Question
Hello,
My name is Ev, I'm a 26-year-old female. In 2007 (21 yrs) I had a discectomy to treat a large central/left herniation of my L5-S1 disc which had been causing severe pain, as well as significant weakness to my left leg for over 18 months (couldn't stand on my toes, maintain normal gait, etc.).  At that point I had tried over a year of PT, traction, ultrasound, etc. to no effect (the surgeon later told me he wasn't all that surprised it hadn't had any effect - apparently it was a larger herniation than he'd thought from the MRI).
Anyway, the surgery worked, I woke up without pain for the first time in almost 2 years and was ecstatic.  I did all the things I was supposed to do - walked (and later swam)incessantly and did PT for recovery, including ultrasound and massage for the scar tissue.  All seemed to be well and I returned pretty much completely to my previous level of functioning.
I am an otherwise fairly healthy 26 year old female. The only regular medication I take is my symbicort inhaler for asthma.  I am recreationally active (I exercise, row, and play pick-up games of soccer, hockey, etc., but I'm no athlete).  I have to admit I don't always really look after my back - I have an unfortunate tendency to jump from high places and to let kids jump all over me.

Now, five years later, I'm experiencing some symptoms that I'm afraid may be signalling a recurrence.  I don't have the same debilitating sciatic pain I did back before the surgery, but I am experiencing some lower back pain.  What's really worrying me, though, is that I am having some issues with (*ahem*) mild anal leakage (thank goodness for the perceived anonymity of the internet). It's been happening pretty regularly for the past few months - not huge amounts, but enough that I now always need to use liners in my underwear. I honestly can't tell if I'm getting myself worked up for nothing, if this could somehow be related to the my old spinal issues, or if it's something else entirely.
Any ideas? Or am I just neurotic?

Thanks in advance for your time!

Answer
Hi Ev,

I am very sorry that you are having to deal with such a potentially embarrassing issue.

From your description and little history above, the good news is that it does not sound as if the disc herniation has returned.  Is there a possibility, yes, but unless you have had some form of traumatic event, for example while playing "pick up" sports you got injured, it's unlikely to have the injury return.

Outside of the "anal seepage" it sounds like mechanical lower back pain that should be addressed by a chiropractor.  Being that you do not have radicular pain down your legs and into your buttocks that helps rule out spinal nerve involvement.  Neurologically, it sounds as maybe there is some pressure "pinched nerve" at the SI#Sacroiliac#joint as many of the sacral nerves control pelvic #genitourinary #genitals and bladder# and anal# functions.  

Another big question to ask:  Have you had any changes in your diet recently?  Fast food increases, soda, excess gas, digestion issues?  These may be the real culprits if the SI joint is ruled out.

Go see a chiropractor, you won't be sorry, assuming you have a really good one in your area that still does manual manipulation.  Many chiropractors have turned to using gimmick tools that work for "everything" which is not true.  If after a few adjustments to the SI joint resolves the issue, then great!  If not see about your diet and make appropriate changes AND see a cholorectal specialist.

I hope that this helps.  Feel free to ask more questions.

Sincerely,

Dr. Kevin Kaldy
Chiropractic Physician
www.lasvegaschiro.com
[email protected]


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