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Am I out of options?

radiopicrradiopic Posts: 1
edited 06/11/2012 - 8:53 AM in Degenerative Disc Disease
A little about my history. I am a 43 year old female who has always minor back issues. If I did too much, my back would be a little sore, but no big deal. A few times I would have severe pain in my back, but I could pinpoint what brought it on, as in shoveling snow, or starting golf season. I would go see the chiro and do some ice, and it would get better in a few days. In mid February, I had the same type of severe pain, but I had not done anything out of the ordinary to bring it on. I did the chiro thing again, and she suspected a sprain. After a few days it didn't seem to get better, so I went to urgent care, and my GP. They suspected a herniated disc. I did a few weeks of pain killers, and followed up with PT with a therapist who follows the McKenzie guidelines. This lowered my pain, but it has not gone away. I then got a MRI, and saw a specialist. The results, in medical terms? "At the L4-L5 level there is degenerative disc disease with decreased disc alignment decreased signal. Furthermore, there is a central disc protrusion that contains a superimposed annular tear. This narrows the AP thecal sac dimensions to approx. 9.5mm. This is just tangent to the dural origins of the L5 nerve bilaterally. There is minimal bilateral neural foraminal narrowing at this level secondary to ligamentum flava and lesser extent facet joint hypertrophy"

So, I have had 3 epidural steroid injections. They seemed to provide pain relief for about 5 day after each shot. My doc seems to think that the only options left are living with it with the help of PT and acupuncture, or a fusion surgery. My consult with the surgeon is June 6th.

My pain levels vary, but I am always in some pain. Sitting for long periods of time seems to make it much worse. I do not seem to have the common problem of numbness/pain in my lower extremities. It is just a solid pain in my lower back. My doctors do not want to prescribe narcotic pain relievers, even though they seem to be the only thing that works when I have a bad day. I feel like they look at me as a drug seeking addict just by inquiring if I can get them. Why is that a problem when I obviously have a documented issue, and no history of pain medication use or abuse? I have tramadol, which does not seem to help at all. I also have muscle relaxers, which are fine when I need to get a good night sleep, but I can't take them at work, as it makes me very sleepy.

I'm looking for advice on what to do next. Fusion scares me, but having this pain for the rest of my life is not an option. My doc said if I get get out of this "episode" I may never have another one. I have been in the episode since February, so I'm a little pessimistic. I tried the conservative options, now I'm wondering if surgery is the only thing left? I think I would be more apt to wait if they could give me some meds to handle the bad days, but I guess that isn't an option. Is the pain from the annular tears, or the disc protrusion? Can the tears ever heal? If the doc talks about episodes, is he only referring to the protrusion and not the tears? An I too young for the surgery, or am I too young to have this chronic pain? A lot of people say that surgery only made the problem worse.

I'm hoping there are a few people on this site that can give me their guidance, or share their experiences with me. Maybe provide some feedback on what I should talk to the surgeon about? I already printed out the "38 questions to ask before surgery" I am big on research, and I am trying to educate myself. There just seems to be a lot on conflicting information out there.

Sorry this post goes on and on...I just wanted to be as thorough and complete as possible. Replies are GREATLY appreciated!


  • Hi Radio and welcome to SH. :)

    I can't help you ( sorry ), but wanted to say "hi". I am sure some of the more experienced members will respond soon. If not soon then after holiday weekend, as many people are away right now.

    If you look at my sig (below) you see that I have several of your issues as well as lots of nerve damage, which brings other issues with it. I was told I could not be helped except for controlling my pain levels. However everyone is different.
    Plus I was told that about 6 yrs ago and now I am getting ready to ask again, maybe something new has developed since then.
    L1 - S2 "gone" useless in 1 way or another. DDD. RA. Bone Spurs. Tons of nerve damage/issues. Stenosis. Both knees replaced. 50 yrs old. I had a great fall (hence my user name) at age 41 and it has been a domino effect every since.
  • Hi Radiopic, you're not out of options, you're just beginning. My "pain journey" is similar to yours, except I am four years further along. (But I really do hope you find some answers sooner than I have.)

