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DrThomasMd
DrThomasMd, Board Certified MD
Category: Neurology
Satisfied Customers: 57071
Experience:  Internal medicine doctor, diagnose and treat neurology patients, many years
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For Dr. Mark I had a microdisectomy in february 2010

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For Dr. Mark I  had a microdisectomy in february 2010 due to left sided L4-L5 herniated disc with foot drop. An MRI of lower lumbar in November 2011 showed severe facet arthritis at L5/S1 and L4/L5. There is residual degenerative broad based disc protrusion mildly abutting the thecal sac. Superimposed upon this there is focal signal abnormality within the left lateral recess that demonstrates diffuse enhancement and is round like in appearance at 9mm. The left L5 nerve root is thickened at this point.The appearances are in keeping with scar tissue causing compression of nerve root. Also L5/S1 there are adequate signs of decompression. No definite signs of nerve root compression or scar tissue formation. Severe facet arthrosis is seen from L3-S1" I have been in physio 3-4 months. When I initially went my physio said I was wobbly, and my balance was not so good. My stabilisers were not switching on and core strength was weak, though I was fit otherwise. I am 5ft 5 and 63 kilos age 40 female. My physio said I have gotten much better and core has improved allot  She often gives me a back rub and when she presses on my facet joints it mimics the pain in my thighs. She often remarks my glutes are very tight and when she presses the muscles they hurt alot. I have full range of motion and straight leg lifts are normal. I do ballet class once a week, power walk 3 times a week for an hour. I also do core exercises 3-4 times a week. My problem is I often have a diffuse lower back pain and sometimes an ache into both thighs. I may even wake up like this. Sometimes I will have a more pronounced left leg pain starting at buttocks with some numbness. Sometimes even an ache in calf. These pains are neither incapacitating and this is all on the mild low moderate. If I lie in bed and put a pillow under my knees, my left leg will start to ache. I try to stay off the anti-inflammatory but I do not know if I am doing more harm than good not taking the anti-inflammatory. I take 2.5 mg daily of Neo Mercazole, 40 mg daily Inderal, 100 mg Lyrica daily. I am not sure what I should do from here. i am not expecting to be perfect, but is this something I should be worried about (mild sciatica)?? I do not know the source of the pain. Is it the disc bulge, the scar tissue, the facet joints, pirformis?? Am very confused as to what I should do above and beyond. Thank you so much.

Submitted: 1 year ago.
Category: Neurology
Expert:  Camille-Mod replied 1 year ago.

Hi,

My name is XXXXX XXXXX I am the Moderator for this topic. Dr. Mark is not available right now, but I have sent him a message to follow up with you here, when he comes back online. If I can help further, please let me know. Thank you for your continued patience!

Camille

Customer: replied 1 year ago.
Ok I will wait for Dr. Mark. As a moderator arebyoumatvall involved in reading any of the doctor answers?
Expert:  Camille-Mod replied 1 year ago.
Thank you for your continued patience ;-)
Customer: replied 1 year ago.
Hi Camille, when do you think I can get my answer??
Expert:  Camille-Mod replied 1 year ago.
Hi,
I am really sorry. Dr. Mark has not responded and I believe he may be away. I will open your question to other professionals so you won't have to continue to wait, ok?
Expert:  MDPhD to help replied 1 year ago.

Hello and thank you for your question. I'd be happy to help unless you would like wait for Dr. Mark.

DM

Customer: replied 1 year ago.
Thank you very much, but due to it being related to spine, I would rather wait for Dr. Mark.

Thank you
Expert:  MDPhD to help replied 1 year ago.
No problem, I will opt out
Expert:  Camille-Mod replied 1 year ago.
Dr. Mark is not available, I am sorry.
Customer: replied 1 year ago.

Then can you please give this to someone within orthopedics spine/neurology? I do not want a dermatologist or an endocrinologist answering my question if it relates to orthopaedic spine problems.

Expert:  Camille-Mod replied 1 year ago.

Hi,

I am sorry but unfortunately I have exhausted all of my efforts to find a Professional to answer your question. I am sorry.

Thank you,

Camille

Customer: replied 1 year ago.
Can you find someon to answer my question? I am a member. Thank you.
Expert:  Camille-Mod replied 1 year ago.

Hello,

Thank you, XXXXX XXXXX continue to look for a professional to assist you. Please let me know if I can be of any further assistance while you wait.

Best,

Camille

Expert:  DrThomasMd replied 1 year ago.
Hello from JA
I am very experienced with this situation and can help you.

First of all
Have you had a follow up MRI since your surgery?
Customer: replied 1 year ago.
Yes. My last MRI was in November 2011. I posted the results in first paragraph. My surgery was in Feb 2011. I have had no MRI since.
Expert:  DrThomasMd replied 1 year ago.
OK
And have you seen a rehabilitation specialist
Customer: replied 1 year ago.
I have been in physio since last December. My physio said that I was wobbly when I started physio due to lack of core strength, though my abdominal muscles were strong. So I started on a core program until very recently. With all the exercise I do, I just didn't notice a noticeable improvement. I ave full range of motion no limitations. She said my stabiliser muscles are not switching on and I often have tight gluteus and sometimes hamstrings. Sometimes when she massages my back I get pain as she goes over the facet joints. They are very tender to touch. That's really all the information I have.
Expert:  DrThomasMd replied 1 year ago.
I don't mean a physiotherapist

Apparently you have not seen an MD called a PM&R doctor, physical medicine and rehabilitation...is that correct/
Customer: replied 1 year ago.
I am in Oz. I am not sure of what sort of doctor that is?
Expert:  DrThomasMd replied 1 year ago.
sorry, OZ?
Customer: replied 1 year ago.
Australia.
Expert:  DrThomasMd replied 1 year ago.
OK
PM&R doctors, also called non invasive orthopedists are spialists in getting you out of pain without surgery.

The pain you have is most consistent with disc pain.

A repeat MRI is in order.

Before going back in surgically, I would see this specialist, as they will have a variety of physical techniques to try and get pressure off the nerves.
OK. If you have further questions or details, use reply to expert.
Otherwise please choose a positive rating . But, still come back if you need to…think of something later, etc. Bonuses are appreciated.

DrThomasMd, Board Certified MD
Category: Neurology
Satisfied Customers: 57071
Experience: Internal medicine doctor, diagnose and treat neurology patients, many years
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