Can damaged nerves cause lumbosacral pain?

Hi,

Welcome to icliniq.com. I can understand your concern. The following are important findings in your computed tomography (CT) and magnetic resonance imaging (MRI) of the lumbar spine. 1) There is disc desiccation in L4-L5 disc level. 2) There is a mild posterior disc bulge at L4-L5 disc level and a small left posterior lateral annular tear. 3) There is mild to moderate neural foraminal compromise in the right L4-L5 neural foramen and is prominent in the inferior part of the foramen. 4) There is moderate to severe neural foraminal compromise in the left L4-L5 neural foramen and is prominent in the inferior part of the foramen. 5) There is a mild bilateral neural foraminal compromise at the L3-L4 disc level. 6) There are sclerotic changes in the pars interarticularis of the L5 vertebral level on both sides. Now, coming to your problems despite taking treatments, I would like to make a few comments. 1. Nerve compression-related pain is experienced differently by different individuals. 2. Pain depends on the size and number of pain fibers affected. A nerve contains fibers that carry many sensations, and pain is one particular sensation. 3. A person can have a more severe nerve compression on one side, and the pain can be intense on the other side (assuming there is nerve compression on both sides at a particular disc level). 4. Your condition does not require any emergency surgery. I usually do not recommend surgery unless it is a severe condition and when the benefits following surgery outweigh the risks of continuing medical treatment. Some nerves are compressed, but it is more evident on the left side. However, we need to respect your clinical complaints and proceed with treatment based on other investigations as well. In your case, we have to go by the electromyography report, and also, a detailed evaluation of the S1 nerve root pathway is recommended. Regards.

Hi,

Welcome back to icliniq.com. I did take note of the sclerotic changes and have mentioned it as "There are sclerotic changes in the pars interarticularis of L5 vertebral level on both sides." There is no discontinuity of the bone, and therefore I would not like to call it a fracture. However, it is surely a point of degenerative change and stress in the bone that has evolved as diffuse sclerosis in the area. In my personal opinion, lower back surgery involving bones should be done only when there is an absolute indication to decrease the pressure on the spinal nerves. Following lower back surgery, 40 percent of patients get benefitted, 40 percent of patients have persisting problems, and 20 percent of patients might have worsening effects of the condition. Therefore a lower back surgery will not always solve the problem. Regards.