Mri results
 

So I finally had a new MRI , and got the results yesterday.All my disc above the fusion are normal.No bulges , herniations , stenosis.

The fused level(l5-S1) looks good to.The report does state that there is a lot of scar tissue midline and to the right of the fused level surrounding the nerve root.

My question now is can the scar tissue be causing all this pain , and if so what can be done to calm it down.I cannot sit at all as my buttock feels like it is on fire.

I am by far not a professional , just a spiney like you. But it sure sounds as if the scar tissue is causing your problem. What did your doctor say or have you not seen him yet?
I've had scar tissue and lots of it removed from my knee, but i sure don't know about the spine or other places in the body.
judy

scar tissue
 

I'm not sure if it does or doesn't cause alot of pain although it was certainly blamed for my pain post my failed second disectomy at L4 and previous to this I had a discectomy at L5S1 and developed scar tissue at rt S1 nerve root. Had terrible burning in buttocks down legs/calves/to bottom of feet tho worse burning pain was in buttocks and legs for 5 years post failed 2nd surgery. Was told that the sacral nerve roots all exit same place and had clumped together re scar tissue so pain signals getting mixed up/diffuse pain vs. localized. Not sure how accurate that *diagnosis* was though it seemed to fit the pain bill at the time.

I had about a year of myofasical releases along with much done with piraformis work done for about a year as well I started to get significant relief in buttocks re burning pain although not sure how much was coincidental, also started pain meds and ESIs about the same time. I really think the piraformis work helped quite a bit though.

Essentially scar tissue was blamed for my burning pain for those years until MRIs showed rebulging of L4 and L5S1 disc levels and after the really bad burning pain went away I was left mostly with back pain that had worsened re DDD, L3 annular tear, L4 and L5S1 disc rebulging.

So you might want to see if you can find a good physiotherapist that can work with your regarding scar tissue formation. Years ago I was told that I could have a RAZC (??) procedure to try to get rid of scar tissue though it supposedly works best (if at all) with new scar tissue formation like during the first year.

I recall Dr.Anthony Yeung saying something like giving a diagnosis of scar tissue as a cause of pain is because it's not known what's actually causing the pain. That's really paraphrasing and I'm sure Mark or someone else could straighten that out for me.

I also think I recall there's good scar tissue and bad scar tissue or perhaps scar tissue has it's place in healing though perhaps too much of it is a bad thing and/or in the wrong place(s)like around nerves/nerve roots. Hope you can get someone to work with you to break it up or ??get it removed if thought that would be successful tho not sure how successful that's thought to be.

If you're having burning type pain related to scar tissue have you tried Lyrica, Neurontin, Topamax, or some such drug like this for some relief? good luck!

I did talk to a PM doctor and he said he could give me a ESI in that area and see if I get any relief.

I also will try and set up an appointment with a another DR and get there impression.I have been stretching every day for months , and the pain stays the same.

I do have a rx for neurontin , so I will see if that helps.

neurontin and ESI
 

Try them both and see if you get some relief. Whatever works to help reduce pain.. I took Elavil for 5 years re neuropathies and then Neurontin for 12 years and just was able to stop taking it this past summer. ESIs used to really help me (had them for 10 years). Hope either or both are helpful to you!

I will try the ESI , set up for wednesday.Hopefully I get some relief .Looking for another DR to try and get a fresh look at my situation.

Wish me luck

Mike

Definately!
 

Wishing you pain alleviation w/the ESI. I've had 6 different practitioners perform ESIs on me and sometimes the results vary w/approach and getting the right place and of course personal skill/knowledge of the person performing the procedure. Please do only with fluoroscopy (guided). Otherwise is like a blind shot.

The ESI will definitely be guided , nobody is going near me blind.The Dr did mention that there is no sedation.Never had one that way.

no sedation
 

I had a number of them w/o sedation just local anesthetic and I used to prefer that as it was much less time spent at the ambulatory surgery center though in latter years I prefered w/sedation.

I've had many procedures done without sedation. multi-level cervical and lumbar discography, panels of diagnostic injections, nerve ablations and ESI's. It's kind of like going to the dentist... hurts like hell for a short while, then it's over.

Good luck!

Mark

Good luck , i hope the ESI's bring substantial relief for you. I've had an upper endoscopy without sedation (one of my very bad decisions) . My spine surgeon does have an anesthesiologist and gives sedation . My preference after such a stupid decision in the past!!!
judy

the ESIs
 

I had w/o sedation didn't hurt at all because of skilled anesthesiologist performing them with the exception of 2 (over a period of first 5 out of 10 years worth which was usually 3 to 4 ESIs/year). Again there was local anesthetic and then use of fluoroscopy. One of the times it was w/a newer PM doc that wasn't doing my ESIs but wanted to but after that one time I only went there for scripts. The second time I had a "painful" ESI (and that explanation about too much of the steroid material injected and abutting the nerve was given) hurt sooooo bad for about what seemed like 5 minutes *tho could have been 1) that I decided to continue w/the PM and getting ESIs though w/sedation.

I still see this PM and have for the last 7 years.

Good luck and don't worry about no sedation~ just proceed and see if it helps. Hope so!

ESI update
 

So I had the ESI last week and have not really had any relief.The Procedure was the best experience I have ever had.

Little to no pain at all.The Dr is very gifted , He feels I will need to have 2 more ESI'S done and we will go from there.

I still feel the same.Cannot sit at all , and have been having quite a bit more pain in the sacral area.I do get alot of tailbone pain as well.

Thank's for the help

I had pain relief for only 1 week for each of a series of 3 ESIs. I also had differeing opinions as to if I'd receive any benefit at all... but I had to try.

What comes next for you? Obviously something isn't right... but what? I know how difficult this is and I'm so sorry your relief is elusive.

Good luck, Dale

my very first
 

ESI gave me worse pain for about 3 days to a week and then settled into incredible pain free bliss. It was so awesome. I hadn't felt that happy in ages!

I found that for my L5S1 bulge that caudal approach was about the same as any other but in terms of L4 a transforaminal approach worked really well.

The selective nerve root block was tried as well and seemed to help.

The burning butt feeling which I had for ages plus burning legs was helped w/neurontin and then years later adding low dose Methadone plus the ESIs plus having a great PT doing soft tissue releases and myofascial work on me.

I don't know whether it was just the scar tissue or my piraformis muscles were involved but I had bilateral everything. Some days one side was worse than others but man o man.. it was nasty stuff.

Sitting was something I didn't do for a very long time. Good luck whatever you'll be trying. I think it's good to go ahead w/the other 2 ESIs as well just to see.

If the second ESI produces no results, what would be the purpose of the third?

Are they indended to inject steroids into different locations?

Hey Dale ,

I have no clue what is next if these offer no relief.I guess I will start looking into the piriformis.

I have been trying to eliminate everything possible to get some clue of what is causing this pain..

how many
 

I agree Mark , if I get no relief from the 2nd I will ask to expore other options.
I could see if I was getting some relief , but nothing is touching the pain so far , and its been a week.