I have a couple question that I hope someone might be able to help me with.
How do/can you tell if the pain in your Lumbar is muscle pain, not spasms or disc pain?
My Lumbar is always achy and uncomfortable 24/7, never no relief for 9 months now, somedays tho the pain feels like it is bone pain like my whole lower spine is aching and throbbing, somedays it is just a achy, uncomfortableness with presser, I have hot, tingling into my left butt and a different hot pain in my right butt. I have L3/4, L5-S1 herniations, L4/L5 bulging all with encoachment on the thecal sac and lateral recesses, I also have L5-S1 impingment, all comfirmed per MRI & EMG. I haven't had a disogram yet due to Insurance company putting a hold on all care pending a IME, which was done last Monday but no report yet from the dr.
I'm wondering if the pain I feel is from not using the muscles or is what I am feeling the "bad disc", if it is muscle related how can I or what exersixes can I do to help regain my muscle strength. I can't walk for more then 5 minutes without my feet or legs going numb and tingling, so I no I can't walk or do a treadmill and elliptical!
Thanks for you help!
My only thought would be to see about getting some PT to help your muscles. You'll know if it is muscular if PT doesn't help, and neither does stretching or what not. That is the only thing I can think of right now. Sounds to me though like it probably is a combination of everything. Best wishes
With what you describe, I don't think it is muscular in origin. Not to say that your muscle aren't tense and tight....they do that to protect the nerves and that, of course, is a cycle. Try soaking in hot water, using ice packs, and slow, short walks to help stretch the muscles. Unless given particular exercises by a spine specialist, I wouldn't undertake any exercising at all; you could make matters worse.
If you are getting the runaround by the ins. co., you may have to find an atty to stand up for your rights. This sounds like a wc case, and if it is, you probably will need a lawyer to fight for you.
Good luck to you and please keep posting, let us know how you are doing.
if you feel achy pain in your backside, there is a possibility it's sciatica caused by your piriformis. that muscle runs deep under the glutes, so makes it hard to work with.
i think it does depend on what the mri is showing, like carol said. if they don't see a disc impinging the nerve, then a muscle (like the piriformis) may be the cause.
i think a big factor for you to pay attention to is whether the achy pain (or any pain) is continuing down the back of your thigh. that is the sciatic nerve that's impinged, and that nerve runs under the piriformis. in some of the population, that nerve actually runs through the muscle, making it more likely to feel that kind of pain.
the sciatic branches from the spinal cord arouns the l3-4/l4-5 location, so even if you have disc-related pain (like the pinching found in an mri), the piriformis could be involved as well. your pain may not be from just one problem.
i currently have 3 - the pinched nerve (piriformis-caused) took 10 months to id, the annular tear at my l3-4 took 3 years to id, and i just id'd the si joint as a seperate problem after 4 years. because all of these are in such close proximity, there was confusion about whether one was radiating or if the problems were distinct from each other. i'm coming up on my 5th anniversary of living like i'm a convalescent.
keep plugging away - persistency is definitely the key! and, regardless of what stage you're at in this journey, this board provides an amazing amount of support. i joined around the time of my idet, and although i'm feeling better than i have in 5 years b/c of the procedure, i still feel this board keeps me going and that there are others out there who understand. it's been a catharsis for me in so many ways.
good luck, and i hope this post helps in you in some small way.
It's probably a combination of both - as has already been stated. Generally speaking, "achy" or "dull" pains are often the result of muscle...while "sharp", "shooting", "stabbing" pains are caused by nerves.
L3/L4 disc affects the L4 nerve...which innervates the inner leg and medial foot and may also be causing some of the discomfort in the buttock region. L4/L5 disc affects the L5 nerve which produces its pain distribution in the buttock region, down the lateral aspect of the thigh to a little below the knee. And L5/S1, would produce that "sciatic" like pain down the back of the buttock, thigh, and leg.
In addition to nerve pain caused by disc, you may also be experiencing referred pain from the facet joints. Patients with facet syndrome often complain of LBP with hip/buttock or leg pain.
With all that you have going on, it's very likely that your muscles are trying to stabilize the spine and body the best way they know how...so there is probably some muscle spasm...and depending on how long this has been your case, perhaps even some trigger points. Before doing any exercises, definitely talk to your doctor. There are some specific exercises that he/she may encourage for this as well as some others that they may discourage you from.
