It appears you have not yet Signed Up with our community. To Sign Up for free, please click here....



Back Problems Message Board
Post New Thread   Closed Thread
LinkBack Thread Tools
Old 03-09-2012, 04:42 PM   #1
Newbie
(male)
 
arborbert's Avatar
 
Join Date: Mar 2012
Location: Ann Arbor
Posts: 3
arborbert HB User
Young man with back pain and sciatica, please help!

Hi,

I am new to the forum, but recently I have been suffering from back and leg pain for a month and I am seriously worried about it. I went to see the doctor and he recommended me physical therapy, but I don't see sign of improvement...I actually feel it is developing... Here is how things happen: (as brief as I can)

Background: 23 years old, no accident, was perfectly healthy until...

[COLOR="Blue"][Start] Went to gym, tried some waist/leg exercises I didn't do before, felt exhausted.

[+1 days] Started to feel pain and sting on right outer thigh, especially when walking.

[+4 days] Went to see doctor. Leg raise positive. Reflexes and muscle strength normal. Naproxen proscribed.

[+5 days] Started to feel pain on right calf, and the area behind the knee.

[+6 days] Started to feel stiff back.

[+8 days] In rare cases sting and pain on left leg.

[+12 days] Obvious pain on spine (lumbar area) when bending forward. Lower back pain started. Pain on hip and the right front thigh.

[+15 days] X-rayed. Perfect spine, according to the doctor.

[+20 days] Physical therapist gave me some exercises to do at home and told me to avoid bending.

[+25 days] Good news: No leg pain and sting for most of the time.

[+30 days] Developed CONSTANT SORENESS ON THIGH, CALF, KNEE AND EVEN ANKLE OF BOTH LEGS. Also, stiff back remains. I can't bend forward because it causes pain in the back. Piriformis very tight, according to therapist.
[/COLOR]


I honestly don't know if I am getting better or worse. The good side is that I no longer feel obvious pain and sting, I just have soreness now. But the bad side is the symptom seems to spread, from right outer thigh, to the whole right leg, back, hip, left thigh, left calf, and finally both legs.

Should I be worried about this? I am a student and I am seeing doctors of the university health services. They didn't find the exact cause but they said it is usually not a big deal for young people. But for me I don't believe it could take so long to recover. It is now more of a mental burden to me... My father even scared me over the telephone: "I hope it's not bone cancer!"

Any suggestions and comments are greatly appreciated! Thank you!


----------------------------------------------------------
I guess I should post my update here:
----------------------------------------------------------

Thanks all for your help!

Update since my last post:

I had an MRI a week ago. The report indicates that I have 3 mild diffuse bulged discs, mild facet antropathy, stenosis of the lateral reces, central canal stenosis, thickened ligamenta flava at L2-L3, L3-L4 and L4-L5. Looks like L1 is the only normal one.... The canal stenosis seems to be congenital, but other factors together contributed to a moderate to severe canal stenosis at L3-L4 level. Additionally, I have mild straightening of lumbar lordosis and Schmorl's Nodes on L3-L4 level.

I know it sounds terrible... I didn't realize I have so many abnormal/broken parts on my spine until the MRI... Feel depressed... A single gym visit couldn't account for this much...

The doctor referred me to the spine center of the university's medical center for further diagnosis. (I am in Michigan and I believe U-M medical hospital is a good place to continue). I need to wait for nearly a month until the mid April for my first appointment... I will definitely request more tests and try to find the real causes of my symptons.

The symptoms basically remain the same.

That's all. Thank you for your help and I will continue posting updates. If you have any other suggestions please tell me!

Last edited by arborbert; 03-25-2012 at 10:08 PM. Reason: Update

 
Sponsors Lightbulb
   
Old 03-10-2012, 02:02 AM   #2
Senior Veteran
(female)
 
Join Date: Nov 2010
Location: USA
Posts: 6,740
teteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB User
Re: Young man with back pain and sciatica, please help!

Welcome to the board. I missed your post earlier, but am responding now mainly to say "hello" as upon the first reading of your post, all your symptoms don't bring anything to mind.

It can be frustrating to have a cluster of symptoms that are painful and keep us from leading an active life, and yet the medical community cannot really figure out what's going on.

I have one thought for you that you can run by one of your doctors. It is a long word: spondylolisthesis. This popped into my thoughts because of your age and the scattered nature of your symptoms.

Spndylolisthesis is a condition where one vertebra slides over the top of the adjacent vertebra. There are several types of spondy. One is particularly common among adolescent athletes who are involved in activities where there is contact, such as football, or where the back is forced into extension, such as gymnastics, diving, ice skating, dance, etc. I won't go into all the technical details, but it is a development that does not necessarily cause pain. Many people have it and are never aware of it until the spine is x-rayed for another purpose. On the other hand, depending on the amount of slippage and whether it is still in the act of slipping, it can cause a spinal nerve to be pinched. This pinching can vary in intensity and cause the pain to change depending on how much the nerve is being pinched. The best way to see this condition is to have a flexion/extension x-ray.

