Far Lateral Disc Protrusion

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66 year old male

First , 3 Weeks of the worst pain I've ever had, started lower left lumbar and moved to left buttock, deep in the left hip, down front of thigh and into top and left of the knee. Not sciatica since it crosses over to the front. Could not get meds that even put a dent in the pain, thanks to the federal government control over prescribing effective meds, even when called for.....

Finally get an MRI after initially denied by the insurance company.......MRI finding, besides all the age related degeneration, a large far lateral herniated disc L3-L4. Less then ten % of disc herniation present this way.

Now over 6 weeks in and only marginally better, acute pain when standing or walking, less pain while lying down and some relief when sitting in certain chairs.

May need surgery. This type is more difficult to repair, more painful and problematic for permanent nerve damage

Any advice appreciated. Wait it out, orthopedist or neurosurgeon?

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  • Edited

    just a thought has your hip been xrayed. the pain you described sounds familiar to pain when my hip was bone on bone from osteoarthrits. arthritis in my back l4-l5 herniated disc and anklosing spondylitis. not a lot can be done. however many pain clinics offer nerve block injections to help with pain.

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    • Edited

      Thanks for responding.

      The pain went from the lower lumbar deep into the left hip and stayed there for 2 weeks or so, before wrapping around the front thigh into the knee. It was so intense I thought a might have fractured the hip and I first went to an Orthopedist hip specialist. They took x-rays and based on those and the physical exam, determined this was spine related.

      The symptoms correlate to the L-3 nerve compression, or so I'm told.I also have stenosis

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  • Posted

    Update 3 months in, slight improvement but the pain still persists while standing/walking. I've been in physical therapy and have had a steroid spinal injection, which did not help at all. It's the L4 nerve as the pain is mostly in the front thigh, into the top of the knee.

    Next up will be a micro discectomy about 6 weeks out from today. That will be 4 1/2 months from the start. I really had hoped to avoid surgery but I can't stay like this.

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  • Posted

    3/3/2023 follow up. Did not get surgery. The protruded disc must have shrunk enough to back off the nerve.

    3 months in starting feeling improved and by 4 months or so I'm back to the gym, limiting the type of activity I do.

    The spine injection did nothing, they were going to do another 3 weeks prior to scheduled surgery, I asked why if I'm getting surgery anyway (I thought so)

    My take away,

    Pain management was a joke, they prescribe useless meds that don't come close to alleviating the nerve pain, since they are hampered by federal recommendations denying meds for patients who really need them

    .The epidural may not be worth the risk

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