How JustAnswer Works:

  • Ask an Expert
    Experts are full of valuable knowledge and are ready to help with any question. Credentials confirmed by a Fortune 500 verification firm.
  • Get a Professional Answer
    Via email, text message, or notification as you wait on our site.
    Ask follow up questions if you need to.
  • 100% Satisfaction Guarantee
    Rate the answer you receive.

Ask Dr. Charles Your Own Question

Dr. Charles
Dr. Charles, Doctor
Category: Health
Satisfied Customers: 7167
Experience:  Internal medicine specialist
6554558
Type Your Health Question Here...
Dr. Charles is online now
A new question is answered every 9 seconds

I have spinal stenosis in my cervical, thoracic and lumbar

Customer Question

I have spinal stenosis in my cervical, thoracic and lumbar spine. I have gone through horrible experiences with pain. I had aching numb arms and hands for awhile and still it causes pain to rest my forearms against anything. Even my own lap. Now I suddenly developed severe pain in my right leg. It hurts the most to stand still and it hurts in some degree all the time. I have a numb right foot and outside of my right calf. It feels as if i cant move my toes and its hard to slip a flip flop on between my toes. When I walk it hurts down the back of my thigh and behind my knee almost like a pulled muscle. The pain in my entire leg is excrutiating. It is near unbareable. I do have a herniated disc in my low back but no back pain at this time. What could this be? I am having a difficult time performing any normal activities of daily living.


I have also had ncs on upper extremities and i have had surgery on my neck during which two cages were placed in my neck. I have also been diagnosed with carpal tunnel in both arms, the right is moderate to severe. The left is mild to moderate. One study showed I also had ulnar nerve damage but now the tests dont show that. The spinal stenosis is near severe. My Dr. said im at a 7 and severe is 8.


I am 48years old. One Dr. said my neck looks as if it belongs on a 90 year old. I do not have athritis or any autoimmune disease. I also do not have osteoperosis etc. Please forgive my poor spelling. I was attackted and injured.

Submitted: 1 year ago.
Category: Health
Expert:  Dr. Charles replied 1 year ago.
Dear customer,
I am Dr.Charles and I’m happy to help with your question today .I need the following information from you,so that I can provide you the complete & best answer:

What is your age?
When were you diagnosed with spinal stenosis?
Are you overweight?

I am online and is waiting for your reply.

Kind Regards-
Dr. Charles


Customer: replied 1 year ago.

I am 49 years old. I just had new MRI tests on my lumbar and cervical spine. I got the results about a week and a half ago. The report says spinal stenosis. I do believe I had that same diagnosis in 2011 though not as severe. The disc herniation is the first time being discovered in these new tests.


Expert:  Dr. Charles replied 1 year ago.
Dear Lynette,
Thanks for the valuable info you had given.I’ve taken a close look at your question & the reply and come up with the following answer:

The symptoms you have described seems most probably because of nerve root compression.Any compromise of the nerve space in the spinal column can lead to compression of the nerve endings.This occurs because of wear and tear or injury or degeneration of the discs.

The severe pain in right leg,numbness in right foot and outside right calf is most probably due to compression of nerve root.Sciatica is generally caused by the compression of lumbar nerves or sacral nerves.

This occurs because of lumbar radiculopathy,spinal disc herniation,wear and tear, or injury or degeneration of the discs.

As you had history of herniated disc & spinal stenosis,this seems to be the underlying cause of this pain.These are the causes of all your Pains,numbness & other symptoms.

Non surgical treatment options are:Nonsteroidal anti-inflammatory medications (NSAIDs),Cold therapy, heat therapy or both,Oral Steroid Medications,Transcutaneous electrical nerve stimulation (TENS) delivers a tiny electrical current to key points on a nerve pathway,Epidural Steroid Injections.Injections of cortisone can be administered directly in the area of nerve compression.

If you have tried for these medications & injections,non-surgical treatments & other conservative treatment and they haven't helped reduce your pain,then surgery is the only option.

So I advice you to make an appointment with your neurologist for examination to confirm these causes as the root cause of your symptoms & then treatment will be done accordingly as described above.if the pain is very severe or you do not get an early appointment,then go to ER as shots will be given accordingly.