I'll give you some additional thoughts in the morning. I feel like my brain is already asleep at the moment. You can find some good information on spondylolisthesis on the internet if you are curious and want to learn more. This is just a guess on my part as to what might be causing all your symptoms....After reading about it, you can decide if it matches what you are experiencing to some extent, and determine whether it is worth mentioning to the doctor.

 
The Following User Says Thank You to teteri66 For This Useful Post:
arborbert (03-10-2012)
Old 03-10-2012, 02:45 AM   #3
Junior Member
(male)
 
Join Date: Feb 2012
Location: Aus
Posts: 12
Runner800 HB User
Re: Young man with back pain and sciatica, please help!

In regard to exercises and remaining active, people have a tendency following an acute back injury is to rest. It's good that you're doing the exercises. For your condition, you might find that lying on the side with the hips and knees slightly flexed (fetal position) with a pillow between the legs helps (it minimizes pressure on intervertebral discs and neural foramina ie; the tunnels carrying exiting nerve roots).

And just FYI - studies have also shown that bedrest beyond two days actually worsens back pain. You should resume daily activities, but avoid heavy lifting or excessive bending (which it sounds like you're on top of).

In regard to imaging, I agree with tetonteri (she gives good advice so listen to her!) re; the xray and possible spondy.

Further xrays may be required with special positioning. Xrays are sometimes limited though because they are a two-dimensional representation of three-dimensional anatomy. Soft tissues, such as muscles and nerves, cannot be easily interpreted using xrays. Therefore, the most common abnormalities seen on xray involve bony structures (so spondylolysis, amongst other things.)

Magnetic resonance imaging, or MRI scan, is the gold standard as it is better at distinguishing soft tissue. Because of this it is the test of choice for soft tissue problems eg; disc herniation, ligament strains, muscle damage and tumors. I'd suggest you ask for an MRI if your pain continues.

You shouldn't be too worried about it, you might find that with conservative measures, the pain disappears in a few weeks. If not however, my advice is to go back and see your treating doctor - ask for further imaging to be done - and if appropriate, ask for a referral to see a specialist.

 
Old 03-10-2012, 03:01 PM   #4
Newbie
(male)
 
arborbert's Avatar
 
Join Date: Mar 2012
Location: Ann Arbor
Posts: 3
arborbert HB User
Re: Young man with back pain and sciatica, please help!

tetonteri66 and Runner800,

Thank you for your suggestions. I tried to look for information about Spndylolisthesis and the symptoms described are surprisingly similar my situation. But they also suggest that an X-ray can help rule out the possibilities. I had a normal X-ray two weeks ago and the doctor said it was perfect. Should I request further imaging like CT or MRI? The doctor is somewhat reluctant to provide a referral of MRI (I need to go to the medical center instead of clinics) when I mentioned it earlier, as he said it is usually a pre-surgery examination.

Thank you!

 
Old 03-10-2012, 04:57 PM   #5
Senior Veteran
(female)
 
Join Date: Nov 2010
Location: USA
Posts: 6,740
teteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB User
Re: Young man with back pain and sciatica, please help!

A regular x-ray will probably not show the spondylolisthesis. You would need a flexion/extension x-ray which is done when you are bending forward and leaning backward. This shows if the vertebrae change position and alignment when your spine moves. Sometimes this x-ray will show a lumbar spondy better than MRI.

Mine wasn't clearly seen on my first MRI, but the surgeon saw enough that he suspected it and sent me across the hall to get the flexion/extension x-ray. The spondy was very obvious on it.

This would be cheaper to get first. If it doesn't show anything, and your symptoms remain the same, then I would go for the MRI.

 
Old 03-10-2012, 06:12 PM   #6
Junior Member
(male)
 
Join Date: Feb 2012
Location: Aus
Posts: 12
Runner800 HB User
Re: Young man with back pain and sciatica, please help!

No prob Arborbert, all the best.

 
Old 03-13-2012, 12:25 AM   #7
Newbie
(male)
 
Join Date: Mar 2012
Location: Philadelphia,PA USA
Posts: 3
Sprinter76 HB User
Re: Young man with back pain and sciatica, please help!

I know your pain buddy, been through all of the testing. Request an EMG it's a nerve test and can pretty much pinpoint at which joints affect the problem. This did for me confirmed what my physical therapist thought. Next step is pain injections in the back works wonders but only last about 2 months for me as I have some other physical problems that contribute to my back problems. Backs are like brains, doctors just can not diagnose the problems unles your disc blown out and they can see it. For ease of mind I was told I had a slightly bulging disc-if you say so doc. Anyhow the lower back muscles get tight and as example put your fingers in between your bicep and inner elbow squeeze together and make a big He-man muscle feel how tight it gets on your figers? that's what your muscles do to your spine and the pressure on your discs pinches nerves and magically you feel pain, I know it sucks but that's reality and pretty simple if you think about it but I'm not a doctor. I was out of work for 4 months being a labrat sent to therapy as you have been doing, no diagnostics no recommendations until I made some demands after speaking with my family doctor he immediately sent me for the EMG, 2 weeks later I got the shots and back to work. No cure for me so far just go get shots every 3 months. I also bought an inversion table and hang upside down to stretch my back- helps a great deal so I recommend it. Goodluck and go make some demands in the morning. I'm new here myself so hopefully this will help you out.

