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New to site - considering what to do

AceAAce Posts: 26
edited 06/11/2012 - 8:30 AM in Lower Back Pain
Well, I have been reading on this site for quite a while but never posted. Like most people I am looking for answers and trying to decide what to do. Any advice would be appreciated.

I am a 49 yr old guy. I have been active all my life including playing college baseball, competitive volleyball and running, weightlifting, hiking - you name it. After my kids came along I became a little less active but still kept up a regular exercise routine. I am otherwise very healthy and not overweight. In other words trying to do everything right.

When I was 16 and 17 during baseball season I developed very bad sciatic pain in my right hip and leg. To make a long story short, with rest and a good chiro, I recovered. I have had off and on basic stiffness in my lower back over the years but nothing a good hot shower and a couple of Advil could not take care of.

About 1.5 years ago, I noticed that I could not stand for long periods of time without my lower back getting VERY stiff and painful. Once again, sitting down would make it all better. It would bother me on and off until December 2008 when I decided to go back to a local chiro who had a good reputation. Basically he was not helping me much and after one particular session (Jan 21st), I seemed a good bit worse the next day. I quit going to him. My family doc suggested I get an MRI which I did on Feb 4. I saw a neurosurgeon shortly after and he said (as the chiro did) that I have a grade 2 spondolo between L5 and S1. He recommended PLIF and basically no other hope of trying anything else. I have gotten gradually worse since seeing him and now am at a point where I cannot walk upright without lots of pain and stiffness. I look like a hunched over old man. I have a job where I sit all day (thankfully). I do as little walking as possible. My pain and stiffness go away almost as soon as I sit down. I have no problems sleeping or not much. I can ride a bike for hours with no pain. But standing and walking are very painful.

I decided to go see a OS for a second opinion last week. He said too early to talk about surgery but if he did do the surgery he would do anterior and posterior, where the NS said he would do PLIF only.

The OS is sending me for an injection next week followed by PT to see if that helps and said to see me in 8 weeks.

I would like to stay away from surgery if possible but recognize that it might be the only way. I have some questions for anyone who cares to chime in.

1. Would inversion tables help any? I tried one in a store the other day and it actually did help for a few minutes but I wonder if daily use would help me.

2. I understood why the OS said he would do anterior and posterior fusion as opposed to just posterior, but is one really any better than the other?

3. Will continue to keep walking like I am cause further problems with nerves or muscles since I am so bent over?

Sorry for the length of this, but I have many other questions and am very frustrated. I know my wife is as she has to do almost everything around the house including all the yardwork along with everything else a mom with two kids has to do. Currently she is not working outside the home so she has time for it.

I just don't want to jump into surgery without trying everything else. I can live like this but don't want to be this way forever.


  • Hi I hope the epidural injection helps. They've helped me. I've had 5 of them in 14 months. I also walked hunched over like that until the Pain Management Dr noticed my facet joints were affected and received injections to help with that. I don't have spondy but see if the injections help first. 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
  • Thanks for your suggestions and good luck yourself!
  • I understand where you are coming from. Back surgery is a major surgery and you want to make sure it's the right thing for you. Just my advice, but I would try other options before surgery. I guess the exception is if you are having nerve problems too or bathroom issues along with the back pain. I'm glad to see you got another opinion. It sounds like surgery is most likely going to be what you need but like I said these are my opinions and I am in no way a medical professional. I know wwhat it's like walking hunched over like and old person. I still get like that even after surgery.
  • I can totally relate to what you are going through. I had spondylolisthesis at L4-l5. I waited over 3 years and saw a total of eight spinal specialists (ortho, neuro, physiatrist) as I couldn't believe there wasn't some new technique to treat this condition other than fusion. Also, I didn't seem as "bad" as others I read about on the back forums! But finally I could not stand for more than one minute and I was driving down the driveway to my mail box to get the mail!!

    I was like you in that I would get instant relief as soon as I sat down and had no or little pain when sleeping. But we cannot spend our entire life sitting, so I decided to go ahead with fusion.

    Many other back problems can be resolved with conservative treatment, but I was told there were no choices for me. But it depends on how much space you have in your central canal and if there is enough space for the nerves to get through without being compressed.

