Anybody have L5-S1 nerve irritation not from spine?

[mmarsh]

Hi all. I've been to the 2nd opinion doc again and he thinks we should rule out any problem with L5-S1 that is not spine generated. Just wondering if anybody has experienced this. He thinks we should do an MRI of the pelvis to rule out some unknown problem. I'm so tired of being in pain and would love to find the source. If it's not the spine, then can it be from somewhere else? If you had/have this experience, could you share? Thanks in advance.

M-

[claudia]

If im not mistaken, I've been told that sacroiliac joint dysfunction can cause nerve irritation and the symptoms can be very similar to disc related nerve pain. I know cause i'm dealing with it right now. I hope this helps and best of luck in figuring out the source of your pain.

claudia

[Justin]

In addition to SI joint dysfunction, it could be an iliolumbar ligament sprain or even a sacrotuberous / sacrospinous ligament sprain.



Quadratus lumborum (a muscle) dysfunction is implicated in a lot of Spine Patient pain syndromes. This muscle connects from the transverse processes of the lumbar spine to the ilium (a part of the pelvis).

[Santorini]

MMARSH,
I think it is great that your surgeon is considering non-spine causes for L5/S1 nerve irritation. I wish that my surgeon would have considered this. Through my own research I've learned that my nerve issues could be from an SI joint instability although this seems to be a difficult thing to diagnose. I will be curious to hear what diagnostics your surgeon uses. Good luck.

[Santorini]

In addition to SI joint dysfunction, it could be an iliolumbar ligament sprain or even a sacrotuberous / sacrospinous ligament sprain.



Quadratus lumborum (a muscle) dysfunction is implicated in a lot of Spine Patient pain syndromes. This muscle connects from the transverse processes of the lumbar spine to the ilium (a part of the pelvis).

Justin,
Would you know how to diagnose an issue with any of the ligaments that support the plevis around the SI joint? I tried to ask a surgeon this question and remarkably his response was "your just asking about ligaments because you can't find the answer on the Internet'. I thought no, I am asking this because I feel completely unstable in my lower lumbar hip area and have to actually hold my legs/hips steady just to get down the stairs but of course I just said nothing. My guess is that there really isn't anyway to know diagnostically if these ligaments are damaged or lax.

[Vanessa]

M-

I am very interested in what happens with your situation. I'm having quite a bit of difficulty with my doctors in giving me a straight answer as to what is going on with my radiating pain. I'm glad that you are seeking out another opinion with someone who is willling to look beyond the norm. I hope you find peace and are pain free!

Justin,
Would you know how to diagnose an issue with any of the ligaments that support the plevis around the SI joint? I tried to ask a surgeon this question and remarkably his response was "your just asking about ligaments because you can't find the answer on the Internet'. I thought no, I am asking this because I feel completely unstable in my lower lumbar hip area and have to actually hold my legs/hips steady just to get down the stairs but of course I just said nothing. My guess is that there really isn't anyway to know diagnostically if these ligaments are damaged or lax.

That BS comment from that surgeon, is what irritates me with doctors. They really do expect us to 100% rely on what they say and not do any research/thinking for ourselves. If every surgeon was 100% effective and accurate in solving our pain, we wouldn't need to look for alternate resources on finding what works/does not work. Im sorry he told you that! Doing research on your own and becoming knowledgable on your own health is something every patient should do. Again, sorry!

[KBear]

That BS comment from that surgeon, is what irritates me with doctors. They really do expect us to 100% rely on what they say and not do any research/thinking for ourselves. If every surgeon was 100% effective and accurate in solving our pain, we wouldn't need to look for alternate resources on finding what works/does not work. Im sorry he told you that! Doing research on your own and becoming knowledgable on your own health is something every patient should do. Again, sorry!

Amen to that.

[claudia]

I think I read somewhere that if the SI joints are whats causing the pain, that most of the time its the ligaments that are the problem rather than the actual joint. That is also one of the reasons why people who have SI joint fusions continue to have pain. I have also read that not many doctors consider this as a pain generator and focus only on the discs, when in fact the SI joint is what actually causes sciatica in many people. Its actually called "pseudo-siatica". I have come to the conclusion that this is one of the reasons for the so called "failed back surgery". If a person complains to doctor about having pain in the legs, and the MRI shows an ugly, black disk, the doctor will probably conclude that that is the problem. When in fact you can have a disc that looks suspect on the MRI but is acatually causing no symptoms at all. If the pain is actually coming from somewhere else, like the SI joint, or the piriformis muscle, which can also cause sciatica-like symptoms, then having surgery of the disc is going to do nothing, or even worsen the pain. This is why it is so important in order to have a succesful surgery to properly identify the pain generator(s) and rule out all other possible causes. Mmarch, not many doctors consider the SI joint as the cause of sciatica, so I think yours is on the right track. And for anyone else with nerve pain down the legs and considering disk surgery, or who have had surgery and are still in pain, it would be a good idea to rule out a painful SI joint before proceeding, which can be easily done with a lidocaine injection (not medical advice, just one of the things I have learned from this experience).

[Imp0ssible0ne]

I'm glad that people are beginning to look at the pelvic area as a back pain generator. A few years ago I had a grade V annular tear at L5/S1 but no one was really sure if that was causing the back pain and L5/S1 root numbness so I sat on it for two more years, consulted 5 surgeons with varying conclusions....then finally had the fusion.

So I'm lying on the couch recovering from the fusion and happened across an article about the piriformis muscle which I had never heard of. Anyway Piriformis syndrome fit my symptoms TO A TEE. I closed the laptop and decided for forget about it while I recovered. I mean, what are you going to do at that point?

So, I was kinda better after the fusion, largely because the surgeon put the fear of God into me about doing the rehap walking, but I still had the leg numbness and some of the low back pain. The surgeon dismissed the piriformis theory.

The wheels turn slowly and 18 months later, I'm still in the process of nailing down the culprit. Naturally the pelvic MRI looked fine.
The doc I saw today says the piriformis is definitely involved but might not be the entire enemy. Going to have this and that injected and ablated and see what gives. I'll certainly be back on this thread if I come across anything remotely useful.

[Justin]

Justin,
Would you know how to diagnose an issue with any of the ligaments that support the plevis around the SI joint?

Tenderness over the SI joint would lend itself to ligament problems, but tenderness is involved in many other spine dysfunctions as well. Thus, there's really no "clear cut" diagnosis for ligamentous injury--it's almost a diagnosis of exclusion.