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Please help. Opinions needed

Darren35DDarren35 Posts: 4
edited 02/04/2014 - 2:46 PM in Chronic Pain
I have had varying amounts of lower back pain for two years. Some days bad, some days not bad. I have had steriod injections and radio frequency ablation and neither worked.

My question -by looking at my signature is the degree of damage I have sound like a surgery might be needed. Or does it not sound that bad compared to what others have? I know my pain, but I don't know much about my diagnosis. Have appt with neurosurgeon on March. 3.

L5-S1 Moderate Sized central disk herniation. Degenerative loss of disk space height.
L4-L5 Small central disk herniation
L3-L4 mild diffuse disc bulge
L5-S1 Moderate Sized central disk herniation. Degenerative loss of disk space height.
L4-L5 Small central disk herniation
L3-L4 mild diffuse disc bulge


  • dilaurodilauro ConnecticutPosts: 9,859
    Welcome to Spine-Health and how to get started

    It is a forum violation for any member to provide another member with a diagnosis of any diagnostic tests. However, that being said, there are some rules of thumb I have always applied

    Mild Problems that can cause discomfort, but for the most part can be treated by Physical Therapy and other conservative methods.

    Moderate These problems are more defined that the mild ones and can disrupt your day to day life. Many times, a combination of Physical Therapy, other conservative treatments and a blend of medications can help manage this situation. Hopefully, at this level you can do all the things you are suppose to do, listen to all the limits and restrictions given to you by the doctor and avoid surgery. But as in life, there are no guarantees.

    Red These are the conditions that normally require surgery to correct. This does not mean that surgery is mandatory, but you need to understand all the pros and cons of your condition and what the doctor(s) recommend.

    I always strongly recommend that patients need to try all the various conservative treatments if not once then twice, before thinking about surgery.

    However, only your doctor can tell you for sure, if surgery is required now vs later. Generally, a doctor would want to have the surgery done sooner, where there are nerves involved. When a disc situation is impinging on a spinal nerve root, you will probably experience sciatica pain. But beyond that, when nerves are involved, you would not want to wait too long before having that corrected. When nerve damage goes untreated for a period of time (I cant say what that period of time is, because it will vary from patient to patient and from condition to condition), there are chances that a person may permanent nerve damage

    When it comes to surgery, talk this over with your doctor, your family and loved ones. Spinal surgery is a very personal and important action. You need to understand all the Pros and Cons that come with the spinal surgery.

    I am not a doctor, so what I am about to say is only my personal opinion. Based on what you provided, I do not believe surgery is needed at this time.
    Ron DiLauro Spine-Health System Administrator
    I am not a medical professional. I comment on personal experiences
    You can email me at: rdilauro@veritashealth.com
  • Any thoughts?
    L5-S1 Moderate Sized central disk herniation. Degenerative loss of disk space height.
    L4-L5 Small central disk herniation
    L3-L4 mild diffuse disc bulge
  • Have you tried other treatments..physical therapy etc? Not all things improve with age & back problems are definitely not like wine or cheese! I know that when you're in pain your priority is to get the pain to stop but I try to remember that things can get a whole lot worse & a great physical therapist can really help you strengthen your body & limit any further damage.

    I hope it goes well on March 3rd. Surgery is a HUGE step. I hope that your problems can be managed with more conservative measures. Please keep us posted.
    Osteoarthritis & DDD.
  • None of us is qualified to give you an idea about whether or not surgery is necessary. That decision is made by your surgeon after his review of any imaging studies, his physical exam of you, and review of your symptoms. The usual steps are given below in the link at the bottom of my post. You might want to read it , so that you can understand what the steps to getting treatment are and when they tend to occur.
  • Im3uedIIm3ued Posts: 5
    edited 03/04/2014 - 5:16 AM
    Darren, It may not be the consensus of online pain forum populations, but try to accept that for a long time now, it's been widely recognized that spine surgeries of all types, not just fusion/fixation, are being performed way too often.

    May I suggest about finding an advocate? Find an old retired hospital RN or an old, retired surgeon, no longer living where he practiced. It should be easy. They can give you a lifetime of anecdotal wisdom.
    You are the only person who should decide about the "necessity" of surgery.

    A few of the pertinent factors would be:
    Your age. Your weight. Your financial need to remain working.
    Are you working still? Can you possibly remain working with this pain and it's associated misery?
    Do you believe, after these two years, that most radiating nerve pain causes diminish with time?
    Are you being compensated for your spine injuries or unemployment? Is it enough?
    Can you accept this?....that your "signature" of spinal diagnoses, images of disc herniations, even if they show nerve root compression, do not translate to severity of pain. Many millions of people in this country are walking around, no spinal symptoms at all, and their MRI's would show lots of severe herniations, bony compression of nerves,
    If a chiropractor, osteopath, or other practitioner told you that you should become a master at fulfilling your work and family roles WITH this pain, could you accept that?

    I'm sorry about your long two years of pain.

    Post edited to remove doctor bashing, this violates forum rules

    Post Edited by Liz The Spine-Health Moderator Team

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