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Help me understand my condition please

Hello, I am a 21 year old male with chronic lumbar and cervical spine pain.
I remember having lower back pain as early as 15 years old. I told this to my doctor but he said I was too young for back pain and didn't even do an X-ray. I've always slept on my stomach (its the only way I could sleep as I have had insomnia since 16) and often had to put a pillow under me, then two, then three to alleviate the back pain, which was minor in comparison to now. Also I played Linebacker and was on the wrestling team in high school, both of which required a lot of running. For the most part I was fine, but once in a while I would have excruciating pain in my lower back to which I responded to by sucking it up and finishing the run, even tho i'd be close to tears by the time i finished (sports mentality). Over the years I've played on a lot of injuries, including a partial meniscus tear. Part of this mindset came from my desire to be a Navy SEAL since I was 7 years old and my love to overcome a daunting physical challenge.
When I was 18, I started feeling this weird clicking feeling in my lower spine/tailbone whenever I sprinted but didn't think much of it. I still continued weightlifting and was a certified personal trainer by this time. When I was 19 I was in the gym doing squats with only 185 pounds (I had maxed at over 400lbs) when all of the sudden I felt this weird, excruciating pain in my lower back. It was completely different than anything I had ever felt before but it went away immediately when I stood up. I stood their for a second and when the pain did not return I tentatively started to go down again. immediately I felt the same pain again and at that point I walked out of the gym. But I still had to work that day. I made it through half the day but then had to go home. By the next day my back only ached a little but I had this tingling feeling going down my leg and my left hip felt really tight. After about a month of this I finally went to the doctor, who was skeptical about a bulging disc because of my age, but she gave me a X-ray anyway. Upon review of the X-ray she immediately referred me to get an MRI. However this took several months because I have an HMO and my insurance company took forever to approve it.
The MRI showed that I have lumbar spinal stenosis and a bulging disc in L5-S1 and an inwardly herniated disc in L2-L3. It was believed that The l5-S1 bulge was causing the sciatica. The ortho's response to this was to prescribe three epidural injections, all of which did absolutly nothing. However after the very next day of the second injection I had extreme pain in my neck and could barely move for the next three days until it subsided. The pain management surgeon said that this had nothing to do with the epidural. About two months later the same thing happened in my neck again and the Ortho surgeon referred me to a neurosurgeon and another MRI of my cervical spine. Turns out I have a complete straightening of the cervical vertabrae (lordorsis) and a bulging disc in c5-c6. The neurosurgeon also diagnosed me with lumbar arthritis.
Ok, fastword to today. I'm almost 22 and my pain has progressed to the point that I have absolutely no life. I tried physical therapy, didn't help. I bought a latex memory foam bed, an inversion table, a home cervical traction unit, a foam roll, thera cane and multiple ice bags. I stretch, Ice and do various exercises religiously every morning and every night. All it does is help me make it through the next day. I have trouble walking more than 15-20 feet at a time. I have sciatica pain down to my toes, (although my foot just goes numb usually by mid day) and chronic lower back pain. My neck constantly hurts and the "knots" in my shoulders are massive. I am very familiar with myo-facia release from when I was a personal trainer, but none of these techniques alleviate the knots. I've tried chiropractic and deep tissue massage. Nothing has helped.
Unfortunately I have to work a 40 hour week. At one point I worked 65 hours a week, which I know didn't help me, but I qualify for almost no state aid and have to support myself.But this is all I can do. I go to work and come straight home, just doing basic erends after work is a gut-check for me.
As I stated before I have an HMO, which has made getting medical treatment extremely difficult. The first Ortho I saw was extremely rude and literally walked out on me when I was in the middle of a question. I have received several different diagnosis to the point that I'm not even 100% sure whats wrong with me. The only general consensus is that I'm too young for surgery. However I feel that my age is holding me back from sufficient treatment because doctors are skeptical of my level of pain, just like the doctor said when I was 16, "your too young to have back pain". This is partialy my fault because I was too prideful during the first round of appointments to truly admit how much pain I was in. However my pain level has increased 5 fold over the last two years, there has to be something I can do because I can't keep living like this. I have an appointment with a different ortho surgeon on september 20th to start the process all over. Is there anything specific I should bring up to him? What surgical options do I have? Any input would be greatly appreciated. Thank you.



