I wasn't sure where to post this since I've got a hodgepodge of pain that could go in a variety of sub sections so figured I'd just start here. Will try to be informative but keep it short.
In June 2017 I started having a deep ache in my left testicle, severe lower back pain, and burning pain on the inside of my left thigh not going past the knee. This was mainly with sitting and would be relieved with standing. Moderate lower back pain is something I've dealt with on and off for the past ten years so didnt think much of it. I had a similar instance of left testicular pain with accompanying back pain in 2008 and it cleared up on its own after a few months by me just ignoring it. This time around it came on with a vengeance and I ended up going to the ER where they sent me home diagnosed with epididymitis. A couple weeks later after no relief I went to my primary who ordered a lumbar MRI.
My MRI report is below the line at the bottom. I was told by my primary that the MRI didnt really show anything that conclusively could point to my pain as someone who has zero pain could have the same exact MRI report. After I went through a whole urology workup to rule out that as the cause, I was referred to Pain Management (PM). PM doc said same thing; that the report didnt show any serious damage that would blatantly point to my back as the problem and that my issues at 3-4, 4-5, and 5-S1 were mild at best. PM doc did a trans epidural bilat at L4-L5 with maybe 50% relief and followed it up with another a month later at just L4 with no relief. Another PM doc wanted to do facet injections in hopes of a possible ablation. Both sets of test injections gave me 80% relief of backpain but didnt touch the leg or groin pain. We followed up with bilateral L4 L5 facet ablation on Sept 28, 2018 and the back pain was reduced; and has stayed reduced by 90%. No impact on groin or leg. As much as I am grateful the back pain has been severely reduced, my leg and groin were and continue to be my chief complaint.
PM doc also did an genitofemoral nerve block and inguinal nerve with no relief. He said we can try SI joint nerve block next.
I've been doing PT for the past three months with minimal improvement. There has been slight improvement in both leg and groin pain but nowhere near being alleviated. When this all started I was unable to sleep on my left side at all and had trouble sleeping through the night. Now I'm able to sleep on my left side for a little while before pain starts and am also able to sleep through the night. I'm able to walk comfortably, drive a car, go up the stairs, pick up my baby, all with minimal discomfort. Its sitting that cause the leg and groin to co crazy so I try and avoid it. My job has been nice enough to let me work from home since this all happened.
I've read a lot on this board over the past couple years about people going through all kinds of crazy pain so I feel bad for even complaining about mine. So my questions are these:
1: If my mild disc bulges (indicated below) were pressing on a nerve root, would the MRI report say that? Since they dont mention nerve roots does that mean nothing is pressing on them?
2: Since my pain is not debilitating as it is for so many in here, should I forget about reaching to a surgeon for an opinion (in your opinions of course)?
3. Since its been 18 months since this all started, should I assume conservative measures will not fix this or should I cling to that hope since there has been some improvement; even though small?
4. Anyone have just leg pain as their chief complaint but back pain is moderate at best?
Thank you for reading my ramblings.
Neurontin 600MG TID - no success
Percocet 10MG as needed TID - moderate success
MS Contin 30MG BID - moderate success
NSAID - all of them; moderate success
There is normal lumbar lordosis. Vertebral bodies demonstrate normal height. There is mild disc desiccation and intervertebral disc space narrowing at L4-5 and L5-S1. There are small disc bulges and annular fissures at these 2 levels. There is mild retrolisthesis of L4 on L5. Marrow signal is within normal limits.
The cord demonstrates normal signal and terminates at L2. Visualized portions of the retroperitoneum are within normal limits.
T12-L1: There is no evidence for central canal or neural foraminal narrowing.
L1-2: There is no evidence for central canal or neural foraminal narrowing.
L2-3: There is no evidence for central canal or neural foraminal narrowing.
L3-4: There is mild bilateral facet arthropathy. There is mild bilateral posterior osseous ridging. The central canal is patent. The neural foramen are patent bilaterally. There has been no significant change when compared to the prior examination.
L4-5: There is grade 1 retrolisthesis of L4 on L5. There is a mild broad-based disc bulge with a small superimposed central disc protrusion and annular fissure. There is bilateral facet arthropathy and ligamentum flavum infolding. The central canal is patent. There is mild bilateral recess and neural foraminal narrowing. There has been no significant change when compared to the prior examination.
L5-S1: There is mild disc desiccation and intervertebral disc space narrowing. There is a mild circumferential disc bulge. There is a small superimposed central disc protrusion and annular fissure. There is mild bilateral facet arthropathy. The central canal is patent. There is mild left neural foraminal narrowing. There has been no significant change when compared to the prior examination.