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When is conservative treatment enough?

MamacitaMMamacita Posts: 5
edited 06/11/2012 - 9:02 AM in Lower Back Pain
I have been suffering from lower back pain for most of my adult life. It got worse about 11 years ago. At times I cannot walk. I am not comfortable sitting and laying down (even with legs elevated) has excruciating pain when getting up and waiting for my back to load (I dont even know it that is actual term but that is what it feels like) My back kills me. The pain radiates into my hips and mostly down my right leg. My leg feels week and heavy and I have fire comeing out my foot. I have been seeing the pain doc for 10 years and have had so many epidurals, nerve blocks, rhyzotomys etc. Also, I am on pain meds My most recent MRI states L4/5 mild disk space narrowing with minimal disk bulging with no focul protusion. Moderate facet hypertrophy with fluid in the joint spaces bilaterally. These changes can cause mild amount of central and bilateral later recess stenosis and mild bilateral foraminal stenosis. L5-S1 Mild diffuse disk bulging without focul protrusion. Minimal facet hypertrophy. Mild bilateral foraminal narrowing. No central or lateral recess stenosis.

I meet with a neuro surgeon on Friday and I think I will have a breakdown if he tells me he cannot do anything (like he has done in the past). Can anyone advise me on what to do?

BTW I have tried phyical therapy, massage therapy, all the previous injections, medicine...hell I even went to some lady that sang some voodooish song while she waived her hands around my back (I was and still am desparate).

Isn't 10 years of trying to fix this condition enough?


  • It's difficult when someone has had pain for so long and seems to be no answer surgery wise anyway. I have only had 4 years of chronic pain and just went to my 4th PM Dr. for a med change and assessment.

    New methods to change to Fentanyl and use a nerve pain med and go to a Pain Psychologist and group therapy.

    Pain Management is really important so hopefully you have a PM Dr. that's working with you to try different methods to help manage your pain. I've been coming to this site since I injured my back and found the support and new ideas have helped me get through it.

    I wish I had more answers to give you other than do a search in the blue box above on what to ask the Spine Surgeon. Hoping he has some answers for you. Never give up hope. 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
  • Thanks for your comments. Fentyl scares the bageebees out of me. They just put me on Kadian a long acting Morophine with Percocet as breakthru meds when needed. That scares me too. My PM Doc is good but I am now opting for surgery if they will do it. I gotta try. However I bet my appt on Friday will be the same as always....your MRI says your back is messed up but nothing worth operating on...yet they will put me on massive meds. Its frustrating.

    Also I have tried every nerve pain med and arthritic/inflamation pills out there with no good results

    Charry I hope you improve. I feel for you.
  • I'm nervous about Fentanyl also as I wanted to do warm water aquatherapy and concerned about the drug being released too quickly. Maybe I'll wait for the swimming and see if the meds work first. I take MS Contin right now and it's just not enough. Best wishes. 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 totaly know where you are coming from when i was in your place for about 16 years with same symptoms and mri never give reasons to have surgery,

    You can have a hell of a lot of pain but if they dont see something thats a direct cause on an mri they dont know what to make of it,
    They kind of look at you like a deer looking at the headlights,

    Mri sadly dont show pain and many times they simply dont know where pain is realy coming from, After many years i had a discogram for the 1 st time by a pain specialist and confirmed i had a leaking disc from my l4l5 and this never showed up in any mri in my 16 years of back pain,

    At that point finaly surgery was offered up and i sighned up so fast for my artificial disc replacement i could not care less i just wanted a fix aftef 16 years of dealing with it,

    Sadly i never realised some cases surgery can cause nerve damage and make a person worse then they were before they had surgery, So in my case i wish they never found the leaking disc to begin with and left me be,

    This is the reason dr,s often are not offering up surgery for some where its not very clear is the direct cause,

    When spine is still stable enough to there standard its assumed no surgery will help and spine is still ok and any compression is too litle to be concerned about,

    Which i guess in theory is true , But it dont take a lot for this level to have slight problem and another level to also have slight problem to the point pain is always there and inflammation is always there and brings you to the point of finding yourself in so much pain and arguing with the dr now why you feel 1 way and the medical opinion is you are fine,!

    Best of luck with your appointment friday and let us know what dr says,
    Flexicore ADR 2004 resulting nerve damage l4l5 Fusion 2006 same level, 2009 hardware removal with lami !
    2012 scs implant ,
  • Ps. Does the lady that sings voddoish songs sacrafice chickens while drinking goats blood?

