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newbie In severe pain what do I do?

AnonymousUserAAnonymousUser Posts: 49,671
Hello everyone,
I am new to this site and find it very interesting. I am a 28 yr old male that is very active and healthy- so I thought. About a month ago i started getting a sharp pain that shoots down my right leg and into foot originating from my lower back. To make a long story short, i had a mri taken and here are the results:
A large disc protusion arises from the L5-S1 disc space extending into the right lateral recess with a likely extruded fragment measuring 10 mm in cross-section, causing compression of the right ventral sac and right S1 nerve root compression and displacement is evident.
Large disc extrusion at L5-S1 extending into the right lateral recess with right S1 entrapment.
I have seen a chiro, two med docs, and pt.
They all have told me that surgery is what i need. I am currently doing pt and have no relief. The leg pain is so bad 24/7. I have an appointment a week from today with a surgen. Any input would greatly be appreciated. Im scared of sugery and would like to know if there is anything else to do to fix my problem, but if that is what I need then so be it. Thanks


  • Are you on nerve meds for leg pain? I'm on Lyrica and amitriptyline as well as muscle relaxant and pain meds. I hope you get some pain relief. I also find heat soothing. They should order an EMG for your leg. You may have to try everything conservatively at first with Epidurals and meds but the Dr would let you know that. Also get a 2nd opinion Surgeon. Take care. Charry
    DDD of lumbar spine with sciatica to left hip,leg and foot. L4-L5 posterior disc bulge with prominent facets, L5-S1 prominent facets with a posterior osteocartilaginous bar. Mild bilateral foraminal narrowing c-spine c4-c7 RN
  • hi and welcome to the forum! :H we are here to offer you support and answer what questions we can. please be sure and get a second opinion, especially if surgery is recommended!!! the more information you have the better for you!! please keep us informed! good luck, Jenny
  • It is important that you consult with a fellowship-trained spinal specialist. When a disc ruptures and a fragment is compressing a nerve, it makes it much more difficult for it to heal on its own.

    Depending on how severe the pain is, you might want to ease up on PT until you have consulted with a surgeon. Depending on what the PT has you doing, it could make the extrusion worse.

    If you should develop any bowel or bladder problems, it is a sign of cauda equina syndrome and you should get attention immediately. This is one case where they will do surgery immediately. This is nothing to wait on as the damage can be permanent. CES does not happen frequently, but I wanted to be sure you were aware of it. When it does occur, it is more common when you have an injury to the S1 nerve area.

    Please keep posting with your comments on questions. There is lots of good information on this board and people who are there for you.

    Gwennie :H
  • I have been told by my doctor that there is nothing to give me for my nerve pain. The pain is so severe though that when i went to the dr office a week later to get a slip for permission to stop working, I asked again for something and they gave me vicodin. Not the medicine i was looking for due to the adiction involved if not careful, but must say it helps. I have actually had 4 different opinions now and they have all been surgery, but I will know a lot more when I see the surgen thursday. I will also see two surgens to get two surgen opinions. When i was at my last pt a doctor that does steroid shots to avoid surgery was there and looked at my mri. He told me that i was not a candidate for shots and that I needed to see the surgen as soon as I could. This doctor works with the surgen i am going to see.
  • Thanks for the info. I was actually justed released yesterday from pt because it was causing more pain than relief. I am now going to take it very easy now until I see the surgen on thurs.

    Thanks, Russ
  • Just wondered if I should not lift my 2 yr son anymore. Do not want to cause any more damage. Thanks. This is very good forum, and am very glad to have found it.
  • I'm not sure about lifting. Maybe your 2 year old could sit in your lap instead. Good luck with your appt. Charry
    DDD of lumbar spine with sciatica to left hip,leg and foot. L4-L5 posterior disc bulge with prominent facets, L5-S1 prominent facets with a posterior osteocartilaginous bar. Mild bilateral foraminal narrowing c-spine c4-c7 RN
  • Yea i am trying not to lift him up as much. Sometimes have no choice like to put him in his car seat. My wife is being very supportive with me but works full-time and is also 5 months pregnant. Being out of work now will definatey make my life a lot easier though.

    Thanks Charry.
  • I have not been informed of this by any of my docs and would like some info on it please thanks.

  • I agree about not picking up your son. My last three PT sessions really intensified the pain, especially when they put me in a traction machine. Never been on one until recently. I told them that the traction hurt me more, but they did it again. I am not going back to PT until find someone that I can trust.

    I just had microdiscectomy and it really help me with the pain. I, too, had take days off for pain. Walking and standing was almost impossible.
  • I don't mean to sound harsh about not picking up your son, but he is two years old and probably weighs at least 20 pounds. If you don't use proper lifting technique, lifting a small toddler can hurt your back.

