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Degenerative Disc Disease - 25 year old

Good Evening-

Approximately 3 years ago I started with Sciatic Pain.... down my left leg but it was manageable. I saw the chiropractor who told me my L5 disc was slipped and it was definitely sciatica. Well, I kind of dealt with the pain but noticed the pain intensifying (after a rear end car accident in 2010) and then over the last 4 months I have been noticing the pain getting progressively worse and numbness going down my leg. I recently saw an Orthopaedic Surgeon on 10/2/12. He did an X-ray and sent me for an MRI. He put me on Medrol, Tramadol and Meloxicam. I stared physical therapy and got the MRI on 10/12/12. Today I went to get the results- the report shows a large left posterior paracentral disc herniation projecting into the left lateral recess and left foramen, encroaching upon passing left S1 nerve root and exiting left L5 nerve root. Additionally, a high-grade left lateral recess intermediate to high grade left foraminal. Further, L5-S1 level degenerative diseases, spondylolisthesis left-sided spondylolysis with left lateral disc herniation causing left lateral recess and left forminal encroachment. The surgeon placed me on Hydrocodone instead of Tramadol and told me to continue to Meloxicam, and physical therapy as well as get an epidural steroid injection treatment plan. Then, surgery is almost necessary if all doesn't work.

I am only 25 years old and he said "you have significant back problems for someone your age"- has anyone else had a similar problem? Any advice as I go into this treatment?

Olivia Douglass
Olivia Douglass
MIS TLIF L5/S1 on 5/1/13


  • I am sorry to hear about your pain.

    You may wish to read my history on my profile (rather than repeat here).

    Unfortunately, unless you can get your nerve de-compressed via conventional methods (such as what is recommended on this site and recommendations such as given to me by my consultants, weight loss, advise in books, get a good physiatrist, what has been recommended in past by other members based on their experience, etc), you may end up with surgery and a long recovery period. Hmm, I know this sounds grim and extreme, but if you read up on what people have said in this forum, you will understand potentially what may occur and does occur to many people. Knowledge is power. Educate yourself, take control.
  • natannnnatann Posts: 66
    edited 10/17/2012 - 2:47 PM
    I was your age when I had my first surgery. What has helped the most over the years was physical therapy, traction, and Pilates. You might have to have surgery, but doing therapy is the most important part
    When I was doing my pt& Pilates I had a good 4 years with DDD without having any major episodes of pain and rarely had to take any med's.
    Note Please keep in mind that what works for one person may be harmful to another person. Never to anyone's suggestion in terms of treatments and/or exercises without first discussing it with your doctors and getting their approval. This is VERY IMPORTANT

    Spine-Health Moderator Team
    99/00 L4/5 & L5/S1 herniation
    2001 L5/S1 microdisectomy age 25
    severe DDD at surgery level
    2011 pars
    2012 RFA L/3/4/5
    7-02-13 L4/5 l5/S1 360 fusion ALIF PLIF
    DX spondylitis , DDD, scoliosis, and slight kyphosis
  • Good Morning!

    Thank you both for your response! The pain is almost debilitating at times and I am continuing physical therapy but they are being very cautious as there is extreme damage. The thing that gets me the most is the numbness and shooting pain that happens at random times. I go on 11/1 to see a physiatrist for a consultation to determine if I am a candidate for epidural steroid injections (although with the recent spinal meningitis outbreaks I am very nervous). I am also continuing the meloxicam in hopes that my pain may be relieved.

    I will browse through the forums to see what others have experienced. As for possible surgery I assume that it would consist of a spinal fusion? Not just a laminectomy?

    Olivia Douglass
    MIS TLIF L5/S1 on 5/1/13
  • Hi Olivia.
    What surgery would be offered would depend on what the doctor perceives is the root cause and surgical familiarity / expertise. Insurance considerations. Potentially quite a few things. Much of this is discussed in the website articles. You may wish also to read up on artificial disc too. Fusion reduces mobility and puts more stress on adjacent disc/s.
    In the meantime, your pain level sounds bad. Can you discuss / update your surgeon with your current pain rating and ask how he/she approaches managing pain?
  • Thanks again for your response. My pain level is more manageable than the numbness that I experience down my left leg. I am going to the pain management doctor on 11/1 for the consultation and then will follow up with the surgeon if the steroid injections don't work. I would rather not get surgery but at this point in the condition it is all so frustrating and I just want it to be better. I guess we shall see.
    Olivia Douglass
    MIS TLIF L5/S1 on 5/1/13
  • Is indicative of nerve damage. The concern is that it may lead to permanent nerve injury.

    Your surgeon / PM can order a EMG study to quantify the nerve and muscle impacts.

    Muscle motor function can be affected; resulting muscle weakness, atrophy and permanent stretching of muscle.

