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  • Baybreeze....Neurogenic Claudiication Anyone?

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    Old 01-20-2007, 04:59 AM   #1
    ms_west
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    Baybreeze....Neurogenic Claudiication Anyone?

    [COLOR="Red"]Hi,

    In another post (I bumped this quote up because I did not want to hijack someone elses post), you wrote:[/COLOR]

    "With my lumbar stenosis, I developed really severe neurogenic claudication. It felt like a very deep, intense, burning, cramp-like pain in my lower spine, down into both sides of my rear, and down the backs of my thighs. It was a different feeling than the sciatica pains, which were more sharp & stabbing.
    That claudication was due to the nerves in my spinal canal and surrounding blood vessels being compressed. I also had bad muscle spasms. This would happen any time I tried to stand up straight and forget about bending backwards....that would bring me to my knees. The only time I got relief was leaning my body on top of a shopping cart or sitting down & bending forward.
    Do you find any relief if you bend over? Or does the pain feel worse if you bend backwards?

    Were you ever told what type of stenosis you have and what exactly it was caused by? Some are caused by discs pressing into different types of nerves and some are caused by bony overgrowth. I had 2 centrally herniated discs plus alot of spurs and bony overgrowth also inside the vertebrae, plus a long ligament that runs up and down the spine was buckling into my canal. All this transpired for me over 3 1/2 years time until I could no longer walk.

    I cannot say what is causing your pain but it's possible it could be claudication. I also think you should see a spine specialist and have an MRI done."


    [COLOR="red"]Wow! These symptoms sound so similiar to me. I have had right leg sciatia for over 3 years. Lately, I have been experiencing more and more very deep, intense, burning, cramp-like pain in my lower spine and into both legs. The pain will come on very quickly and I can't get my medicine in quick enough. It takes away my breath. There is no pattern to onset. I get it sitting/laying down. Last night, I was up and down with it. It comes on with a sudden vengenance. Does this sound like what you have??? How did you get diagnosed with neurogenic claudication? How have they treated you?

    I had a s1/s2 fusion in 1982. Very successful. No pain until 3 years ago. Laminectomy (removal of bone spurs/nerve was flaming red -- surgery took 4 hours) May 2006. I was perfectly fine until September 2006 and I put some dishes in the dishwasher and bang the pain was unbelievable. Leg pain/Back pain. MRI shows not hernination. Treated with steroids, pt, and selective nerve block. Am awaiting fusion - anyday now.

    I have had this pain since December after they did a selective nerve block. My pain was gone for 2 days and returned full blast. I have never had pain in my toes and this burning cramp until that nerve block.

    I did tell my physician about the foot pain and he was not really concerned about it saying it was typical for my type of case.

    Any comments or feedback would be appreciated. I know you are not a doctor but I find your posts to be very helpful.

    Thank you.[/COLOR]

    Last edited by ms_west; 01-20-2007 at 05:00 AM.

     
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    Old 01-20-2007, 07:10 AM   #2
    Baybreeze
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    Re: Baybreeze....Neurogenic Claudiication Anyone?

    Hiya, Pepper...

    It does sound alot like some symptoms I had.

    First, about 4 years ago now (time sure flys!) I started out with minor, annoying, on and off lower back pain. I also had some swellings up and down my spine. I saw a walk-in doc when I had a large swelling in my lumbar spine (first I thought maybe something bit me or I needed a new mattress) All that doc did was give me painkillers (no xrays, no other tests). Over time I would get low back pain that got worse & lasted longer. I also had tender spots on my vertebrae that started traveling up my spine. I had finally mentioned that to my current rheumy, who gave me various numbing injections. I tried so many things and my pain kept getting worse. I developed that deep burning, aching pain while standing & walking..and eventually my body found a more comfortable position......I felt much better if I walked bent over in almost a 90degree angle. I also felt better if I sat down bent forward.
    Then I devloped very localized, sharp stabbing, nauseating pain in my lower spine that I could pinpoint. This ended up to be sciatica, which mostly shot down my left leg. It went into my rear & down the side of the leg. Though after some time, it also went into my groin and spread to the front of my leg. It would not be constant, it would mostly happen when standing or walking. I also could no longer lay down on my back or with my legs stretched out. I had to lay in bed on my side with my legs curled up to my chest. Otherwise my feet and lower legs engulfed with pins & needles and fell asleep. Sometimes while walking, my left foot would get some pins & needles also.
    When I started vomiting from pain and could no longer do anything normal, I told my rheumy how bad it got. He sent me for x-rays & several MRI's right away. Xrays only showed mild scoliosis and some spurs. MRI's showed degenerative disc disease, spinal osteoarthritis, severe central canal stenosis in L3 to L5, and 2 herniated discs (one with a tear). I also have thickening & buckling of a ligament that runs up & down the spine. All of this was pushing into my spinal canal, squeezing it together. Think of it like a clogged drain <LOL> or plaque build up inside an artery.

