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Delaying the Inevitable???

So after 9 months of no insurance and horrible back/sciatic pain, I got my insurance and had my MRI and just as I thought, not good, not good at all. As I say I've got a major blow out at L4/L5, and as the MRI report states "severe spinal stenosis". I was in physical therapy at the time, I showed my physical therapist one of the pics from the MRI (prior to getting the report, the problem was obvious), she advised me to get into my primary ASAP, as this was NOT GOOD AT ALL. So I did, pretty much the same reaction from my primary. He said I needed to get into the surgeon ASAP, and called to squeeze me in as there were no appointments available for 3 weeks.
So my appointment was today, I had x-rays and brought them all the reports, MRI's etc... bracing myself for the word surgery (as the MRI shows the disc is pressed up on my spinal cord so much, there is not much room left, and the disc below is bad as well) I saw the surgeon's PA, who said she wants to first try injections before surgery, BUT wants to see me back in 3-4 weeks because of the severity of the disc. She also wants me to get in to do this ASAP because of the severity, and personally called the office that would preform the injections to get me in asap. But instead of getting the usually series of 3 shots, I will only have time for 2 before I come back to see her so she can see if they are helping reduce the bulge.

Now my questions are (and of course these are what I thought of AFTER the appointment):

1. I truly appreciate the "surgery is the last resort" concept, I would like opinions on is this just to say, we tried everything before surgery and I'm just delaying the inevitable?? As it's been 9 months since this has started?

2. Without getting another MRI, how is she going to know if this is working? Before I was told to stop physical therapy (because of the severity of the bulge) it was helping. I haven't been able to stand this straight or long in months, but that doesn't change the size or severity of the bulge. Let's say the shot's take away some or even all of the pain and numbness, is she going to consider that as "working"?? To me that's not fixing the problem, it's a bandaid. I understand the concept of the steriod decreasing the inflammation to allow your body to heal itself, but I'm wondering if this has gone on too long?

3. Are there any of you out there that have had injections on a severe hernation, that have received the shots and your body actually healed itself?? I would love to be more optimistic, but I feel I also don't want to kid myself that a surgery isn't going to happen in the near future.

So Wednesday was my first injection...OUCH!! I was under the assumption I was going to receive a "twilight", whatever it was they gave me just felt like I took a Xanax, not too happy about that. It's now Friday and I understand these do not work immediatley but so far I'm feeling the same if not worse. I go back in 2 weeks to see what, I don't know. I asked the doctor, so in 2 weeks we will do this again and his reply was "well we will see". Why can't I just get a straight answer?!! I'm a big girl, I can handle it, it's getting really frustrating not know if I'm going through this for no reason!!

I would appreciate any and all opinions and comments, I know every case/person is different and I'm totally new to all of this besides my brother having 4 back surgeries. I never injured by back this is lovely genetics, although my brother is the only other one with this condition that we know of on either my dad or mom's side.

Thank you in advance for all your help!!!!


  • I don't know if you are delaying the inevitable by doing the conservative treatments or not. Only you and your body can tell you that. I can only tell you about my experiences.

    I was in a low speed rear-end MVA back in April and started having back pain. My chiro referred me to a pain management specialist who did injections at the L5/S1 level and ordered an MRI. Those seemed to help but did not completely resolve the pain. We then did a rhizotomy (aka nerve burning or RFA) which worked for about a month. In the mean time I was referred to a neurosurgeon who said I needed suregery but asked me if I could live without it. At the time my answere was yes, for now. After that month my pain came back worse then before. I also developed tingling on and off down into my foot on the left side which has now progressed into my groin. My PMS ordered a discogram with a followup CT to detemine not if I need surgery but what kind of surgery I need.. It said basically the same thing as the MRI just a little bit worse. I now have an appointment with the surgeon on Friday to determine what the appropriate surgery is.

    I was delaying the inevitable but that doesn't mean that you are. I would get another opinion (I have had 5 - 2 doctors, 2 PT's, and a chiro). Then tell him/her what your experience has been with the injections and the PT. Besides if you are even considering back surgery you should get at least one more opinion. If your current surgeon gets offended or doesn't want to give you information on other doctors then they are not the suregon for you. Good surgeons have no issues with second opinions. Keep us updated on what you decide to do and how you are progressing.

    Single level L5/S1 360 fusion with 6 screws and a rod (10/29/12)
    Diagnosis: Grade 1-2 spondylolithesis, Pars Defect, L5/S1 disc tear anterior and posterior, DDD, spinal stenosis
  • Well today (9/21) I had my second injection. The first relieved some pain for a few days but the numbness never went away. On Wed. I had my follow up with the pain management Dr. to see how the first shot went. He seemed to think that a second shot wouldn't do much either but said unfortunately we not only have to please you, but also your insurance company (we all know that game too well!). So he tried a different approch by going into the herniated disc versus around it to see if that would make a difference and relieve it a little more. My follow up with my surgeon is next Thursday, so we shall see how that goes. But from talking to the pain management doctor both today and my last appointment, I asked his opinion (and to give me a realistic answer) and he seems to think that I most likely will have to have surgery more sooner than later. It is what it is, I guess I just feel as everyone that sees that MRI gives me the "Holy Sh*T!" reaction, which makes me think, obviously this isn't good by any means, so why wait or better yet what would the potential consequences be for waiting. We all seem to agree this isn't going to heal itself!! I just it's the impatient part of me coming out wanting to know all of these answers, yesterday!
    But again, thank you for your response, I truly appreciate any comments. I feel my mind is going 90 to nothing costantly and it's nice to hear other people's stories! Take care and I will update when my next appointment comes around!
  • I had my follow up with my PMS and my surgeon yesterday. My PMS took the time to go over the pictures that he took during my discogram and said there was nothing he could do with a laser. It wouldn't work and I would have to have another surgical procedure. I asked him what kind of surgeon and he said he would let my surgeon answer that. Went and saw the surgeon next. He is going to do an ALIF with screws and a laminectomy. He also said that he knew the first time he saw me this is what he was going to do. I get the same reaction when people look at my MRI & CT as you do.

    The best advise I can give you is to do your research before you see the surgeon. I have been researching everything for about the last 2 weeks. When I went in yesterday I took a list of questions and my mom with me. He actually took the list and spent the time to go through all of them before I left. Also doing the research prepares you for what the surgeon might say. I knew going in he was going to tell me that I needed a fusion so when he actually said it I was not shocked or surprised at all. This really helped me deal with the fact that I was definitely going to have to have a major surgery. Right now it is another waiting game for the insurance to approve the procedure. However the surgeon felt that there was going to be no major issues since I had gone through all the conservative treatments already. I am probably going to have my surgery in 4-5 weeks. Definitely keep us updated on your appointment.

    Single level L5/S1 360 fusion with 6 screws and a rod (10/29/12)
    Diagnosis: Grade 1-2 spondylolithesis, Pars Defect, L5/S1 disc tear anterior and posterior, DDD, spinal stenosis
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