Thank you everyone for your input, I will wait to see my dr and ask about the exercises. I just scheduled a disogram for March 21st, so I guess I will know for sure then what is going on in my back. Hopefully, this disogram won't get cancelled as well, problems with Car Insurance denying procedures, saying I don't need them when all my drs. Neurosurgeon, PM, PCP and Neuroligist all agree that my care is at a stale mate until I can get the Disogram, so it's meds until then, but I hate meds cause they make me so sick & drugged and don't take the pain away. UGH What a nightmare!
Thanks again all you help! It is great to know there is a place I can come to get advise and help from others in the same boat as me.
Well the disogram just got cancelled, the reason was that my health insurance will authorize the disogram but not surgery so they said there is no point in getting the disogram because they wouldn't be able to do surgery. I can't beleive this, I mean I'm just suppose to live like this the rest of my life? All my injuries were due to being rear ended and I've been having one problem after another with my car insurance and pre-certs, they just flat out refuse to allow treatment for me, all my injuries are clinically documented and all my drs Neurosurgoen, PM, PCP and Neuroligist agree that my next step is disogram, because Neurosurgeon said if she scraps off the herniation at L5-S1 that could help my leg and feet pain but not my back pain. I just can't believe this, I just want to be pain free and normal. Sorry for the vent!
Last edited by lindabobinda; 02-16-2005 at 01:03 PM.
Linda, have you thought about getting an attorney to help you with the car insurance company? My injuries also came from a car accident, and I was having a terrible time with the auto insurance company. My surgery was scheduled and I was ready to go into surgery. Less than 24 hours before surgery, my surgeon's office called me and said they cancelled the surgery because the insurance company wasn't going to pay. I tried to handle it myself, but I ended up getting an attorney because I couldn't get anyone to listen to me. The minute my attorney talked to the ins. company and faxed a letter to the surgeons office, they put me back on the schedule. It ended up being a month later, but at least it got done. We are still having issues with the ins. company, and it's now in litigation, but I'd much rather deal with this now that I'm feeling better instead of in pain. You can go and have a consultation with an attorney, and it's usually for no charge. Good luck, and if you have questions please feel free to ask!
def dont' give up and don't let the insurance company decide your health future. I think Jessie's suggestion is a good one, seek an attorney to help you out or atleast let you know what your rights are. DON"T GIVE UP!
I do have a attorney, I'm waiting for him to call now. He has told me before that he could draft a letter but it probably will not hold any weight as he is not a "Medical Doctor" per say. I'm so upset and frustrated, I had a IME last Monday and just got the report and the dr said that I am at my Maximum Medical Improvement, how can that be when I haven't had surgery or anything yet, just the MRI and EMG? How can they legally get away with this. I can't do anything and am in pain 24/7, left leg and both feet tingle and go numb, as well as my lower back and butt. This is so unfair and wrong! My family is suffering as well as I am, I have 2 children and can't do much of anything because I can't sit for long, can't stand or walk for long. This is so wrong and unfair, I just can't deal with this emotionally. I don't take the meds because they don't work, they make me sick, nasty to my family and make me feel all weird and drugged out plus they don't even touch the pain. Sorry for venting again this is just so frustrating and upsetting. I'm glad you got approved with help from your laywer, these Insurance Company's are so unfair and unjust. My Neurosurgeon just called and they are requesting the report from the IME and are going to do a word for word appeal on that doctors report, so that makes me feel a little better, but the fact that I have to remain in pain yet another month or so just makes me so angry, it's already been 9 months. Sorry for the vent again and thanks for allowing me to get it out, it helps. Again I'm glad you are making progress, good luck and I hope surgery goes well and you get relief.
Last edited by lindabobinda; 02-16-2005 at 07:05 PM.
i had a discogram, and didn't have to have surgery to "fix" my annular tear. had an idet, which is NOT surgery. what's their problem???? i think an important question is how many mris you've had so far. i had 4 prior and 1 post to the discogram, and the annular tear was NEVER shown!!!!
regardless of what they "cover," you are allowed to at least find out what the problem is!!! stick with it...be a ^%%$ if you have to. that's the ONLY way i got anything done. this "we'll be as aggressive as you want" offer should be taken up on.
and don't go through all that treatment garbage until you've got the problem properly diagnosed. if nothing else, trust me on this - i'm coming on my 5th anniversary, and i don't want others to go that long if they don't have to. be careful with yourself, and please keep us posted!