    Walking bent over should not hurt anything. You are bending over to compensate for pinching you are getting normally. When you bend forward, it opens up the canal a bit and gives you a tad more room for the nerve.

    An inversion table might provide a little relief and would not hurt anything (assuming there aren't other issues!).I guess only your doc can say for sure.

    Have you taken any oral steroids? That provided a bit of relief for me. I went through all the conservative threatments and several alternative treatments like acupuncture and body work stuff, but ultimately I had to have surgery to ream out the central canal to make room for the nerves. If you do not have a problem with stenosis, you might be able to avoid surgery.

    Do you have a copy of your MRI? It is pretty easy to see if there is any room, or not.

    Please feel free to ask questions. I feel like I have walked in your shoes and am a bit ahead of you on the path!!

    xx Gwennie
  • A few things I forgot: be sure that you avoid any activity that involves putting your back in extension. This includes swimming -- any stroke that you would do on your stomach. If you do any physical therapy, be sure to stress that you have spondylolisthesis. Otherwise, they will have you doing a couple exercises that involve arching your back.

    You want to avoid anything that allows you back to extend backwards. This includes sleeping on your stomach, or even lying on a massage table (on your stomach). You should have a small pillow under your waist so you don't have that concave curve in your spine.

    If you are uncomfortable walking, try shortening up your stride. Avoid walking up and down hills or uneven terrain.

    Do you know if your spondy continues to slip? Some people on this board have talked about feeling the instability. I never did, but I just had a grade 1 spondy.
  • Thanks Gweenie - I have not tried oral steroids but will ask about them. I really have not tried anything other than Valium and Vicadin that my family doc prescribed, but they basically do no good, so I am not taking anything right now. I just try to walk as little as possible and as you know it's quit a drag.
  • My back certainly feels unstable and has sharp pains if I tried to walk in a normal upright position. I have to either arch my back way back (almost hyperextend) or hunch over which is what I usually try to do.
  • Hi Ace I am pretty new to this site but have found it to be a great place for information and advice and support. The big words used by the medical people confused me but you can look them up here and you feel better empowered to ask more questions. I to walk hunched over and find that the more steps I take the more muscles spasms happen. My physio said if it hurts don't do it!! Leaning forwards for me is very helpful and I use my computer chair for support. My recliner chair is my best buddy, along with a hot water bottle on my lower back. I'm waiting to have L4/S1 fusion, with excision of right transverse process of right L5 with a TLIF and cage at L4/5. The injection you talk of I think is what I had last august, personally it didn't last very long, but it helped the docs diagnose what the best treatment would be.You asked about the effect of walking hunched over all the time. I talked to my physio. she suggested core exercises and weekly massage to try to keep the balance of my muscles in good shape, just better to have massage sitting on a massage chair rather than laying down.I really understand when you say that your back feels unstable. I have some pet-names for the various "pains", steel-spike up my spine! or "buttock-burn" even "spastic-back" for the muscle spasms.I'm sorry that I can't give any exact fixes-still groping my way along the journey. Just remember this site is here and the people will listen and hear and support you.Good Luck and hope you get the answers you need soon Hugs n' Love Winkie
  • I like those names. Sounds just like me. The Steel Spike in my spine especially. Thanks, Winkie.

  • Ace,

    I had the first hand experience with the pain itself and suffered for 5 long years till I finally found the correct methods of exercises and since then, I AM PAIN-FREE. If you want to avoid having a back surgery and get back to normal, listen to the person who can help you recover through the correct methods of exercises. Remember, that he is not a licensed medical person though he knows exactly your pain and sufferings. It is to everyone's disadvantage not to listen and believe the person who can make your life happy.


  • Hi Ace...I have grade 2 spondylolisthesis at L5-S1, too along with DDD and severe bilateral spinal stenosis...so I can certainly relate to the pain, limitations, and frustrations you are dealing with. Despite the daily low back pain, I like to consider myself an "active" person. I'm a 43yo woman that recently took up the hobby of doing triathlons. Yes, the running can be quite painful at times, but I'm able to manage it if I keep to a slower pace and shorten my strides.