    One may have to weigh up the relative risks of potential nerve damage from surgery vs potential damage of ongoing nerve compression. This is a discussion you should have with your surgeon/s. Get more than one surgical opinion.

    Hopefully the nerve root block injections will reduce swelling and nerve compression.
  • odouglassoodouglass Posts: 264
    edited 10/25/2012 - 7:59 AM
    I have been taking my Meloxicam on a regular basis and do notice a decrease in pain traveling down my leg, but the numbness is still present all the way down my leg and is rather annoying and catches me off guard. I was wondering about nerve damage, since it has been going on for so long. I am currently going to physical therapy (which I begin to question the necessity) and I am unable to do much with my left leg (cannot straighten it when laying down, etc). I feel like I have a lot of unanswered questions- but then again the doctors are trying all that they know to see what works. I just wonder if the physical therapy is actually doing any good for me?!
    Olivia Douglass
    MIS TLIF L5/S1 on 5/1/13
  • Other than the spondy your MRI sounds alot like mine and so do your symptoms & progression. In my opinion, you should not worry about the shots too much. If people are still getting bad medicine there is gonna be some big-time lawsuits out there. I also have followed your treatment pretty closely. Mine was chiro then ESIs and finally a microdiscectomy in sept. Recovery is slow and frustrating 7 weeks post-op. But even with bumps in the road I am wayyyy better now than before surgery. I do feel as if I treated the disc past the point of it getting better, but do not regret trying everything I could pre-surgery. Also my insurance would not approve surgery without seeing a non-surgical roadmap.

    I have alot of posts on the subject, look to those for further details if you like. Ths website & forum is a great place to research!

    Good Luck!
    L5S1 REMOVED herniation. Years of pain & compression. Microdiscectomy complete!! Trying to be super smart & safe with recovery!
  • I'm 31 and I'm having the same issues now. I was having the shap leg pain going thru my thighs. They would go and come. But now since I was going to physical therapy for my cervical surgery it have put more pressure on the lower part. Now my low back pain, buttocks pain and leg pain has gotten worry. I just had cervical spine surgery 3 mths ago. Still haven't recover from that. I went to the doctor 10/17/12 and now they talking about lumbar spinal surgery. I'm scared for the injections because some people was dying over of them, because some had fungi in it. I feel like into you g for all of this. My uncle told me right after I got my first surgery, once they cut on you, you would need another. Three months later he was right.
  • I seriously feel your pain, I am only 21 years old, and have had now over a years worth of PT, chiropractic care, aqua therapy, TENS units, and all conventional methods, I recently just recieved my first Facet Joint injections, I have 5 herniations, plus DDD, and Schuerermanns, and Mild Scoliosis, but the injections honestly think it made my pain worse, and my next step is surgery as well.. Best of luck, I feel you.
    Anna Renner
  • Hi Olivia,

    Sorry to here about your pain. I definitional support the comments about treatment - Pilates, physio, chiro, acupuncture - they all have there place and they can all offer some value. See what works for you.

    I first saw signs of DDD in 2002. Through some pretty long treatment I manged to put off any surgery until 2011.
    On my blog http://l5-s1fusionrecovery.blogspot.com.au/ I have all the scans up since 2002 and you can track the condition over time.

    I have had also 2 awesome years since my microdiscectomy, then a relapse, I have a PLIF on Friday for the L5-S1 level. I know I'll be working hard on the recovery!!

    Prevention is th ebest, but sometimes surgery is necessary!!

    Good luck
    PLIF L5 S1
  • Good Morning-

    I have my appointment with the pain management doctor tomorrow about steriod injections, I am quite nervous as I know the current situation with spinal menningitis from these shots. I also am apprehensive as nothing has worked thus far and I am on the road to surgery. Physical therapy is hurting more and more each time I am there, I told them this and they are being more gentle!! I will let you know how my consultation goes tomorrow. When the spine doctor says "you have significant back issues for a 25 year old", you kind of cringe.
    Olivia Douglass
    MIS TLIF L5/S1 on 5/1/13
  • odouglassoodouglass Posts: 264
    edited 11/09/2012 - 4:02 AM
    Good Morning-

    So, the pain management doctor's appointment went well. It was a long wait but he explained my MRI and my conditions more in depth. He also did some tests on my left and right legs and said that my left leg actually failed all of them. He then had me sign a waiver for the steroid injections and I left. His surgical assistant called me yesterday and scheduled my injections for 11/16, 12/7 and 12/28. She said the Wednesday before the hospital would call me to tell me final details, what time to arrive and all. I am nervous as I am not sure what to expect- my husband is taking me there and back. Any tips or ideas on what to expect during and/or after? Thanks!
    Olivia Douglass
    MIS TLIF L5/S1 on 5/1/13
  • I had extreme excruciating pain due to being positioned on my tummy which, for me, was a position that compressed the L5/S1 nerve. (One time i fainted due to pain). And once they have you positioned, you aren't allowed to move. So make sure you are positioned as best you can before they start.

