I am 40 years old and received an injury at work back in February which was reactiveated this past August. The original injury occurred in a self-defense workshop in which I broke my right wrist and sprained my lower back. The only tests done on my back were x-rays which did not show anything. After 4 weeks of physical therapy pain was still there. I was given muscle relaxers, etc. but the pain never left.
In August I was moving a stationary bike, again at work, and hurt my lower back even worse. This time, besides excruciating pain, I also had weakness in left leg, numbness in left toes and foot. Twuice my left leg gave away, causing me to go down on my knees. On one of these occasions I felt like my left leg was paralyzed and could not get up so my employer called an ambulance and sent me to the hospital. They gave me muscle relaxers I.V. and sent me home with Vicodan. I saw a Neurosurgeon who recommended phys. therapy again - 4 weeks, three times a week, no success. Then he ordered a MRI - it showed a protruding disc at L-5,S-1 with inflammation present. He sent me to a Physiatrist (pain specialist) who examined me and had me receive an Epidural injection into L5-S1 area. The physiatrist said that should do the trick. That was 3 weeks ago and the injection wore off several days ago. They are now talking about giving me another epidural in a few days.
I went for a second opinion on my own outside workman's comp. This neurosurgeon said he thought I had nerve damage in my left leg and sent me for an EMG. I have not gotten the full report yet from the neurosurgeon, I see him next week, but the Dr. who performed the EMG told me he saw significant damage to the nerves throughout my entire left leg. Now my casemanager through comp. is wanting the results (free) but is also saying that EMG's are only about 40% accurate. Is this true? Also, if a Neurosurgeon knows there is significant nerve damage but is not totally sure where it is coming from can he still do endoscopic surgery or would exploratory surgery be the most viable solution? I'd truly appreciate your medical opinion.
Thanks for the question. As you can imagine all tests have limitations and that also includes EMG's. Unlike MRI scans that can be physically taken with you and examined by other doctors EMG's are more subjective and dependent on what is visualized at the time of the procedure. For this reason variablity exists and becomes somewhat user depend. It would seem alittle strange that with the MRI that you describe and the mechanism of injury that an EMG would reveal damage in the entire leg. Nerve injury usually causes problems in a specific nerve root distribution. Ongoing nerve/muscle injury would be an indication for surgery but things are not adding up to me. It will be intersting once the final report is in. If the data is too confusing you should consider a second opinion. Good luck
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