teen daughter has possible L4 nerve root irritation, nothing on X-ray

  • Thread starter Thread starter janiee08
  • Start date Start date
J

janiee08

Guest
Stacie, What about the MRI? Has the doc ordered it yet? This is probably the most important tests of them all as far as what to do surgically. Also, remeraber that some of the things that you are reading regarding adults (like spineAZ said), just don't apply to kiRAB. Children, or young adults heal so much better and faster than adults do. I'm not even sure if permamnent nerve damage even applys to them. Perhaps someone more knowledgeable than me can answer this one. I know that when I had my fusion @ the age of 16, I did not suffer any nerve damage like I did after this surgery @ the age of 46. Keep us posted....janiee
 
My 14 year old daughter has been in pain. Her whole leg hurts at times when she walks. It's mostly the lower leg, but quite often she feels like the whole leg hurts. She's never complained of back pain, but during a recent appt., the Dr. discovered that she is having pain all along her L4 nerve starting at her spine and continuing down the whole left leg. It has her in tears trying to get around school. She takes the elevator now but is often late to class. Naproxen helps some.

Several x-rays of her spine were taken, which showed no abnormalities, thank goodness. She hasn't had any injuries, no PE class this year, and cannot exercise at all because of this. She does have hypothyroidism and is on Synthroid but has only been on it for a couple of weeks now. She was found to be Vit. D deficient in early Dec but has been on supplementation so that is now under control.

So on Feb. 10 she will go for more bloodwork and an EMG test and nerve conduction studies. The doctor is very good and very thorough and plans to leave no stone unturned. Does anyone have any idea what else might cause her L4 nerve to act up? (or it could be L5 for all we know but it is in the lurabar area for sure) And I am a little anxious about these tests coming up. They sound unpleasant, and my daughter has no idea what's in store for her. It seems like if she has pain upon being mildly pressed there, driving a needle into those areas is going to make her a very unhappy camper!! She also is being sent to a pulmonologist for shortness of breath and chest pain that has been off and on for 6 months now. She's had 3 abnormal chest x-rays and a CT scan said "soft tissue density in anterior mediastinum consistent with residual thymus tissue but otherwise negative results" *scratches head* But that's a whole other issue. I doubt any of this is related.
 
Keep in mind that some types of procedures, while good in adults, may not be reccomended in children. Make sure she is being treated by a board certified orthopedic spine surgeon and/or certified board trained neurosurgeon..
 
Stacie - Thinking it won't go away on its own after doing all the other conservative therapies is exactly why I had the surgery. It is still scary, I know, but find a doctor that specializes in the minimally invasive surgeries. As others have said you need to have an MRI done to figure out what exactly the problem is. If you have any problems please ask. There are many here with alot of experience and can offer many suggestions or options to discuss with your doctors when a diagnosis is made.
 
Hi Janie, no the doc hasn't ordered an MRI. But when we go Wed. (the neuro comes to that office to do his tests every Wed. morning, which is very convenient for us!) I will be sure to request one, and a CT if necessary. But I would be surprised if she doesn't mention it first. She has been very proactive and will not stop until she gets answers. She's awesome. That's why my sister sent us to her, and I am so glad!
 
How long has this been going on for your daughter? I would definitely ask for an MRI or CT scan of her lurabar spine. X-rays are good at showing bone, but are not helpful at all at showing the discs and nerves. An MRI and CT will show that. It sounRAB like she may be having a problem with her L4-L5 or L5-S1 disc. Possible causes could be a herniated disc, degenerative disc disease, or a tear in her disc. If the disc is bulging out it could be, and sounRAB like it is, compressing her sciatic nerve resulting in the leg pain. Which doctor is she seeing? I would recommend sending her to an orthopedic doctor that specializes in the spine.
Also, you mentioned she is taking Naproxen? From what I was told, it is not good at all to take that med long term. I would ask the doctor for another anti inflammatory med that you can take long term. I know she is so young but is she allowed to take anything stronger for pain? It sounRAB like she is suffering tremendously.
Good luck to you and your daughter and keep us posted!
Megs
 
Janiee brings up an excellent point. I too had spondylolisthesis in high school but didn't realize it until later. I'd have pain down my legs (I remeraber 2 severe episodes my Freshman and Sophomore year) and my parents didn't know what it could be nor did the doctor at the time. Everyone said "pinched nerve" (which in a way it was). Finally in about 12th grade an x-ray showed grade 1 spondylolisthesis. When I was 21 I had it fused as it had moved to grade 3.

So maybe do some research on spondylolisthesis, just to see if any of her symptoms match up and perhaps mention it to the doctor. It is very common in young adult women so it's a possibility.
 