Please remember to rate my service once you have all the information you need. If you have any other questions, please ask me – I’ll be happy to respond.

Thank you! XXXXX
Dr. Charles





Customer: replied 1 year ago.

I am taking oxycontin, norflex, and mobic. Nothing is touching this pain. I stay on a heating pad most of the day and walking is very difficult. I try changing positions constantly and get very little relief. My primary Dr. gave me shots under ultrasound directly to the area I hurt the most in. He pressed on various areas and a spot on my buttocks sent me through the roof. I read sciatica gets relief if you sit or lean forward. I also read you have back pain with it.


I also have alot of perfectly round sores that are painful and wont heal. Could they be connected. They have been on my buttocks for a couple years and i get them on my face and arms as well. Now I have some on my legs.


I have had most of these issues for a couple years at the least. How will i know if its permanent? My neurologist has me scheduled the 23rd of this month for a nerve conduction study. He also referred me to Stanford. I saw him on a wednesday and by that friday Stanford was calling and I see them this coming monday. It all took less than two weeks to get that apt. Should I be worried?

Expert:  Dr. Charles replied 1 year ago.

Dear Lynette

 

As you have already tried the oral medications,heating pad,changing the positions,shots in painful area & other treatment but still there is no relief from pain,so I think surgery will be the best option now.

 

The painful round sores on buttocks & other area does not seem to be related to this & you need to consult your skin doctor for this.

 

As you are already scheduled for appointment with neurologist on 23rd,I advice you to wait for this & then after tests the treatment will be done accordingly.

 


You need following tests:

-Electromyography(EMG)

-Nerve conduction studies,

-Certain blood tests,

-Electro physiological studies

-Nerve conduction velocity (NCV)

Also I would advice you to wait for the Stanford appointment to consult the specialized doctor & discuss the surgical option to get the lasting pain relief from this.

 

Surgical procedures may involve removal of bone and disk tissue or may remove bone spurs or disk material (decompression) and provide lasting pain relief.You may need either decompression surgery or a stabilization surgery, and often, a
decompression and fusion are done at the same time. Artificial disc replacement
(ADR), sometimes called total disc replacement (TDR), is a newer and somewhat
more complex procedure than fusion.

So your neurologist will decide the best option accordingly.

 

Please remember to rate my service once you have all the information you need. If you have any other questions,please ask me - I'll be happy to respond.

Thank you!


Kind Regards-

Dr. Charles






Customer: replied 1 year ago.

I am sorry I fell asleep last night.

Wow that is alot. However I knew most of that already. I feel you were simply repeating what i already told you but threw in some technical info to make it sound official. I am not trying to offend you. I was looking for a possible diagnosis. I mean the MRI results already tell me i have nerve compression.

I also am confused or i obtained some bad info, but if it is something along the lines of peripheal nueropathy - excuse the mis spelling, it certainly does include the possibility of sores that wont heal.

Speaking of the sores i would also appreciate an opinion here, they are perfectly round, deep, painful and very red around the outside border. Any clue what it may be?

Expert:  Dr. Charles replied 1 year ago.
Dear Lynette

As I said above that the painful round sores on buttocks & other area does not seem to be related to this & you need to consult your skin doctor for this.You may need skin biopsy for this to know exactly the underlying cause & hence the treatment.

As I said above sciatica is the most probable cause of your symptoms.As you are already diagnosed with spinal stenosis & herniated disc,this is the underlying cause due to which the sciatic nerve is compressed resulting in sciatica.

I had already described the surgical options for you.Final decision will be taken by your doctor after clinical examination & considering various factors.

Total element replacement devices, during which a device designed to preserve motion is implanted after decompression.
Surgery for lumbar spinal stenosis can be very successful in most cases for the leg symptoms.

So your neurologist will decide the best option accordingly for which you are already scheduled on 23 rd of this month.

Hope this helped.

Please remember to rate my service once you have all the information you need. If you have any other questions,please ask me - I'll be happy to respond.
Thank you!

Kind Regards-

Dr. Charles


Customer: replied 1 year ago.

