
What Does This CT Scan Regarding Difficulty Walking Indicate?

I need some more information
Detailed Answer:
this is really 2 questions in one:
1) is there anything terrible in my ct scan?
2) what is happening with my back and will it get better?
as far as your ct scan this is a pretty normal scan for someone of your age. it shows some degenerative changes we loosely call "arthritis" but nothing severe
that requires surgery. you have some areas where the arthritis could pinch a nerve which is what is most likely happening to you. in order to help with this I need some more information
along with the back spasm did you have buttock/thigh/calf/foot cramps?
which side is the back pain on?
did you have an emg?
did it start in the back and then move lower on your leg and now improving the same
way it worsened?
any weakness in the leg?


I have had peroneal pain due to posterior tibial dysfunction prior to this back issue.
Sounds pretty certain
Detailed Answer:
At least from the history you gave, that's a pretty convincing story for a pinched nerve. All of the symptoms you mentioned are caused by that one problem.
Epidural steroid injections work really well and you will probably have good relief. Peroneal and posterior tibial dysfunction are a separate problem.


The CT scan states that there isn't any nerve compression....will a pinched nerve show up on a mri?
I now have a problem with restless legs and insomnia, that did not exist before all this...what have you found to be most often effective?
Most of the pain is at L5-S1. Last night I am starting to get sharp pains at the top of my Lt foot. Is this unrelated to the back?
No, no, and yea
Detailed Answer:
epidurals work well for pain control of the symptoms going down your leg but the underlying problem that caused it is still there. if you overdo the pain will come back. your arthritis isn't that bad though so there isn't really anything that will happen if you overdo it except more pain.
the MRI will show the nerve and discs better but there will probably be little in the way of severe disease. your MRI will probably be read by radiology as mild. lots of times the pinched nerve will show up on the emg but not MRI, sometimes at sites where the arthritis isn't that bad. depends on where the irritation is.
most likely any symptoms you have currently are from the bad except restless legs which is its own disease.sometimes epidurals help restless legs though if the sensations you're having aren't actually a brain problem


I have recently stopped tramadol and am having severe insomnia,...from reading online, it appears that restless legs could be related to tramadol withdrawal as well as the insomnia. I guess it is something I will just have to put up with, because nothing is working.........benadryl or gravol or tylenol and naproxen, or chamomile tea or muscle relaxant. and I use a cpap for sleep apnea....so enough of trying to find an insomnia remedy. Have been to the public pool and hot tub, 2 nights in a row with no improvement either.
if the pain is/was due to a nerve that is pinched or compressed, it is important not to contribute to further compression. my job entails a lot of sitting...if the epidural controls the pain and I go back to work and sit a lot......it will hinder any long term progress. However on the other hand if the epidural contains a corticosteroid ? it may reduce inflammation and compression?
because the pain came on acutely,....I tend to think of it as something that can be resolved, rather than chronic arthritis.
severe lower leg muscle spasms preceded all this, are muscle spasms related to nerve compression?
Yes,
Detailed Answer:
Hi,
Thanks for writing back.
Sorry that was supposed to be "from the back". Cramps are very common. If you truly have restless legs none of the treatments you mentioned are indicated for it. Most of what you mentioned are treatments for sciatica/back pain/cramping. Treatment with Te injections will actually help you sit longer and the job you do has nothing to do with the long term outcome other than put you at risk for progression of your lumbar arthritis if you don't use proper ergonomics and posture,
Regards,


Right now, there are several ways that I can overdue it: sitting too long, walking too much, and as you mention improper ergonomics( eg moving too quickly and/or in the wrong way).
My job entails sitting for very long periods. eg most of the day.
Without the epidural, I can not sit for more than 2-3 hrs per day. that is, here at home.
With the epidural I guess, due to the absence of pain, I could sit for 8 hrs / day.
It makes sense to me, that if I were to choose to sit for 8 hrs/ day with the epidural, that it would be a step backwards rather than forwards. My understanding from my physiotherapist, is that I will not be able to sit for 8 hrs/day as I have previously.
Restless legs must have been part of withdrawing from use of tramadol. Gone now.
I am choosing to put up with the pain and limitations associated with the pain, rather than use the tramadol, because of side effects. Slept fine with 1/2 tab gravol. Wake up with some pain, but bearable,...since I am not at work.
I live in Abbotsford, BC, Canada, and work as a nurse case manager for community health.
Sort of
Detailed Answer:
sitting isn't really a step back and neither is standing. your problem is likely to completely resolve with the injection and allow you to sit much longer. you can expect that your pain will return at some time but there isn't much you can do to provoke it intentionally besides incorrect lifting techniques. day to day activities are unlikely to provoke the pain

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