    After a couple of real bad ones, I talked to the surgeon and he got morphine provided for me before going in and i also asked for oxygen which helped prevent fainting. I rememberthat there sometimes was a bit of pain when the steroid is put in as it pressurises the vicinity around the nerve until it diffuses into the adjacent area.

    Having said that, with the 4th one, I recall that it was over and done well before I expected. So the morphine and oxygen must have worked a treat and i prossiby had a quicker doctor that time.

    Hope all yours goes like my last one.
  • Hey Olivia,

    I also am 25 years old, and currently suffering from sciatic pain. My MRI results are as follows:

    At L5-S1, there is a broad disc osteophyte complex with superimposed left paracentral inferiorly migrated extruded disc which impinges upon the left S1 nerve root in the lateral recess. Also demonstrated is facet disease with mild foraminal narrowing.

    In other words..... THIS SUCKS. I am an active person and this is really an impediment in my life right now. My symptoms started 10/7/2012. I have been going to the chiropractor and doing some pool excersices. I have also been taking collagen (2000 mg) a day. Today, 11/14/2012, I can say that I have been improving. My biggest issue is sleeping at night. I cant find a position that works. Currently, I am on the floor. Last night, at about 3 am, I woke up in pain. I got up, iced it for about 5 minutes, then went back to sleep on my stomach. I woke up a little sore, but not nearly as much as other days. Again, Im writing all this to you because I am in your same situation. I'm a young guy and don't want this to affect my life. I have promised myself a total life change as soon as I get better. By this I mean doing Yoga regularly, Pilates ect..... whatever works. Personally, the chiropractor is helping me. Surgery for me is my absolute last option. I wish you the best and will keep everyone posted with my recovery.


    I WILL Beat This
  • So, I had my first injection today! Besides waiting for 2 hours as they were running behind, it could've been worst. My blood pressure was high but that was due to nerves I bet. Well, the pain was excruciating when he injected the corticosteroid in- it was like a lump of pain that would hit all down my leg as then numbness took over! I am in pain now and home taking it easy. I sure hope the other 2 aren't this bad and I get some relief!
    Olivia Douglass
    MIS TLIF L5/S1 on 5/1/13
  • Was it an ESI (epidural steroid injection) or a nerve root block injection?

    They often inject a diagnostic anaesthetic as well as the steroid. The diagnostic anaesthetic portion provides fast pain relief by anaesthetising the nerve which confirms that this location is the pain generator.

    So did you get this portion? If so, did it confirm pain generator source?

    Do you have any new numbness, especially on or under your foot?

  • According to the paperwork it was an ESI. I guess I got that other part- it was severe pain when he injected the steroid. I have worse pain and a little more numbness than I did before.
    Olivia Douglass
    MIS TLIF L5/S1 on 5/1/13
  • Hope the pain settles soon for you. You didn't go there to get more!
  • He also put me on a medicine called Nortriptyline for the tingling and numbness that I started last night. However, today the pain is a little different and more severe than before the injection. I talked to the surgical center this morning and she said that it is normal for some people (especially those with nerve damage and an inflamed nerve) to experience more pain on the 1st but that the 2nd or 3rd might calm it down. Anyone have a similar experience?
    Olivia Douglass
    MIS TLIF L5/S1 on 5/1/13
  • Ms PixieMMs Pixie Posts: 154
    edited 12/04/2012 - 4:03 PM
    Hi Olivia,
    Just wanted to share my 2 cents from having had many ESI's over the years due to cervical herniations, ddd and a damaged nerve. From my experience an ESI's can hit very differently from time to time. If you have a lot of inflammation around the nerve going in to the procedure, it might hurt a bit when they inject the steroids and you might hurt for a couple of days after. Right after the procedure and for x amounts over hours you will still be a little numbed up from the anesthesia they mix in, and the next day when that is gone, there is a chance that your nerve is irritated from the procedure and reacts by firing off a little more, upping your pain. Not that often has it helped me with just one injection, I always have more benefit after a second and a third injection. So, eventhough you might feel more pain after the first injection, dont shy away from a 2nd and 3rd - the nerve will most likely calm down. Maybe not completely, it seldom does if something is there pushing on it (herniations, bone growth, scar tissue), but perhaps enough to give you temporary relief to get through PT, work, exercise etc. In my case, injections did just that - gave me enough relief to function for about 4 years, until nothing helped anymore and I had my cervical 2 level fusion. Once they opened me up, they found large bone spurs that was damaging the nerve and no injections could have taken care of that in the long run.

