Question
Hi there!
I'll try to keep this brief, July I had excruciating low back pain, with pain going down buttock, saw Ortho, had MRI, which showed "Slight bulging disc, but definitely NOT pressing on any nerves." The next week or so, noticed "dead" spot on top of left foot, with gradual tingling sensation going up left leg. I took lortab for pain, and was given celebrex and cortisone injection. Back felt better, but numbness and tingling in foot and leg persisted. By Aug. tingling was affecting left arm. Oct affected my left side of face, tongue and lips, with diminished sense of taste. Have been having dull headaches and started having dizziness in Nov. Saw Neuro, told him my story..HE suspects MS, but MRI just showed small lesion in left frontal white matter with area of increased signal in medulla. Planned to do another MRI 3 months apart.
Well, this week I have had a "horrible" numb, yet burning sensation on my tail-bone region, with radiating numbness throughout buttock region, and decreased sensitivity in genital area(ranges form 'dull' to electric burn sensation in vagina', with mild numbness in right upper thigh. I am scared to death, could this be "cauda equina syndrome?"
I called Friday and spoke with Nurse at Neuro office,she said "hang in there" and gave me Lunesta to help me sleep,has sheduled MRI of head and neck and x-ray of lower back this afternoon..... mentioned something about steroid treatment, but Neuro said it would interfere with scans.  My qestion is......is an x-ray on lumbar region enough?
I was really expecting MRI instead. Is it possible it's all "in my head?...meaning neurological?"
I am leary of aggressive steroid treatment, is this normal for numbness in bottom area???????? ADVICE PLEASE!!!!!!!

Answer
You are smart to be leery of steroid treatment, it is good for short-term, but can wreak havoc to the body with long-term use.  Some of the problems could be "in your head", but it could also be in your brain, hopefully the scans will show more.  What I am concerned with, and without a proper exam I am just speculating, is that the areas of numbness you are describing are very localized, which leads me to think it is a type of caudi equina syndrome.  I don't know if you have had a recent fall or other injury, but it sounds to me like you could have some injury to your tailbone itself, and/or some muscle issues that are irritating the nerves in that area.  Again it is difficult to give you a proper answer without seeing you myself and performing some test.  I suggest seeing a chiropractor along with your scheduled appointments with the neurologist.  There is a lot of reasoning that is to difficult to explain in writing, it better to demonstrate in person.  If you are interested in another professional opinion and you want to see a chiropractor, I am a member of a wonderful group that treats the whole body.  Go to www.sorsi.com to locate a doctor near you.  I am in Minnesota in the Twin Cities, if you are near I would be more that happy to see you.  If you have other questions or concerns, or need any other clarification with future exams, please email me.

Dr. Starbuck