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Posted by ccf neuro M.D.* on March 15, 1998 at 00:03:30:
In Reply to: Numbness/Tingling in legs-Sciatica? posted by LSW on March 07, 1998 at 23:06:07:
I was diagnosed with coccydynia (coccyx pain). In addition to the coccyx pain I have constant numbness and tingling in both legs and in my left arm. I also have intermittent pain in my legs from my buttocks down to my toes. I've received 3 epidural injections and am taking PT. I'm back to work after being off for 4 months. I'm doing a lot of sitting at work and the numbness and weakness has increased more than ever.
Originally I had an EMG test that was ok, but was told I had diminished sensations in the lower extremities with the pinprick test. I feel as if the numbness/tingling pain has been ignored with my treatment of coccydynia. I don't know if the coccydynia has flaired up the sciatica or some other nearby nerves. I was told the injections would coat the nerves and help with inflammation. The coccyx pain has decreased with the inj. but after being off work 4 months and now sitting 80% of my working day I come home and lay down and put my feet up.
I'm wondering if I need another opinion. My brother's neighbor an M.D. told him coccydynia should not ever give pain down the legs and that there is never any numbness produced, as the nerves that run down the legs have exited from the spine long before the coccyx.
I'm concerned the increased numbness, tightness, etc. in my legs may mean I'm doing additonal damage to something.
Any suggestions or comments?
Thank you. -LSW
Let me first apologize for us missing your question and the associated delay. Sciatica is a very particular, specific variety of pain that begings in the lower back and shhots like lightning or an electric shock down to the back of the thighs and legs to the toes. Gradual pain, aching pain, and tingling are not indicative of sciatica. True sciatica is most often due to a herniated disk and can be detected by a bedside examination maneuver known as the straight leg raise. EMG is an electrical test used to study whether there is any damage to any nerve roots in the lower back. Coccidynia is pain in the coccyx and does not produce sciatica, or any leg symptoms. The presence of such symptoms in the legs would suggest an additional problem may be going on. Sometimes one can have inflammation of the nerve roots in the back without actual damage that would be detected by EMG. Antiinflammatory drugs or epidural cortisone injections are good ways to try and treat such inflammation. Another condition to beware of that is sometimes very difficult to diagnose is one known as lumbar canal stenosis. This very gradual onset problem produces tingling, pain, and even weakness sometimes in several nerve roots in the legs, triggered by prolonged standing, walking, or sometimes even sitting. The telltale sign of this condition is that pain or numbness someone chronically has from it disappears or is greatly relieved when they are pushing a shopping cart, or are in a similarly stooped position. Only a CT scan or MRI scan of the lumbar spine (lower back) can diagnose thia problem, and ONLY surgery can fix it--- epidurals and drugs will NEVER help it or fix it. If you would be interested in a second opinion at the Cleveland Clinic, our department of neurology's phone number is 1-800-223-2273, extension 45559. Another alternative would be our spine center. Please remember that information provided on the forum is intended for general medical informational purposes only, and that the actual diagnosis and treatment of your specific medical condition should be strictly in conjunction with your current treating physicians. We hope you find the information useful.
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