    Once the pain is gone, you learn to pick up your son without hurting myself. Good luck and congratulations on your second baby!
  • An EMG is where they do a test by putting needles throughout your bad leg and send electricity through it and get a reading at the response time of your nerves and muscles to detect any damage. They will also put litlle read stickers is what I call them on your leg and put a two prong device on different parts of your leg to get some more readings. I honestly hated this test some say it wasn't so bad and I agree once it was finally over 40 min later. And I consider myself tolerant to pain but I guess not electricity. Mine read out with minimum damage but I definitely do not want it again. Did you see a neurologist and they recommend that or were you just bringing it up? hope all goes well and welcome to the Family!
  • it sound like you will require a discectomy /laminectomy .regarding pain control ..has you doctor mentioned gabapentin to you ? a large dose of this or other drugs with a similar profile should help with nerve pain . there is also a device called acticare .this may help you with pain before and after surgery
    see [ URL removed by Moderator Bruce as its against forum rules to promote commercial sites ]
    good luck
  • Don't worry about the EMG for now. This will not be among the first tests a surgeon is going to recommend to you. If he feels you are in danger of permanent nerve damage, he will recommend surgery, whether or not you already have damage (which is unlikely). At this point, EMG (electro myogram) would not reveal any information that would influence the surgical decision. If you are curious about the procedure, there is an instructional film about it on Youtube.

    Until you find out what specifically is wrong with your back, avoid any activities that involve bending (forward or backward in extension), lifting more than a gallon of milk, (lift your son only when absolutely necessary) and twisting. Also it is important to avoid reaching up over your head or anything where you are reaching with your arms extended while your body is twisting, even ever so slightly. Also try to watch your posture, keeping good body mechanics as much as possible. Watch sitting in overstuffed furniture, slouching, etc. You could take the maximum dosage of Aleve per day to try to handle the inflammation and try either ice or heat for comfort. Usually one is more comforting than the other -- personal preference.

    Continue to walk as you do not want to lose muscle tone or conditioning and it is good to keep the blood circulating.
  • I havent seen a neurologist, but seen it on the forum. Thanks for the info though. I was told by the doc that some have permanate nerve damage and some do not. Ill just hope for the best for now until I see the surgen in 5 days. Does not sound like very mush fun, but I guess it would speed up the surgery process if surgery is needed.
  • Thank you. It will be a lot easier now that I am not working. My job consists of lifting, bending, twisting, and reaching all day long, so now lifting my son maybe twice a day being as careful as I can be should not be too bad
  • Hunter80,

    PT will not help you it will only make it worse faster. Steroid injections will probably help with the pain a little but only for a month or two. I had exactly the same thing as you. Like mine, your herniation is too large to heal on it's own. When my pain was at it's worst it was a 9 on a scale from 1 to 10. Alternating every 4 hours with Vicodin and Motrin 800's would bring the pain down to about a 5, but that's no way to live your life. The vicodin is addictive and the Motrin eats your stomach. Not a good long term solution. I went with the microdiscectomy. It wasn't too bad and I was back at work in 2 weeks. I now have scar tissue issues but even that isn't nearly as bad as the huge disc herniation. It's not an easy decision but I don't regret going with the surgery.
  • I was shocked when you said your doctor told you there was nothing to give you for the nerve pain. Where is he from-the stone ages? Unbelievable. Let him know that medication like Lyrica, Neurontin, and Cymbalta are FDA approved for treating this kind of pain. The vicodin is helpful but it doesn't target the burning, stabbing, pins and needles, and numbness sensations you get when there is nerve irritation and impingement. It takes a combination of medications to treat disc herniation pain- a painkiller, nerve pain medicine, muscle relaxer, and an anti inflammatory medication like Naproxen or Motrin.

    I think you should get a second opinion because I have serious doubts about your current doctor's expertise. Take care and I hope you get the right treatment to recover from this.
  • Thank you for the info. It is great to hear from others that have had this problem, and the sucess stories of surgery. I cant wait to be able to do the things that I was able to do before my disc problem. I also have done a lot of research on the surgery, and it definately sounds like the right thing to do in my case. Thanks,
  • I agree with you 100% on my current doctor. He is no longer my medical dotor. I have seen other doctors though in the meantime and they have all said surgery because the disc is just too far gone. I will know here very shortly for sure though as I am going to a surgen on thursday. Thank you very much and I will keep posting as I hear more.
  • Please be sure to consult a Neurosugeon... not a neurologist. My first surgery was a blessing! Felt better immediately and was walking the next day after surgery. Unfortunately, my surgery only lasted 2 years before the disc herniated again. But they were 2 years of wonderful... no pain whatsoever.

