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New Member - Lumbar Pain - Please Help!

gfdwarfggfdwarf Posts: 7
edited 06/11/2012 - 8:58 AM in Back Surgery and Neck Surgery
My name is Dan and I am a 47 year old male, father of four kkids (ages 20, 15, 5 and 2). I live in the Twin Cities of Minnesota. If you are willing to read my story and offer any opinions or help understanding what I am up against, I would greatly appreciate this kindness. I desperately want to return to being an active, healthy father and husband. Any help or opinions would be greatly appreciated.

I am at a tipping point of frustration with my back challenge and though I realize that relative to the situations that many of you suffer with I am probably fortunate, I still need to find a solution that will enable me to get my life back to some sense of normalcy.

I have had what I considered a "bad back" for about 5 years or more. This was traditionally chracterized by events when my back would "go out" and I would be laid up for 5 days or a week and it would gradually get better and I'd be symptom free afterward. The pain was always in the same spot, around L4-L5, just to the right of my spine. This would happen about once every few months, maybe 3-4 times per year. I understand now that much of this pain was likely muscular in nature.

Last January, that all changed when I took a hard fall from a height of about five feet (slipped on ice off our front steps) and landed with my full weight on concrete (I am 6' 4" and 270 pounds) directly on my lower back. After an excruciating period of a few minutes when I thought I had been paralyzed by the fall, I was able to crawl back into my house with my wife and son's help. I endured for a couple days, but visited the ER two days later and had xrays and finally an MRI in April of 2011. I had a tremendous bruise and a lump the size of a baseball just to the left of my spin in my lower back (even now, 11 months later it seems still the size of a golf ball).

The April 2011 MRI showed two bulging disks (L3/L4 and L4/L5). The report read:

L3-L4: Mild disc bulge. No central or foraminal stenosis.

L4-L5: Degenerative disc disease with disc dehydration. Broad-based disc bulge lateralizes to the right where there is a right foraminal annular fissure. Moderate right foraminal stenosis with nerve root contact but no definite compression. Left neural foramen is patent. No central stenosis.

I visited an orthopedic surgeon (on referral from my family doc) and he basically told me that a simple discectomy, or disc shave was not possible since my bulge was foraminal. He said that my only option would be fusion and he felt that based on our discussion, I was not ready for that at the time. And I agreed. I had heard many horror stories about fusion and I was only 3.5 months post injury and felt that I would get better. He suggested a PT regimine and I attended regular PT sessions for six weeks this past summer, under a doctor's supervision, working to strengthen my core. I have continued the strengthening exercises with use of a Roman chair at home, as they instructed me, at least up until the last week or two. I also had one cortisone injection that had limited effect.

During this time I did a fair amount of work using my back. We had two major storms in our area and we lost many trees and I did a lot of wood cutting and cleaning up over many weeks. This work caused me a lot of pain and soreness, but I basically just worked through it, iced my back after the work and used pain medications (Vicodin, Percoset, muscle relaxers) at least 5 days out of every week. I had periods of less pain and at time went a week or ten days without pain meds, but the problem always came back.

During this period my pain was characterized by a burning pain and soreness that permeated my entire lower back centering around my spine and the injured area. The spot where I fell, the primary impact area, is just to the left of L4/L5 is still sensitive to any physical pressure and as I mentioned before, still feels like a lump when I lie on my back on a hard surface. And it hurts as well, almost all the time. If I sit in a chair (as I do for work) for more than an hour or two, I am ready to climb the walls with discomfort and pain. I would also get right leg sciatica - numbness, aching, pain, tingling, etc., but this has come and gone and frankly is not my biggest concern in terms of tolerating the pain. My pain on a scale of 1-10 was typically in the 3-5 range (I consider myself to have a reasonably high tolerance to pain - I am not a complainer typically).

About two months ago (sometime in September 2011) something changed considerably and the pain described above was joined by a much more significant electrical impulse sort of pain that would come at varying times (often associated with lifting or shifting my right leg). There have been days where I feel it only 3-4 times in a day (my best days) and times where it is essentially bad the whole day (like the last three consecutive days). These jolts of pain seem to be in the very center and core of my spine, right around what I think is L4-L5. They are excruciating and each time I feel them I let out a yelp (I cannot help it). The pain subsides reasonably quickly, as I adjust my position, but some lower grade pain lingers. But they are so bad that they make me want to take extreme caution when moving at all and basically restrict me from doing much at all (lifting kids, driving, going outside, etc.). Basically I fear moving too much and experiencing the pain again.
My family doc ordered another MRI to see if something had changed considerably and I had that last Friday (11/18/11). The results, to my surprise, were not a lot different from the April results:
L3-L4: Mild disc bulge. No stenosis.

