Absent Reflexes?? Crossover Pain??

[losingmymind2day]

Hi!!

I had my appointment today with my family doctor. He had me come back today because when I went last week I was in waaaaaaaay too much pain for him to do a "proper" examination.

So, he believes even more now that I have a "Centralized Disk Herniation". They way he explained it was because I am having "crossover pain" and have "absent reflexes".

SO, when he explained it to me, I STILL have NO IDEA what all of that means, and whether or not if I should worry about what's happening. I don't go back and see him for another 6 weeks, unless I get my MRI before that and he will call me in for the results.

I am hoping that maybe I can get some answers from some of you here.

THANKS AGAIN for your help!!
Aimee

[Maria]

Aimee,
re Absent reflexes~ this is considered a definate neurological sign, which can be indicative of nerve root compression.

Crossover pain occurs when straight raising of the patient's well limb elicits pain in the leg with sciatica. Crossover pain is a stronger indication of nerve root compression than pain elicited from raising the straight painful limb.

So what's the plan now? I hope whatever it is, your pain is alleviated soon!

I've been going thru a massive flareup the last few days and I feel 200 years old!

Hope you're feeling better soon~

[losingmymind2day]

OKAY!!!

SO, in other words, I guess it makes sense when he said he is SURE I have a Herniation.....He didn't say what level though...

The plan now?? Hmmmmmm.....He won't let me start Physiotherapy until he sees what the MRI is going to say, I guess the plan is to just sit around and wait for my MRI and then go from there.......

Thanks Maria for your help!! I hope you FEEL BETTER SOON!!

All the best,
Aimee

[Maria]

Aimee,
You stated you didn't have a proper exam because you were in way too much pain~ my PM didn't want to fully neuro exam me today either as he said he didn't want to flare me back up with spasms so he did a partial exam to check out flexion (bending forward) and extension (bending backwards) plus great toe strength (L5 involvement).

Anyway, depending on what your doctor would exam and his findings, that gives him good insight into what level(s) may be involved. Waiting for an MRI so as to either not flare you up worse if in an acute stage would make sense however if there is a severe neurological deficit/finding that could be overlooked by not doing a full exam.

I'm thinking with your previous findings and your current subjective complaint your doctor is making a call based on this as to what is going on ~ then wait for the MRI to give a more definitive diagnosis.

I think if you called back and asked what level he thought was involved you'd get an answer because likely he made notation (documentation) of his thoughts/findings and at what level he thought might be suspect (pending confirmation re MRI).

Tho it does sound like on whatever he checked out on you he was able to make somewhat of a diagnosis. Such as absent ankle reflexes? Or patella tendon reflexes? Or which reflexes were absent if I might ask?

[dshobbies]

Aimee,

I'm sorry that it's looking more and more like a herniation. There are 2 things that I know of that might help your pain on a temporary basis.

First, lay on your back, knees bent. First bring one knee to your chest and hold for 3-5 sec, then the other. Repeat several times. If you can, then bring both knees up together. This should provide you with some temporary relief.

The other is the use of an inversion table if you have access to one. Start with just a few seconds, several times a day until you get used to it. This too should provide some relief.

You should also stretch out your hamstrings as much as you can. Most people with chronic back problems have tight hamstrings.

My best to you, Dale

[losingmymind2day]

Maria-

He said that my reflexes in my knees and ankles bilaterally were absent. So, absent reflexes means nerve root involvement, right??

Thanks for all your answers and helping out with all this, it has been a relief to be able to talk to people about this.

Talk to you SOON!!
Aimee

[Maria]

Can possibly indicate nerve root compression. Sounds like your doctor has an idea of what he thinks is going on and wants confirmation with films. Rest of exam helps with correlation of findings as does subjective complaints.

Remember that the really important *emergent symptoms* are loss of bowel or bladder tone, loss of extremity function, severe weakness or numbness of involved extremities and unrelenting progressively worsening pain that is severe.

You are on a conservative course currently it appears to see if symptoms abate while awaiting MRI appt. which may take some time in Canada if I understand you correctly so I hope you will be seeing your doctor again before the MRI should you need to.

[Maria]

Janene,
I guess I want to add that I'm not a spine guru or anything like that. Just someone that has had back probs for almost half my life so kind of going from there. I don't mind questions at all altho I don't always know the answer tho am giving some general info.

Incontinence/loss of bowel or bladder tone = no control over your functions such as having bowel movement and not feeling it, just going, same with urination, you just go/no control.

Ok, re central disc bulge/protrusion/herniation~ when I have a severe flare up (like recently) I cannot bear down to have a bowel movement as I feel pain right in the center of the area where my spine hurts and it's like a slicing pain or I have likened it to a sledgehammer coming down on a surface ~ a big ouch! So I cannot push for low back pain limiting me.

I think this might be what you're feeling. The involved disc is irritated and when you push you are putting weight on this disc space and sort of squishing the disc and irritating disc material may leak out and irritate involved nerve so if there's a problem there you may feel it very intensely. At least that is my take on it. Every time I've had a severe flare up or a prolonged period of flareup pain, I go thru this. I've had 2 discectomies (removal of bulging disc) but still have disc bulge at L4 and L5S1. And you are probably having some degree of muscle spasms contributing to your pain syndrome (thobbing in spine, etc).

Stool softeners are helpful then so that you don't get constipated unless you don't really have a prob with going, just have to push to go or push too much. Remember to drink plenty of water, and eat well with fruits, salad, whatever helps you *go* more easily~

And bombs away with questions.. I know others here will fill in with more answers, add to, correct, whatever re answers~ most of us here have been where you're at in the wondering what's going on stage and waiting to have to have it dealt with or just get an MRI, find out what's going on~

Hope you will be feeling better as well. I'm doing much better today post my visit to doctor and shot of toradol altho I went to do laundry this a.m. and stepped off a curb of about 6 inches w/o realizing it was there. Jolt but no pain like the previous days!! Hope no pain will ensue from that ~ had to miss step on side that is most bothersome usually! Oh well, so far ~ so good!

[ans]

Dear Losing...

This is what I think Maria is concerned about. Very rare but not good.

http://www.emedicinehealth.com/cauda...e/page3_em.htm

Take care ~ ans

[Maria]

What I'm trying to point out with the *emergency* signs is that there is a window period of time that spinal situations can be addressed. Cauda Equina is one of those rare but truly emergent situations in which one must respond immediately and be seen in terms of window period of time. One would not sit around and wait to see when their bowel or bladder tone would return or legs would become useful again and so forth..

Before my first spine surgery I was having something akin to stress incontinence with leaking of urine however I wasn't coughing, sneezing or doing anything associated with stress incontinence rather I would just "leak".

I had my first discectomy in '89 and that problem was corrected~ I also had a Urology consult during my hospitalization (had urodynamic testing even before surgery).


you have to be your own best advocate and speak up for yourself, and the self educating process when one has a spine problem is great as it gives one more insight to what the doctors are referring to but especially it allows you to form and ask educated questions and often find out information you wouldn't otherwise do so as you just would have no clue...

Google away~ even tho not all that is on the internet is true yet there are some really good websites for information/educating and ChiroGeek's Home Page is one of them. Also check out Back Pain: Trusted Information for Pain Relief | Spine-Health
check out the lending library section here to see what books might be recommended and there is an article section as well that is being developed.