L5-S1 Radiculopathy...

[rpowell01]

I am curioius about something that is bothering me. I do have L5-S1 radiculopathy caused by OA. Yes I am one of those ppl who the VA has cursed to die on some waiting list on seeing a surgeon. So next week I am going to a private surgeon's office and if he says surgery should have been done or I need it then I am going to do my best to force the VA to pay for the surgery. I want my quality of life back but the VA is hampering this.

My question is for those who have or had L5-S1 radiculopathy in both legs, feet and toes. I have the normal pain and numbness and the ice cold feet. But what is bothering me is if anyone of you who had these issues also caused the feet and toes to turn purple/blue when the ice cold comes on? It comes and goes with the ice cold feeling. My feet use to turn red with the ice cold but now they turn purple/blue.

Good news is the VA lied to me when they said there is no surgery. How is that good news? Well my brother in law just had surgery last week for L5-S1 radiculopathy caused by OA which in turned caused his L5 joint to become week and it fractured. The surgeon told him that they see this all the time with OA patients. Bad news is the VA didn't add the post views of my last TWO MRIs, this is the view of the BACK of the spine where they could see if there is a fracture.

Anyway I am going to pray and hope the surgeon can get me back on track.

[Navy04]

Sorry to hear of your troubles. bud. I was supposed to have back surgery last year, well the VA waited so long I ended up with a hole in my spine the size of a half dollar, caused by the spine and neck working against each other. VA Chiro Doc just told me to go home and hope for the best, WTH! I just had a C&P for this on Tuesday, as the VA denied my bone issues before do to them IDIOTS ordering X-Rays instead of MRIs. Earlier this year finally got MRIs, and R Shoulder, Both Knees, Back and Neck are shot. God Bless you bud, and good luck.

[Vync]

Hey Rpowell,

I am SC for lumbar and bilateral radiculopathy into both legs, but also had similar issues you describe. I recommend definitely getting your feet/toes checked out. If you have diabetes, get them checked out as soon as possible. It could be one thing, two things, or multiple things. The last thing you want is for this to advance to the point where you risk losing your toes or feet.

I'll share my experience with it, but yours might not be the same as mine. I am not a medical expert, but toes turning purple/blue sounds to me like a potential neurological or circulatory issue, or both.

My wife has worked in surgery for years and said I needed to get it checked out. She told me to go see one of her favorite non-VA orthopedic surgeon with whom she worked with for years. A round of blood work came back normal, which ruled out diabetes. Arterial ultrasound ensured that my blood flow to/from my feet was normal. Then came the fun. First, an EMG which hurt like hell. Results were off by a bit, but it also differed when I sat up or laid on my back (if they don't check both ways, they are not doing it right). Then came a pressure sensitivity test, luckily covered by my private insurance. It found that I had lost 60% of my ability to sense touch in both legs/ankles/feet. The diagnosis was a combination of lumbar sciatica and nerve compression at several locations. Surgery was performed to relieve pressure on the nerves and remove scar tissue. I was out of work for several months. Six months later, the other leg was done. Retesting found I now had a 30% deficit on each leg, so I consider it a big success, but the lumbar sciatica is still a major factor, including possible damage over time to the nerves. Compared to the roller coaster of pain and numbness, I am feeling much better, but still have significant problems - although less debilitating.

Good luck with your feet! I hope they can get it sorted out!

[rpowell01]

Hmmmm I had an EMG last year and it came back positive for Bilateral L5-S1 radiculopathy. It is also my understanding that blood vessels also route in almost the same paths as the nerves in this area so I am wondering if one of the vessels is getting pinched. Also, in my neck I have the same issues and my pain management neurologist told me about the blood vessels getting pinched. My face would turn pale white but that happened around May 2013 and it was diagnosed that I pinched a blood vessel in my neck. So, I am wondering about the same thing in my feet.

I had a whole heart and circulatory workup back in 2012 and everything was fine. They did EKG and even a 3d CT of my heart and they said everything was fine and clear.

What I have noticed is they turn purple/blue when I sit. If I stand they go back to normal or if I lay down they go back to normal. What I do also know is when I sit for more than 5 minutes my low back's pain level goes up so I have to stand for a minute or two.

I can't wait to see the private surgeon next week because the VA's medical is a joke, well it is at James A. Haley. All they want to do is feed you pills then get you in a catch 22 situation by prescribing the pain killers to you then request that you go through their in patient pain program. If people don't know this program is mainly for people who have been on opiates for awhile and the staff at James Haley is using it to trap people when they prescribe pain killers to veterans.

Forgot to add that I am NOT diabetic so that rules out a reason why.

I need to file for sciatica which I haven't been able to get out of the house to go file it. I guess I need to do it on ebenefits..

Edited September 26, 2014 by rpowell01 (see edit history)

[Vync]

Definitely sounds like a circulatory problem of some sort. Not sure how they would end up diagnosing that, but I assume that if your heart checked out ok then it must be further down the line. Also, one other thing to think about is lymph vessels, which could also be part of the problem. I had some issues with them being blocked at one point and my limb swelled up like someone injected a bunch of yellowish clear liquid in spots. All better now, body absorbed the excess, but it felt really unsual.

