Working Diagnosis:
Lumbar foraminal stenosis and L4/5 anterolisthesis causing radicular leg pain with running
Treatment:
L5/S1 intralaminar epidural steroid injection
Outcome:
The patient felt 95% better after the injection.The patient was able to return to running 40 miles per week with a long run of up to 24 miles with very mild pain He did not have any pain at rest or with daily activities. He has resumed marathon training.
Editor's Comments:
This case illustrates the importance of remembering to include the lumbar spine in the differential of lower extremity complaints. This patient may have been able to avoid multiple years of increasing discomfort if addressed earlier.
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