I’m 63 and now when I walk for a short distance the back of my right leg starts burning to the point I can hardly walk. What is this?

Leg pain from walking is called claudication.  Neurogenic claudication is leg pain from nerve compression in the spine.  This is called stenosis and results from thickened ligaments, bone spurs and disk herniations.  Some people are at increased risk of spinal stenosis because they were born with a smaller spinal canal then normal.   This is called congenital spinal stenosis.  Spinal stenosis and neurogenic claudication presents with back pain and diffuse leg pain and numbness from walking which is relieved by using a shopping cart or sitting down.  Some people describe it “like walking on a cloud”.  Vascular claudication is leg pain from narrowed arteries in your legs.  It is brought on by walking and is relieved by sitting or standing still.  People usually have absent pulses, skin and hair changes in there feet.

You probably have spinal stenosis compressing your spinal nerves and decreasing blood supply to the nerves.  If the nerves can not get enough blood and oxygen they “suffocate” developing pain and numbness in the legs.  Stopping and sitting down or bending forwards decreases pressure on the nerve, improving blood supply and decreasing pain.

Many people benefit from rest, physical therapy, anti-inflammatories, nerve medicine (such as neurontin), steroid injections and surgery.  Please click on Sciatica for more information on lumbar spinal stenosis.  Please contact Executive Spine Surgery for a consultation on spinal stenosis.   Good Luck!

What can be done? Can it be fixed easily? What are Schmorls nodes? What is an annular bulge?

These are 3 separate problems:

1. Schmorl’s nodes – Schmorl’s nodes are disk herniations into the vertebral body.  The disk squeezes out of the disk space into the bone.  This is usually not usually painful or treated.

2. L5-S1 degenerated, bulging and protruded disk – Over time disks wear out from injury, aging, wear and tear, genetics, work and sports.  Your L5-S1 disk is degenerating, wearing out and likely collapsing and bulging into the spinal canal pinching the L5 and S1 nerve root.  A protruded disk is larger then bulging disk.  This may be the source of the pain and is often fixed with discectomy or spinal fusion.  Click link to read more on sciatica and disk herniations I have a pain in my left butt that goes all the way down my leg. What could that be?

3. Spinal stenosis – is narrowing of the spinal canal.  The measurement varies but is in the range of 11 mm.  More important than the measured size of the canal is the appearance and the amount of nerve compression seen on MRI.  Spinal stenosis may be treated with pain injections or surgery.  Minimally invasive treatment options include MILD procedure and METRx tubular laminectomy.  JOIMAX is currently working on new endoscopic treatment for spinal stenosis.

I would recommend seeing a spine surgeon to determine the best treatment for your back.   Good Luck!

Does a pinched nerve (sciatica) always stay pinched unless surgery is given? Will it always show up on an MRI if surgery is given?

Disk herniations cause leg pain (sciatica) by pinching the sciatic nerve in the back.   Disk herniations may resolve on their own over a year or so, but they usually just get a little smaller as seen on multiple MRI .  Surgery is the best treatment to physically remove the disk.  Today this can be done endoscopically (endoscopic discectomy) though a very small incision the size of your finger nail. The endoscopic port is placed right onto the herniated disk and the disk is removed with tiny instruments.  This is a new minimally invasive treatment for back and leg pain.

Disk herniations may show up after surgery on MRI scan, but it usually is smaller.   Postoperatively the the disk that is seen is a combination of disk, bulging ligaments and scar tissue.

For more information on sciatica please contact Executive Spine Surgery. Good Luck!

L5S1 Hernation, S1 nerve compression.

You have a herniated disk in your spine pinching your left S1 leg nerve causing sciatica.  For more information please see my blog posting on sciatica.  Most of these disks can be removed by an extremely minimally invasive surgery called endoscopic spine surgery.  This surgery can be done awake through a small incision the size of your finger nail.  Pain relief is often immediate and you are usually discharged home 1 hour after surgery.  To schedule an appointment contact Executive Spine Surgery.  Good Luck!