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Lower back pain since 2005 despair

richardmrrichardm Posts: 16
edited 06/11/2012 - 9:01 AM in Lower Back Pain
Hi there,

I wrote on here a couple of years ago about what the back consultant said was L4 facet joint problem. I have had the pain since 2005 and it is constant. It is so bad 300mg of Tramadol are not enough, and I cannot lie on my front or my sides at all ever. I am always in pain and have disturbed sleep because of it, and sometimes cannot lift myself up off the mattress. The pain is in the centre lower back L4 – the small area is very tender to touch too. I have had cortisone injections and the first lot were 100% successful and I felt amazing...but it only lasted 7 weeks. I then had rhino frequency, but that didn’t go well, and it upset my legs. More recently I have had further cortisone injections with about 70% success lasting about 7 weeks. As time goes on the condition and my mobility deteriorate. I am only 38 now and otherwise fit and healthy. I find zig zag walking movements painful, (so shopping areas can be difficult), as are quick turns, bending backwards, lying on my front, twisting is an absolute no no. Yet, I have just had an MRI and a preliminary view suggests there is nothing serious. The physio said that’s what he expected.. But I’m utterly confused, how can I be in this much pain for so long for it not to be serious? The physio says I have scoliosis and that’s what he wants to work on as this is massive over use of the muscles on the right. I had an orthopaedic guy look at me and he thought it was a lesion and or cord compression, but surely that would have shown up? I am convinced it is a very bad facet joint as the pain goes entirely when I get the injections. The physio wants me to start twisting etc but I know this will cause me to be in agony the day after, (because of, I believe, the facet joint). I asked him about the facet joint which must be where the problem stems because when I get the injection it is sometimes 100 successful. The physio said I would still have access to the pain management team for the cortisone injections..but shouldn’t it have shown up on the MRI . I am really very concerned about doing all these bending twisting movements he wants me to do as I will be in bits for days after.

Can someone tell me why the facet joint problem has not showed up? What is going on? I feel desperate...


  • Hey Richard, Mri realy dont show everything that will show where pain is coming from unless its real obvious,

    There are so many other tests to try to confirm where the pain generator is,

    Even if injections helped in the facet it could be from inflammation and who realy knows whats causing the inflammation,

    Spine is much more complicated then some people would like to believe,

    My mri never showed anything for almost the 20 years i had back pain,
    Then i had a discogram test and showed disc was leaking and was the cause of my back pain,

    My 1 surgery was right after that discogram and went with a clinical trial of the new artificial disc replacement, Now i wish i would of just left it alone and i was able to deal with that pain then the pain i have now,

    If there was a cord compression that should show up in an mri, Have they done a mylogram on you yet to get a beter view?

    Mylogram shows more then the mri so when mri dont show anything many times mylogram is recomended,

    Best of luck. Hope it all turns out for you, Surgery should always be the last option after all alternative treatments failed,
    Flexicore ADR 2004 resulting nerve damage l4l5 Fusion 2006 same level, 2009 hardware removal with lami !
    2012 scs implant ,
  • I went for several years with back pain that nobody could explain, and no tests could confirm anything was wrong. I finally paid for an MRI several years ago, just so my physiotherapist and I had something to work on. A few years later I had a second MRI; it was read and a report was written, which included my facet issues, but it also said there were no remarkable changes with my SI joints, yet my rheumatologist took a close look and said there WERE remarkable changes. (My bone scans also showed significant 'uptake' in my SI joints, which usually indicates inflammation and the possibility of other things.) It makes me angry, but I think sometimes things are 'missed' on these reports; I know everyone makes mistakes, but when it affects your treatment options, it is really annoying.

    I have facet joint issues at L4/L5, and I can tell you they cause me a TON of grief. I have had four rhizotomies (radiofrequency ablations), which have been extremely helpful, but only for a limited time. Nerve blocks have been helpful, but again only temporary, and the occasional course of oral prednisone has also helped. Unfortunately, there is nothing permanent that can be done about facet joint issues at this point, according to my surgeon and my pain doc. It is very, very frustrating.

    I have found that I have to keep up a stretching routine to try and keep everything from going into spasm, and I have just started gentle yoga to see if that is something that I can manage without paying for it afterwards.....so far it's been 50/50. I spend a LOT of time on ice or heat; even when there is inflammation, at times the heat helps the pain more than anything else. I go to physiotherapy twice a week, and to massage if and when my body will allow. I, like you, can not deal with laying on my stomach for more than a couple of minutes. I have to be very mindful of which shoes I wear if I'm going walking, as the wrong ones can cause me immense grief at the end of the day. I have to stay on even ground, if possible, and not jerk or twist unexpectedly. The pain can literally take my breath away and cause me to walk like I have a 2 x 4 strapped to my back!

    Keep your chin up, and be proactive. Hope you find something that will give you some relief.

  • It's SO FRUSTRATING! I have had lower back pain and pain where the thigh and hip meet since 2007. I have also been told I am not a candidate for surgery. But nothing has helped. Not S.I. injections, not facet injections, not rhizotomy, not physical therapy, not acupuncture. I feel your pain!!!
  • Not sure what that is. Can you give us a link to it? I do use an Interferential. It's similar to a TENS, but much more powerful. TENS never helped me. Mine is an IFC-8100 from Zynex Medical. The good thing is that my insurance pays for the pads they send each month. There is supposed to be a deductible, but they don't bill me.
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