Back and Neck Injury/Sciatica & more

Question
Hi Dr. Carr. I’m 35, and have had a few instances of sciatica and herniated discs over the years, including a period 3 years ago which ended up with a series of 3 shots, which gave me complete relief. Recently, I was going through a marathon study session, and ended up with a pretty sore back. This turned into back spasms a few days later. Went to the doctor, they gave me flexeril and tramadol. These basically did absolutely nothing for me, and my spasms turned into INTENSE squeezing and sciatica. Called the doctor, who gave me baclofen and valium. Still, doing absolutely nothing. So, the weird part, is when I stand up, that intense squeezing is at it’s at it’s absolute  worst. So painful I can’t stand still, except movement hurts too. When sitting with my knees up, I feel the sciatica the worst, but the squeezing and pulling pain isn’t quite as bad. I also noticed this morning, that I had work harder to empty my bladder completely. The doctor told me to call tomorrow if nothing is better….but I’m honestly nervous something is really wrong. I’ve never had this much intense squeezing pain in my back before. Do you think it’s just a simple pinched nerve, or maybe something more?

Answer
You need to see the doctor, locally, IMMEDIATELY.  There is a CHANCE, however small, that what you are experiencing is CAUDA EQUINA SYNDROME, and it’s serious.  It’s where the disc, or something else, pushes on the nerves of the low back that it affects your bowel or bladder.  The onset can be slow or quick, depending.

Here’s a couple of links:

http://www.spine-health.com/conditions/lower-back-pain/cauda-equina-syndrome
http://www.webmd.com/back-pain/guide/cauda-equina-syndrome-overview
http://emedicine.medscape.com/article/1148690-overview

I also touch on it on my lumbar disc article on my site:

http://dynamicclinic.com/lumbar-disc/

Prepare yourself, because without seeing you, I’m recommending an MRI of your low back immediately, STAT, and not tomorrow.  In fact, if you feel numbness or a “weird” sensation in your “saddle area”, (everywhere you would touch a Western saddle), I want you to get yourself TAKEN, not you driving, to the ER for emergency management, and possible intervention.  It’s a serious thing that needs to be ruled out ASAP.

With all that said, it could be a single disc pushing on the nerves to your bladder, but the imaging solution is still the same. (MRI)

Now then, I haven’t done any testing or evaluation of you in my office, but based on what you are telling me, YOU NEED TO RULE THIS OUT FIRST.  I would call your doctor, tell him your symptoms, and what you know about cauda equina syndrome.   However, if you have more of the classic signs, such as bowel issues or that saddle parasthesia, just skip trying to make an appointment.  Get yourself TAKEN to the ER instead… don’t drive there on your own.

Read the articles I sent, and see if you agree.   This distance medicine sucks, and I wish I was in Michigan to see you personally.

PLEASE PLEASE PLEASE FOLLOW UP WITH ME ON THIS.  I WOULD LOVE TO BE WRONG ABOUT YOUR DIAGNOSIS.

Sorry to be such a wet blanket here, but I want to make sure that you are safe.