  • sandisandi Posts: 6,342
    edited 08/29/2012 - 10:34 AM
    You will probably be sent for a new MRI and or a CT scan to see what is going on. I would be sure not to downplay the symptoms you are experiencing, especially the numbness. That is usually a sign of nerve compression, and given the history of your L5 disc, it is not surprising. You are young by most standards to have the back problems that it appears you have, however your age is tempered by your sports history , which makes the likelihood of injury more likely.
    As far as what surgeries might be recommended, there is no way for us to suggest any, first because we aren't doctors, but more importantly, you would need new studies to determine if there is nerve compression and any other conditions that may warrant surgery. If there are, the surgeon will recommend surgery that he feels will best help your conditions.
    Good luck
  • BkinsBBkins Posts: 364
    edited 08/29/2012 - 11:00 AM

    I would sugges that you write everything down with the dates you had things done, who did them, and what the results were. Don't try to spew it out while your talking to the Dr. I think each one of us has tried to remember what was done and by who but end up missing something that may or may not be important. With a list it helps that you are not going to waste a doctors time.

    He most likely will do a exam and ask a bunch of questions. There is no need, and I would say not to, ask about surgery options. If surgery is needed he/she will tell you so. Surgery is absolutely the last thing I would want to hear about. Usually surgery on the back starts a cascade effect of things going wrong. Sometimes it can be a very slow cascade and sometimes it will be a fast one. Make sure you are clear on what is hurting, or numb, and the degree of hurt involved. I would make sure they understand what you have written down, or said.

    Take any test results you may have even if they are old. I have found that it also helps to have someone else in the room with you as most of us hear what we want to hear even if its not said. The second person in the room can tell you if it was said or not. I have also found it helpful to write down what was said by the Dr. for future reference. This can be done in your car or when you get home but do write it down.

    You most likely will find that a HMO insurance plan is not very good. You are stuck with their Dr. unless you go out of network which is very expensive. Most HMO's don't have good back surgeons or good other specialities. I hope you luck out on this front but odds are you may not.

    Let us know how you make out. Somebody on this site will be able to help with questions you may have after seeing the doc.

    Good luck.
  • Sorry you are so young and having this bad of pain. Great advice already given to you above. Wanted to add a couple of things.

    Writing down your history is great. In fact, make it concise and legible enough that you can just leave it with the doctor. Many appreciate this very much, especially after they order new tests and want to refer back to your symptoms. Also, taking someone to the appointment is great advice. If possible, I would take your parent/parents as you are young. Another person can help you remember things, give their observations to the doctor, and(sometimes sad to say) give credibility to your story.

    Shorten your story. The first two paragraphs could be summed up as, "I've had back pain since I was 15. I played many sports including football. At 19 I did 400 pound squats and that's when I started having pain down my leg. That's when I had my MRI and it showed...I saw an ortho surgeon who performed a series of 3 lumbar epidural injections which gave me no relief. My cervical MRI showed...So my symptoms today are:..." I appreciate hearing your whole story but you will lose the interest of the surgeon if you throw in all of the little details initially. I'm sure you know not to complain to the dr. about the other dr's lack of interest, etc. We want to hear about it, but you will lose their interest and put them off. You may very well know all of this but I'm telling you because I've seen many folks who don't.

    Many HMO's will require a round of 3 epidurals before talking about surgery I would make sure that you mention you had a series. They may want to do another series. Besides another MRI or CT scan, they may even order a discogram. That is kind of like an epidural with xrays and a CT scan. It often will show things that don't show on an MRI or CT. Dye is injected into the discs for pictures and to see how much it takes before your symptoms are reproduced(very short explanation.)

    I agree that I wouldn't go right in asking what kind of surgery they can do. Also, you may feel desperate, but I have to say that it seems like once they start cutting they just keep on cutting. You might end of worse after surgery. Some of us have been there.

    I hope you aren't still sleeping on your stomach. Also, I hope you aren't doing ANY exercises without specific instruction from a spine doctor and physical therapist. Cut out that cervical traction machine and chiropractor without very specific instruction from a spine specialist. You need to hold out till you see the new ortho surgeon. I worry you might be doing more damage in the meantime.

