mri spine lumbar wo contrast

[Spear40]

A week ago I gradually started feeling numbness from my right foot toes and now the whole foot.There is weakness on my toes and cannot push them up but can push downwards. There's a piercing pain from my lower back(above my buttocks-around the hip area) all the way down to the foot.I cant stand on my right leg w/o support and can only limp when walking but with severe pain. MRI results indicate Right central/foraminal extrusion-type disc herniation at L5-s1 measuring 1.4x0.8cm, causing moderate canal and right neural foraminal stenosis, and slightly displacing/compressing the exiting nerve root.Degenerating disc disease with modic type 2 endplate changes at L5-s1.

I'm concerned about the muscle weakness that causes me to limp.Is there a possibility of normal activity? I'm in excruciating pain though on medication. Please advise ...

[Spear40]

I greatly admire your courage and determination to coping with your condition. Rarely do we come across real survivors who turn up willing to encourage others who feel down like me. You sound strong and I thank you for giving me the support and enlightenment that I really needed. I do not know any close relative or friend who has been in such a situation and that was why I was panicking and trying to caste doubts on my docs.
I will be seeing the docs at the clinic on Tuesday and hopefully will find out more about my condition. Frankly, I felt at ease after getting the answers and info from you. Stay strong and comfy.  

[ggreg]

I'll give a quick response to your two questions at the end there.  The incident on the airplane, the doc was just doing what's called "moderate treatment," and thus advised you to stay laying down and resting a lot.  It's not that he kept quiet a possible dreadful outcome if you took a plane trip.  Docs typically do not go into great detail with a patient about how a disk is doing this and might do that later under some circumstances, and percentages and possibilities.  They advise you based on your current situation.  On the second question, if the limping is caused by disk or muscle weakness, I am living proof that limping can indeed be caused by a tore-up back.  I limp and lurch all over the place.  But muscle weakness can also cause limping, of course.  It's just we've been basically uncovering a back problem, and hopefully you won't get to the point of "muscle wasting."  And yes, sleep wherever and however you want, but for me, I am more comfortable on a firm bed with fifty million cushions on it, I keep my knees bent because of my bad back.  I mean, I don't think you should sleep on a kitchen table or anything.  Sorry, but this is getting sort of funny to me.  Time for my break this morning!  Glad I could help a little.  Hang in, all this will straighten out, and at least now you have the information from someone who has "been there, done that" to sort of lean on when you don't think you're being attended to properly.  

[Spear40]

Thanx for the detailed response. The docs prescribed steroids for 5 days and I set a followup appointment with the hospital clinic next week. The neurologists who asked for the MRI was vague to my questions and insisted everything was going to be more clear when I check in with the clinic. They even said that I should return to my normal routine and avoid relaxing and only apply heating pads to my lower back if possible. Yesterday after posting my concerns I went around my normal activity and taking the steroids as scheduled but at the end of the day   I was still in excruciating pain. I also went bike riding with my kids and it seemed the medication was not working. My thigh muscles feel so strained and painful but I keep on moving.
I started applying the heating pad to my lower back but the leg muscles from my hip to my foot still pain a lot. I had asked the docs whether massaging my foot which feels numb could be of helpful but they said that the root cause was from my disc; so I think you enlightened me and prepared for what to expect next.
A while ago, in Jan.'10 when I suffered some lower back pain while shoveling snow, my doc had prescribed oxycodone and advised me not to sit down or stand up for more than 30 minutes. I kept that in mind till I made the mistake of taking a 7 hr. long flight to Europe and thats when immediately I felt the pain piercing thru my leg. I stayed there for 2 days with pain building up and upon my return my toes started going numb. Is it possible that my doc knew something when I first had the lower back pain in the first place? I changed my doc since my toes started going numb b'cos I feel he didn't alert me of problems with my disc till I saw another doc.
My question now is that is the limping associated with the disc or muscle weakness? When I get up from bed I really limp with severe pain but gradually after 10 0r 15 min the pain reduces. Can sleeping on hard surfaces help? The docs say it doesn't matter and advise that I should position myself some place comfy and avoid feeling the pain.
Once again, thanx for preparing me mentally and letting me know what to expect within the next few weeks.
  

[ggreg]

Well, the physician who ordered the MRI should be telling you in some upcoming appointment as to what might be done to help your numbness, limping, and pain.  Since you have degenerative disk disease, even should they could possibly surgically go in and fix the current situation, or help you regain normalacy through medication and physical therapy, they will still need to also revisit with you on a yearly basis, to monitor how things are going in your spine, so they can hopefully jump on top of whatever problems are bound to come up now and then, and take care of you before you wind up with all these symptoms you have now.

But to answer your question in a straightforward way, yes, there are many things neurologists and orthopedists and physical therapists can do for you, to make your quality of life as close to normal as they can get it.  Sometimes they'll want to go the moderate route of treatment, which would include things like some really good medications to relieve the pain, and also perhaps physical therapy designed to strengthen muscles and improve physical activity, to where you won't have much trouble walking like a normal person.  Then sometimes they'll want to go the surgical route, which they may very well indeed want to do this, because of the impingement on the nerve root, the disk herniation, stenosis, and so forth.  They can fix all this by a variety of methods, sometimes laproscopically, sometimes with a more invasive operation, to where they might remove the damaged disk, and either fuse the vertebral bodies or replace the disk with a mechanical type disk.  By the way, I think it's still in trials, but they've got a new disk that is much better than the old one, that allows a person to move around really well for many years, and I saw a documentary where the guy who got one of those was able to get up the very next day after surgery and walk normally for the first time in many years.

This muscle weakness can indeed be fixed, just like how athletes train to get their muscular bodies in top working order to meet the challenges of very difficult physical tasks, well, this is done for people who lose strength from illness, by physical therapists showing you what all you can do to get your strength back.  

Now, I do have something to say about your medication situation.  Some medicines work better than others, some people need different medicines than others.  Therefore, somewhere in the midst of all this, you will need your physician to try other drugs on you until one finally works to kill that pain.  I have two types of back pain.  One is in my thoracic spine, it is a deep, diffuse, and profound ache-type pain and NOTHING touches it, altho opiates are better than nothing, so I have lived with it for many, many years.  But the other pain is in my lumbar spine, and it is so sharp that I cannot sit or stand for more than about a half-hour at a time, without either getting up if I've been sitting, or laying down if I've been standing.  But they gave me a medicine that overnight made that sharp pain disappear completely... a real miracle.  Lyrica is what worked for me, it is prescribed for several reasons, sometimes for fibromyalgia (muscle pain all over), sometimes to stop spasms, and sometimes for people like me, which is for numbing the nerves.  So, that's something you can suggest to your doc, if he needs any help hunting down the right stuff.  The drug has to be upped in dose a number of times in the first few months, until you reach a plateau of comfort.  I started out at a low dose, and now take 100mg 3x daily (I think that's it now).

So, you need to schedule a followup appointment with your neurologist, or with whomever is giving you care, or if you already have an appointment set up, be sure to go to it, because that is when you can find out WHAT their treatment plan will be for you.  And if they go for one particular treatment and it just doesn't do the trick, then they'll go onto the next treatment plan that might work, and so forth.  All they want to do, the whole reason they work as doctors, is to HELP THE PATIENT get better.  Success rates vary, depending on a lot of variables, and docs are fully prepared to try lots of things until they reach at least SOME level of success.  But in your case, I do think the medical community can definitely help you feel and get worlds better than you are right now.  Hope some of my thoughts help you.