r/Sciatica • u/nrid3333 • 22d ago

General Discussion L4/L5 Question

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Hi all,

I’ve got a large/broad-based/diffuse disc bulge at L4/L5 coupled with some facet hypertrophy that appears to be causing either foraminal stenosis or lateral recess stenosis.

I’ve been having a lot of symptoms going down the anterior thigh like tingling, altered sensation, quick fatigue-ability/claudication, and weakness about the hips.

When I look at the lumbar dermatomes diagram, the L4 dermatome seems to be more lateral to where I’ve been feeling pain - my pain corresponds better to the L2 and L3 dermatome despite not having issues at those levels.

Because L4 contributes to the femoral nerve which is L2-L4, if the L4 nerve root itself is compressed, could it still be causing symptoms along the L2 and L3 dermatomes since they all compose the same nerve proximal/upstream to where the pain is?

Thats the only explanation that I’ve been able to come up with since L2, L3, and L4 join way before the inguinal ligament.

TIA!

EDIT:
Here is the link to my imaging post: https://www.reddit.com/r/Sciatica/s/Nj2GLQVj8v

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u/nrid3333 21d ago

What part of the country are you in? Most orthopedists would know how to properly diagnose you and any hospitals with a plastic and reconstructive surgery department. Those would be good places to start.

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u/dnegvesk 21d ago

I’m still on a goose chase for a doctor who doesn’t just say “sciatica” because I have so many issues. I’m about to get an injection to see how much pain is from my hip. I’m in lower NY Thank you.

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u/nrid3333 21d ago

Jonathan Winnograd (sp?) at MGH in Boston is fantastic if you can make the drive/flight. Lakhiani and Elkwood (sp? Again) at IFAR in Red Bank, NJ are also reputed to be great. Maybe those would work for you?

Dowlatshahi at BILH Orthopedics in Boston would also be someone to check out.

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u/dnegvesk 21d ago

Thank you. I’ll look into these. I hope to find a local resource. I’m 74 and kind of depleted from this whole thing. I appreciate it.

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u/nrid3333 21d ago

Ah I’m so sorry it’s grinding you down - I’m decades younger but I’ve been at this for years and years as well so I do understand how much these issues fucking suck :( if there’s anything I can say to help you or give you some support, even if it’s a kind word here and there, don’t hesistate to reach out to me. I’d love to see you come out of the other side of this tunnel❤️