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Need advice please!

I am new to this forum - I've been looking here for a few days and finally registered to hopefully get some help and advice.

For 5 weeks now, I have had a bulging disc at L5/S1 and L4/L5. Began with horrible pain in right glute - a deeper pain than I've ever felt before. It has changed week to week and day to day, but currently, I am awake in the middle of the night (nothing new - nights seem to be the worst - I just toss and turn painfully all night trying to find a comfortable position). Currently, the pain includes: tingling/numbness in foot, toes and calf; sharp pain in glute, pain while laying, standing, walking, etc.; inabilty to stand up straight (I've gotten myself very crooked over the past several weeks as my body tries to shift to reduce pain). I am generally active, and this has changed everything for me (I am a 40 year old female, normal weight, generally jogged (not excessively) and stayed fit. I read on here how people deal with this for months and years, and honestly, I can't fathom being able to do this.

Here's what I've done so far:
1) first week, I went to a chiropractor. This was my first visit ever to a chiro, as I generally didn't buy into them. Anyway, went there three times that week for adjustments and electronic stimulation. No relief. They did x-rays and said I had some degeneration of lowest vertebraes. Wanted to put me on 12 week program of treatment. Thinking back to that week, although in pain, I was much more flexible and movable then, compared to now (I can't even IMAGINE trying to stretch like that now).
2) second week, I went to an orthopaedic/sports medicine doc. He also did x-rays, saw the same degeneration; gave me two shots in lower back (a steroid and ???) and put me on a steroid pack for 6 days. Shot gave me relief for that day only, but the next day, I remember things getting worse. Steroid pack did nothing.
3) next week, was ordered for MRI and back to orthopaedic. Told I have bulging disc at L5-S1 and to a lesser extent at L4-L5. I don't have all details of MRI, but they mentioned "annular tear" - isn't this a herniated disc? (not sure that it matters).
4) week 4 had first of three epidural shots. No problem with the shot itself (other than the intense pain when the medicine was injected for about 30 seconds - doc said that was good to have exagerated pain where I'd been hurting because that meant he'd "got it in the right spot".) Felt better that day and the next, but by the 3rd day, pain was back and is worse than ever (I am now one week out from that first shot). By day 4, I was bent over and crooked, and barely could walk for 2 days with the pain. I am better now (relatively speaking), but still in alot of pain.
5) yesterday, I went to another chiro, thinking I'd try the "spinal decompression" machine. They said I am definately a candidate for this and told me it can "heal" the discs and the tears in the disc. But it is $4200 for 20 treatments (or $250 each to "try it out"). Seriously if I knew it would work, I would pay the money in a heartbeat and start today....but not sure if it works. Thoughts???

As far as pain medicine, ortho prescribed muscle relaxant that first time I saw him and hydrocodone. I've gone through two prescrips of hydrocodone (only taking at night - trying to suck it up during day with ibuprofin) and yesterday asked for a stronger med as the hydrocodone isn't effective. He gave me percocet 5/325's. I took one last night at 6 pm and didn't feel any relief, and one at midnight. I did get a couple hours of fitful sleeping but by 3 am I gave up and got up (laying down seems to be the worse). So obviously, the percocet isn't the answer. I will try 2 at a time today (prescription says I can take 1-2 ever 6 hours), just to see if it makes any difference, but don't suspect that I will stay on these (I really don't like to medicate, so won't take them if no noticable difference).

What I plan to do is as follows (along with questions for you all):
*Bump up my follow up appointment with ortho to Tues/Wed (currently scheduled for Friday). Ask him for recommendation to see neurologist? I just don't know if ortho is who should be my main point of contact for this or a neurologist?
*Ask for different medicine? Seems that people recommend nerve medicine vs. pain medicine on this forum. Makes sense to me, since this nerve pain is unlike other pain I've had in the past and the pain medicine is doing nothing.
*Proceed with my series of epidurals - one next week and one in 3 weeks. Ortho told me I may only get 10-15% relief on shot one, so think I should see this through and hope for better results with shot 2.
*Should I try to start PT now, or wait to finish shots? Should I concurrently try the spinal decompression? I just can't wait week to week to week, slowly trying to fix this.
*Ortho mentioned surgery if nothing else works. He said it wasn't that big of a deal - small incision in lower back, remove part of disc, a few stiches, and outpatient. To me, based on my reading, this sounds like microdiscectomy? Should I do this if shots don't work? (again, I'm ready to fix this, not super scared of surgery; more scared of what this pain is doing to my life and livelihood/kids, etc....). But then of course, i read the forums and the horror stories from people who regretted the surgery...

Thank you all for listening. I look forward to any insight you can provide.


  • Hi there,

    I need to give quick advice/insights but I will try to come bac on.

    If you are having lower back issues, do NOT use the chiropractor unless your doctor is ok with it. Sorry but my personal opinion is that not all chiro's are good. They could do more harm than good.