    There are lots of options, it will just be up to you whether you want to go down particular paths or not, but there are lots of different doctors/therapists/etc. you can see who will help you decide where you want to go.

    I am like you, in that I had the mild problem for many years, then at 42, after a roller coaster ride, I have had severe pain that I never recovered from - that was four years ago - I can't work, and I live the life of an old lady now. But I am not sure how debilitating your pain is.

    I am also like you in that my pain is primarily "axial" - i.e. in the spine, rather than radiating down the leg. Also, I don't have the numbness/tingling/motor loss - it's just all pain. These make it trickier to treat. I have DDD, a bulge and a tear at L4-L5, like you.

    You can see surgeons (orthopedic or neurosurgeon) and they will give you their opinion. Neurosurgeons in particular, however, are less interested in "straight pain" and more interested in "nerve issues" - the numbness/tingling/motor issues - because in many ways it's easier to treat. If you see a surgeon, they may order a discogram (search "discogram" on this site, and you'll get lots of info). If you have a positive discogram - that's good, because it will show the pain is coming from your L4-L5 disc, and that is the disc to treat. (Always remember, the pain magnitude and pattern, does not always match the pathology in the spine.) My discogram was negative, so it is ambiguous where the pain is coming from, and that is why I have never had surgery.

    You can keep going to Dr's/Specialists, etc. until you find an answer - but this search can go on for a long time (4 years for me, over 20 years for some here) - or maybe you'll get lucky.

    Also - be VERY CAREFUL about PT/Chiropractors, etc. If your pain is worsened by activity, listen to your body first, and then the therapist (OF COURSE - JUST MY OPINION). But I have experienced myself, and read many stories of PT and chiropracty just causing a LOT MORE PAIN - MAKING THINGS WORSE (in situations like ours).

    If you are in pain, and you are getting desperate, and none of the above Doctors/specialists, etc. etc. can help you very quickly, get yourself a pain management (PM) doctor. When you're having trouble finding "the fix" and you are in lots of pain, your PM doctor is your best friend (if you find a good one - your PM doctor is the key to the world (at least for me) - without the pills my Dr gives me, I couldn't get out of bed, let alone the front door - so make sure you find a doctor you trust (and who trusts you!). There are also lots of different methods you can learn to manage your own pain - heat, ice, recliner chair, low impact exercises/stretches, CHOCOLATE!!!

    Finally - spend time here; research, read, post questions, answer questions, etc. Lots of info and very supportive crowd here (and the drug seekers for the most part seem to skulk off pretty quickly, unlike many other sites). All the best.
  • Sorry to hear you have back issues. I also have Degenerative disc disease after a herniated disc and facet joint issues. It is painful for me and it's hard to understand why a Dr. is willing to do surgery but no Dr. will not offer any pain medications. I had to see my Dr. frequently to find the right amount of pain meds to get tolerable relief.

    I really think that's unfair and think you need to find a Dr. who will help with Pain Management. Especially give you a chance to see if you can live with the pain with meds before going into surgery. I've spent more than 3 years in pain and unable to work or enjoy a normal life and surgery isn't an option for me from the Drs I've seen.

    You may want to get a second opinion if surgery is offered and make sure you ask the Surgeon if you wait for surgery will the nerves be affected in any way. Do your research and hope you get some pain relief soon. 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
  • I agree with Charry about the Pain management and second opinion. I have what the OS has termed "crushed discs" there essentially gone as far as space between the vertebrae are concerned but protrude into the nerve canals. Because I get relief from the injections the OS said I would be a candidate for surgery when the injections no longer work. If you don't get relief from the injections they say getting pain relief from surgery is less certain. Don't stop looking there is help out there for you.
    laminectomy c4/c5 2008, ACDF c4-c7 Jan 20 2014 sched
  • A recliner chair is home furniture that is very comfortable and
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    Post Edited by Authority Member Liz

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