L4-L5: Degenerative disc disease with mild loss of disc space height and disc bulge. Right central annular fissure. Moderate right foraminal stenosis as a result of a foraminal disc bulge or protrusion
with nerve root contact but no definite compression. Left neural foramen is patent. No central stenosis.

I am scheduled to revisit the same ortho surgeon that I saw in May on December 8th. I have had the problem longer and have grown less patient with it and also less hopeful that it will heal. I also want to ask whether the fact that my L4/L5 fissure is now described as "right central annular" (vs. last time being " right foraminal annular") would make me a candidate for a simple disc shave (discectomy), which I have heard great things about, in terms of success rates. The stenosis is still foraminal, so I fear he will say the same thing, with fusion being my only option.
Is that likely?

I am also scheduled to go see another orthopedic surgeon on December 22nd - this is a doc that was highly recommended to me by a good friend who has had back problems far more significant than mine.

I find myself hoping for a surgical solution, as after 10 months of suffering with this and seeing no improvement (in fact it has gotten worse), I am very tired of the problem. I am tired of pain meds too. I am continually having to explain to my kids why I can't do the things I want to do and I have now spent a year of my life avoiding by necessity activities that are core to my life (active dad, outdoorsman, tennis, skiing, etc.). Though I try to keep my outlook positive, this pain cycle wears on me and I find myself less patient, more down that usual and not the person I want to be. I am ready for a solution. But fusion still scares the heck out of me!
Among my questions are:

1. Is the change I noted in the MRI results significant? i.e. should I be hopeful that a disc procedure may be more possible now?

2. Is it true that a foraminal bulge is not operable (from a simple disc shave/discectomy standpoint)? My family doc seemed to not understand why this would be the case and questioned that opinion.

3. Are the MRIs I have had sufficient to diagnose the issue?

4. I worry about use of pain meds long term. I have been told by a couple docs that as long as you are using them to combat pain, you are OK. I try to do without them when I am able, but for two months now I have never skipped more than a day. I do not take them all day, usually just late afternoon and evening, to help with sleeping.

5. Is the electrical impulse pain I described indicative of the fissure/bulge? Or could it have another explanation?

6. I fusion really as bad as I am imagining it? Should I open my mind to it? I am not willing to live the remainder of my life like I have this past ten months.

Again, thank you all so much for your kindness. Finding this site has given me hope that I am not alone in this struggle. I feel blessed for my problem being limited to what I have. I am not feeling sorry for myself, just anxious to find relief and a long term solution that hopefully helps me regain my lifestyle to a reasonable degree.

Kind regards,


  • sunny1966ssunny1966 VIRGINIAPosts: 1,385
    Welcome to spine health.

    Your frustration sounds so much like my own! I don't have any advice/suggestions for you since I haven't had any lumbar surgery. I just wanted to say that you're not alone in this and I'm glad you found us. There are many here who can share their experience with you and I'm sure they'll be along soon.

    I just wanted to welcome you and bump this up so those more knowledgable than I can help you. Best of luck.

  • Thank you Debbie - very kind. It was immensely helpful last night to read of so many experiences, but at the same time quite intimidating to see how bad things can get. The value of that perspective is tremendous!

    The funny thing is, at any given time I can think about my pain, put it in perspective and think "it's not so bad". But then over longer periods, when it is constant and unyielding your ability to rationalize it becomes more limited and you feel like screaming!

    A strange beast is this pain...
  • sunny1966ssunny1966 VIRGINIAPosts: 1,385
    I do the same thing! I also get out and do stuff and think to myself "if anything was really wrong with me I wouldn't be able to do this". Have you ever thought that? I mean most of the time I can bend or whatever. Then, wham, it's like someone has a clamp around my lower back/hips and is squeezing me in half! I really don't understand it.

    Hope you find the answers you need soon. Feel free to PM me if you ever need to vent. The only thing I'm better at than venting myself is listening. lol

  • to the SH Board! You're definitely in the right place, since we've all been there done that when it comes to spine issues and therefore relate to what you've been experiencing. Feel free to vent whenever you need to; spine issues can be frustrating, as you've said.

    As for your questions, here goes: #1: only a doctor can answer that one; #2: good thing you're getting a second opinion Dec. 22, and when you see hum/her you should ask about that; #3: based on what I've heard plus personal experience, doctors tend to feel that it's best to add other tests, such as EMG/NCV, which measures things like nerve cconduction velocity, to see if there's something like a pinched nerve, which makes it easier for them to come up with a treatment plan; #4: that's something to mention to and discuss with the doctor on Dec. 22; #5: only a doctor can tell you if the "electric" sensation is caused by the fissure or bulge. I sure wish we could fully answer your questions, Dan, but since we're not doctors we're not qualified to answer them and we'd be very likely to steer you in the wrong direction. But we're here to show we care and we can offer suggestions that are based on personal experience or reliable sources (then ask your doctor about them).