    I have never had an injection, but I did go through 6 weeks of PT. Sadly, the PT did absolutely nothing for me...likely because I'm already so active and the exercises were not challenging enough for me to build up my core strength. So now I just make sure that I incorporate plenty of core-building exercises (I do lots of stability ball stuff, and planks) in my daily workout. I've been to a neurosurgeon, an orthopedic spine doc, and a chiro...the NS and OS both suggested epidural injection and then fusion surgery...both of which I'd like to avoid at this time. I had been going to the chiro 2x/week for E-stim (TENS) treatments, along with some suggested exercises...but felt that I wasn't progressing very much with him...so I stopped going.

    I bought an inversion table in Jan. 2008. I started using it every morning after waking up and before I went to the gym. I would invert for no more than 5 minutes. Within 3 months, my horrid sciatica was completely gone. One problem solved. Now I just have the low back pain. I still use the inversion table daily, mainly because it just feels so good on my back. I can instantly feel my spine decompressing after I get in the inverted position. It doesn't work for everyone, though...so your results may vary. But I've been very pleased with what it's done for me, and I will continue to use it on a daily basis until I drop dead...LOL

    Good luck with everything...and I hope you find some relief for your pain.

  • Sorry to hear about your issues Ace!. I can only tell you about my history and hope it helps. 1989 posterior fusion L5-S1 due to congenital defect done by the best Orthopedic surgeon in Phoenix and a friend assisted. Pain was exactly as you describe. At that time I was also diagnosed with extensive spinal stenosis all lumbar levels. My Ortho surgeon told me of all the options you are hearing about but also told me that in the end it will not be if I need surgery but when. The when would be determined by how much pain I could stand. I had it done with no regrets. You should know recovery time then, as it is now is 13 weeks give or take. Then due to a clown running a stop sign and broad siding me and popping 2 discs above my fusion. I had to have a laminectomy of both L4 and L3 in 1995, again recovery time is 13 weeks. The fusion was fine.

    Due to increasing and excruciating pain for the last year I finally had an MRI done in January which showed a "huge" disc bulge at L2 compressing my spinal cord and a minor one at L3. The spinal stenosis is progressing fine thank you very much :) and the comment on my lumbar area was that is was "disarranged" lol. I saw the films and CD it is a zig zag. The Doctors are surprised I am walking. 3 weeks ago I underwent a microdiscectomy by my Neurosurgeon after a second opinion. I am recovering and the damage the disc caused is on the mend. Bear in mind there is no treatment for spinal stenosis and it is a progressive disease but I am sure you do not have that thank god

    I am going to give you a little heads up. If you are dealing with nerve compression from a disc or any nerve compression or nerve damage of any kind be very sure of your decision. Muscle mass loss from nerve damage is not uncommon and not reversible. Nerve compression damage can be permanent if you wait too long to act on it. This is not like a sprain or spasm this is serious. I would listen to your Neurosurgeon and get a second opinion from another Neurosurgeon and another Orthopedic surgeon. Why? because knowledge is power. I saw three surgeons on my first fusion even though I personally knew the two that ended up doing the surgery. Do not be shy bro

    Regarding fusions. My surgeon felt less was more so he did posterior and no metal (no rods) and it worked out fine - never a problem but you are not me.

    My latest surgery - I saw an Ortho for a second opinon - he wanted to do a laminectomy of L3 again and microdiscectomy of L2 - I asked my Neurosurgeon about this and he felt most of my pain would be solved by the discectomy and if not he could always do the laminectomy down the road. Hmmm 4 wks recovery vs 13??? Lets try the 4wks first! So far he is right. The nerve doc knows is stuff :)

    Anyway For What It is Worth. Best of Luck

    Grimace - for a reason
  • Thanks to everyone that has responded to me. I pray for you all each night.

    I will give a quick update. My ESI did no good at all. I have been to PT twice and am doing the stretches religiously but no help so far.

    Saw PA on 4/29/09 and he said "to be honest I think this will end up being a fusion". He put me on Amrix and is asking PT to give me a TENS unit next week. Says they can do an injection that will focus more on the pars defect but I am hesitant since the first one did no good.

    PT wants me to try and stand erect as much as possible but simply can't do that when I walk - too many spasms. I will try all conservative methods before going under the knife, but if I have to I will.
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