    Goodluck and let us know if you see a Neurosurgeon.
  • I wonder if you know anything about the spondylolithesis? This is the slippage of the vertibrae / spine itself! If it slips too far. you will become paralized!
    What grade is it? My husband had a grade 3-4. They fused his using his hip bone (30 years ago). He would have been parallized if it hadn't been caught when it was. He was 17 yrs old at the time. Grade 4-5 is paralized.
    You should ask your surgeon questions to find out how far the slippage is? It could be very important to have surgery soon!
  • I have been told by my surgen that I was born with the type of spondylolithesis that I have. It is because of this that my disc is worn out and herniated so bad. Have you heard of that before? I am scheduled for fusion on march 30. I am startng to get very nervous.
  • Don't worry about the spondylolisthesis. If you have had it from birth (and this is not uncommon -- many people have it and do not know about it until they have an x-ray for some other reason. It does not cause them any pain or symptoms and thus, they do not realize they have spondy.) There are four different types of spondy but they all result in the same outcome, regardless of what caused it. Mine is degenerative, which means mine resulted from wear and tear deterioration. You were born with yours slightly out of place. It results in one vertebra sliding over the top of the next vertebra. The amount that it has slipped is the measurement that is used for the "grade." If you have grade I spondy, it means the vertebra has "slipped" up to 25% from the point where it should be aligning with the vertebra next to it. Grade 2 is 25-50%, Grade 3 is 50-75% and Grade 4 is 75 to 100%.

    Most of the pain caused by spondylolisthesis is from the nerve compression that occurs when the vertebra is out of place and is pressing into the space (thecal sac) where the nerves need to pass. When the nerve/nerves are compressed, this results in the radiculopathy that you feel in your leg or legs.

    As I think we talked about, statistics are in your favor, as fusion for spondylolisthesis has the highest rate of success, as opposed to fusion for a herniated disc, etc.

    It is normal to feel nervous, but you have done your homework. I trust you feel comfortable with your surgeon and have checked him out, you have examined your options and feel that you are making a decision based on facts rather than just doing what one guy tells you to do.

    Sometimes this boards strike fear into your heart as you mostly hear the complaints and the unsuccessful stories. I went into my fusion expecting the very worst. I had never had surgery before and had read all the horror stories. As a result, I surprised myself by thinking it wasn't all that bad! :O

    The one area in which you should really listen to patients rather than doctors is in the recovery process. Too many doctors error on the side of being overly positive, telling patients they will be back to work in a short while, back to normal life in a couple months, etc. The result is that if you take longer, you assume something has gone wrong. When you read through various threads, many people who run into trouble do so because they are impatient and try to do too much too soon. They do not use common sense...like the guy who goes out and plays 18 holes of golf after not having swung a club in 12 months!

    Of course you must listen to your doctor, but also come here and talk with others who have gone through this. I let my surgeon do the technical stuff, but all the practical tips I got here. After all, most surgeons have never had spine surgery!

    You will do fine...and after some initial surgical pain, you will gradually start feeling better and better. Having a positive attitude is very important. Put together a CD with all your favorite soothing music (assuming you like that sort of thing!). Some surgeons will let you listen right up until you go through the doors of the operating room.

    I'm sure I'll think of some other tips before you go in on the 30th....just hang in there!

    xx Gwennie
  • Thank you so much for your support. I was actually relieved in a way fo find out that I had spond because it gave me a reason for my herniated disc. Before knowing that I had no idea what was causing so much pain. I have never had serious trama to the back and was so confused of why this was happening. I am nervous but excited at the same time because I am in so much pain. I just want to get this done and start my recovery. I already told my boss not to expect me back for a least six months. I am going to do exactly what the surgen tells me to do in recovery. If all goes well I should be in good shape for our new baby(sept 5 due date). There is no light duty on my job so I have to make a full recovery before returning. I made a list last week of about 15 questions that I needed answered from the surgen to make me fell even more comfortable with the surgery, and drove up there (45 miles) to ask personally. I was not able to talk to him, but talked to his assistant that actually assists in the sugery. He was very easy to talk to and really took his time with me. He aswered all my questions and more. I felt so much better after that. I am ready for this and ready for my life back. It is amazing how I went from 100% healthy to disabled in such a short time. What doesnt kill you can only make you stronger right? I have a new found respect for people with back problems. Thanks gwennie/
  • Will you repeat the surgery?
  • Hi Hunter,

    I understand your pain. I had pretty much exactly the same as you only the motor sensory areas of my nerve were effected therefore I had no other option but to except an operation, and 5 days after they saw me. They operated quickly as i had no feeling in my leg and after a certain amount of time your brain will stop receiving messages and cut circulation etc to the leg. It doesn't sound like this is happening atm with you but it's not to say it won't get to that. I'd get a second opinion on the fusion. I had a microdiscectomy and they cut out 2/3rds of the disc. I do have alot of problems still but as i mentioned before it effected my motor sensory area of the nerve which was the most damaged.

    Good luck matey and I hope whichever path you take it is the best solution for you.

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