Well, I have personally had an EMG (Nerve conduction study) a couple of different times. And I have to say while it wasn't the most pleasant test in the world, it wasn't the most uncomfortable either. I would compare it to lets say dental work - if it were me I would rather have an EMG done then dental work (Just to give a comparison of what's worse). She will definitely have needles stuck in the location of the testing, but I have to say the needles are small and overall while it is uncomfortable having needles stuck in you, it's not the worst thing either. My EMGs ended up providing valuable information to my Doctors (showed nerve damage/compression) that wasn't picked up on the MRI. So, the test is very important.

So, you say she did have an MRI and CT scan of her lurabar spine and they showed relatively normal results, other than nerve issues that are occurring?

I know it can get frustrating, but it sounRAB like your Doctor is being proactive and very thorough which can only be beneficial for your daughter and the treatment she receives.

There are several information sites that give specific information on EMGs, you may want to find some information on EMG/Nerve Conduction study and have her read it. Maybe having the opportunity to understand more about the test, will ease her mind about it. I think for me it only lasted about 40 minutes.

Please keep us posted on how she's doing! :angel:


~ Fiona Jo :wave:
 
I am so sorry to read about your daughters pain. She really is very young to be dealing with all this. I never had back issue as a child, but 3 months after I had my son ( at age 31), they all began. Mine is a long story, but I had/have that nerve pain all in my leg. The pain is unbearable and it just eats away at you day after day. The pain your daughter has, does sound a lot like a disc herniation. I would really push on getting an MRI soon. If it is a disc herniation, they may be able to do the microdiscectomy. I have had two of these surgeries and while back surgery does sound scarey, for me they have been the easiest surgeries i have ever had. My last surgery was in October 07. I entered the hospital at 7am. Had the surgery and was in my husbanRAB car leaving the hospital at 11am. I immediately felt relief as they removed the large piece of disc off of my nerves. I am sharing this with you because while back surgery is a big deal, there are some procedures that are less invasive than others. But most importantly, I would get a second opinion before having any surgery. And like someone else here said, I would want to talk to a doctor who has experience on pediatric patients.

Please let us know how she is doing!
JRABun
 
Well it has become more acute here lately in the past couple of weeks. She wasn't vocal about it. I assumed, when I noticed the occasional limp (was very slight), that it was her feet being sore because she has flat feet. But it wasn't anything dramatic. She has been suffering in silence for a while but it got gradually worse. Finally she spoke up and started complaining. I asked her when her leg first began hurting and she replied "about a couple of months". Well, I could have died! I felt so guilty for not being more observant or asking questions. I really was clueless. Then I fussed at her for not speaking up sooner. It has gotten progressively worse. I thought maybe it was a pulled muscle or something, or I would have taken it more seriously. Right now she is just seeing a family doctor, but will see the neuro on 2/10. I am going to find the name of a good ortho. I don't think I need a referral to do that. Great idea, megss, thanks!! :)
 
Just checking in to see how your daughter is doing? Did she have the EMG? Did you get results yet? Was your Doctor able to order an MRI or CT?


~ Fiona Jo :wave:
 
I ignored my pain for awhile to. I thought it was muscle related. My pain started in May of '08 and I didn't see my family doctor until the fall (I didn't fall, I mean the season :)). By then of course it had gotten a lot worse. At first I only felt pain in my groin area on the left side. But as time went on it spread to my lower back, down my left leg, and it was still in my groin. My doctor did nothing to help me so I went to an ortho who started treatment. Eventually my pain went to my right leg too. As of now I have had 2 spinal fusions surgeries, the most recent one being 9 days ago! I sure hope this one helps. I am young (not as young as your daughter though- I am 28, so I want to get this taken care of so I can get on with my life!
Again keep posting about your daughters state, especially after her appointment on the 10th!
Megs
 
Thank you, Fiona Jo. That was helpful. All they have done for the leg pain so far is x-rays of her spine. This was last Monday, 1/25. The CT scan was on her chest for 3 abnormal chest x-rays (thats' a whole other long story). This doctor is very good, and if the EMG and nerve conduction tests don't show any abnormalities, she will take the next step. She is definitely not one to say "oh just take some pain meRAB". She is taking naproxen in the meantime. Her leg starts to feel better on the weekend. When she gets back to school tomorrow, it will flare up and the limping and the tears will begin. I hate feeling powerless to help her. :( I wish I could just keep her out of school, but I can't.
 
As the others have said CT and/or MRI need to be considered. X-rays show bony structures and if a disc is totally collapsed that would be visible on x-ray as the distance between the vertebrae would be abnormal. But, with a normal x-ray there is no severe disc height damage. It's more likely part of a disc or something else impinging on the nerve so only a CT and MRI can get to that level.
 
