Debilitating back pain is frustrating at any age, but at 32 years-old, it was especially disheartening for Kaitlin Liguori, who had played volleyball since she was 12 and has always stayed active through exercise and fitness. She’d successfully overcome back and neck discomfort over the years, but now she was no longer able to continue with the active lifestyle she enjoyed due to severe pain in her lower back. In fact, she was struggling to even walk.
“My legs were numb, and I couldn’t fully use one of my legs,” Kaitlin says. “I felt like I was going to pass out from the pain.” To make matters worse, she adds, the pain was impacting her bladder function.
Turning to a trusted provider
Kaitlin had dealt with minor neck pain in the past, but she was able to find relief with the help of Travis McClain, DO, a Physical Medicine & Rehabilitation specialist with The Christ Hospital Health Network. Specifically, Dr. McClain provided relief to a herniated disc in Kaitlin’s neck by using steroid epidural injections to help relieve the pain and reduce the inflammation to allow the disc to heal on its own, without the need for surgery, which is often the case.
After positive outcomes under Dr. McClain’s care, it was natural for Kaitlin to schedule with him when she developed a new pain in her lower back. But by the time she arrived for that appointment, the pain had progressed to the point where it was obvious that this time was different.
“I saw her walk into the room, and she could barely use her leg,” Dr. McClain says. “She’d even brought her mom along to help her get around, so I knew this was something more serious.”
Kaitlin had recently visited an emergency department due to the pain, where they ordered an MRI that was still pending physician review. Dr. McClain was able to get a copy and review that MRI and his suspicions of something more emergent were confirmed. He told her “This is Cauda Equina Syndrome. You’re not leaving here today without a plan for surgery. You don’t need an epidural or more medication; you need an intervention.”
Immediate access to comprehensive care
Dr. McClain immediately called his colleague with The Christ Hospital, Jared Crasto, MD, an orthopedic surgeon who specializes in minimally invasive surgery of the spine. Within half an hour, Kaitlin was sitting in Dr. Crasto’s office only a few miles away.
“It’s great that as a team we have these open lines of communication,” Dr. McClain says. “It allows us to make those decisions quickly and get the best outcomes for our patients.”
Dr. Crasto confirmed Kaitlin’s diagnosis of a large disc herniation at the L4-5 level that was making her issues worse because the swelling and compression on the nerves were indeed causing Cauda Equina Syndrome.
“This occurs when the severity of the herniation occludes the space for the nerves to travel down the legs,” he says. “When this happens, people can start to lose function of their legs, bowel, and bladder.”
In cases such as Kaitlin’s, the progression from normal back pain to Cauda Equina Syndrome can progress rapidly. She says the pain and trouble while walking quickly increased until it became so severe that she had to take off work the week leading up to her appointment with Dr. McClain.
Cauda Equina Syndrome can progress quickly to the point of permanent damage, including paralysis, so Dr. Crasto scheduled Kaitlin for emergency surgery the next day to remove the portion of the herniated disc in the lumbar region of the spine that was compressing her nerves.
Instant relief after a positive surgical experience
The surgery was successful, and the experience was much easier than Kaitlin expected. More importantly, the relief was immediate. “It was not as scary and a lot less painful than I thought it was going to be,” she says. “It was quick, and the recovery was minimal. The difference in pain was night and day. Just being able to comfortably sit up in the hospital bed and walk the next day was incredible after what I’d been through.”
Kaitlin could now walk without pain and immediately began working with a physical therapist on a controlled recovery to help her regain as much of her previous strength and function as possible.
“While the procedure offers immediate relief of much of the pain, other symptoms can take time to resolve,” Dr. Crasto says. “it can take six to twelve weeks to complete recovery, so immediate activity is limited to walking and early stages of physical therapy.”
After about six weeks of therapy post-surgery, Kaitlin was walking with ease and feeling better than she had in a long time. While she has no plans to get back to activities such as volleyball that put more impact on her back, she is looking forward to getting back to more regular physical activities. “I’m really looking forward to getting into hiking,” she says.
When to see a doctor
Dr. Crasto says people who experience consistent minor back pain should be on the lookout for a gradual progression of symptoms. “If you have pain that wasn't so bad a week ago, but now it's getting worse and worse, you should seek medical attention,” he says. “Especially if out of nowhere you lose control of your bowel or bladder or have significant numbness in what we call the saddle region – which is where you would be seated on a horse.” He adds that you should also pay attention to symptoms such as pain shooting from your lower back down your legs, or sudden weakness in your legs.
Kaitlin agrees with Dr. Crasto’s advice and urges people to pay attention to their bodies if they feel their back pain is getting worse or progressing into other symptoms. “Don’t wait,” she says. “Don’t let it get to the point where it becomes a really severe, scary issue. If the pain is that bad, talk to a doctor.”