Glad to hear you are not diabetic. That was the first thing that came to my mind. Whatever it is, I hope they figure it out.

[rosypalm]

Best of wishes.

[rpowell01]

Was thinking I might have circulatory issues because I don't walk as much as I use to? I've been stuck in my bed for the past 4 months. Seriously, I don't walk out of my bedroom except to go to church and that is about it because I am in that much pain.

[Vync]

Oh man, I have been bedridden for long periods of time like that after I had surgery on one of my limbs. My wife had me doing minor stretches, working with elastic bands, and small free weights. She said that if I just sat in one spot, atrophy would set in and blood would pool up. It hurt like hell until my recovery got moving further along, but I did it because I knew she was right. Of course, I could not raise my heart rate too much because I did not want to risk ripping my sutures or breaking a sweat under the dressing, but it did help to a degree.

Have you been able to get an appointment to get checked out? I hope they are able to give you some form of a recovery plan to at least alleviate some of your pain and address your toes, etc...

[rpowell01]

Vync thank you for the posts. I go this Friday to see an Orthopedic Surgeon to see if he can do something for the pain. My brother in law was also in the same situation and after this surgeon corrected his issues he was going within ONE WEEK post surgery. I think my biggest problem is the opiates, I am not a big fan of these meds but gave in to them last October.

If the surgeon says the same thing that the VA MDs told me where there is no surgical fix then I will go through with James A. Haley in-patient pain program that last 19 days. In the mean time I will also go back doing the stretches, elastic bands and small free weights. Yep I use to do them also but everytime I did the pain got worse each time afterwards, except the stretching. I do know if I walk I hurt but I also know its not going to make it worse, its just too hard to do it with all that pain mentally breaking down the brain.

[Vync]

I hope everything works out.

My VAMC sent me to a "back class" and then referred me to PT. Their PT program was very lacking compared to a private PT program.

[rpowell01]

I've been through the back class, ESIs in my lumbar and cervical and just completed PT about two months ago. Nothing has worked whatsoever. Also when the therapist keeps telling you that surgery is needed I think its time to see a surgeon so that is my next step come Friday.

[john999]

I don't believe any decent orthopedist will tell you there is no surgical fix for a spine problem. The thing is that pain is subjective and even successful surgery may not cure the pain even if the surgery fixes the function. If you have severe numbness in your lower limbs that is probably pressure on the spinal nerves due to disc problem. That is what orthopedic back surgeons do for a living except maybe at the VA. I use the same VA as you and they are horrible and dangerous to your health.

[rpowell01]

You are correct about that VA facility John.

I would rather try something than to just sit here and die away. At least I know something was attempted, I can deal with that.

[rpowell01]

Well, well, well I might be finding out in a few days if a certain medication if causing circulatory issues causing my feet to turn purple/blue. I take amitriptyline and one if its side effects is: circulatory side effects!!!!!

I don't like that stuff and told my MH Doc that I wanted off of it and to be given Sertraline. My dad takes that and he says that it helps him a lot better than the other stuff.

Fingers crossed on this one.

[Vync]

Amitryptyline is more so a MH med, but they give it to people because it can help address pain. It's kinda like a trial and error routine to find the right combo of meds that help, but with with side effects you can tolerate.

[rpowell01]

Okay I need some help here if anybody may know this. I went and see the Orthopedic Surgeon today and what I expected was not what I wanted to hear. He examined me and he said that I do have L5 radiculopathy per his testing. He said I have weakness in my big toes and the numbness I have in my shins all represent L5 issues. But it is baffling him is the EMG showing S1 bilateral radiculopathy.

Now here is the kicker, there is nothing on the MRI showing the reason WHY. He said I have a bulge at L5-S1 but there is nothing showing any nerve impingement. So he is ordering a new MRI and if that comes back negative he wants me to see a Neurologist.

Now I am kind of worried because I was a Nuclear, Biological and Chemical Specialist. I went through Ft McClellan and I did go through their Nerve Agent Facility they had there. I am worried I could have been exposed.

So, my question is how in the world could someone have L5 Radiculopathy on clinical testing, S1 radiculopathy per EMG and an MRI not showing the reason WHY?

Would a discogram be appropriate in this situation?

Just looking ahead just in case the new MRI coming up doesn't show WHY.

This is how I am feeling at this moment:

Edit: I want to say the surgeon said something is going on in my spine and it could be elsewhere than the L5 and S1. He someone can have issues in their thoracic spine and it can cause pain down low like this. Dr. Bash even told me this last year. I am curious if the straightening of my cervical spine might be the issue here, pushing down on my spine and causing other issues. Hmmm.

Edited October 3, 2014 by rpowell01 (see edit history)

[Vync]

EMG results may change. They gave me one while laying down, but I had different results standing up. Gravity matters.