 
Old 03-25-2012, 10:06 PM   #8
Newbie
(male)
 
arborbert's Avatar
 
Join Date: Mar 2012
Location: Ann Arbor
Posts: 3
arborbert HB User
Re: Young man with back pain and sciatica, please help!

Thanks all for your help!

Update since my last post:

I had an MRI a week ago. The report indicates that I have 3 mild diffuse bulged discs, mild facet antropathy, stenosis of the lateral reces, central canal stenosis, thickened ligamenta flava at L2-L3, L3-L4 and L4-L5. Looks like L1 is the only normal one.... The canal stenosis seems to be congenital, but other factors together contributed to a moderate to severe canal stenosis at L3-L4 level. Additionally, I have mild straightening of lumbar lordosis and Schmorl's Nodes on L3-L4 level.

I know it sounds terrible... I didn't realize I have so many abnormal/broken parts on my spine until the MRI... Feel depressed... A single gym visit couldn't account for this much...

The doctor referred me to the spine center of the university's medical center for further diagnosis. (I am in Michigan and I believe U-M medical hospital is a good place to continue). I need to wait for nearly a month until the mid April for my first appointment... I will definitely request more tests and try to find the real causes of my symptons.

The symptoms basically remain the same.

That's all. Thank you for your help and I will continue posting updates. If you have any other suggestions please tell me!

 
Old 03-25-2012, 11:41 PM   #9
Senior Veteran
(female)
 
Join Date: Nov 2010
Location: USA
Posts: 6,740
teteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB User
Re: Young man with back pain and sciatica, please help!

You will be in good hands at the U of M Spine Center. You will be examined and should come out with a diagnosis and plan of treatment that you can trust to be accurate.

Being 23 and somewhat new to all this spine stuff, your MRI report probably sounds quite devastating, but for those of us who have been at this game awhile, there may not be as much wrong as you are presently thinking. I think the doctor will be able to find ways to manage your issues "conservatively."

My guess as to what happened to set off your problems is that you have a smaller than normal central canal. This means that there is just enough room for the nerves in a normal situation. You attempted some new activity at the gym, something certain parts of your anatomy were not used to. Perhaps you aggravated a muscle or ligament...there was probably some minor injury which led to some inflammation....Given that there was barely room for the nerves to begin with, anything new that is pressing on the nerve is going to cause a problem. Once a nerve becomes irritated, it can be very difficult to settle it back down. Just when you think you are feeling better, you engage in a bit more activity, the nerve is again irritated, things swell and you are right back where you started.

Once you have an area that the body reads as "injured," other muscles and soft tissue will take over and begin to "guard" the injured area. The body automatically fights to maintain stability. This can result in muscle imbalances, changes in gait, posture, structural alignment. This may come about as a compensation, such as favoring one side to protect the sore side, etc. This is often done unconsciously, and it can result in more imbalances and things getting irritated...one problem leads to another one.

You write that the narrowing of the central canal is particularly bad at the L3-L4 level. Stenosis is a narrowing and can be caused by degenerative changes or a person can be born with a central canal that is on the slim side to begin with. In your case, you have a bit of both. The spine surgeon will look at your MRI and will perform a physical exam and basic neurologic exam and talk to you about your symptoms to determine just how much the stenosis is causing you pain and limiting your movement. My guess is an epidural steroid injection will be ordered in an attempt to reduce any inflammation, calm down the nerve or nerves to see if that will resolve the pain caused by the stenosis.

Stenosis is a condition that people can and do live with for a long period of time, using pain management treatments as needed. If a nerve is showing signs of being too badly compressed, then a small surgery to relieve the compression is contemplated.

While most of your issues are judged to be mild (on a scale of minimal, mild, moderate and severe), it is somewhat troubling that you have an assortment of issues that indicate some degenerative changes going on in your lumbar spine at your age. This may be something you will want to discuss with the spine surgeon when you meet. As you suggest, none of these issues were caused by your time spent at the gym.

I doubt it will be necessary for you to request any specific test when you meet with the spine surgeon. The doctor will know what to do with you. It's just too bad you have to wait another 4 weeks to get in. But at least the wheels are now set in motion and you will be getting some answers in the near future.

 
Closed Thread




Thread Tools

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is Off
Smilies are On
[IMG] code is Off
HTML code is Off
Trackbacks are Off
Pingbacks are Off
Refbacks are Off




Sign Up Today!

Ask our community of thousands of members your health questions, and learn from others experiences. Join the conversation!

I want my free account

All times are GMT -7. The time now is 07:55 PM.



Site owned and operated by HealthBoards.comô
Terms of Use © 1998-2014 HealthBoards.comô All rights reserved.
Do not copy or redistribute in any form!