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Chronic Lower Back Pain with Normal MRI

steffanisugarssteffanisugar Posts: 7
edited 06/11/2012 - 8:45 AM in Lower Back Pain
Hi guys! I'm a 26 yo female that has had chronic, but tolerable back pain since I was 18. For the past 6-7 months however, it has become excruciating. I have seen an orthopedic surgeon (as I also have carpal tunnel syndrome in both wrists), and his x-ray of my back showed a spina bifida occulta and degenerative disc disease. I then saw a neurologist, who performed an electromyography, and he concluded that I had multiple lumbar radiculopathies in my L5 and peripheral neuropathy as well. Not to mention, I also have fibromyalgia. I went for my first MRI this week, and all the results were normal. I have worked as a CNA in a nursing home, and had three children with epidurals, one of which produced severe spinal headaches, and my back has definitely been worse since then, but nothing like what I'm experiencing now. I am being seen at a pain clinic, where the doctor told me, before my MRI, which he won't see until next week, that he also thought I had lumbar radiculopathies and wants to do epidural steroid injections. I would like to know what other things could cause daily back pain of a level 7 on a 0-10 scale. I currently take the following medications: 7.5/325 Norco 4x daily, 400mg Neurontin 3x daily, Meloxicam 15 mg once daily, 60 mg Cymbalta once daily, 0.5 mg Xanax twice daily, 5 mg Ambien once daily. Can you guys help me figure out what is going on? Even with all this medication, my pain level is still normally at best a 5 1/2.


  • I'm sorry you're having such pain and although my EMG also showed I have lumbar radiculpathies also I have Degenerative DD which is causing the nerve pain in my case. I have found some relief from the epidural (caudal) injections which are different from the epidural that you have in childbirth. I'm not able to return to my job in Healthcare either and am on Long term disability. I hope you get some relief from your injections and keep us posted. 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
  • Charry,
    Thanks for your support! I pray that my pain management doctor will continue to pursue the source of my problems! Any other info anyone can provide will be awesome!
  • Hi Stef.

    You are so young to be traveling down this road! My opinion, you should continue to pursue the route you are going. Keep working with your PM and your Ortho.

    Unfortunately you are young and I have heard, especially from reading on this site, that some doctors tend to not take the young ones as seriously. The best advice I can offer you is to keep making appointments with them and say, "Now what." Let them know you have no intentions of letting up.

    What ever you do do not give up.

    It can be a tough road but please find a way to MANAGE YOUR PAIN that works for you and still affords you a way of life for you and your family as you pursue the cause of your pain.

    Injections work for many people. There are other things you can do. From Ice and heat therapy to PT, trigger point injections, tens units, accupunction, nerve drugs, the list goes on and on. All things you really need to discuss with your doctor to decide what is right for you.

    AS to the source of your pain, OH MAN, that is the million dollar question. Compressed nerves, bone spurs, arthritis, disc bulg, scar tissue, hip problems, SI Joint... Should I go on? As you can see, I'm no doctor but I do hope you continue to pursue until you prevail.

    This site has some great articles on all of the above and the forums contain many threads on so many EXPERIENCE's with them all. Please, take a look around and keep us posted on your progress.

    See you around,
    Take Care.
  • Thanks,
    I have no intention of giving up. I go back to see my pain management doctor on Aug 2nd, so hopefully he can pursue other avenues. I have been doing PT, but to be honest, it hurts and I don't see any improvement. However, I'm still going to go. The pain medicine reduces my pain from an average 7 to a 5..still pretty bad in terms of my personal pain scale. What other medications can I discuss with him? I have concerns about getting nauseated. I also can't take phenegran bc it completels zonks me out and I have a three month old baby at home. For the same reason, I can't take Flexeril, and Robaxin doesn't help at all!
  • it can be a long, frustrating and possibly fruitless exercise in trying to find the causes of our pain.
    It may not be just one thing, but several.
    It may be something that cannot be diagnosed.
    It may be something that cannot be treated.
    Sorry to sound a bit negative, but you need to be aware.
    Medical science is not nearly as advanced as we would like to think, and all medical practitioners vary in experience, training, knowledge and care.
    So there are lots of variables.
    Don't give up, and take a very close interest in what is said by them.Ask questions until you are satisfied.
    Consider also dietary causes. Modern diets are notoriously poor, lacking essential vitamins, minerals etc.
    Try eating only fresh food for 2 weeks and see what happens.
    I have had a huge benefit from taking large doses of magnesium chloride, with a dramatic reduction in headaches caused by tight back muscles.
    Try a remedial massage to see how your muscles are coping, as they also can cause awful pains. Doctors tend to ignore muscles yet they are a major culprit.
  • When I had my daughter, I had horrendous lower back pain. I went to physical therapy, and besides the modalities and strengthening, he did some great work with me regarding how to bathe my daughter and pick her up without straining my lower back.

    That particular physical therapist was very good. I have been to several since then who have proven to me that not all are that great. But my back went from very painful to only mildly painful in a few weeks.

    After my son was born the same thing happened, but this time with severe sciatica. I was with an HMO and wasn't able to go to the same PT and the PT I went to just wanted me to do a lot of extensions, which made it worse. It turned out I did have a pretty severe herniation, but by losing quite a bit of weight I was able to take the stress off enough to relieve the pressure and the pain.

