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Lumbar Disc or SI Issue/Sciatica

I am new to the board. I am 26 years old, male, overweight (in the process of getting that down), healthy otherwise, fairly active (I teach & coach football for a living). I have had past back issues: When I was 19 I was diagnosed with a bulge in the L5 disc. I had injections done at that time and it really helped, have had SI joint issues also in the past but usually they resolve fairly quickly. A few weeks ago (4) I shuffled in a drill at football practice, my back felt like it gave out, had a shooting pain in my lower left back and was in pretty good pain for about two days. I went to the doctor and was prescribed Mobic & muscle relaxer which really helped the pain. Now I am having this issue, after about a week I began having Sciatica pain down my right leg, mostly the outside of my calf and top of my foot. My back pain is actually pretty limited but am having some stiffness along with a very tender spot to the right of the S1. My regular medical doctor has ordered an MRI and am waiting for insurance to approve (fun fun). Wanted to kind of see what y'all think may be going on if this is disc or si related and how serious do y'all feel this may be. I really would like to avoid surgery if at all possible. The sciatica pain is what is bothering me the most, 300mg gabapentin has helped and sometimes gets it to stop but I really don't want to be on it for the rest of my life. I have read a lot of threads on here and this seems to be a good community to discuss this in so thought I would join. 

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1

Comments

  • It's likely what you already know. A bulging disc. Or perhaps it worsened and is now ruptured and spilling out, and thus irritating your nerve. You'll know soon enough. Hopefully some weight loss and PT will cure you. Good luck

  • Ok so got my MRI results back, they are as follows:

    FINDINGS: Mild smooth scoliosis is
    convex left. Alignment is otherwise normal. No compression fractures or
    suspicious bone lesions. There is mild multilevel disc degeneration with
    multiple small degenerative Schmorl's nodes in the vertebral endplates. No
    evidence of discitis or osteomyelitis. Cauda equina and conus medullaris have
    normal signal and location.

    T12-L1 through L4-L5: No disc herniation,
    canal stenosis, or neural foraminal stenosis.
    L5-S1: Small left paracentral
    disc protrusion. No canal or neural foraminal
    stenosis.


    IMPRESSION:
    1. Small left paracentral disc protrusion at
    L5-S1.
    2. No canal or neural foraminal stenosis.
    3. Multilevel disc and
    endplate degenerative change.

    One question I have is what do they mean by "protrusion" is this more in line with a bulge or a herniation/rupture? I have to say my pain has improved over the past week & a half and I am also down 15 pounds over the last three 1/2 weeks. Down to taking a mobic in the morning and one 300mg gabapentin  in the evening. Still not 100% but closer to 80%. I am going to see my specialist Monday of next week to see what he has to say. 

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  • challengercchallenger Posts: 1,236
    edited 07/09/2019 - 9:50 AM

    Hopefully this is just a bump in the road but one you need to remember every time you start to do something, take that advice from a dummy that didn"t.  

    challenger
    Veritas-Health Moderator


  • VUDore92VVUDore92 Posts: 12
    edited 01/16/2019 - 12:52 PM

    Thought I would post an update. I went to my spine specialist in late December and he did not seem to think the disc bulge is causing my sciatica but ordered a Nerve Study anyway. After having the study it showed that I have Bilateral sciatica which seems odd for such a small bulge. I am scheduled next week to have Epidural Spinal Injections which I hope will help, I had them done in 2010 and it worked well for a long time. Have been excising, using the elliptical at the gym and have been stretching on a regular basis. Most of the pain/pins & needles feeling & pain has been in my calves & feet, nothing really above the knee.  

    I wanted to ask about this issue though: I have been having some urinary issues since around the time I started having back pain. On & off and mainly when I am sitting I have had a sensation in my urethra that there is pee stuck in it. I have never had an issue with emptying my bladder, no leaking, no bowel issues. Have had some spasms in the perineum area but not numbness. Felt like a prostate issue so went to an urologist who put me on an antibiotic and flomax. It has seemed to help but still have on and off bouts with this, just really annoying and was curious if it could be related to my back. Wouldn't think its CES because the MRI showed no issues in that area and my spine specialist didn't seem to think it was related to my back. Just weird how it mainly flares up when I sit & also seems to wax and wane with back pain. Could it be Pedunal Nerve Entrapment possibly? 


  • Any thoughts on this?

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  • You sound like a hypochondriac (although I am this way too so no offense intended).

    I have trouble getting a pee stream initiated too but I’m unsure if it’s a side effect to medication causing this or suspected nerve root impingement.

    Good luck with your injections next week. They didn’t help me. 

    After I had the follow up with the injections doctor following injections he wondered if they didn’t work because of aiming them at the incorrect body part.

    Only one doctor who’s looked at my lumbar MRI has said I have suspected nerve root impingement. And it wasn’t the injections doctor.

  • Yeah you might be on to something there, I can tend to use Dr. Google a bit too much on stuff and it will make you believe you are dying. Appreciate the feedback though, hopefully the injections work. Just weirdness with my back, but maybe it will improve.

  • If you really want to address the bladder retention issue try getting a referral to a pelvic floor rehab specialist PT. I'm female and have these issues but it has helped me.

  • That thought has went through my mind, the flomax has helped which tells me it’s my prostate, just may be non bacterial chronic so a pelvic floor Pt may help. 

  • I tried pelvic floor therapy and it didn’t help. 

    The therapist dismissed me a week early because it wasn’t helping and we both were getting frustrated.

    Sometimes it’s a pesky disc/nerve causing the symptoms.

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