    Injections are many times used for diagnostics as well. If it helps, it will tell the doctor what target area might be the problem and what nerves might be affected. Not all things show up clearly on x-rays and mri's. Not all my bone spurs did, and had I not had surgery in the end, I would have lost most of the use of my left arm. I am now 7 months into recovery after surgery and its too early to tell if I have permanent nerve damage in the arm, but its way better than before surgery and Im still healing.

    Good luck with your continious treatment! If surgery is suggested, ask for more than one opinion and proceed when you know that you can live with that decision regardless of the outcome. But also have in mind that sometimes surgery results will be greater if less damage has been done rather than more, going into it. Once a nerve is severly damaged from being compressed too long, not even surgery might be able to correct that completely.

    All the best,
    Cause: car accident & genetics
    Effect: herniations C4-7, stenosis, osteoarthritis, myelopathy, neuropathy
    Non-invasive Treatment: everything under the sun
    Invasive Treatment: 2 level ACDF, C5 & C6, May 2012
    Moving Forward: SCS
  • How are you traveling now? Has the pain reduced?
  • Thanks for checking in- I appreciate it. I had my 2nd injection on Friday and was quite anxious/nervous this time as I knew what the expect. Well, that caused my blood pressure and pulse to be high (again) so now I have to monitor that at home and talk to my PCP about possibly putting me on blood pressure medicine- sure hope that isn't the case as I am 25, not overweight but it does run in my family. The 2nd injection itself didn't seem to hurt as much during but my left leg was completely numb for 20 minutes after the procedure so I had to wait there longer. Pain level has gone down but I still see the inability to do things I used to be able to- bending, reaching, etc.-without pain or getting 'stuck'. He added me to take Gabapentin for the nerve pain along with the Nortriptyline and pain killers.... just waiting to see what happens with this BP and pulse along with the new medicine that he gave me. 3rd and final injection is scheduled for 12/28 and then after he will assess me a few weeks later to see where to go from here.
    Olivia Douglass
    MIS TLIF L5/S1 on 5/1/13
  • Hi Olivia.

    good to hear that the pain after the first injection abated with time.

    How's the numbness in the leg now? What was it like prior to 2nd injection? Have you searched here for other people's experience with Gabapentin? Some find it good.
  • odouglassoodouglass Posts: 264
    edited 12/27/2012 - 12:50 PM
    I actually had to stop taking the nortriptyline as it was making my moods VERY bad! :( I am not really taking the gabapentin either as it did the same! I am going tomorrow for my final injection and hoping that I get some more relief. I thought the pain had subsided at least some but today it is back.... usually in my leg but now in my lower back.
    Olivia Douglass
    MIS TLIF L5/S1 on 5/1/13
  • I remember only being 11 or 12 when I first started feeling sciatic pains :(
    My first discectomy was in 2000 when I was 19 so unfortunately it can start very young.
    However, some can successfully get past sciatic problems without suffering again for many years, so please don't feel that all is lost yet.

    Best of luck
    2 level Discectomy 2000 open surgery
    L4/5 Discectomy & L5/S1 Laminectomy 2005- (Cauda equina) open surgery
    5 x joint injections 2012
    Discogram Dec 2012
    Dec 2012 - 360 Lumbar Fusion L4 -S1(BMP), Disc replaced L3/4, Bilat trocanter injects
  • Hello-

    Sorry for the delay in posting again, life has been busy. I am done with the three epidural corticosteroid injections and experienced some minor pain relief. However, I did see the orthopedic this morning and he checked out my leg movement and recommends me to see the surgeon to at least get a consultation. He said that with me being 25, a laminectomy or discectomy might be the best right now, and then perhaps a spinal fusion in the future. The pars defect is one that they like to catch earlier, but since it is all done and the damage is done, a brace may not help. He also told me that I can get another round of injections in 6 months, but if they aren't working, why keep getting them. My consultation with the surgeon is Feb 27th! :(
    Olivia Douglass
    MIS TLIF L5/S1 on 5/1/13
  • Finally got in to see the neurosurgeon and the news was that surgery inclusive of a discectomy and TLIF is inevitable. Due to my age he was little hesitant but also very encouraging that I should get it done. He stated that the recovery period was at least 6 weeks and that I should get it done sooner than later. I am a little bummed and nervous- I really, really, really wanted to have kids soon (we dont have any yet) and was working to save leave up at work for that (the Government does not offer paid FMLA) but now this surgery may delay that option. Also, I only have 2 weeks of leave on the books at this time, which makes it hard to get anything done surgery wise! :( The pain and weakness of my left leg is insane, he said that it is really weak and he would recommend it sooner than later. I really did like this doctor, and do think that he would do a GREAT job... just nervous about the whole thing! :(
    Olivia Douglass
    MIS TLIF L5/S1 on 5/1/13
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