    It's always been something with my back, but I have definitely found that things like "physical therapy" and "orthopedic surgeon" are not constants- they are variables. You can visit one and have one experience, and then visit another and get an entirely different response.
  • Scary... I can almost tell the exact same story as you (other than I'm twice your age & being male had no experience w/childbirth) #o

    I too have carpal tunnel in both wrists & just had the 1st surgery last week. To deal with my constant back pain I take Cymbalta & Meloxicam/Mobic & Lyrica instead of Neurontin. I also use a Fentanyl patch which you may want to discuss with your PM Dr. It releases the meds through your skin & only replaced every 3 days. It may also help with your fibromyalgia.

    Some things you also may want to try or discuss with your PM Dr:

    1. facet block/injections
    2. SI dysfunction/injections
    3. Discogram

    Hopefully 1 of these tests will determine or rule out what may be causing your pain. As the others stated... never give up pursuing a resolution to your pain. I've been advised to ask the Dr/surgeon/specialist: if you were in my shoes, what would YOU do next?

    Good luck with your appt on Mon. Let us know the next step(s).

  • My last appt wasn't very productive, except that my frequency of Norco was increased to six times daily. Unfortunately, that isn't telling me what's causing the pain! I go to physical therapy this week and back to the PM the end of the month, so I will know more soon.
  • I am in the same boat as you are. I have had several MRI that were normal. I also had complete x-rays which showed minor retrolethsis, my doctors do not think that is the cause of the pain i am experiencing. My pain is due to deep muscle spasms near the place of rear bone displacement so i think it is that. Please ask your doc for complete x-rays. Also, if you feel comfortable in sending your MRI to me, I can take a look at it. I have been in the medical school for a year before experiencing this crippling back pain. Therefore, I have some knowledge and experience on it and wouldn't mind thoroughly taking a look at it.
    I can look for possible annular tear, buldge, compression etc.

    I saw you had discouraging experience with your pain med doc. Do not count too much on your docs.Been through the road. In the end they are just doing a business. Do not mean to be harsh, but that is the bitter truth. What you can do is see as many doctors as you can to obtain different opinions.

  • I had severe back pain for 2 1/2 years and went through every Dr Nuero and Ortho, until I went to a spine clinic where they did a discogram and found 3 disc with tears. I had all normal mris and xrays and Cts. So try suggesting that. Discogram will show small tears that dont show up on MRIs like mine didnt. Good Luck
  • Steff, I would suggest that you consult with a Sports Med Doctor who treats backpain with Prolotherapy injections. The SI joint expands during pregnancy and often times becomes painful after pregnancy due to the ligaments remaining overstretched which results in the SI joint being hypermobile. A hypermobile SI joint will cause backpain.
    Prolotherapy are safe and effective.
    Recommended reading: Healing Back and Joint Injuries by Dr Valdez
    Good Luck
  • Hi,
    I'm 31 and I live in Portugal. I have lower back pain since 1996 and nothing wrong shows on MRI, CAT scans or x-rays. I have not done a discography yet, as no doctor suggested it to me. I do not take any pain med but I can't drive.
  • Hey guys! Well......not much as changed since my last post. I recently saw a rheumatologist, who did a battery of blood testing, and my c-reactive protein level was 6.8. I go tomorrow for my first epidural steroid injection. I am currently on Percocet 10/325 4x daily, and Baclofen 10 mg 3x daily, but still have lots of pain, especially at night and in the early morning. I spoke with my neurologist regarding a discogram, and he said an emphatic no! He said that I have a lumbar radiculopathy at the L5 nerve root, and it isn't operable, so there's nothing that can be done. Add to this Fibromyalgia and Neuropathy, and I'm in a whole lot of discomfort and pain with no end in sight, at the age of 26!!!
  • Hi Steff:

    Google non surgical spinal decompression therapy in your area and consult with couple of doctors that offer this service to see if you are a candidate for it. If so, definitely give it a try. It is painless and hopefully save you from drugs and possible surgery. I am surprise nobody knows about this wonderful scientific discovery. Good luck and keep us posted.
  • Sorry to hear the epidural didn't help. Did they do facet joint injections too? I even asked for a discogram and they wouldn't do me either> Are you doing Physiotherapy or aqua therapy with your Physiotherapist yet? A lot of people find relief with the warm water at a therapeutic pool. I had my Dr. fill out a medical certificate so I could get a disability membership. I hope you can get some relief soon. 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
  • j.howiejj.howie Brentwood, Ca., USAPosts: 1,730
    I think you have a lot of good suggestions here. But I think you really need to find the pain generator to address it.
    It sounds to me that you'll need to get a new spinal specialist orthopedic or neurosurgeon to order the tests that might show it. A disco gram was mentioned. And that probably would show it. But the other route would be the one I took when they couldn't find it on the traditional MRI.
    I heard about a person with a similar problem who had a "stand up MRI with dye and flex and extension. The machine that dose it is made by Fonar. I googled it and it showed the difference between a traditional MRI laying down with no pressure. And the "stand up" MRI with your spine under natural compression. And Wa La! It showed the problem that I was having. (disk encroaching on nerves)
    It's a little more expensive than a traditional MRI. and a little harder to find a radiologist that has one. But worth the effort!!!
    Good luck, Jim
    Click my name to see my Medical history
    You get what you get, not what you deserve......I stole that from Susan (rip)
    Today is yours to embrace........ for tomorrow, who knows what might be starring you in the face!
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