    Fusions are often successful, and if the doc you'll see in December advises you to have one, don't be scared off by the horror stories you see on this Board; there are many more people who've undergone successful fusions and no longer feel the need to post here. Best wishes, and keep us posted. >:D< , Ess
  • I can't tell you for sure what I would do in your situation, but I wouldn't be to afraid of having a fusion done. This is just my opinion, but I've had all kind's of different back surgeries, from minimilly invasive, to laminecktomies, to fusion's, and I really didn't notice much difference in the pain of each one, compared to the pain I was already in. Most of my surgeries I felt better after surgery than I did before. But as far as having sugery, only you can answer that. Luckily I didn't have to answer that question the first time. But when you get to that point where it start's effecting everything you do, including your family time's, you'll know it's time. My kid's, thank goodness, are older now and don't require the care that your younger one's do. I am so sorry that you're going through this with kids as young as yours, I can't imagine. I am 47 also, and I'm looking at my first cervical fusion, which I have put off for a couple of years now, but it's time to do it. I'll be praying for you to make the right decision, for you and your family. If you have any more question's just ask, unfortuntly I have alot of experience with back surgeries.
    11 back surgeries, fused from L3/S1. Now have four herniated disc in neck from C3/C7. And two new herniated disc in lumbar at L1-2, L2-3. Passed 73 kidney stones, five surgeries on left ankle that now has seven screws in it and is fused. Both shoulders
  • Hi there,

    I did manage to read through your history. It stinks that you are still in so much pain.

    I will give you insights but not directly answer your questions.

    1 - lower back surgery is a slippery slope so the doctor that suggested to hold off was right.
    2 - would any shots help with inflammation?
    3 - when you visit the doctors and they make their recommendation here are 3 questions to ask them
    a - if this were their spouse or child, would they recommend this?
    b - if they were to recommend something that is more conservative, what would it be?
    c - if this recommendation doesn't work, what's the next step?
    d - ask them if their recommendation doesn't work, how will they/you know and how long will they wait to take the next step?

    I wish you well.
    I'm trying to avoid a fusion b/c I have just heard too many stories that say it really didn't resolve their issues.
  • Kwilson400KKwilson400 Posts: 42
    edited 07/15/2012 - 4:25 PM
    I understand your frustration..
    June 2011 L5-S1 Lamenectomy/Discectomy
    Dec. 2011 Repeat L5-S1 Lamenectomy/Discectomy
    June 2012 New tear L5-S1 w/ Perm. Sciatic Nerve Damage
    Currently- restrictions (including no work duties) for a min. of 3 months to allow disc time to heal
  • Can you get more opinions from additional spine surgeons?

    Have you tried traction?

    Other kinds of tests: EMG nerve conduction test
    CT scan with dye injection

    I am sending you a private message with some helpful links to good information (since we are not allowed to post them here). Keep an eye out for a big blue box that says "you have a new private message" at the top of your screen the next time you log in here.
    On the sunny and mild Central Coast of California

    L4-L5 endoscopic transforaminal microdiscectomy June, 2007
    L5-S1 endoscopic transforaminal microdiscectomy May, 2008
  • hello can you explain the viorus
  • I'm glad you're seeing ortho spine surgeons. I recently had L4-S1 rebuilt (11/21/11) by one, but I wasted a lot of time and expense with a neurosurgeon prior to this. Recovery is a tough road but I feel like I have a chance now.
  • Hi Dan, i wanna start with Welcome to SH ! I agree this site is Awesome. I have had back pain for a little over 3 yrs. Unlike you though, i didn't fall. I work at a car part factory, 4 yrs ago. My surgeon thinks thats where my problems began. Anywho he told me the only fix for me was spinal fusion surgery to remove a bulge that was pinching a nerve near the 5th lumbar. Physical therapy and injections would help with pain But not repair the problem.I had the surgery, So here I am 3 months later with less pain . Well the pain before surgery is gone. New pains from the pins in my back. As for pain meds but i am on Larcet 7.5/650mg. I take half a pill every 4 hours. I can drive but choose not to, house chores - i am learning to do them differently . I know that's weird but at least I feel a bit better that I can help. This is just a suggestion but why don't you do something with your kids that doesn't require heavy duty stuff, watch a movie together . I don't doubt they love you and your an amazing dad. But its a small way if saying I'm still Dad. I usually help my kids with their homework or we watch a movie. I can't wrestle with them anymore but i still try to do the little things. You know.. As for the doctors, do your research when u can and arrive at appt with your list of questions.... Find out All options before You decide anything... I am here if u wanna talk and I look forward to an update.. Help for find some releif , Best of luck and i hope I didnt offend you with any part of this comment ,IF I did , please let me know if I over stepped any line. I am sorry if I did.
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