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Possible Surgery--good or bad?

About a year ago, I began having excruciating low back pain whenever I was on my feet (standing, walking, whatever) for more than 5-10 minutes. I had to leave my job because I couldn't perform my duties. I waited a few months and then saw my GP. She guessed it was from me being so heavy (300 lbs on a 5'4 frame) and sent me to physical therapy.

Being out of work, I could only afford to go to 2 or 3 sessions before I had no gas left in my tank and no money to buy any more. I continued to do the exercises they had given me, and also looked online for other exercises. No effect.

About a month later, I got my student loan refund check and filled up my gas tank--I visited the chiropractor. He took an x-ray and told me I have something called a transitional segment on my L5 vertebra and sacrum. If I understand correctly, this basically means that the bones are fused together at the end, when they should not be. It is a congenital thing. He did electro-ice therapy (where patches were put on my lower back and low levels of electricity went through them while I sat against an ice pack) and then he did the manipulation on me. I went three times and it did not help, then I was unable to go anymore, again because of no gas in my car and no money to buy it.

I went back to my GP and told her that, at my mom's request, I was going to go see a spine surgeon. She ordered an MRI of my back, so I took the MRI and the X-Ray with me. He told me that I had a bulging disc, but nothing that warranted surgery so he was 'not sure why I was there'. He told me, pretty much verbatim, that I need to ignore the pain as best I can and learn to live with it. He said I need to lose weight. I was so shocked that I was literally stunned into silence and unable to tell him, but I can't even stand--it's very hard to exercise when you can't stand.

My GP then sent me to a pain management doctor. He looked at my MRI and said, yep, you've got a transitional segment and a bulging disc. He told me will develop arthritis in my back within the next 20 years. He said that any walking on a hard surface will irritate the nerves. Then he said, I see that you've already tried therapy and the chiropractor, so we're going to give you steroid injections, and if those don't work, it'll be surgery.

Well, the injections did work. The first session, he gave me 3. The second session, two weeks later, he gave me 6, because I told him I was experiencing very intense sciatica after the first round (which I was). The back pain is much better, but now I get bouts of intense hip/back/and leg pain, even if I'm just lying on the couch.

He guessed that the injections will work anywhere from 6mos-1 year. But I'm afraid to go out and get another job, because if I wake up one day and the shots aren't effective any more, I'll have to leave the job or get more shots. I don't want to get constant steroids, I've heard that getting a lot of those is very bad for you.

Frankly, I want to tell him that I want to go ahead and get the surgery. I'm 23, relatively healthy besides being heavy--I feel like I will recover from it, and have less risk of complications, now when I'm 23 instead of waiting till I'm 40 or something. Also, like I said, I'm afraid to get a job because the shots could stop at any moment. He said that any walking on a hard surface (and what isn't hard?) will hurt my back more--how can a person function? I'm terrified that it'll become herniated merely from doing activities or daily living. I feel that surgery, even with all its risks, is the best way to go.

Can I just get some others' experiences? Even if they're not exactly the same, just hearing I'm doing the right thing would be great. Or even hearing I'm doing the wrong thing, because that would help me analyze the situation in another light. Thanks all.


  • Hopefully someone will come by and have more input than I. I have not had surgery so I can not comment on this. Bump

  • PaulPPaul Posts: 730
    edited 05/17/2013 - 6:01 AM
    Well, I just want to chime in here and say "thank you." You taught me something new. I never have heard of a transitional vertebrate. I had heard of auto-fusion but never transitional.

    re: weight. I took a culinary course and I learned how to cook. Now, most of my plates have a protein, a vegetable or two, and maybe a starch or a carb. I avoid using unhealthy cooking methods, unhealthy dishes, and also addressed the portion sizes I was consuming as well as the times of day I was eating. I switched to drinking water only. Since then, I have lost 25 lbs. I think my back is happier with me because of it.

    I remember when I was in pain. I could not stand up straight or walk much. No way was I able to exercise or do pt. People kept telling me to do pt but they had never experienced back pain themselves. It was frustrating.

    I would avoid chiropractic adjustments. Some swear by them, but I swear at them.

    Just curious, what specific surgery are they proposing for you?

    On the sunny and mild Central Coast of California

    L4-L5 endoscopic transforaminal microdiscectomy June, 2007
    L5-S1 endoscopic transforaminal microdiscectomy May, 2008
  • kenpo1980kkenpo1980 Posts: 18
    edited 05/17/2013 - 12:03 PM
    First, let me give you my background. I herniated my L4 and L5 discs about two and half years ago doing crossfit. I initially met with an Orthopedic Surgeon and his initial recommendation was pain management with Vicodin and about ten sessions of PT and one steroid injection. This all actually seemed to work and I had a period of almost a year with almost no back pain whatsoever and I even lost thirty pounds through working out.

    About six months ago I started to notice my back pain, and the sciatica, coming back with a vengeance. My first time around I barely even touched Vicodin but this time I was in so much pain that I was popping about six pills a day and I could not sit for more than five minutes. I went to my ortho again, we did the MRI and when the results came back he said I needed to get a microdisectomy, which is a procedure in which they remove the disc material pushing on your sciatic nerve. I had the surgery done by a neurosurgeon almost exactly a week ago and I feel pretty awesome other than a bit of stiffness here and there.

    As to your situation, first, like Paul kind of said, I would generally avoid chiropractors at all costs unless you find a really good one. My opinion is that any internal back issues need to be worked on through legit PT and if you just have muscle back pain you just need a good massage. Some may disagree but that's my opinion.

    Secondly, if any doctor told my I had a bulgiing disc and asked me why I was even there I would run for the fricking hills. The fact is that this is one of the most common reasons people see spine surgeones and there job is to help you make the best decision regarding getting rid of your pain - most of the time this is PT and some pain management medications to get you throught the process but sometimes surgery is the only answer, as it was with me. When my neurosurgeon went over my MRI it was really clear why PT was not going to do anything about my bulging disc.

    Also, my Ortho told me he rareley does more than three steroid injections. He said that if you need more than this you probably need surgery and you have already had a lot of these. I guess every doc is different but it seems like a bit much to me.
  • I would recommend that you try to find a job that has medical benefits. A doctor could give you pain patches to wear while at work, then take the heavier meds to get you through the night. Perhaps the company would even offer short and long term disability. If you could make it through a year of work, you'd be well set up for any surgery that you might need.
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