    After telling you to make sure you are concise at your appointment, I sure did get wordy, didn't I? :)

    One more thing, before I saw a new doctor that I thought might do an epidural that same day, I cut out all NSAIDS(advil, motrin, aleve), aspirin, vitamin E, anything that interferes with the clotting process 7 days before the appointment. I'm not advising you to stop your pain relief measure, but just letting you know that those can interfere if you get a quick appointment for an epidural or selective nerve root injection, etc. Those tests can be diagnostic as well as therapeutic so please don't refuse them because your previous series did not work.

    Good luck to you. We truly feel your pain here! Please make sure you post an update as we want to hear how you are doing and what the doctor said!
  • idk53iidk53 Posts: 21
    edited 08/31/2012 - 9:19 AM
    I really appreciate the advice, especially in regards to my upcoming appointment.
    I should also mention my family history. I know my Grandpa had back surgery but I do not know the details. My uncle was medically discharged from the military at 22 and recently (he's in his 40s now) had a Laminectomy to alleviate a bulging disc in the lower lumbar region (he also had spinal stenosis). My aunt Has degenerative disc disease (I know that's a very broad term) and is discussing surgical options with her doctor. Also my 29 year-old sister was recently diagnosed with lumbar arthritis, so unfortunately this appears to run in my mom's side of the family.

    I purchased the cervical traction unit while still undergoing physical therapy and used it as directed by the therapist. Same thing with the exercises. However my fear is that I am getting progressively worse and I cannot afford to wait until I am in so much pain that I can no longer do my job. Unfortunately bills don't particularly care how I'm feeling. Which is why I'm trying to figure out what options are available to me, so I have educated questions for my Doctor. Once again. all responses are greatly appreciated. Thank you.
  • postureperfectpostureperfect Posts: 1
    edited 09/05/2012 - 4:58 AM
    Hi. Let me introduce myself. I had lower back pain starting in my mid 20's into my thirties. It all started about the time I began lifting weights. It did get worse over time, and my sedentary habits and 'on & off weight training' over the years really compounded my problems. I had very much 'lost touch with my body'.

    My body clearly felt 'amiss', but, I had no idea how to fix it. In my effort to fix it, I made matters worse! One day in the gym, while doing split squats with ridiculously heavy dumbells, I suddenly felt some burning in my left leg and then my foot went numb! Fast forward to today, following many, many months of study and trial & error application of what I learned, I no longer have sciatica.

    LESSONS LEARNED: Don't ever apply generalized advice to your specific problem. You must understand where you are, and how you got to where you are today. You MUST possess expert-level understanding of how the body (your body) works, to undo your own disfunctional progression. (This is a level that so very FEW professionals ever reach) This expert-level understanding is the ONLY thing that can overcome probably the #1 reason why many people with spinal issues never get back to "Square One" >>>>>>>>> Body Awareness (Proprioception). As the dysfunction progresses, the body's central nervous system makes adjustments 'on the fly' that changes what you perceive as 'normal'. How can you ever get back to normal when you don't know what normal feels like?

    Too Young? I think what the doctor(s) are trying to tell you is--look for your solution elsewhere. You are young, strong, and generally healthy, despite your painful-weak back & sciatica. Surgery is AN option for everyone. But, it is usually the option of LAST RESORT. This is for many reasons, the #1 of which is...The outcome, even if the surgeon performing it is literally the best in the world, will be of permanently substandard quality compared to the spine you have right now. 100 is too young for spine surgery, if you are fully functional at 100, with pain. As your options become less in your quest to remove the pain NOW, you may start to believe, thru the process of elimination, that surgery is the only option. Not so. Surgery probably costs much more than you realize. And, I'm not just talking about money here. I think you'll agree with me that the BEST solution is hidden within you.

    All I can think is, what a wonderful opportunity this is for you. Please don't get angry at this. I know you are very motivated to get out of this predicament you're in right now. But, please don't let motivation turn into desperation. (You can't see clearly when you're in a desperate state.) At your age and with your background in personal training, you now have the opportunity to experience how resilient your body truly is. Don't let your fears drive your decisions. They are probably unfounded, anyway. Your family history doesn't have to become yours. You CAN back out of this, as soon as you find reverse gear.

    Are you willing to look until you find reverse? I can assure you, the rewards of taking possession of your own body are well worth it!

