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No Evidence Pain!

AnonymousUserAAnonymousUser Posts: 49,671
edited 06/11/2012 - 8:31 AM in Lower Back Pain
New member here. 40 yr old male- athletic, active, in shape (until last year plus due to inactivity)

I could repeat a lot of what I have read here but basically chronic lower back pain. Can't concentrate kind of pain. Read and post to forums during work kind of pain. Most severe is when I sit, especially on hard surface, stand, drive. Activity helps when its not at an elevated state. My problem is that xray and mri dont really show anything 'significant'. Because of that I dont seem to inspire any concern or curiosity from the medical community and I cant even relate to friends and family other than "back pain". I played college level sports and know when something is wrong. Can MRI's be wrong? Totally?

I have core weakness and I have worked on for a year, (My body shimmies and shakes uncontrollably when I pass a certain range of bend, like the beginning of a situp) but core exercises hasn't really helped. I dont think it is "an exercise" issue- too severe. I've had an epideural, tried synergy release therapy, cortisone/lydecaine injections, massage, skelaxin, naproxen, various pain meds- no avail. One begins to question sanity after a while.

Curious if anyone "took a flyer" on surgical intervention and had success.

Tks- bjr


  • Welcome to SH :H I'm sorry you're having a lot of pain and on top of that, you have to deal with not knowing the cause. Do you have any pain radiating down your leg?

    I had similar symptoms- couldn't sit, stand, walk without pain; driving hurts etc. and the MRI showed 2 herniated discs at L4-S1 and severe DDD. Maybe you can talk you doctor into ordering a test called a discogram in which they can replicate the pain and pinpoint which disc is generating pain. It is invasive and can cause discomfort, but it does reveal things like an annular tear (tear in the outer layer of the disc) which doesn't show up on MRI's.

    Whatever is going on, I hope you get the relief you need. Take care
  • Thank you. No, no leg pain. I had sciatic discomfort in left buttock to the back of thigh- not all the way down the leg. Thankfully the epideural took care of that. My ortho said epideural will not relieve sciatic pain but it did for me; or an amazing coincidence.
    I will look into discogram.
    Regarding pain or discomfort of procedure, like most people on this forum, I will tolerate a lot if I think I can find a cause and better yet relief from the constancy of it.

  • Welcome to the board.

    Could you provide a bit more detail about where it hurts, when it hurts, (like walking, lying down, sitting, etc.)Do you have pain in the lower back or ??

    At what level have they been injecting you? They must suspect something or how would they decide where to put the injection.

    I am confused about the comment from your ortho that an ESI would not relieve sciatic pain. Are you satisfied with this doctor? I can't imagine why he said that to you. Is he a spinal specialist?

    If you did have sciatic pain, chances are that you may have some nerve compression somewhere in your lower spine. It could be coming from a bulging disk, from a stenosis in the central canal or in a foramina, or you could have a slippage of the vertebraa which can cause a "pinched" nerve.

    Of course none of us are medical professionsals, so you might want to see another specialist who can hopefully diagnose your problem.
  • Hi BJR,
    Sorry to hear what you are going through. I was at your stage over a year ago and very frustrated so I know exactly how you feel especially not having others understand what you are feeling. I agree with meydey on the discogram. From my own experience and what I've heard from others this can be a good indicator of exactly where your pain is coming from and may show something that didn't appear on MRI. It is uncomfortable but it's just one more test you have to check off your list of things to do to diagnose your problem.

    Please keep us updated and I'm glad you came here for support.
  • I am concurring with Ming and Meydey. I had the same issue as you for over two years. Every test and injection and therapy did nothing. No MRI or CT or Myleogram showed anything. I finally went to a spine clinic and they told me that not all tears in discs show up on the above tests. Had the discogram and it showed three discs that had tears. Two with annular tears. If your ortho wont do this, find one that will. It is probably what you need to show what is wrong. Im no Doctor, just been in your shoes and know what it is like to think you are going mental. And believe me, I was really hurting too. Good Luck and let me know what you find out.
  • Thank you all/ iowarobin,gwennie17,ming (I will copy you all on the same response- hope this works)

    I will try to provide some details. First, MRI done about 1 month after the most 'dramatic' onset of the condition which was after snow skiing. I am advanced skiier and had no accident- just came on like a freight train- seized up and 'put me down'! Thats why I am (was) prone to believe it is soft tissue.

    MRI: SAG?AX TI and T2 on a 1.5 Tesla GE Signa EXCITE high field closed

    FINDINGS: Minor retroliisthesis of L-5 on S-1. Mild L5-S1 disc degeneration with a shallow broad posterior midline disc protrusion, whcih contacts the anterior and medial aspects of both the right and left S-1 nerve roots and the anterior sac.
    Mild L5-S1 facet arthropathy
    L4-5: Mild diffuse bulge
    At L1-2 through L3-4, ther are no disc degenerative changes or posterior displacements. Biconcave endplate changes at T12-L1, L1-2, and to a lesser extent L2-3 and L3-4. Mild disiccation of the L1-2 disc.
    The tip of the conus medullaris terminates normally.
    No asymmetry of paraspinal musculature.

    1. Shallow broad based posterior disc protrusion at L5-S1, whcih contacts the S1 transverse roots, left greater than right. This may produce S1 root irritation.
    2. Mild L4-5 and expecially L5-S1 disc degeneration. Mild L4-5 disc bulge.
    3. No acute fracture or bone marrow edema. No acute lumbar facet arthropathy.

    Gwennie: * Hurts most when sitting- more on hard surfaces, then standing, then kneeling, then walking, then lying down, then heavy activity, then light activity. Yes, pain mostly all in lower back. Constant ache/throb with some occasional "nervy" shots here and there.
    * Every professional and non seems to concur that issue is isolated to L4,L5, S1 locale.
    * Yes, ortho is spine guy- actually trained at one of the Steadman-Hawkins outposts!
    * The sciatica went away thankfully, but, as it never extended to knee or beyond- no one (other than me) seemed too concerned.

    Ming: * I will look into Discogram. Thank you. (Uncomfortable has new meaning now-so test should be ok w/ me)
    Iowarobin: Same as Ming- will look into, thanks.

    Any one of you have the "shuddering" and muscle weakness in back/stomach core? I have that too I can tell but rehab didnt help....
    Also, I see your meds references- I take naproxen and aleve, ultracet, darvocet, oxycodone- try to take as needed and sometimes find relief, sometimes not; so it is hard to pinpoint which ones are best. I have tried Lyrica too.

    Regards- BJR
  • See reply to Iowarobin: thanks
  • See reply to Iowarobin. Thanks

  • hello iowarobin!

    i don't mean to disrupt this post, but could i ask you for the followup when you got your diagnosis from the discogram of annular tears? what treatment/surgery did you have to repair the annular tears, if any? & what were the results? thankyou so much!!

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