    If yes does she take appointments cause i am all in, please send me her info,

    I think this pain is a curse and it has to be aproached as such, git-ir-done
    Flexicore ADR 2004 resulting nerve damage l4l5 Fusion 2006 same level, 2009 hardware removal with lami !
    2012 scs implant ,
  • So I went to the neurosurgeon(NS) Friday who once again told me...I don't really see anything on the MRI that surgery will cure. I couldn't hardly walk into the office. He said he can see I am in pain and then suggests maybe it could be diabetes (I know I DONT have diabetes - I have had a ton of blood tests along the way). Last year when I couldn't walk they did all sorts of tests and stated I had fibromyalsia and I might have cancer (which I don't have but I had to see an oncologist a few times to assure that I didn't have it).

    So the NS does a few pressure tests to assure he hasn't missed anything by just looking at the MRI film and with one push I had electrical volts going up and down my leg and he just looked purplexed. So I now have to have my 4th EMG. I am at my wits end.

    BTW the first EMG's stated I had nerve problems and possible facet issues and this doc sent me to the Pain Doc. 3 Yrs ago I had another EMG and it again said I had problems and then they did a mylegoram which stated I had mild bulges, degenerative discs, facet hypertrophy and other issues but the doc said there was nothing they could fix. Last year another neurologist (hack) doc that did the EMG stated I had no problems on the EMG. The NS I met with yesterday stated that the previous Neurologist is a hack. So why was I referred to him last year???? (fyi:this is the doc that said I had the fibro and cancer)

    So I have to wait another 2 weeks for antoher EMG and more money for them to again write me off. I sure wish I knew what doctor would be able to figure out my back issues and get me out of pain.

    FYI the reason I saw the NS this week was becuase I asked my Pain doc if he would do a myleogram or the diskogram to see if a disk was leaking. He wanted to assure the NS would do surgery if he found the leakage.

    I cannot believe they can put a man on the moon but they cannot figure out my and cure my pain :(


    Recent MRI: L4/5 Mild disk space narrowing with minimal disk buldging w/o focal protrusion. Moderate facet hypertrophy w/fluid in joint spaces which cause mild amount of centeral and bilatersll recess stenosis and mild bi foraminal stenosis. L5/SImild diffuse disk bulgeing w/o focal protrusion. minimal facet hypertrophy and mild bilateral foraminal narowing with no central or lateral recess stenosis. FYI: when the MRI was over I couldn't raise my leg or get off the table. 2 assistants had to lift and turn me as I cried.

  • I bet an animal dr could find the problem before a spine surgen, I would agree to maybe 1 or posible 2 emg but if its not showing anything then a serious compression is simply not there, And how much money can they make on 1 person doing so many emg is simply crazy,

    Sounds like you might have stenosis but not showing up on the laying down mri,

    Wonder if it would show up on a stand up mri as some people claim sometimes it finaly shows up because there is weight on the spine standing up and having mri,

    Its either that or your back to drinking chicken blood and sacraficing virgins in to the volcano,

    Good luck, Sorry you are not having much luck, It takes only 1 good dr with looking at all your medical records and mri and emg to know what is the real cause,

    You just need to find the right dr that thinks beyond emg and mri and can go off the smptoms more so then just computer image thats never 100%

    Its no wonder many times during surgery they come out and say wow it was much worse then they thought, That alone tells you the image sometimes aint worth the darn

    Best of luck,
    Flexicore ADR 2004 resulting nerve damage l4l5 Fusion 2006 same level, 2009 hardware removal with lami !
    2012 scs implant ,
  • I had the same thing and 3 EMGs one says sciatica from the back the next one I didn't even get results the third EMG they say the sciatica in my leg doesn't have anything to do with my back even though it happened the same time I hurt my back.

    I think a standing MRI would be a good idea also. I hope you get some answers soon. 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
  • the cause? I recently read an article that pain will sometimes rewire the nuerotransmitters and a region in the brain. They found on a brain scan a region that seems to be the source of chronic pain. They are now working on medications to target that part of the brain.

    My NS said that he is reluctant to operate on anyone who doesn't get relief, at least for a little while, from the nerve blocks. If there is even a bit of relief then they know that surgery may help. If they can't pinpoint the pain generator surgery could do nothing or make it worse.
    Really hope that you get some answers soon.
    laminectomy c4/c5 2008, ACDF c4-c7 Jan 20 2014 sched
  • spinal disc problems can be alleviated with an inversion table....
    Live to Pray
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