    Second, go see your orthopedic doctor to review the results of the MRI. See what he suggests. Also, get a 2nd opinion from another doctor. This time try a fellow-ship trained orthopedic spine surgeon or neurosurgeon. Either is fine b/c they both treat spines. It's a personal preference. I've used both. My current doctor is a neurosurgeon mainly b/c I required a 2nd surgery on the same level (the microdiscectomy failed the first time) and felt that with the scar tissue and nerves, I'd rather have the neurosurgeon b/c they train for a few more years and quite frankly, I met about 7 doctors and I really liked this surgeon's approach, skill, and trusted him to treat me as a patient and not just to get another 'successful surgery mark' in his book.

    Don't rush into surgery...it can be a slippery slope. But, do have a plan...you are very wise with your thinking on writing stuff down.

    Get another opinion or 2 and make sure you have a doctor who is not rushing you through an appointment, that is taking the time to explain the back, you issues, your options, and answer your questions.
  • It's been 5 weeks for me too. One day I woke up and couldn't walk with severe calf pain wuth burning in feet and numbness in toes. Received a cortizone injection no relief. Ended up at the ER only given a injection with pain. I've been to 3 different DR. I just started physical therapy took a medrol pack and still no relief. I don't sleep, I can't walk and it's very fustrating with 3 kids I need to take care. Only God knows my outcome and what my decision will be.

    The first Neuro said do Accupuncture and take Ibuprofen.

    2nd Neuro said that his recommendation would be to do a Lumbar Laminectomy.I felt pretty comfortable with him spent about 1 hr with me given me his success rate. He said he would not recommend to wait to long since I have the numbness.

    3rd I went to Spine Ortho He is the one that said to do PT, gave me a medrol pack and I have an epidural appt next week.

    I too know that I need to make a decision I can't go much longer like this. I know that if t somes to surgery I will all my faith in God. That's all I can do.

    I wish you luck with your decision and I wish you to be pain free.
  • OC714. It feels so nice to hear from someone in the same situation. Probably why we are all spending so much time reading this forum. Thanks for the message and I hope you have good luck with the epidural and medrol.

    I have another appointment tomorrow and hope to start moving forward. I will ask for better medicine (nerve medicine), a recommendation to a neurologist (to date only seen chiro and orthopedic dr), and will ask about the spinal decompression.

    Out of curiousity, you said you just woke with the pain. Before that, were you generally healthy or did you have a history of a bad back? Did you do something to hurt it? I think that is the hardest thing for me to accept. I have always been active, always felt strong, etc. and it has changed 180 degrees and I just don't get WHY.....
  • I was given Lyrica but it had so many side effects I did not take it. I had back problems but would go away by the next day the longest it lasted was about 2 wks. I alwyas thought it was because the epidurals during the c/sections. I propably always complained of stiffness in the back but it was very tolerable.

    I never knew how much this can debilate someone. Most day's I cry and it's hard for my kids to see the rock of the family falling apart. I decided I couldn't do this to them they need me more than ever.

    All I can say is that I have full trust in God and hope to have a good outcome.

    What did your MRI show?

    Mine shows a 4-5 mm disc bulge with bilateral neural faromina narrowing with impegement of the L5 Nerve Roots.

    The Neurosurgeon said the only way we can let that free up is with the laminectomy.

    Feel free to PM.
  • First off, I have to agree with DNice about the chiropractor. Most (but not all) of the people I have spoken with that have used them ended up either accelerating their problem; or it made something that was "minor" worse.

    As for the ESI's.. Prior to my back surgery they provided absolutely no relief. But others have experienced some (if not total) relief with them. They might work for you, or they will do nothing at all. In short, what do you have to loose by completing the series? Unfortunately, you generally have to complete the series for maximum relief.

    There are a few scripts for nerve pain out there. I take Lyrica for my nerve pain, and it has taken a lot of the edge off for me. The only side effect I am experiencing is weight gain. Fortunately I can normally manage that.

    I would talk with the doc you plan make your "regular" one concerning the PT and decompression. Again for me, PT prior to surgery helped relieve the mechanical pain. However it did nothing for the nerve pain. But any pain relief is a good thing.

    Since my laminectomy / microdiscectomy I have been able to (generally) return to a normal life. I still have nerve / mechanical pain in my back & legs; but compared to pre-surgery it is 100% better. And having a great PM doc helps me maintain my sanity :)

    I fully understand your desire to resolve this problem ASAP. But I would suggest a methodical approach. The last thing you want to do is rush into something and make matters worse; generally rushed into it by a doc that just wants to add another notch to their scalpel. There are a lot of horror stories on this board when that happens.

    Best of luck, and I hope you find some relief for your pain.

    View my history for all the gory details.
  • Curt - I'm not sure what you mean by after surgery you returned to a normal life but still have nerve/mechanical pain? I thought the surgery was supposed to remove the nerve pain? Why would I want to do it if I still have pain after?

    My doc said that I shouldn't go on the nerve medicine until after the surgery if needed...

    I went back to ortho tomorrow - we have 2nd epidural scheduled for Friday. He changed up my medicine to Soma (muscle relaxant), naprelan (anti-inflamatory) and Ultram (pain). He had given me percocet a few days ago, but I didn't like it, and it really didn't help the pain.

