I'm new here with questions

[Guest guest]

Hi

I've had right leg pain for 2 years, not long compared to others, but it's

now stopping me from working and I'm impatient to get back to a normal life.

My GP (General Practitioner) is now at a loss as to where to go. I have been

referred to PM (Pain Management) by a Nerosurgeon, but I am not sure about

the person he recommended. I googled him and someone with the same name has

been found guilty of Professional Misconduct and earlier this month finished

their period of Supervision which was part of his penalty. What I really

want is to know what I have as I believe that is the only chance I have for

correcting it. Or else for someone to say something definite such as - you

have ???, there is nothing that can cure it, management is all that can be

done. At least I'd know where I stood. At the moment I just don't trust

anyone completely.

I should say that I am from New Zealand. There isn't much choice and they

don't seem to be as advanced as America.

I first noticed the pain in my right leg in Aug 06, I was in bed with a cold

& the pain was thought to be from flu. During this time I had very severe

neck pain during one night. The pain doesn't travel down my leg, it settles

in places in my leg. I had a back x-ray, physio, accupuncture, saw an Ortho

surgeon (referred for cortisone injection), Neurologist (referred to

Neurosurgeon) and a Neurosurgeon (referred to Pain Management), 4 cortisone

injections and 2 MRI's of my lumbar spine 2 years apart. I went through

Activity Based Therapy with a physiotherapist. I've been on various pain

killers during this time but can't take them now. The pain has spread and

increased in intensity. Also I had my right ovary with a cyst removed after

my first MRI. Since then I get pain in my right groin when I sit. The pain

is worse after sitting, on standing, walking isn't too bad, lying on my

stomach is the best place to be.

Can anyone help with understanding my MRI's and where to go now?

Thankyou for reading this and letting me vent. It has been good to get

things clear in my own mind, but I am still at a loss as to what to do.

MRI Lumbar Spine 30 July 07 (with contrast)

L4/5 & L5/S1 discs are dehydrated and have lost a little height.

L5/S1 there is a small right paracentral disc extrusion which contact and

displaces the proximal right S1 nerve root, without obviously compressing

it.

There is an annular defect at L4/5 on the left without associated disc

extrusion.

There is no spinal stenosis. The neural foramina are of adequate calibre.

The distal cord appears normal, the tip of the conus lying at the L1/2

level. There is a vertebral body haemangioma at L2. No aggressive osseous

lesion is identified.

The posterior elements are unremarkable.

A lobulated cystic structure follows the course of the right S1 nerve root

from the proximal portion of the neural foramen into the pelvis. This has a

length of 4cm and a maximum diameter of 2cm and is associated with

enlargement of the neural foramen. No associated enhancement nor oedema is

identified, appearances being typical of a perineural cyst.

A small perineural cyst involves the right S2 nerve root.

The lower sacrum and presacral area appear normal.

Related to the right ovary there is a 3cm complex endometriotic cyst.

MRI Lumbar Spine 19 September 08

Comparison is made with an MRI of 30/7/07

Alignment is unchanged.

A degree of disc dehydration and minor height loss at L4/5 has not

progressed. As previously, there is an annular deficiency in a left

posterolateral position, without significant extrusion.

There has been a slight resorption of right paracentral disc extrusion at

L5/S1. Disc material is now seen to approximate the right S1 nerve root as

it exits from the thecal sac, but is not associated with any nerve

displacement or compression.

No significant disc pathology is idntified more proximally in the lumbar

region.

A slightly lobulated peri-neural cyst related to the right S1 nerve root is

unchanged in size, having a diameter of 14mm and total length of around 3cm.

The cyst occupies most of the right S1 neural foramen, the S1 nerve root

lying at it anterior and superior aspect, and possibly compressed in its

proximal foraminal portion. Cyst extends into the pelvis for just under 2cm

and follows the S1 nerve root towards its junction with the sciatica nerve.

A 7mm cyst lies adjacent to the left S2 nerve root.

No aggressive osseous lesion or paraspinal abnormality is identified.

Incidental note is again made of an L2 vertebral body haemangioma.

The distal spinal cord has normal appearances, the tip of the conus lying at

the mid-L1 level.

From what I understand, everything is normal and doesn't explain the pain

that I have.

Thanks

Helen

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