    My rheumy said the deep, burning, cramping pains that occured upon standing straight or trying to bend backwards was caused by the stenosis.
    My spine surgeon told me these symptoms, along with my having to walk leaning on a shopping cart, were classic signs of neurogenic claudication, which is what it's callled. All that compression inside the spinal canal actually squeezes all the nerves and blood vessels in there. It causes deep nerve pain and cramping due to compression of the blood vessels in there. (PS ..i love my spine surgeon..he was very good in explaining all this to me).

    I also want to tell you....before surgery, I did have series of epidural steroid injections into my spine. It DID help the sciatica and helped to resolve my disc herniations & tear (along with alot of physical therapy)....but absolutely nothing helped the claudication pain. Not even vicodin or muscle relaxants helped this. SO after the epidurals, my sciatica was gone, YAYYY, but the claudication remained. My docs said it was due to compression going on for too long and my condition worsening fairly quickly.

    I see you've already had a laminectomy....I just had this done in L3 through L5 for my stenosis in Sept. He removed the laminae & cleaned out the bony areas he thought could be contributing. I did not have fusion, though. My surgeon wanted to be as conservative as possible...plus there's always a chance I could redevelop stenosis in that area..or in other areas of my spine. If it happens again down the line, then I may get a fusion. But since I'm young and had already been doing PT for 6 months before surgery, it helped strengthen my core & muscles around the spine. And in my case, since I've recovered from my surgery.....I have no more claudication at all! I can stand straight again, I can even bend backwards again!!! Since I do still have spinal OA, I still get some pains in my spine here & there...but it is nothing compared to how I was!

     
    Old 01-20-2007, 07:41 AM   #3
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    Re: Baybreeze....Neurogenic Claudiication Anyone?

    Very informative and well explained post Baybreeze. Thank you!
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    "believe in the beauty of your dreams"- E. Roosevelt

    L5/S1 bulging @ 18, now 46; still there (but no pain)
    Fusion at L4/L5 Apr -2006
    Solidly Fused Nov-2006
    A Success, but still improving!

     
    Old 01-20-2007, 08:18 AM   #4
    ms_west
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    Re: Baybreeze....Neurogenic Claudiication Anyone?

    [COLOR="Navy"]Thank you so much for the detailed explaination. I highlighted our similarities in red. As I read your post, I began crying because this is exactly how I am feeling. I just went grocery shopping and I am sick to my stomach and the pain is a whopping 10+. I am now sitting in my recliner praying for the drugs to kick in quickly. My feet and toes are feeling the pins and needles and I have that deep unbelievable ache in my lumbar area and legs.

    If I am repeating myself I apologize -- I am just so desparate and feeling alone right now that I need to let it out. I have tried researching it online but was very confused.

    My surgeon said during my L5/s1 laminectomy he removed so much bone spur and he thought the disc would be stable without the fusion. He did not want to do the fusion because of my previous fusion on s1/s2 and he wanted to go with the lessor of the two surgeries. He feels it is now unstable and we need to go in for the posterior fusion with hardware of l5/s1, diskectomy, laminectomy, he is going to also check closely on my old fusion without hardware s1/s2, and look at l4/l5 closely. He is suspicious of l4/l5 despite the MRI and CT scans. I have basically given him permission to do whatever he needs to do. I just need to be rid of some of this pain. At this point, I would find 75% acceptable.

    He has also told me frankly that my surgery days are probably not over because of the stenosis. I am 42 feeling trapped in 100 year old body!!

    At this point, I am basically taking percocets or vicodins with flexeril. I don't take the flexeril around the clock and I wonder if I should try it. He took me off my anti-inflammatories because I am on standby for surgery supposedly by the end of the month.

    I am beginning to wonder if that selective nerve root block sent me over the edge. Could this have made it worse you think??

    Last week, I felt half way decent. This week I just want to hide under the covers the pain has been incredible. It has ups and downs. Did you notice that too??

    Body Position and the heating pad do help me. Have you found anything else?

    PRAISE THE LORD your pain has subsided......I believe we are doing the right thing by moving forward with this surgery and your post has certainly helped me more than I can say.

    Thank you so much for taking the time to post a lengthy answer.[/COLOR]

    Last edited by HBMod07; 01-20-2007 at 10:12 PM. Reason: removed huge quote

     
    Old 01-20-2007, 09:24 AM   #5
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    Re: Baybreeze....Neurogenic Claudiication Anyone?

    Hi,

    I am happy to lend any support, advice, or personal experience that can help you or anyone else. Many people on these boards had lent me support & advice when I was in agony and I'm so glad I can do the same in return. Thank you for your kind words.