My apologies i didnt recall you mentioning sciatica however i re-read your response and i see it is there. Can sciatica really hurt this bad? It is near unbarable. It feels like i have rubber bands around my ankle and up a bit on my leg plus like i have a sock on thats much too tight on top of the rubber bands. Don't worry your review will be favorable.


I have trouble swallowing and its been that way since my neck surgery in Dec 2011. I see that plus sores that wont heal and the pins and needles and other types of pain along with trouble using the restroom- I have every symptom but two- and peripheal nueropathy pops up. Is this a possibility and what would be the prognosis for this?

Expert:  Dr. Charles replied 1 year ago.
Dear Lynette
I am happy to answer your follow up questions.

Yes,sciatica pain can be moderate to very severe that may be unbearable & usually shots are required to get relief from the pain.

First, you'll probably need at least a few days of bed rest while the inflammation goes away.Approximately 80% to 90% of patients with sciatica get better over time with rest without surgery. In addition, you may find it soothing to put gentle heat or cold on your painful muscles.

Rehabilitation typically includes exercises to help correct your posture, strengthen the muscles supporting your back and improve your flexibility. Prescribed exercise may include light stretching, walking, and aerobic type exercise. Overall, the vast majority of episodes of sciatica pain heal within a six to twelve week time span.

The trouble swallowing may be due to the complication of your neck surgery & you need to consult to your surgeon who had done this surgery.

The pins & needle sensation/pains you are having is most likely because of nerve root compression/pinched nerve.

If surgery is done,prognosis is very good.Surgery for spinal stenosis can be very successful in most cases of such symptoms.Final decision will be taken by your doctor after clinical examination & considering various factors.

And please do not forget to rate my service once you have all the information you need. If you have any other questions,please ask me - I'll be happy to respond.
Thank you!

Kind Regards-

Dr. Charles

Customer: replied 1 year ago.

Dr. Charles,

 

Thank you for your response. To me it seemed much more informative and was greater appreciated than the previous responses though those were not bad either.

I meant to contact you sooner and let you know that in my first response to you i said on the 23rd i am having a nerve conduction study. The appointment with Stanford was yesterday the 19th. It was a bit disappointing. To explain in the simplest of terms as well as the fastest, I have too many symptoms in some ways and not enough in others and the right symptoms are in the wrong area. All of which the Dr. said does not make me a candidate for surgery. This was in regards XXXXX XXXXX lumbar spine and the horrendous issues im having in my leg. He said its like sciatica but not sciatica. As you did, He suggested epidural injections and possibly physical therapy.

 

As for the issues with my neck, its kinda in pergatory. They say severe spinal stenosis is an 8. I am a 7. More than moderate but not severe enough to be a candidate for further surgery there. He said it can take years if ever to progress though I have progressed and have done so rapidly. The Dr. was conservative which I did appreciate so I wasn't left wondering if surgery was suggested just because he is a surgeon.

 

 

I hope you don't mind but im going to share my MRI results with you in the hopes i can take advantage of you once more and maybe you can explain some of it to me.

 

My neck: with and without contrast, it shows the anterior fusion from c-4 through c-6 from surgery done December of 2011. Development of worsening of central canal stenosis, with at c6-7 and c7-T1. Type I endplate changes at c7-T1 and diffuse thickening of the posterior longitudinal ligament from c6 through T1. There is central canal stenosis with 8mm of residual central canal from c6-T1. There is mild flattening of the cord but there is preserved CSF signal around the cord. There is mild to moderate neural foraminal narrowing due to uncovertabral joint hypertophy most pronounced on the left side at c6-7. Right side predominant disk ostrophyte complex at c5-6 causing central canal stenosis with 9mm of residual central canal but without impingement on the cord.

 

My lumbar spine: with and without contrast. Without neurogenic claudication. New (compared to an MRI of less than a year ago on 12/05/12) right side predominant disk bulge at L5-S1 causing effacement of the right subarticular recess and probably impinging on the right S1 nerve root.

Unchanged disk osteophytosis complex at L2-3, more pronounced on the left than the right, effacing the left subarticular recess and probably impinging on the transversing left L3 nerve. There are reactive type I endplate changes around the disk unchanged.

