By Bernard Preston
Chronic Lower Back Pain
I am interested in your thoughts and suggestions that may be able to help a teenager with 2 years chronic pain from from Figure Skating and Running injury.
Chronic Lower Back and Left Leg pain for two years
. Level 7 to 10 Lower Back
. Only alleviated when lying down (level 3)
. Left high buttock pain - Stabbing pain when any pressure applied
. Sitting causes same pain
. Left leg outer, upper calf and thigh - Tingling sensation
New since surgery
. Pinching in low back when walk or run, extending a leg
. Left outer leg numbing during running
. Left leg tingles when walk
Surgery L5-S1 Artificial Disc replacement
Medication 1200mg Ibuprofin
All conservative therapies
A distressing story for any parent obviously, not to mention your daughter. You mention that she has had all conservative therapies, and I presume that would also include chiropractic.
Does the tingling and numb feeling extend ever, or did it in the beginning into the foot? Which toes? The first thought is that the outer leg is normally considered the L5 distribution. Whilst the L5/S1 disc can affect the L5 root, more usually it would cause the symptoms at the back of the thigh and calf, and side of the foot.
I'm wondering about the L4/L5 disc. On the Dropbox scans it appears normal, but only certain views are shown. Perhaps you'd like to have the pre-surgery MRI read by an independent radiologist.
Ask her please, off all medication for 24 hours to
1. Bend slowly and carefully forwards, then backwards and then to the side, and relate EXACTLY where the pain and numbness increases. So, four answers.
2. Sitting in a normal kitchen chair, would you straighten first her right leg parallel to the ground, lower it, and then the left leg; it's done passively; you lift the leg, not her. In both cases, EXACTLY what does she feel? Does straightening the right leg do anything in the left leg? Then repeat with the head flexed forward on her chest. Do it all gently as it can aggravate the condition.
3. Standing on the left leg, supported by a counter top, can she raise the big toe? And then can she raise her heel high off the ground without strain; on her toes.
4. Using a pin prick her leg and foot and compared sides; is there a difference? Where?
Looking forward to your answers; please be precise. And the dropbox x-rays.
Treat any information and opinion from Dr Google with caution! I cannot examine her first hand.
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