE DIFFICULT FIGURING OUT WHAT IS CAUSING WHAT.

I HAVE MS AND LUMBAR ADHESIVE ARACHNOIDITIDS,IT HAS BEEN TOUGH FOR ME TO FIGURE WHATS WHAT.

YOUR NEURO SHOULD BEABLE TO TELL YOU WHAT NERVES IN YOUR BACK EFFECT WHAT PARTS OF YOUR BODY,

I HAVE CHRONIC SPASCTICITY, A COMBINATION OF BOTH.

TALK WITH YOUR NEURO AND ASK HIM TO EXPLAIN THIS TO YOU

T-LYNN

[6-paq]

Thanks jensequitur...  Yeah, I'm avoiding back surgery like the plague!!   That's why I've been stalling about seeing his neurosurgeon.  :-)

[jensequitur]

With your documented stenosis and disc slippage, I would start treating your back for the most obvious symptoms.  With MS, pain is caused by either a misfiring nerve, or by spasming muscles.  So whether the muscle is spasming from MS, or because of spinal compression, it can be treated by applying heat, cold, and anti-inflammatories like naproxen sodium.  I would avoid back surgery, as I hear that once air hits the bones of the spine, spurs start developing.

[6-paq]

Thanks for your response.   That is weird about your experiences, especially the swelling, soreness and irritation to touch.  I haven't experienced any of that.  I wonder what would cause your swelling?

Yeah, the symptoms are the same and are hard to distinguish, which occurs with a lot of differing MS symptoms, and why I'm so baffled.    

The thing is, there are treatments, etc. that can be done for disc slippage or stenosis like injections, or even surgery if it's bad enough (thankfully, mine isn't). For MS, there isn't.    

I just want to be sure it's more of a back thing vs. an MS thing, and it's bugging me that I can't get a handle on the difference.  I have 2 differing opinions.  

If it is a back issue, then let's look at getting some treatment.  If it's MS, then that's one more symptom that can get me closer to a diagnosis.   DH is pushing me to go to his neurosurgeon, but I'm not up to surgery at this point.....

[jensequitur]

I first started having back problems about seven years ago.  My left leg swelled up, and was exceedingly sore.  My back was also quite painful in the upper lumbar region.

Through self-diagnosis, I figured it was the sciatic nerve, and started icing my back at the spot where it hurt the worst.  I also tried to either stand or lay down, as the sitting was causing a problem for my back.  The leg would hurt to the touch, and tingle, too.

Eventually things calmed down and the leg swelling diminished.  I noticed it was a little bigger than my right, but thought nothing of it, as I figured it was still a little swollen.

Fast forward to seven years later, and my right leg is noticeably smaller than my left.  Along with the weird tingling and numbness in my pelvic region, my guess is that I've got some sort of lesion in my spine that caused the problems to begin with.

The thing is - whether it's a slipped disc, spinal stenosis, or a lesion, the symptoms are the same.

[6-paq]

I'm sorry you've been through so much with your back problems and are in such pain.   I do hope your new neuro will be able to sort stuff out and get you some definite answers!!

I think I'll ask for more PT for my back at my next neuro appt.  I'm in the middle of PT for TMJ at the moment an am getting close to my yearly limit for PT (I've had it for dizziness, back and TMJ all this year).

When I first started with her, I was in such bad shape.  My right shoulder was much higher, my one hip was higher and more forward than the other...

I never knew about the SI joint until my therapist said that mine was very unstable. I don't know how many times she had to realign me.  There is a wonderful sports med doc where she practices that has realigned me as well.  I may go back to him if my neuro won't help with the back.

I think gaining 30 pounds on Lexapro (which I'm tapering off) and increasing my activity isn't helping.  My therapist said that my discs are "slippy" and that I can't do certain things until strengthened.

She said that my symptoms DO match my MRI and what she's found on exam (mild scoliosis, si joint, arthritis).  She is able to replicate my symptoms.  

So, I don't know what to think.  She has 2 PHDs and has been doing therapy for over 30 years.  My neuro has been practicing neurology (and has many MS patients) for almost 30 years.   This is what is so confusing for me.  I'm trying to self-diagnose.

I was getting tingling down the inner front of the left thigh. It only happens when I walk fast.   My therapist took me out around the block until it started to tingle.  She then started working on L2/L3 and the tingling showed up.   She said that you can get some "affects" 2 discs up from your problem disc, so the tingling in that area would fit.  The femoral stretch she showed me does work for those symptoms.

I really think the stuff with the right leg is back related.  The left leg stuff is different, but also responds to activities (my hip arthritis is also much worse on the left leg).  Walking around the house doesn't bother it, but I get tingling acts up when I walk for exercise...  So, I'm not sure if it's a MS thing acting up with exercise or my back responding to the increased walking????

I guess what bothers me is if it's back related, I probably should slow down the type of exercises I'm doing and get it attended to.  If it's MS, I won't.   Getting conflicting answers doesn't help...  But, we've all been there!

Thanks again for your response!

Take care, Pat :)

[Fluffysmom]

I'm writing to wish you luck in finding answers.  I have terrible radiculopathy from an L4-5 herniation, but I've had a neurosurgeon, a neurologist, and my PCP all tell me that I shouldn't be experiencing so much pain from the level of protrusion that I have.  Even the neurosurgeon, who did a diagnostic epidural on me an found that zapping L4 reproduced my symptoms (I told him that L3 did, too, a slightly different dermatome, but I apparently didn't react the same) said that he thought my pain was from nerve root ischemia.

The neurologist said that she disagrees with the neurosurgeon; she basically thinks its somatization.

My PCP agrees that my symptoms don't match my MRI findings, but she realizes that my pain is aggravated by my hypermobile SI joint and pelvic rotation.  Not to mention the right hip labral tear that probably adds to the joy.  Oh, and the mild spondylothesis of a degenerative nature, L4 over L5.

I get horrible pain from driving, too.

So far, no one thinks I have MS except the neuro radiologist that read my brain MRI, by the pattern of my lesions.  Two neurologist disagree.  I'm waiting for an appointment with a third.

Unfortunately, I can't answer your questions about disc issues vs. MS.  I just wanted to make sure that you know that you are not alone in these questions.  I think that the SI joint issues compound the lumbar issues.

Since PT helped, can't you get more?  I've given up for a while because with multiple issues, I felt bad for the PTs that ended up hurting me accidentally.  Maybe my new neuro can help figure some big picture stuff out; i won't hold my breath, though.

Good luck in your search for answers, and I hope you find some relief from your symptoms soon.

Kathy