A right extraforaminal disk bulge effaces the fat ventral to the right L5 nerve root and may be causing impingement on this nerve root.

Moderate facet arthropathy of the lower lumbar spine.

 

If you would explain each of these areas, their meaning and the symptoms each would possibly cause I would be forever indebted to you. I have another Dr. apt as I said on the 23rd for a nerve conduction study and for once would like to show up informed. Alot of the terminology I have not been able to find on my own or if i do the continued medical terminology leaves me even further confused. It is frustrating and I find at alot of Dr. apts they talk fast and you cant get a word in and then it is over. The Dr. at Stanford seemed kind and compassionate and answered questions but I did not have my MRI report in front of me and I think I simply was nervous and worried even being there because I was there so quickly when referred so i had some horrible ideas and prognosis on my mind.

 

Sincerely, XXXXX XXXXX

I promise after this help i will rate you and even without you already get all five stars and my gratitude.

Expert:  Dr. Charles replied 1 year ago.
Dear Lynette T.
Thank you for appreciating for my last post.As your doctor at stanford examined you & advised not to have surgery,I agree with him because he has seen you physically & examined you and also you have not tried all the conservative methods.

The symptoms are most likely because of sciatica but sometimes it is very difficult to reach the exact diagnosis.Epidural injections & physical therapy is the best option for you now.

Also for neck,surgery is considered last option when all the conservative methods are tried & still there is no relief in pain.



Regarding your MRI scan reports of neck:

You are diagnosed with central stenosis at C6,C7 & T1. It means narrowing of the central vertebral canal housing the spinal cord.. It may affect any portion of the spine including cervical, thoracic and lumbar spine and symptoms depend on the portion affected.

There is mild flattening of the cord,but cerebro spinal fluid(CSF) is preserved that is a good sign.

There is mild to moderate neural foraminal narrowing(neural foraminal narrowing means that there is gradual constriction of the foramina (nerve passageways) in the spinal column which can resulted in nerve compression).

There is predominant disk osteophyte complex at c5-6 on right side.(Osteophytes are protrusions of bone and cartilage that can cause narrowing).



Regarding your MRI scan reports of spine:

There is disk bulge at L5-S1,(bulging means extension outside the space it should normally occupy)- they may cause discomfort and disability in various parts of the body if the disc compresses an adjacent nerve root.In your case,this has compressed right S1 nerve root.

Also you have osteophytes as you have in neck compressing the L3 nerve.There is another disc bulge that has compressed the right L5 nerve root.

Other then this,there is moderate facet arthropathy of the lower lumbar spine facet arthropathy is degenerative arthritis affecting the facet joints in the spine.(Each vertebrae connects to the others above and below. The joints that connect the vertebrae to each other are called facet joints).You are having degenerative changes in these joints.

The botXXXXX XXXXXne in simple words is that there is a lot of degenerative & arthritic changes in your neck & spine that has caused nerve root compressions(pinched nerve) at various levels which resulted in pain & other symptoms.

You need to discuss the conservative methods of pain relief like epidural injections,TENS therapy,physical therapy before going for surgery as it is the last option.

Hope I made you satisfied with explaining the reports & your other questions in simple terms.

So please remember to rate my service now,once you have all the information you need. If you have any other questions,please ask me - I'll be happy to respond.
Thank you!

Kind Regards-
Dr. Charles




Dr. Charles, Doctor
Category: Health
Satisfied Customers: 7167
Experience: Internal medicine specialist
Dr. Charles and 3 other Health Specialists are ready to help you

JustAnswer in the News:

 
 
 
Ask-a-doc Web sites: If you've got a quick question, you can try to get an answer from sites that say they have various specialists on hand to give quick answers... Justanswer.com.
JustAnswer.com...has seen a spike since October in legal questions from readers about layoffs, unemployment and severance.
Web sites like justanswer.com/legal
...leave nothing to chance.
Traffic on JustAnswer rose 14 percent...and had nearly 400,000 page views in 30 days...inquiries related to stress, high blood pressure, drinking and heart pain jumped 33 percent.
Tory Johnson, GMA Workplace Contributor, discusses work-from-home jobs, such as JustAnswer in which verified Experts answer people’s questions.
I will tell you that...the things you have to go through to be an Expert are quite rigorous.
 
