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Degenerative Disease, Facet Degenerative disease, and Pain Management questions

CoconinoCCoconino Posts: 3
edited 06/11/2012 - 7:57 AM in Lower Back Pain
I am 20 yrs old and have been having moderate back pain for about two-three years now. I had this checked out a while back by our family physician and was told to go see a specialist after having x-rays done. My mom did not want to pay for it so I never went. The pain has gotten progressively worse. The symptoms are moderate pain in my lower back and during particularly bad episodes (such as when I move furniture or I'm in a car for long periods of time the pain becomes severe and travels down my left leg stopping at the knee. A few months ago I moved to another state and had my father put me under his insurance so I was covered under both parents health plans. During a particularly bad episode I went to the ER where they took x-rays and told me the same thing. They also gave me flexeril and when that did nothing the gave me a shot of something that took the edge off and I know it wasn't a narcotic because I had no incapacitation from it. They then wrote me a prescription for baclofen and meloxicam (which ended up having no effect either), told me it looked like a bulging disc, and get it checked out by my physician. I found a physician here in Louisville KY though a friends recommendation. She expressed that she thought is was either a bulging or herniated disc as well, prescribed me Orphenadrine (Norflex), and had me get an MRI one a few weeks ago. The orphenadrine has done nothing for me either. I got the results today and there was no evidence of disc herniation but the end result reads like this for L3-L4, L4-L5, and L5-S1:
"IMPRESSION: There is no evidence of disc bulge or of herniation. Mild facet degenerative disease is present bilaterally."
My physician also wrote Moderate DDD off to the side on the paper
I was then told I would be referred to a pain management DR.
when I got home I began to do research and was bombarded with a thousand different terms which caused some confusion. I came to the conclusion the DDD is Degenerative Disc Disease. I also looked up the pain management doctor I am being sent to and found there were no positive reviews for him and that he was described as rude, uncaring, and doesn't listen to his patients. I am terrified I will not be taken seriously. My questions are: is DDD the same as Facet Degenerative Disease? What treatments will they do for this? Does anyone know of a better Pain Management doctor in louisville? Is it abnormal for me to have this at my my age? Is there a reason these medications aren't helping at all?
Any help would be greatly appreciated thank you?
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Comments

  • Hi Coconino,
    First of all I would ignore the comments other people wrote in their review. Make your own opinions. If you don't like this pain management doc then find another, its not a big deal. I couldn't tell if you live near either parent, if you do get one to go to the doctor with you. If you don't then maybe an aunt or uncle, older cousin. You need some support during this process. Trust me it helps and I'm 42 and have brought either my mom or dad when possible. Also write all of your questions down so you get them all answered.

    You are correct DDD is degenerative disc disease. No DDD is not the same as Facet Degenerative Disease. Facets are joints of your spinal column, google it and type in Facet Joints and click on images. You asked what treatments do they do for this but you didn't specify which this- DDD or Facet Deg. Dis.? I live in NJ so I can't help with referrals sorry. I agree that you are young to be having these problems but it can happen at any age and I think there is a genetic component too.

    As far as the meds go, they may be just be the wrong medicine for your situation or the dose maybe too low or too high. The Flexeril, Baclofen and Norflex are all muscle relaxers. The last one, Meloxicam, is a non-steroid anti-inflammatory pain reliever, it is also non-opioid. When you got the injection in the ER did it help or not? It could have been narcotic, just because it didn't intoxicate you doesn't mean anything if proper dosage is given. See if you can find out what that medicine was, its important because if it did help your doctor will want to know the name.

    One more thing-NO LIFTING FURNITURE! Until you and your doctor know what your exact diagnosis is take it easy. To be safe do not lift things over 20 lbs or you can ask your pain managent doc. I'm very serious about this-Don't aggravate nerves that are already irritated.

    I hope I cleared up a lot for you. Feel free to ask more questions. Keep in touch, Nenny
  • It definitely did help :)Unfortunately I dont live near either of my parents and my closest relative is a good seven hour drive away :/. I'm planning of called the referral office for my physician and ask them to refer me to the pain management group at the university hospital since its the only place both insurances are accepted. As far as treatments I was just wondering what they would do for both or just in general. My physician spoke of epidural nerve blocks and said that was probably the route I would end up down. So I looked that up of course and was given two impressions:
    1) After reading what the procedure involved it seems like kind of an extreme jump to go from muscle relaxers to injecting stuff into my spine. Or is that a common second treatment?
    2) It looked as if it caused a lot of people more pain than benefit. This could just that people who have a bad experience are more likely to talk about it than people who didn't but still. Now I'm kinda worried.

    It did seem odd to me that if it was a nerve issue, why were they giving me muscle relaxers. But again I'm not the doctor so maybe they effect the body in a way I dont understand.

