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Suggest Treatment For Leg And Back Pain
Question: I have been experiencing horrible leg pain for months that has only been getting worse, started in my left leg and has started in my right now. last week I woke up and my back was killing me. I had an Mri today, and I understand what the findings are, I just wonder what my options are. I am a surgical technologist for a living and the pain has been really bad by about hour two of work.
My Mri findings were L5-s1 there is a large central disk herniation present. There is effacement of the anterior thecal sac. The spinal canal is narrowed to approximately 4.7mm from the above 7mm. the disc material likely contacts the intrathecal right s1 nerve roots. There is facet hypertrophy present. There is minimal right neural foraminal narrowing present. Mild disc buldge at l4-l5 likely representing congenital spinal canal stenosis. Diffuse abnormal signal which may represent red marrow conversion with other etiologies not excluded.
I had an MRI 4 years ago when I had back pain and it noted the abnormal bone marrow thing. the hematologist at the time said that the only thing he could find was that I had almost no old red blood cells all new ones as if I had recently lost a lot of blood. he said that other than doing a bone marrow biopsy there was no way to know for sure what was going on and since I had no other symptoms at that time to not worry. But is has been noted twice now once in my back since then and once on an MRI on my knee. I am worried about the possibility of multiple myloma, and what my options are for my back.
My Mri findings were L5-s1 there is a large central disk herniation present. There is effacement of the anterior thecal sac. The spinal canal is narrowed to approximately 4.7mm from the above 7mm. the disc material likely contacts the intrathecal right s1 nerve roots. There is facet hypertrophy present. There is minimal right neural foraminal narrowing present. Mild disc buldge at l4-l5 likely representing congenital spinal canal stenosis. Diffuse abnormal signal which may represent red marrow conversion with other etiologies not excluded.
I had an MRI 4 years ago when I had back pain and it noted the abnormal bone marrow thing. the hematologist at the time said that the only thing he could find was that I had almost no old red blood cells all new ones as if I had recently lost a lot of blood. he said that other than doing a bone marrow biopsy there was no way to know for sure what was going on and since I had no other symptoms at that time to not worry. But is has been noted twice now once in my back since then and once on an MRI on my knee. I am worried about the possibility of multiple myloma, and what my options are for my back.
Brief Answer:
Not Multiple Myeloma
Detailed Answer:
Dear
I am sorry for the symptoms you are suffering
In my opinion you are not suffering multiple myeloma because MM has fracture, anemia and specific symptoms
You can absolutely rule out it by doing bence XXXXXXX protein in urine, if they are negative MM is impossible
I carefully read you MR report and I think you can try to avoid surgery by wearing lumbar fortress and pain killer to avoid pain
Surgery is absolutely needed when paralysis are evident, urinary problems or spinal stenosis
Anyway you will delay surgery but unfortunately I think soon surgery will be your only solution
Sorry for being so honest
Wish you all the best
Regards
Dr Eris Ranxha
Neurologist
Not Multiple Myeloma
Detailed Answer:
Dear
I am sorry for the symptoms you are suffering
In my opinion you are not suffering multiple myeloma because MM has fracture, anemia and specific symptoms
You can absolutely rule out it by doing bence XXXXXXX protein in urine, if they are negative MM is impossible
I carefully read you MR report and I think you can try to avoid surgery by wearing lumbar fortress and pain killer to avoid pain
Surgery is absolutely needed when paralysis are evident, urinary problems or spinal stenosis
Anyway you will delay surgery but unfortunately I think soon surgery will be your only solution
Sorry for being so honest
Wish you all the best
Regards
Dr Eris Ranxha
Neurologist
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
I love and appreciate honesty. that I understand. should I see a neuro surgeon or orthopedic. I work with a great spine guy but he is orthopedic. haven't done the check for MM it was my own brain going off. As far as surgery they would do a disectomy? would there be pedical screws and rods? is this common in someone my age? sorry for all the fallow ups. really I can deal with my back pain its my legs. after two hours at the OR table they hurt so bad and yesterday I couldn't even hardly walk at the end of an eight hour day. your help and honesty is greatly appreciated.
Brief Answer:
Neurosurgeon
Detailed Answer:
Dear
you need to consult a neurosurgeon, spine surgery isn't done by orthopedics
It's up to neurosurgeon to decide the right time of surgery, probably you should have a disectomy
As your biggest complain is leg pain before deciding for surgery you can try corticosteroids shots on herniation level ( L5-S1)
It will minimize the pain provoked by nerve root comprising
It can be done by orthopedist, radiologist, neurologist
Unfortunately as discal herniation is a mechanical problem it isn't related to age
It can be more at younger as they daily activity has more physical stress
In my opinion you should wear a lumbar fortress, use pain killer, schedule a cortisone shot.
If you don't feel any result after them schedule surgery
Hope i have helped you in clarifying all your doubts
Don't hesitate to contact me for further questions
Stay healthy
Best Regards
Dr Eris Ranxha
Neurologist
Neurosurgeon
Detailed Answer:
Dear
you need to consult a neurosurgeon, spine surgery isn't done by orthopedics
It's up to neurosurgeon to decide the right time of surgery, probably you should have a disectomy
As your biggest complain is leg pain before deciding for surgery you can try corticosteroids shots on herniation level ( L5-S1)
It will minimize the pain provoked by nerve root comprising
It can be done by orthopedist, radiologist, neurologist
Unfortunately as discal herniation is a mechanical problem it isn't related to age
It can be more at younger as they daily activity has more physical stress
In my opinion you should wear a lumbar fortress, use pain killer, schedule a cortisone shot.
If you don't feel any result after them schedule surgery
Hope i have helped you in clarifying all your doubts
Don't hesitate to contact me for further questions
Stay healthy
Best Regards
Dr Eris Ranxha
Neurologist
Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.
Above answer was peer-reviewed by :
Dr. Prasad
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