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Looking for advice

dakoopddakoop Posts: 17
edited 06/11/2012 - 8:44 AM in Lower Back Pain
I have been dealing with lower back pain (L4/L5)off and on for a couple of years. I have had multiple MRI's, Xray's and also a discogram. I have tried PT and pain injections, nothing lasting very long as far as relief.
They tell me that I have DDD in those discs along with bulging , cracking and all kinds of other stuff. They are talking surgery.

Here is my dilema. On most days my back is sore. I play Volleyball once per week and it really doesn't bother my back. Work seems to bother it more, I am always on the move, up and down, always in motion.
On some days the pain is horrible, can't stand straight, cant sit, cant lie down.

In my mind I keep asking myself, how can surgery be in the picture if I can play volleyball? How much pain do I have to be in for surgery to be the right option. I have been wrestling with this for a long time. I figured it was time to get some input from those who have been in my shoes..



  • My thought is to wait as long as you can stand it. If work is causing the worst pain then find a way to modify or adapt. But wait as long as you can because most people have problems in the years after a fusion.
  • I agree with Kris, but also think the type of surgery makes a difference. There is a huge difference in looking at a fusion as compared to a less invasive disc surgery.

    I think it really comes down to a quality of life question, and to me, it sounds like if you're able to play volleyball it's hard to want to mess with that. The big thing to think about with the fusion is that it is permanently altering your anatomy- you will not be the same as you are now. For some, this sounds great because the pain is so severe. For you, it sounds like perhaps that is a frightening prospect which might be an indication that it is too soon to be looking at the fusion. But, I'm also a person who has tremendous pain sitting and know that while it can sound somewhat trivial it can really make life miserable to not have any sitting tolerance, so just the pain you experience at work may impact your quality of life enough to want to go forward. If volleyball is the only activity that is not causing you pain that is definitely something to think about since most of your time is spent doing other activities that it sounds like cause you pain.

    I'd encourage you to talk to your doctors about the options as far as types of surgery. I had IDET to patch up a disc and it was a relatively easy procedure and one that I am *so* glad I had. If you're a candidate for a minimally invasive type procedure that may give you some more options to think about when deciding whether or not to go forward with a more aggressive treatment.
  • And also, have you tried medication? I mean, even something like an NSAID or a nerve pain medication? Those might push of surgery quite a bit longer.
  • I think I have tried it all. Drugs, both pain and nerve, massage, injections, pt, chiro. I even bought an inversion table and a tens unit.

    I guess what I really want to know is what made those that had surgery decide to get it. Is managable on most days pain grounds for surgery?

    I have talked to some that wonder why they didn't do it sooner and then there are the horror stories.
  • DaKoop being that your pain is intermittent you should consider that you may have a hypermobile SI joint caused by damaged ligaments or ligament damage elsewhere.
    If done correctly Prolotherapy can tighten up the ligaments in the SI joint.
    If you Google Prolotherapy you can find more info and doctors who use Prolo.

    Prolo is helping me a lot, it's a low risk high reward treatment.
  • Si is a problem too. Google here i come:)
  • I have to agree with the others that it really depends on what type of surgery they're suggesting and seeing what other treatments might work.

    The fact that you can play volleyball (I just can't imagine doing that) says a lot. I doubt that there's any one of us here that have had lumbar fusion that were able to play volleyball before surgery.

    So I think it's definitely a case of finding a low-invasive or non-invasive procedure to help your back pain. I can tell you that, being an avid golfer for many years, after having both a cervical and a lumbar surgery, my golfing is extremely limited and it's actually a miracle that I can play at all. I can play 9 holes (but sometimes have to quit after 7 due to pain), but doubt that I'll every be able to play 18 holes again.

    Good luck on your decision. Like it was said, lumbar surgery is extremely invasive and you aren't likely to get back to normal until a year, if ever.

  • My back is out again can't stand or sit or lie down. Missed 2 + days of work for it. My question, how do I know for sure it is the two degenerative discs? They did a discogram and said they were bad but every time my back goes out I get pain relief when the chiropractic frees IP my si joints.
    So is it discs?
  • If Chiropractic makes you feel better by freeing up your SI joint then you probably have loose ligaments at the SI joint. This is the same problem that I had and I spent a ton of $ and years with a Chiro only to learn that Prolotherapy will tighten up the ligaments at the SI joint permanently. Now I have no pain at the SI and I don't need a Chiro.

    Did your Chiro adjust you by using side posture, which is where he lays you on your side and leans into you?

  • Yes I lay on my side and they push down on the top bent leg.

    I checked w my insurance and they know nothing about prolonged.

    can si issue cause you to not be able to stand up?
  • dakoop said:
    Yes I lay on my side and they push down on the top bent leg.
    That's side posture and he's trying to pop your SI joint back into place because the ligaments are not strong enough to keep the SI in place.

    I must have had side posture adjustments over 100 times over a 10 year period. It helped short term.

  • can si issue cause you to not be able to stand up?

    probably, but it never did with me. It just caused a nagging pain and I got a lot of popping and clicking like noises when I did stretches or sometimes when just moving around. If you lye face down, flat out on a floor and push your hips into the floor, this will tighten up your upper glutes, do you feel any pain or ache in your lumbar at the center belt line?