    I did start work again not too long ago Because I needed the money to pay for the doctor and its been killing me since we have to lift stuff at least once a day X| I actually was s=considering going to Urgent Care tonight but my friend didnt want to take me. Neither my physician nor the PM doctor have called so ill be calling around tomorrow to see whats up. They wouldnt have referred me to a PM doctor if it wasnt serious right?
  • Let me answer a few more questions.
    1. Epidural nerve blocks are definitely the next step for you since you tried the typical meds and they didn't help. This is actually very common and not a big jump at all.
    2.Again, disregard other peoples comments b/c everyone is different and there are hundreds of different nerves to be dealing with so ignore their complaints.
    3. About the muscle relaxers, your nerves control your muscles so they are hoping to give you relief without having to go down the epidural path.
    4. I agree they would not have referred you if you didn't need pain mgt help.
    Keep asking if you have more questions.
    Nenny
  • Welcome to Spine-Health. You can find a lot of information on this site via the search function for the problems you're having. Also the members of the forum are very helpful, knowledgeable and supportive. There's a lot of collective knowledge and experience here.

    Facet problems and DDD are two totally different issues. Everyone has DDD to some extent or another, it just depends on how bad it gets in what timeframe. It's something everyone has, but for some it becomes a problem that has to be dealt with while with others, they have it but it never bothers them.

    Facet disease is a whole other issue. I have that problem myself and it can consist of losing lubrication and having bone rub on bone. I don't know exactly what your facet issues are, but getting facet injections are standard non-invasive procedure for that problem to begin with. They can often help the situation and usually aren't painful. Just make sure they're done with an x-ray (fluoroscopic) while they guide the needle to the proper area.

    Why you're prescribed muscle relaxants I'm not sure, unless you're having muscle spasms as a result of your issues. I'd think that pain medication would be more of a benefit. But if you find the PM doc that's right for you (caring, get along well with, understands your issues) then you should get some relief with the conservative treatments suggested, along with the proper medication.

    Yes, you're pretty young for these issues, but spine problems don't go by age.

    Good luck in finding the proper treatment and doctor. If at first you don't find the right doctor, keep looking. There's one out there that will be right for you and will help as much as they can.

    Take care,
    Cath
  • So some good news :). I called my physicians referrals office because I had not received an update on my PM appointment. They informed me that the doctor they were originally going to send me to doesn't take my insurances, so they are going to send me to a different one. I looked up the new PM doc and he has a lot of really good reviews and 2 or 3 bad ones so I have hope that this might turn out better than I had hoped. I brought up the Universities Hospital idea to her and she kinda got snappy saying she'd check but "she wished she had known about this earlier". I told her that I had just contacted my insurance group in NM about it later on last week and she seemed better about it. Don't really know what that was all about.

    I am considering moving back home to New Mexico though or maybe even to Nevada to live with my father. Reason being I asked one of my co-workers who works in the pharmacy at our store about PM in Kentucky and whatnot and she told me they've had such a problem here with people pretending they're in pain and going to PM doctors for drugs that doctors here are very wary of young people going to PM and are more likely to not listen to them at all and turn them away completely w/o even trying other methods of treatment.

    I guess that explains why they didn't give me pain killers. Although my friend at work did say that since Ive been persuing this for two or so years, I have no drug use history, no drug record, I've been prescribed Vicodin 3 times in my life and didn't go crazy with it, and since I'm also prescribed Ambien for insomnia for about a year and amphetimines for ADHD from the age of four till now and I've never had to up my dosage of either (if anything I've had to lower it for my ADHD meds) it should show any respectable doctor I'm not in it for the drugs and this means I'll have a better chance of them listening instead of showing me the door.

    I cant imagine though that any doctor would turn away a patient who has proof of an ailment just because they had a drug problem at one point if there are other methods of treatment available anyway. That seems crazy.

    I forgot to mention this in my first post but one of my moms friends had cancer on her ovaries and a few other health problems and was given a bunch of meds and she gave me a few Methocarbomols (I had to call her to get that name. Who could remember that? lol) when I had a particularly bad episode that she was there to witness one day. She said they were a muscle relaxant and should help, but just like everything else I mentioned they really didnt have any effect, just made my head kinda fuzzy. But back to this year when I went to the ER the nurse was going to give me those at first, but when I told her I'd tried those before and they didnt help she gave me an odd look and asked what I wanted then. I'm assuming this is what my friend meant by docs being wary. I told her my knowledge of this stuff consisted of this:
    1) vicodin helped when I had surgery for wisdom teeth and also when I had surgery for a ganglion cyst in my wrist
    2)Methocarbomol doesn't do anything for my back.
    3) After my surgery on my wrist when they wheeled me to the recovery room the nurse came in and told me they were going to give me a shot of fantanyl in my IV (Had to ask my mom for that name). I proceeded to black out for four hours after that and woke up all itchy. I wouldn't want anymore of that stuff EVER!

    I told her I had no knowledge of anything else as far as painkillers went and she seemed less irritated. and then gave the script for Baclofen and Meloxicam.

    And thank you Cath :) I haven't had any muscle spasms. My friend at our pharmacy thought it was odd too, esp since this is the fourth one we've tried and it isn't helping. She said she's surprised they haven't at least given me Tramadol or even Tylenol 3.

    I've noticed also that over this past month specifically when I'm walking and I put my full weight on a leg it's almost like my knee can't take the weight and I start to fall. It always catches and I stand back up again. This has happened before but just not as frequent as it has been this last month. Has anyone else had this problem? I don't know if its due to my back or not.

    Ill keep you guys updated and thank you all for being so helpful :)
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