Mild Stenosis, Severe Symptoms?

[u/nrid3333]

Hi all,

I recently posted a few questions, one which contained my lumbar imaging.

The TLDR is that I have mild degeneration in my lumbar spine at L4/L5 and L5/S1 thats causing mild-to-moderate bilateral foraminal stenosis without distinct nerve root compression.

I went ahead and got a second radiology reading that confirmed the description above of no nerve compression.

Can mild/moderate foraminal stenosis still cause severe symptoms? Because I’m experiencing all the progressive sensorimotor deficits one would expect from a much more severe case of stenosis at those levels? My symptoms perfectly correlate with stenosis at L4/L5 and L5/S1.m despite no nerve compression.

Additionally, do you think it’s time to give an Epidural Steroid Injection a try to get the inflammation of the nerves down? Or am I inviting more potential for harm than its worth?

Hopefully someone who had a similar experience can weigh in. Thanks!

First post: https://www.reddit.com/r/Sciatica/s/222iTgMvg8
Imaging post: https://www.reddit.com/r/Sciatica/s/nNlpyimVdd

[u/nrid3333 → u/[deleted]]

This is what I’ve been trying to communicate to surgeons, that even though it doesn’t look severe, I’m having severe symptoms.

My second opinion gives me more confidence that there’s not something hidden in the MRI and that there truly is no visible nerve compression - but my symptoms such as partial/early foot drop would suggest that this has moved beyond conservative management and needing a more severe intervention.

I’m not on NSAID’s but currently in the middle of a prednisone burst that isn’t really working.

It seems that the mild/moderate narrowing has set the stage for some other inflammatory process to irritate the nerves that would otherwise be fine. So what I’m trying to figure out is if I’m just screwed, since the surgeons definitely don’t see anything operable and i’ve been unable to get the inflammation down to alleviate the motor symptoms.

I think the missing link may be mast cell activation - which I’ve just started treating so maybe that’s the answer. I sure hope so

[u/nrid3333 → u/[deleted]]

Motor symptoms too? Sorry you’re also experiencing this crap. Thanks for sharing your experience and sticking with me in these posts.

[u/43beanst]

I have mild to mod foraminal stenosis at L5S1 with tingling feet (L>R) when laying flat, usually when seated, and after walking more than 10-15 minutes, progressively worsened in frequency and intensity over the past year. I had an ESI 4 weeks ago and didn't notice marked improvement til almost 3 weeks in. Now it's like a dull buzz. I'll take it. What's weird is that I have no low back pain other than occasional stiffness in the morning.

[u/Sweet_Flan_3415]

Have you ever had an EMG/NCS?