Think of your nerves via the garden hose analogy. If the hose is crimped or leaks anywhere, it impacts water flow, I.e. pain, numbness. I hope they are planning a full spine MRI. Most require you to lay flat, but some you can sit up. Again, gravity matters. A bulging disc presses differently when you move or are vertical. Discograms can provide more insight for specific discs, but I never had one.

[rpowell01]

Sorry for such a late, late reply, I forgot that I posted this. I had another lumbar MRI (probably 5th one in 10 years) and they checked to see if I had any clots in my legs. The MRI was negative for anything compressing my spinal cord, I do have the dried up disc at L5 and I do have progression of Osteoearthritis throughout my thoracic and lumbar. I told the surgeon's PA that my mid back and neck are in bad shape and she said she wants to work on one thing at a time. I've been waiting and waiting to get some shots in the joints because the PA said they are inflammed pretty bad. I am not diabetic.

Since my last post nothing has changed, feet still turn purple and get cold and they stay numb all the time. When low pressures/rain comes my toes start hurting really bad and the pain gets worse in the back of my legs and buttocks.

The pain I have accepted but my feet turning blue/purple is bothering me. I have a friend who has the same issues he got from a car wreck. He says his feet and toes get "ice cold" but his doesn't turn color like this. I just took photos of my feet to show my VA PCP so hopefully we can get some test done on this.

[ArNG11]

Sorry for such a late, late reply, I forgot that I posted this. I had another lumbar MRI (probably 5th one in 10 years) and they checked to see if I had any clots in my legs. The MRI was negative for anything compressing my spinal cord, I do have the dried up disc at L5 and I do have progression of Osteoearthritis throughout my thoracic and lumbar. I told the surgeon's PA that my mid back and neck are in bad shape and she said she wants to work on one thing at a time. I've been waiting and waiting to get some shots in the joints because the PA said they are inflammed pretty bad. I am not diabetic.

Since my last post nothing has changed, feet still turn purple and get cold and they stay numb all the time. When low pressures/rain comes my toes start hurting really bad and the pain gets worse in the back of my legs and buttocks.

The pain I have accepted but my feet turning blue/purple is bothering me. I have a friend who has the same issues he got from a car wreck. He says his feet and toes get "ice cold" but his doesn't turn color like this. I just took photos of my feet to show my VA PCP so hopefully we can get some test done on this.

Sorry to hear. I asked for acupuncture and trigger point injections. Those are the next step according to the VA. I'm taking what I can get for the moment. I have had radio frequency done before so I am not expecting any grand results. Id be happy with some relief. I am reconsidering having the discogram done. At this point it's just a matter of whether my private insurance will do it. I figure it be years if I tried to get that done through the VA.

Rpowell your problems are at the L5-S1 right? I have been reading about fmri. Basically functional MRi. It may shed to light. I kind of agree that and EMG needs to be done in different positions besides the prone. The nerves may be getting more pressure on them when your spine is compressing at various angles and pressures. There was another procedure similar to X-rays with dye. Not sure if any this will help. But good luck.

[rpowell01]

My VA PCP is not help whatsoever. I seen me Friday and didn't have any explanation for the feet turning blue/purple when I sit down. I emailed Dr. Bash and asked him if L5-S1 radiculopathy would cause this and he replied YES but with not explanation.

I finally was able to drop the Humana Advantage medicare crap and was schedule for the facet blocks on 2/17. I am praying these will work because I am sick and tired of living like this (NO LIFE WHATSOEVER) and I am tired of taking these pain killers. I've been thinking of replacing the pain killers at night before I go to bed with a bottle of wine cooler. I don't drink and may have a wine cooler every 2 years or every year on my anniversary. But I think this may help my sleeping issues. I believe wine can be a good medicine if used properly and not used to just get drunk.

I also purchased me a testosterone booster (supplement) to see if I can gain some energy so I pray this helps.

ARNG the procedure your talking about just checks for disc herniations and I can't even think of the name right now. But, the VA doesn't do these anymore per my VA PCP.

After these facet joint blocks they want to try a rhizotomy if the blocks do not work. Right now I am willing to be used a guinee pig just to get treatment. If you know a doctor who is a test doctor let me know because I am willing to do anything right now!!!

[john999]

I went for years without a DX for the pain at the base of my neck which radiates into my left shoulder. Nothing showed up on MRI or X-Ray. In 2011 at least 15 years after I started to complain about pain an MRI showed some stenosis at C-5. Even with that I could not get unanimous opinions on surgery. I went to excellent neurosurgeon and orthopods and they all disagreed with each other. One thing I did learn is that they can fix the problem and you will still have pain because by then nerves are damaged. I even had a surgery in 2004 because I was told it was my shoulder that was the problem. Now I have ruined shoulder and C-5 still causing pain. If think if I had nerves so impinged that I had numbness I would probably just go for it and get surgery, but what do I know. When it gets bad enough you will do whatever you think will help. There is always a doctor who will oblige you.

John