Lower back, buttock, thigh pain

[paulettes]

I have been suffering severe pain which started in lower back and down outer thigh and sometimes down to ankle. Recently, pain also in groin area. It has been 12 months and Physical Medicine physicians have performed various procedures: Had left L5-S1 transforaminal epidural steroid injection, two lateral femoral cutaneous nerve blocks, sacroilliac joint injection and iliotibial band injection. Also prescribed high dosage Gabapentin 900mg 3 times daily which did not help.

Had  Physical Therapy which resulted in increased pain. Also tried Acupuncture and Chiropractic.  Sitting makes pain extreme. Doctors indicated that MRI results do not seem remarkable for this level pain.

IMPRESSION: Mild degenerative disc desiccation at all lumbar levels, Bilateral facet spurs L3-S1, Broad based bulging disc L1-2 1-2 mm, Broad based bulging disc 2-3 mm L3-4, L4-5, Combination of above produces mild canal stenosis at L4-5 and and L3-4. EMG normal. Could these mild results cause my level of pain. Should I now see a surgeon?

[Bhupinder Kaur, MD]

Hello,

The pain that you are having is due to the disc changes in the lumbar area in your spinal cord.There is buldging of the intervertebral disc (which acts as a cushion between the two vertebrae)at all lumbar levels,This buldging is causing narrowing of the spinal canal through which the spinal cord is passing and this narrowing is causing compression or entrapment of the nerves which is causing spinal stenosis. Spinal stenosis is a medical condition in which the spinal canal narrows and compresses the spinal cord and nerves.

Treatment includes weight loss, and activity modification, such as using a Walker (tool) to promote a certain posture. Epidural steroid injections may also help relieve the leg pain.

If the symptoms are more severe, a laminectomy or foraminotomy may be indicated to take pressure off the spinal nerve.As you still have the pain inspite of the steroid injections,so in my opinion you need a surgery like laminectomy/formaneotomy.Pls consult an orthopedicain/neurosurgeon for this.

Hope it helps.Take care and regards.

[tyronCu]

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