My name is Josh and I am currently in recovery from an L4-S1 Fusion. I am 34 years old and I can tell you this surgery is by far the most difficult thing I have ever had to deal with. Since my operation about 8 weeks ago I have suffered from severe sleep deprivation. Tonight is particularly bad so I thought I'd share my story:
My back pain began when I was 22 years old. I was very much into weightlifting and injured myself hoisting up a 405 pound barbell. The exercise as I am sure some of you are familiar with is called the deadlift. My technique at the time was terrible and I performed no warm up. In other words, I was just asking for an injury. At that time in my life I just followed the older veterans in the gym without much thought. Because I was young and strong I never gave any thought to the consequences. In retrospect, I was quite foolish and my actions would initiate future years of back pain and turmoil.
The pain from the deadlift started the next day and I noticed that I had a tremendous amount of pressure above what seemed to be my tailbone. I didn't give it much thought because I thought it would go away. Eventually it did, but I was left with a dull, yet constant ache to the left of my lower back. I continued my daily activities and looked upon my lower back as more of an annoyance than a disability.
Over the years I would periodically injure my LB again doing either squats or the deadlift. It did not seem to matter that I had learned how to do these exercises correctly. It seemed that the initial trauma to myself at 22 had not been healed and the residual damage would be triggered now and again by these exercises. However, because these exercises were so productive in many ways I continued to do them. You see, they did not injure me for the most part unless I went incredibly heavy or had a lapse in form. In fact, I felt as if these movements did much for strengthening my LB and could be viewed as "injury proofing" tools.
Well, when I would occasionally re-injure myself the LB pain would be more pronounced and chronic. Despite these setbacks I continued to push through my LB problems and move on with my life. I was determined not to let my LB stop me from accomplishing my goals.
During this time I had begun to work as a personal trainer at several commercial gyms. I thoroughly enjoyed meeting new people and helping them to become healthier. I studied human anatomy, movement, exercise physiology, nutrition, stretching/yoga, sports psychology, and any other subject matter that I thought would help me to be a better teacher.
I was very strict with my clients so as to make safety a priority. My number one goal was to prevent injuries in any of my charges ...... especially their lower backs. Over the years I was able to successfully rehabilitate dozens of people - many with severe LB issues. Many of these people had failed to derive benefit from formal physical therapy. I was making a name for myself as a trainer, but was frustrated with my inability to fully rehabilitate myself. I had dropped the squatting and deadlifting at this time. Nevertheless, my back condition magnified and I decided to see a doctor about it for the first time when I was 29.
The doctor ordered an MRI and on my return visit said I had Degenerative Disk Disease. I was shocked that my image did not indicate something more substantial such as a herniated disk. He recommended physical therapy for me which I passed on because that was pretty much what I did for a living. I explained that my injury was not related to a muscular imbalance, poor flexibility, or postural problems. At that time I was a lean and athletic 6'1 165 pound man. I had a washboard stomach and clearly delineated para-spinal muscles. Didn't matter, the doctor said I needed to work on my "core" muscles. I explained to him that my muscles were strong, but some damage in my LB was preventing me from using them. I reiterated that my profession requires me to help people develop their "cores" and that I had rehabbed many people's LB injuries over the years. However, the programs I used to help others were failing me. If I did even light "core" exercises I would have back spasms and walk improperly for sometimes weeks at a time.
I never went back to him and would not reschedule a doctor's visit for about a year. By this time a doctor client of mine took an interest in helping me and suggested I see a popular University of Pittsburgh Neurosurgeon. With this doctor I had another MRI, multiple x-rays, a cat-scan, a bone-scan, a sonogram, and a fluroscopy. Potential diagnosis ranged from a slipped 12th rib that may be impinging on my intercostal nerve to an anomalous transverse process. Of course DDD was still in the mix and a possible calcification. In the end I saw a cardio-thoracic surgeon for the suspected "12th Rib Syndrome" and two other orthopedic doctors at the Cleveland Clinic. None of these doctors could figure out what was wrong with me. Other than degenerative conditions in my spine there was nothing they could identify as a pain origin.
Frustrated and convinced that no one believed I had a legitimate LB problem I decided to give the doctors "a rest" for a while. During this time I continued to exercise as best I could. I tailored a program around my injury and bought any equipment I felt might help me recover from this chronic pain. I had started my own training business and had some of the best equipment around. I had machines that would work both the stomach and lower back muscles. Of course, these exercises continued to help my clients, but they would only exacerbate my symptoms.
In addition to my exercises, I sought out trigger point therapy, rolfing, deep tissue massage, chiropractic, inversion therapy, disk injections, anti-inflammatories, acupuncture, and anything else I could think of - nothing helped. I even tried just walking and yoga without my normal strength training. I couldn't seem to find an exercise modality that alleviated my pain.
My back took a turn for the worse at 32. I was doing a leg raise for my stomach and I felt "something click" in my LB. The pain was terrible and I was not able to walk very well. Every time I would extend my left leg to take a walking step there would be severe pain in my LB. It felt like there was a rope tied from my big toe to some nerve in my LB. Yet, I never really had sciatic pain in all of these years - my LB pain was more localized.
The fact that my LB pain was more localized concerned me. I always felt that if I had sciatic pain the MRI would have picked up a herniated disk. Then, with a clear cut diagnosis I could have undergone a disectomy. Unfortunately, because none of my imaging tests discovered anything, the doctors seemed rather dismissive. I have always felt that because I was young and in good shape the doctors did not believe that my pain was so severe - almost like some sort of reverse discrimination.
I would not see another doctor until I was 34. I saw an orthopedic doctor who looked at my x-ray and said that L5/S1 was collapsing and that this was the cause of my pain. He said that he believed when there was nothing left of the 5th lumbar disk that I would have complete pain relief. He said he suspected that within 5 years I would be fine. I asked him about a disk replacement and he said I was too young for that procedure. He said the replacement would not last 10 years before I'd need another one. My response was basically who cares. If a disk replacement ceased my pain for 10 years wouldn't it be worth it? Besides, in 10 years wouldn't technology and medical advancements provide replacements that could last 20 or even 30 years? He said if I went to enough surgeons that someone would do a fusion. I asked him if a fusion would help and he said he did not recommend it. When I asked him why he referenced adjacent segment disk disease and explained about other levels breaking down requiring more surgery in the future. When I asked him, despite the possibility of that happening, if he thought a fusion might help me with my back pain he did not give me an answer.
So, a couple months later I went for a 2nd opinion and that orthopedic doctor told me that with my history and no relief that yes, a fusion might help me a lot. I asked him if a fusion has helped people with just localized LB pain as opposed to sciatica and he said yes. The results are less predictable, but I think in your case it could help. He also said that if it didn't work I would probably be the same - no worse than I was pre-op.
Well, I am almost 2 months post-op and I am not very pleased to say the least. My pain is much worse than before surgery and I have to resume work. I have continued to pay all of my business overhead since my operation and cannot afford to take anymore time off. I do not feel ready at all to resume work, but I don't have any other options. I plan on instructing my clients verbally and do not intend to lift any objects.
I can say that my recent bout of insomnia has only added to the stress. Because I live alone in an apartment I have had to "weather the storm" with very little help from others. Trust me when I say I welcome any and all help!!! My journey alone through this ordeal is certainly not mentioned to brag to anyone. My story is not unlike many people on this forum and I sincerely empathize with others who are suffering. I believe that in my specific case I may have made the worst mistake of my life. I can sense myself spiraling down into a deep depression. I can only hope that with time I will slowly heal and then I can rehabilitate myself to some meaningful quality of life.
Thanks for listening,