    Post edited for solicitation by moderator team.
  • The spammers and illegal drug pushers are out running rampant this weekend! LOL...
  • idk53iidk53 Posts: 21
    edited 09/02/2012 - 9:24 AM
    Alrighty postureperfect then how do I un-do spinal stenosis and arthritis?
  • davrunnerddavrunner Posts: 478
    edited 09/04/2012 - 8:57 AM
    Your right to ask "how do I un-d spinal stenosis and arthritis". There are soo many snake oil salesmen out there trying to push their "cure". They know that when we are in pain and frustration sets in we will try anything. I have tried several of the "end your back pain today" treatments, most only mask the pain, it's still there. There's even one out there made from cobra venim.

    You can't un-do arthritis, you may be able to slow the progression but no way to undo. Stenosis can be helped with surgery and sometimes with Physical therapy.

    I also come from a family of chronic back patients. I feel lucky that I didn't have to go through what my father did. His back is literally wired together with stainless steel wire.

    You are not too young to have back problems, but realize that the surgeons may be looking out for you, if they perform surgery now it can cause more surgeries later on. I had a lamenectomy 4 years ago and now need 3-level fusion, my neck has deteriorated at an increasing rate due to growning destabilization.

    What you should also keep in mind most back surgeries are not done to stop the pain but to stabilze the spine. All the dr's I've gone to have told me if you get pain relief from surgery it's a bonus, not the reason to do surgery.
    Good luck to you and let us know how you are doing.
    laminectomy c4/c5 2008, ACDF c4-c7 Jan 20 2014 sched
  • IDK53,

    Take it from me a moderator. Over the time I have been here I have seen so many post. Everyone promises a cure to handle everyone situation on the board, from snake creams, eating healthy, supplements and so on. I think you get the idea. We don't like to shoot down any of the ideas. I say it is up to you the member to read the post and you can tell whom is really trying to help you and whom is really pushing something. It is always our words of caution when you pose a question your going to get all kinds of advice, however you don't have to take them. So take the good with the bad and you make your best decision with research you are doing. I think the first few post, gave you some good concrete advice.

    I also wanted to tell you, that is it not uncommon for our younger patients to be dismissed at the doctors office. It has a lot to do with pain medications and saying you have back pain, is a very easy one, as it is very hard prove. Unfortunately for you, your going to have to work around those issues. But keep working, and pushing for answers, you don't want to me old and still in pain. Anyway good luck and keep us posted. Ps I will be editing some of the post above for content, but I can't edit the whole thing, as it is just a opinion as all the rest. If I can help you in anyway don't hesitate to pm me. Take care.
  • idk53iidk53 Posts: 21
    edited 09/05/2012 - 5:36 AM
    tamtam said:

    I also wanted to tell you, that is it not uncommon for our younger patients to be dismissed at the doctors office. It has a lot to do with pain medications and saying you have back pain, is a very easy one, as it is very hard prove. [quote/]
  • This is exactly how I have felt and is why I included a bit of my sports history in my first post. I do not mean to sound arrogant as I am having a little trouble in figuring out how to phrase this. I have often wondered, is my pain really that bad and am I just being a whiner in comparison to some of the people out there that are in extreme pain? But then I think about all the times I have pushed through pain to acomplish a goal. Don't get me wrong this is by far the most pain I have ever dealt with, but I think my background in wrestling better prepared me to deal with it mentally than say someone who has never pushed themselves? Once again I do not mean to sound "superior" or any thing like that, and do apologize if I do.

    I worked 65 hours a week between two jobs from February until June of this year. During that time my sciatica progressed to the point where I could not walk more than 10ft without being in extreme pain in my left hip and down to my toes and have to sit down. Luckily I was able to quit the second job as it was becoming too much. The problem I ran into with physical therapy is that I simply couldn't even get to the exercises that would help strengthen my core and improve posture because we couldn't get past trying to undo the damage from working so much. I had a hard time even doing a hamstring stretch while lying flat on my back. Now once I stopped working two jobs this did improve, but still not to the point where I could make any significant progress with the physical therapy and so it was the therapist call to refer me back to pain management.