 
 

What Customers are Saying:

 
 
 
  • I can go as far as to say it could have resulted in saving my sons life and our entire family now knows what bipolar is and how to assist and understand my most wonderful son, brother and friend to all who loves him dearly. Thank you very much Corrie Moll Pretoria, South Africa
< Last | Next >
  • I can go as far as to say it could have resulted in saving my sons life and our entire family now knows what bipolar is and how to assist and understand my most wonderful son, brother and friend to all who loves him dearly. Thank you very much Corrie Moll Pretoria, South Africa
  • I thank-you so much! It really helped to have this information and confirmation. We will watch her carefully and get her in for the examination and US right away if things do not improve. God bless you as well! Claudia Albuquerque, NM
  • Outstanding response time less than 6 minutes. Answered the question professionally and with a great deal of compassion. Kevin Beaverton, OR
  • Suggested diagnosis was what I hoped and will take this info to my doctor's appointment next week.
    I feel better already! Thank you.
    Elanor Tracy, CA
  • Thank you to the Physician who answered my question today. The answer was far more informative than what I got from the Physicians I saw in person for my problem. Julie Lockesburg, AR
  • You have been more help than you know. I seriously don't know what my sisters situation would be today if you had not gone above and beyond just answering my questions. John and Stefanie Tucson, AZ
  • I have been dealing with an extremely serious health crisis for over three years, and one your physicians asked me more questions, gave me more answers and encouragement than a dozen different doctors who have been treating me!! Janet V Phoenix, AZ
 
 
 

Meet The Experts:

 
 
 
  • Nurse Milli, RN

    Nurse (RN)

    Satisfied Customers:

    4043
    20 years experience in many areas of Nursing. Both Hospital and Private Practice experience.
< Last | Next >
  • http://ww2.justanswer.com/uploads/NU/nursescare4u/2013-3-31_03429_JApic.64x64.jpg Nurse Milli, RN's Avatar

    Nurse Milli, RN

    Nurse (RN)

    Satisfied Customers:

    4043
    20 years experience in many areas of Nursing. Both Hospital and Private Practice experience.
  • http://ww2.justanswer.com/uploads/agketch/2008-7-14_184046_drketchresized.jpg Dr. Ketch's Avatar

    Dr. Ketch

    Doctor

    Satisfied Customers:

    102
    Medical Degree, Former Assistant Professor at School of Medicine at Yale University
  • http://ww2.justanswer.com/uploads/FA/FamilyPhysician/2013-8-31_191624_JA550x500Photo.64x64.jpg Family Physician's Avatar

    Family Physician

    Doctor (MD)

    Satisfied Customers:

    5622
    Emergency Medicine and Family Practice for over 26 years
  • http://ww2.justanswer.com/uploads/drphophalia/2007-08-23_095626_dr._arun_phophalia.jpg Dr. Arun Phophalia's Avatar

    Dr. Arun Phophalia

    Doctor (MD)

    Satisfied Customers:

    17025
    MBBS, MS (General Surgery), Fellowship in Sports Medicine
  • http://ww2.justanswer.com/uploads/VA/VANP/2012-6-6_235535_Skye2.64x64.jpg A. Schuyler, NP's Avatar

    A. Schuyler, NP

    Nurse Practitioner

    Satisfied Customers:

    12170
    Board Certified NP, MS, RN. Private practice & hospitalist
  • http://ww2.justanswer.com/uploads/TA/tazechip/2012-6-7_135230_drpic.64x64.png Dr. Chip's Avatar

    Dr. Chip

    Doctor (MD)

    Satisfied Customers:

    10029
    Over 20 yrs of Family Practice
  • http://ww2.justanswer.com/uploads/neurosurg/2009-10-06_120923_profile.jpg Dr. Mark's Avatar

    Dr. Mark

    Doctor (MD)

    Satisfied Customers:

    6234
    U.S. Physician/Surgeon in Neurosurgery
 
 
 

Related Health Questions

Chat Now With A Health Professional
Dr. Charles
Dr. Charles
Health Professional
7167 Satisfied Customers
Internal medicine specialist