I went to the hospital for a scheduled procedure on my back to help alleviate the pains a herniated disc had been causing. So far, it seems to have helped.

So, I guess because things have been pretty busy at work and at home lately, I haven’t had much of a chance to provide an update on the situation with my back yet (however, I didn’t find some time for a very odd conversation regarding 20th century minimalist plays…). The results of the MRI were, literally, black and white obvious: I have a herniated disc in my lower back. The L5-S disc, which is by the way the one just above that oddball sixth lumbar vertebra of mine (just a coincidence, though, as far as anyone knows). The disc has bulged out to the right enough to press against one of the major nerves for my right leg (the sciatic nerve, it appears). The pressure on this nerve causes the sensation of pain in my right hamstring, from buttock to knee. It’s important to note, just in case you’re hoping to glean some sort of medical information from this, that this pain is very hard to distinguish from an actual hamstring or other leg issue. If your having pain in your leg, you should consider seeing a doctor (I recommend a orthopedic or sports medicine specialist, personally) to determine what the cause is. I know Angela and I were both very surprised.

While the sensation of pain was very real, the fact that my leg has nothing to do with it was a very odd thing to get used to. Even after learning this, I found myself instinctively limping as though it would relieve the pain or even grabbing and massaging my hamstring muscles as though it would make any difference. Now, after having some time to adjust to what is causing it, I find myself distrusting my lying brain and spine. And I don’t mean that to be funny. I have noticed myself actually ignoring sensations in my leg – writing them off as figments of my back simply poking on a nerve.

While I don’t wish to engage in a tangential debate on the topic of intelligent design, I feel pretty strongly that using that description for this section of the human nervous system would be a stretch. As any good process engineer or software designer will tell you, having such an easily corruptible signal or feedback path is a very big design error. You very much do not want your main monitoring system to be so easily misled.

So, this past Thursday morning, I went to the radiology department of St. Mary’s to have a ESI, or epidural steroid injection. This is a pretty simple procedure but it’s still very cool to me. I was taken into the flouroscope x-ray (similar to this machine) room at the hospital and laid on the movable table. The machine they have is bi-axial so they were able to have real-time imaging of my spine from both the side and rear angles. The doctor, after numbing the area with lidocaine (which felt like getting stuck with a hot poker in my spinal column, just so you know), injected a tracking dye into the area. Once he was able to see the exact path, the steroid then replaces the dye on the needle and is injected along the same pathway. The doctor indicated to me that it wasn’t actually that important that he hit the exact spot, as the steroid would act over a relatively wide area (roughly two vertebrae). About halfway through the procedure though, I began to notice the sensation of pressure in my right upper leg, exactly the same spots where pain was living the past couple of months. I asked the doctor if he had begun injecting the cortisone and, sure enough, he had. As he continued the pressure built up on the nerve until it felt as though my leg had swollen up like a balloon and could burst. But as the fluid moved around, that feeling went away, thank goodness.

They kept me around for twenty minutes or so just to make sure everything was okay. Angela came by to pick me up (they didn’t want me driving, which seems a little silly) and she took me back to work. Since, the pain in my leg does seem to have subsided. It may be part placebo effect, but since the pain wasn’t the result of anything real in my leg, what do I care where the relief comes from? Anyway, as the doctor indicated, this isn’t a cure and is only to provide temporary relief. I’ll have to get more shots, no doubt. Hopefully, though, this will help to push (way) back – or even alleviate all together – the need for surgery.

So, I’m going to see the sports-med doc in after a while and I’ll likely do some physical therapy for my back to help alleviate the pressure. Otherwise, I just have to keep aware of the problem and not do things which will compound it.

Oh, and the first thing on that agenda is to get a new office chair at work.

So, the whole sixth lumbar vertebra has kind of been of interest to me. I did some online searching and found an interesting article which explains the abnormality some:

[A]pproximately 10% of adults, have a congenital anomaly in their lower back. One of the most common anomalies is the presence of a sixth lumbar vertebra. Having one extra lumbar vertebra provides no advantage or disadvantage to the individual and is rarely a cause of back problems… [A]nomalies such as these in the lumbar spine and sacral spine are simply variants of normal bony architecture and are typically of no consequence. In other words, it would be very rare for an abnormality such as a sixth lumbar vertebra or extra bone in the sacrum to cause back problems.

I’ll file this under “I found it on the internet so therefore it must be true.” My doctor indicated that mine wasn’t of concern since everything was all aligned. I didn’t ask what happens if it isn’t as I was afraid what the answer might be.

It would also appear that the correct term for this “L6″ bone is Lumbosacral transitional vertebra.

Now this comment was particularly interesting to me:

You may be interested to find that while the homo sapien is characterized by having five lumbar vertebra but homo erectus (the first of the human skeletons found in Africa, including Lucy and australopithecus africanus skeletons) typically had 6 lumbar vertebra.

Something I was at least able to partially corroborate here. Now, before you decide to start poking fun at me for being less evolved than you, keep in mind that modern great apes have only three or four lumbar vertebrae. It’s all relative.