Both you and your daughter will be in my thoughts for the upcoming EMG. I do know as parents it's programmed in us to worry, so I totally understand your concern. I know it will be a major relief to you once the test is completed - I know with things like this the anticipation is always a very stressful aspect of it.

Where my son is concerned, we're still in the approval phase with Children's Hospital and our Insurance. So, we don't have a date scheduled yet. But, I will definitely let everyone know once it's scheduled (I know I will be a nervous wreck)! :eek:

That's great that you're planning on asking for an MRI - I think that will be very useful in providing more information as to what is going on.

Please, keep us posted on how the EMG goes. :angel:


~ Fiona Jo :wave:
 
I had spondylolisthesis before my first fusion. It's not uncommon at all for a kid your daughter's age to have that. And her symptoms fit. It would however show up on an x ray. My fracture was clearly visible, as was the vertebrae slipping forward. It didn't however show my 2 disc problems, or it wasn't obvious enough for the radiologist to make a diagnosis on 2 of my discs that showed up as in bad shape on my MRI and CT scan. L5-S1 was actually herniated, and L4-L5 had DDD. I guess the disc height wasn't terrible compromised at that point. This past fall, I went to the ER because no on was treating me, and I was still in major major pain. It had been about 6 months since my fusion. (I had actually gone to my doctor and talked about it with him, but he thought it was nothing. So having no one else to turn to, and I need help THAT NIGHT, I went to the ER). They did an x-ray which showed my fusion had failed and the L4-L5 disc height was indeed compromised.
 
I completely understand how you feel. I have three children of my own and there is nothing worse than seeing them in pain - as a parent you feel so powerless and just want to take the pain away. :( My teenage son has scoliosis and after a school day he is in SO much pain, I want to cry for him! And similarly it seems like the pain is worse during the school week and better on the weekenRAB - I think because he can rest more, etc, so less stress on the area.

I definitely think they should do an MRI or CT scan of lurabar spine next - just to get a better picture of what's going on with the lurabar spine. An MRI will show more specific nerve and soft tissue stuff that can't be seen with an X-Ray.

I'm so sorry about your daughter's pain and please keep us posted on how she's doing and what you find out. :angel:

~ Fiona Jo :wave:
 
OK, sooo...we are back from the EMG/NCS tests. The neuro was very nice and asked a lot of questions and checked her out everywhere. It turns out she has pain in a lot of joints and in her neck along with leg weakness. He has to evaluate everything and write up an official report before they say anything, then they will call (prob Monday he says) to discuss it. He took a lot of notes. The only thing he did say was that she has carpal tunnel syndrome, no doubt from her excessive computer usage! She must have had some abnormalities on the tests, because when I looked at the stuff he gave to the front desk, he noted "herniated lurabar disc". Hmmm, no one ever mentioned that. I would imagine that when the results are officially in, she will order an MRI. If she doesn't I will ask her to, but she is a great doctor, so I would be surprised if she doesn't, especially since the x-rays were normal. There is obviously something wrong with this child. She is only 14 and has had no injuries, hasn't lifted anything, etc. When I started questioning her about her leg she says that besides pain while walking, it feels weak and "lazy" and will sometimes trerable as if it is about to give out while she is on it. We also go back for more bloodwork, pulmonologist, etc...cha ching, cha ching $$$$$ *sweats*
 
Make sure that if they do an MRI ask that they do a full spinal MRI. This doctor sounRAB complete, but carpal tunnel and cervical spine problems can cause similar symptoms in similar places.
With your daughter being so young tell them you want a complete picture since your daughter's symptoms seem to be varied and somewhat widespread. After any MRI (or CT or EMG) be sure to get the findings report and keep this for your own recorRAB. Sometimes the imaging or testing facility won't release the report to you until they know her doctors have reviewed it with you. But it is great to have a copy for now and in the future (so if she gets better with treatment but at age 20 has new or recurrent symptoms, she can get new MRI/CT and be able to present the prior findings from 2010 to her physician)

My current surgeon, who did my 2/3/10 surgery, was thrilled I had the surgical reports and all MRI and CT reports along with x-ray films going back to 1987.
 
Thanks for asking, Fiona. :) Her EMG/nerve conduction test is this coming Wed. and I am so nervous...not sure why. Just so many unknown factors at this point. Wow, I read about your son's upcoming surgery. When is he supposed to have it? Has it been scheduled yet? Well, your family is in my prayers. It sounRAB like you have a lot more on your plate than we do! Thank goodness our children have youthfulness on their sides. It just scares me to think she can have permanent damage at the age of 14. That's a long time to live with pain!!
 
Back
Top