    If yes and you also are getting a lot of popping/clicking type noises at other times at the SI then your ligaments are loose.

    Insurance usually won't cover prolo but it's not too expensive to pay out of pocket.

    You could also try PT which might help but if your ligaments are loose then Prolo is the only cure I know of. PT and Chiro are just short term fixes.
    I doubt your DDD is a factor. Your Chiro should validate that.

    If you need more info on Prolo let me know.
  • i just tried the floor test and the pain was above the belt and only seemed to happen when bending the lower back
  • dakoop said:
    i just tried the floor test and the pain was above the belt and only seemed to happen when bending the lower back
    Don't know what to tell you about that.

    If you decide to get prolo done be sure that you get a dr who's experienced and will inject your back about 50 times with prolo. Hopefully you can tolerate needles some people are deathly afraid of the thought. It's no worse than a trip to the dentist for drilling and filling.

  • if you can manage to play volleyball and work then my best bit of advice would be to treat with medication {under doctors supervision } you could try a TENS unit on your bad days and they are many items like memory foam mattresses and recliner etc to help you when you are resting .i have had 2 operations and i now need a massive one {a multi level fusion} i was very fit and never out of the gym /i swam 5 times a week and walked the dog for miles every day ..now i can hardly walk to the car or dry myself after a shower and i spend all my days and night on my recliner because i am in pain and or tired ..surgery is a big decision and if you really don't need it then keep well away as you will more than likely have to have more surgery as the years roll on BUT if surgery is your only choice find an excellent surgeon if you live in the UK i can recommend one to you
  • Well at the sake of playing devils advocate...here goes.

    You say you are missing work. Is this consistently happening? Are your back flare ups happening after you play volleyball? Tell me, is Volleyball a passion for you? Something you love and would do above all else. You see, even when we are in intense chronic pain it is often our passions that we give up last. Often we can perform them and not realize the pain until later...

    You said you had a discogram and they said it was the source of your pain and they are recommending surgery on L4-L5. I think you said they found problems with more than one disc. Maybe I missed it in here somewhere but what surgery are they recommending?

    I guess what I am saying is though I could never begin to tell you it is time to have surgery I won't say just because you can play volleyball once a week you don't need surgery either. I did a lot of things while my L4-L5 was literally bone on bone that the surgeon was amazed I could do.

    Unfortunately no one can tell you when it's right to have surgery or when it is not. You will know when it becomes a matter of quality of life for you and when you have the faith in what the doctors/surgeons are telling you.

    Sure we can offer you when it was right for us. When we finally said Uncle. We can offer our hindsight. Would we do it over again?

    I encourage you to read through all the threads on here. There are many that share their stories and experience as well as their decision making process of just that.

    I look forward to hearing more.

  • Volleyball is out of the question now. I can't even stand up. I am using a tens almost non stop.

    I have so many damn back problems I don't know what needs to be fixed. Any one of them could cause the other?
  • I would say your description of your condition in your initial post is a far cry from your description in your latter post. You made it sound like you rarely miss work and can always play volleyball, but now you are saying your back goes out and you can't even walk!

    You say it gets better when the chiro adjusts it. Like you can go today, he'll adjust it, and you walk out? No, more like he says "it will take x days of adjustment" and then your better right?

    Because honestly those sound like the symptoms I have had when I have had herniated disks. And likely the chiro (and prolotherapist) knows as well as I do that within a few days, the inflammation will go down and things will be easier again.

    So my vote is with the surgeon in terms of who got the diagnosis right.
  • This last bad flair up took 5 chiropractic visits over a 7 day time frame to get me upright again. But she was also doing a traction/stretching table the first two visits which made me feel worse than before she adjusted me.

    I am not doubting that my discs are in bad shape my main concern is which came first? Is my si shifting causing the disc flair up or the other way around?

    The surgery he suggested is a fusion for those two spots. I also have a fear that my quality of life now has a chance of being better now than if I have surgery. Doc told me I should never do anything jarring with a fusion. I take that as no volleyball and maybe even no to driving my sportscar that has extra stiff suspension.

    A week or two every once in a while of extreme pain worth it??

    appreciate everybodys input, keep it coming
  • The question is will this be dangerous or get seriously worse if you don't treat it now?

    If the answer is no then you continue to live your life the way it is now. Maybe try some PT or Prolo or whatever you can find that might help.

    If the answer is yes then you have surgery and learn to live with the limitations.

    Since you seem willing to live with pain to keep your lifestyle the question is pretty simple. Ask your surgeon.
  • dakoop said:

    appreciate everybodys input, keep it coming
    OK then. Appparently the Chiro is getting you better so the Chiro is correct that your SI joint is hyper- mobile. Maybe there are disk issues but it is uncertain and so is whether or not surgery will help or hurt you in the long run.

    I would (and do myself) try every safe, reasonable treatment option first before surgery. IMO they do too many fusions these days. Why? because there $ in surgery.
  • I went in for a pain injection today and the pain doc said I should do the fusion.
    What kind of mobility should be expected after a fully healed multi level fusion
  • If your low back pain has lasted longer than 3 months, you will probably benefit from more intensive treatment.Sleeping with a pillow between the knees while lying on one side may increase comfort. Some doctors recommend lying on your back with a pillow under your knees.
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