    So heres my question. Sciatica is my chief complaint for my lower back pain. If I underwent a procedure, whether through pain management or a surgical option, to minimize the sciatica, could I then resume physical therapy with better results? Has anyone had a similar situation?
  • I've had sciatic pain off and on for years. I started getting periodic injections that greatly reduce the pain in my lumbar spine and sciatica. My surgeon said it's a great predicter for how you will do if you ultimately need surgery. I just wish it would work on my cervical spine and upper back.
    If you can get it to settle down then PT should be able to gradually help you strengthen your core. It is a combination of treatments that usually help not one specific.
    laminectomy c4/c5 2008, ACDF c4-c7 Jan 20 2014 sched
  • There is a disease called Ankylosing Spondylitis that starts out,mostly in young men in their teens and 20's. AS affects the spine and causes a lot of pain. It can run in families and it can be very hard to get a Dx. It might be a good idea to ask to see a rheumatolegest.
    I have Ankolysing Spondylits, Ulcerative Colitis, DDD and a bit of OA to make things fun. Most of my problems are due to inflation of many joints, tendons and ligaments. I see a GP, a Rheumatologest, an orthopedic Dr and a wonderful PM.
  • idk53iidk53 Posts: 21
    edited 09/08/2012 - 9:17 AM
    Unfortunately when I initially hurt my back it wasn't that bad and I didn't make it a priority to start physical therapy as this all happened during a critical time with my work and I put work first. The pain was consistent but more of an annoyance than anything. I know now that I completely under-estimated what I was dealing with and think about this often: Had I dealt with it right away would I still be in the pain I am now? However the real question is is my spine structurally worse now (i.e. did the bulging disc herniate?) or is it merely massive amounts of inflammation that has caused such a drastic increase over the course of two years? I'm hoping that cross-referencing my old MRI with the new one that I'm hoping to get will answer this question. However I certainly did do things that I think back on that there is a high probability that I did make the discs worse...
  • For the most part we are incumbent on others to provide a possible solution, historically pain management was implemented at the end when most if not all the invasive idea and treatments had been concluded, research suggest, that it should be done simultaneously and as soon as possible from the beginning.

    You have to look at what you can do and build on that, as Dave said, pain relief is only a product of surgery not the primary objective, if you set the expectation that residual pain will not be evident once surgery is performed you may be disappointed, it is not the panacea of improvement for many here. It is easy to become embroiled with the finite issue, moving forward is about your responsibility very few have left this site fixed, the overall risk of surgery is also a factor. Move forward from a known diagnosis, one step at a time, the mode of best practice are written here at SH.

    Do something positive every day and build on that however small, concentrate on what you can do not what you cannot, adapt new ideas and learn new and inventive coping strategies, be kind to yourself.

    Have a look at this, it may be useful.

    Take care and good luck to you. John
  • I understand what your saying and I try my best to stay patient and keep my resolve. The issue I run into is not what I can do, but rather what I have to do. I live with my girlfriend and she isn't strong enough to carry our 5 gallon water jugs upstairs, so guess who has to do it? I'm the GM of a quick serve restaurant, I have 14 employees but when one calls off and no one can come in guess who has to cover the shift? When a flag on the roof gets ripped off by the wind, I can't risk an employees' safety. None of this is going to change anytime soon. Its like the neurosurgeon said "You just have to take it easy" to which I replied "how?"
  • DaverrotteDDaverrotte Posts: 1
    edited 11/16/2012 - 2:07 AM
    First of all i would like to say how disgusted i am with posture perfects post. It sounds to me like this individual has never experienced pain at this level and consistancy before.
    Im almost out of the woods with my 12 week long episode and although im not sure my advise will help i feel i have to tell u what ive done thats helped me. I'll try to keep it brief.
    I noticed u mentioned that u suffer from insomnia. Is this something that results from the pain? Or is this independent from ur pain? I too have issue sleeping but my recent back issues with Spondylolisthesis and bulged disc (L5-s1) made it much worse. As a result i started taking over the counter PM medications like benedryl and advil PM. It turns out these medications will increase muscle spasms which i believe amplified my pain. After seeing a specialist and getting ambien ive been able to not only sleep but completely relax before bed. I think this has helped me tremendously because it relaxes every muscle while i sleep and lets me heal all night. Seriously man best wishes and get better soon.
    PS if u need surgery just get it. I relate so much when u talk about how u have no life and get right home after work. Its not worth it u only get to live once. U need to get better.

    Please refrain from providing medical advice. What may be fine for you , could potentially be harmful to another The Spine-Health Moderator Team
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