I'm new to this particular forum but not NeuroTalk - have been on the Peripheral Neuropathy forum for some years now.

I have been dealing with lumbar pain for 15+ years, some of which is probably due to my lifelong struggles with my weight. In 2004/2005 two MRI's confirmed that I had a grade I anterolisthesis at L5-S1 with moderate right neural foraminal narrowing. Several subsequent courses of PT together with hot, moist heat and cold compresses helped me deal with the lumbar pain and occasional sciatica that I was experiencing and I have been relatively comfortable for the last 8 - 9 years. I have occasional bouts of lumbar pain or fleeting sciatica but nothing that has required meds.

About 4-5 weeks ago I noticed a fleeting "twinge" in my right buttock which usually indicated that sciatica would follow soon thereafter. This time however, the pain was much more intense, a burning sensation in my upper right thigh together with a cramp or vise-like sensation down my right calf and across my right foot. The pain was worst when I first got up in the AM or during the night, particularly as soon as I sat up on the side of the bed or sat down in the bathroom. It took several hours before I could move around with any degree of comfort.

Sitting was not comfortable unless I sat “ramrod straight”, but walking wasn’t really a problem with no noticeable discomfort going up or down stairs. Bending forward relieved the lumbar pain and reduced the sciatica. Arching my back didn’t seem to affect either pain. The pain was more tolerable when I was lying down and I could sleep for a few hours by keeping my right leg as straight as possible.

After several days I saw my PCP who ordered an MRI and gave me a prescription for vicodin (5 – 500), 1 every 4-6hrs as needed to help with the pain. The vicodin does not seem to be of much help nor is tramadol. I have peripheral neuropathy from Type II diabetes so it can be difficult to distinguish the nerve related pain.

A summary of the MRI results from 4/29/13 follows.
• The lumbar vertebral bodies maintain normal height, there are no acute fractures.
• Multilevel DDD throughout the lumbar spine.
• For T10-T11, T11-T12, T12-L1, L1-L2, L2-L3, L3-L4 there are either no or small disc protrusions, no central canal stenosis or neural foraminal narrowing.
• Interval increase in Grade II anterolisthesis of L5-S1 2nd ary to severe facet joint arthrosis.
• Interval increase in severe right neural foraminal narrowing of L5-S1 with mass effect on the exiting right L5 nerve root.
• Interval progression of mild central canal stenosis at L4-L5 and L5-S1.
• Interval progression in mild to moderate right neural foraminal narrowing at L4-5.

I have an appointment with an orthopod spine surgeon tomorrow (Friday) AM to review my symptoms and MRI and to recommend a course of treatment. I confess that I’m really apprehensive about this since my symptoms seems to have deteriorated markedly since my last MRI but I’m not ready to commit to a spine fusion yet. Does anyone on the forum have experience with more conservative treatment measures being beneficial in a situation like mine?
Thank you for your advice and help – it is appreciated

Alkymst