    Of course I'm not a doc either, just described my experience...and seeing you compare yours, it sure does sound alot alike to me! I think you would agree that a gut feeling says you may also have stenosis with claudication. Especially if you feel better bending foward! It's always possible it can recur or occur in other areas of the spine. Plus having laminectomy makes the spine a little less stable, which is why doing lots of ab & core exercises all the time is very important. My surgeon also told me that since I now have parts of bone missing in spine (from surgery), that area is more susceptible to fracture. So I do have to try to be careful about it.

    Since you've already had laminectomies and fusion...it's always a chance that it can cause other parts of the spine to become less stable. Have you had a standing Xray recently at all? I have read after surgeries like this, sometimes surrounding structures get less stable or sometimes people even develop spondylolisthesis (slippage of one vertebrae over the other, which is probably more noticeable upon standing).

    I know exactly how you feel, though about feeling old. Mine started when I was 32-33. By the time I turned 37, I felt 97. And don't ask me how I functioned or went to work every day in the pain I was in....I guess it was just I had no other choice. I needed income so I had to go. Other than that, I was pretty much housebound, except for going to PT. I could no longer go shopping (only food shopping using a cart)..no more going to movies, no eating out dinner; I couldnt go anywhere that I had to stand up for any lenght of time. And If I couldnt find a parking spot close to a building, I left or I wouldnt make it into the building. It was depressing at times, like when I went to my rheumy appointments. By the time I made it into the building and waiting for the elevator, leaning on the wall all bent over in agony, my face red, breathing hard because my entire body was in spasm....and even elderly folks would ask me if I needed help. How could I let someone elderly who couldnt walk that well themself try to help me walk?? I mean, I really appreciated it, especially the elderly were usually the only ones to offer help..but I just wouldnt feel right about it. It's hard to explain, I hope i'm not coming off the wrong way.

    As far as the nerve root block, I've never actually had one of those so I'm sorry I cant speak from experience on that. I guess it's possible it could triggered other pain. Maybe others who've had them done can shed some light for you.

    Yes, I had many ups and downs as well. As it progressed, though....it was pretty much pain all the time for me. I guess I should have had it checked into sooner. I have the same thing with my lupus flares...one day I can feel fine, the next every part of my body can feel stiff and painful.

    As far as anythign else helping me....moist heating pads seemed to help best for my spasms (but only while the pad was on). I know in some way that physical therapy helped.....it definitely helped that I went for 6 months before surgery to really strengthen everythign ahead of time. Medrol Dose pack (prescription) helped the first 2 days with the higher doses; anything that I could lean on helped; Oh and I even bought one of those plug in mattress lifters <LOL> (that you stick between your mattresses) to raise my head/upper back area while laying down. sometimes it helped me get out of bed when I couldnt move. It also helped me get out of bed after surgery!.
    I also use a dense memory foam mattress pad (which helped a little on some pressure points); plus I sleep using a cervical pillow, even while sleeping on my side. Actually Vicoprofen was the only script that helped me slightly, but I had to stop taking it due to severe widespread bruising. <figures> After I stopped that, I was taking nothing anymore...so needless to say, I think I now have a very high pain tolerance (which is not necessarily good). If I can remember anything else I tried, I will definitely let you know!

    I wish you well...and if you have any other questions, just ask away!

     
    Old 01-20-2007, 09:53 AM   #6
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    Re: Baybreeze....Neurogenic Claudiication Anyone?

    [I][COLOR="red"]Again thank you so much for your support. I am feeling so much better after our chat. I can't thank you enough. Sending you a cyber hug your way. [/COLOR][/I]

    Last edited by HBMod07; 01-20-2007 at 10:13 PM. Reason: removed quote

     
    Old 01-20-2007, 12:09 PM   #7
    Baybreeze
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    Re: Baybreeze....Neurogenic Claudiication Anyone?

    Yes, i've tried muscle relaxers (skelaxin and flexeril)....the skelaxin did nothing at all, the flexeril made me very groggy, but i'm not sure how much, if at all, it helped me. I had also started using big moist heating pads when I started it. The pads gave me a little relief while using them...but once they were off, the spasms were back full force.

    I never actually fell down from a leg giving out but I have come close. Sometimes the sudden, sharp sciatica pains would feel like an electrical jolt and I guess maybe that sudden pain would cause my muscles to lock up or something. But thankfully, I never did fall.

    (((((((((hugs)))))))))) to you too!

     
    Old 01-20-2007, 01:20 PM   #8
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    Re: Baybreeze....Neurogenic Claudiication Anyone?

    Baybreeze, you have been such a help to me today. I guess I did not realize it but I was having a major anxiety panic attack. I feel like this pain is causing me to go or INSANE!!!

    I have found that the heat is a big help as well as the recliner massager. I shall get through this and I am so thankful to have had your help today understanding my pain.

    I will post when my surgery is scheduled.

     
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