    Thanks for posting.
  • I definitely would do the same thing. This kind of pain can be coming from a number of things and what to do about the pain is heavily dependent on that exact cause. Because it's on both sides at the same time, it's probably related to the activity you just went through if that's not your normal routine. Have you done some heavy lifting in that time before the pain started? Do you experience the pain only when you move a certain way? Is the pain the same all the time or does it get better or worse from time to time? These are all questions that a competent doctor will ask you. The doctor will be able to check your movements and do a few tests right up close and personal. Only then will he/she be able to pinpoint the trouble and give you the correct treatment. Any other way or delaying could result in a more serious problem. Don't risk the chance for permanent and untreatable injury. We can't make it any clearer than that. The stakes are too high. First if your forearm is in pain, ease off for a couple of weeks. Not what you want to hear but stop kayaking or any other activity that is straining over using your forearm muscles. You can work your forearms but I recommend keeping it light or just don't do it. You will get plenty of forearm work through secondary exercises when doing back. I would throw in some deads and shrugs. But only after a couple of weeks (yes couple of weeks) of light work to allow your damaged forearm healing time. I have NEVER directly worked my forearms, but I have huge forearms just from doing other exercises....
  • wanna_go_back said:
    Curt - I'm not sure what you mean by after surgery you returned to a normal life but still have nerve/mechanical pain? I thought the surgery was supposed to remove the nerve pain? Why would I want to do it if I still have pain after?
    I have nerve / mechanical pain due to the disks between L4/L5 and L5/S1 being almost completely gone. There was so much damage there that I had a wide laminectomy to relieve the pressure on my nerves as the canal was almost completely blocked by two severely ruptured disks. The micro Disc was to remove all the damaged disk pieces & parts all the way up to L3.

    Unfortunately, my L5 began to rotate towards the back due to the disk between it and S1 being damaged beyond repair and loosing friction. This is causing more pain now that the facets are beginning to impact my nerves.

    But the surgery did what it was supposed to do. My doc gave me the option of a fusion, or laminectomy / microsidcectomy. I opted to skip the fusion this time around fully knowing that I would most likely need it sometime in the future.

    My doc said that I shouldn't go on the nerve medicine until after the surgery if needed...

    I went back to ortho tomorrow - we have 2nd epidural scheduled for Friday. He changed up my medicine to Soma (muscle relaxant), naprelan (anti-inflamatory) and Ultram (pain). He had given me percocet a few days ago, but I didn't like it, and it really didn't help the pain.

    Thanks for posting.
    Here is hoping the ESI can give you some relief. Best of luck and I hope you can get your problem resolved.

    View my history for all the gory details.
  • PE - I only have pain on one side and it is my leg and glutes, not forearem. Not sure if you posted to wrong thread??
  • I'm a Firefighter/Paramedic with back issues so every time I get a call for someone with back issues I pick their brain more than any other call. The surgery scares me because about 90% of the people I've talked to during my medic work have said they got worse or much worse after surgery! Most tell me don't do it. Scarry, to say the least. My private ortho told me don't have surgery unless you have to with NO other option.
  • OK, I'm just offering a few things from the perspective of a former personal trainer and surgical RN who lived with severe pain since my 20s (until cervical issues threatened my life and surgeries became a necessity).

    1. Very, very few instances of back pain can be traced back to a single cause other than trauma such as a fall or MVA. Rather, they result from sometimes years of small injuries that may not even have caused pain at the time. We just notice the final one, the straw that breaks the camel's back.

    2. For pain medication to be effective, it needs to be taken on a regular schedule and a therapeutic level maintained in the bloodstream. It takes much longer to get pain under control than it does to maintain a low/no pain state. So I'd say give your pain medication at least a couple of weeks of regular use before you decide it's not for you.

    3. For injections, there are a number of different injections that are aimed at different types and causes of pain. An ESI is only one type of injection, usually performed in sets of 3 over several weeks to be fully effective. You said you got some relief from the first injection, so nerve issues at the spinal level are present. But, you may also have other conditions that a facet block or a rhizotomy, for example, would better address. A lot will come down to testing.

    I know you're in pain, but you seem to be in a very acute phase right now. For the majority of people, with time, rest, ice, and other conservative treatments, this acute phase will pass. It's when it settles into a chronic pattern *with pain that is intractable and interfering with your quality of life* that surgery becomes one of the options on the table.

    By that point, there is usually deemed severe enough damage that surgery is recommended to halt or delay its progression. There are no promises of pain relief -- nor should there be any promises. It has been found that leg pain is more likely to be reduced, back pain not so much. Some people do feel relief of back pain, but it just can't be predicted. A lot rides on age, physical condition, weight, general health, and commitment to stick to a recovery plan.

    I hope you can give yourself a bit more time to explore your treatment options, give your back a chance to recover some before you opt for surgery. But whatever you choose, I wish you the very best outcome.
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