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I'm not quite sure whether this is going to help but worth a try! Sorry about the length too!

I'm 26 year old female. At the end of February this year I leant forward to pick up an item but was hit with debilitating pain from my back but through my legs and arms. I presumed I'd just pulled something but when I couldn't walk, sit down or reach up to get my phone I realised it was worse. I was taken to hospital and spent a night there as I was unable to stand up for them to assess me (due to pain) the next day my reflexes were checked, all ok and I was told to be on my way. I visited the gp 2 days later (Monday) and was told that it was likely I had pulled something and just to get on with it. I asked for a referral to a spine specialist as I luckily have private health insurance and felt that something wasn't right. The pain continued in my back meaning I walked funny and very slowly to try and ease the pain slightly. I then had an appointment with a neurosurgeon who referred me for an MRI, this came back as me having an annular tear and degenerative disk disease. I don't know the names of the disks but of the bottom four disks the tear was at the top, the next one down is ok an then the last two are "black" when it was explained they should be white when healthy. I was told I'd have to make lifestyle changes and hopefully the tear would heal. I had an epidural injection which gave me no relief from the pain again still across my lower back. I was then referred for IDD traction which again didn't do anything. I had visited a physio in between who gave me simple core strenghening excersizes but was reluctant to offer any more work due to my pain levels. I then questioned visiting a chiaropractor and the neurosurgeon said it was worth a try. I had been back at work for 2 weeks still in pain, using a TENS machine to get through 4 hours and then laying in bed for relief when I got home. I visited the chiropractor twice and after the second visit with some spinal manipulation I was in agony but it was now also down my legs a type of burning and pins and needles pain. Needless to say I didn't go again! Another MRI was done with no change noted. I then had a spinal block injection and another epidural, I had some relief for about 3 days but then back to "normal". I was told the only option left was surgery as I continued to have pain in my back when sitting, walking and continuous uncomfortable pain in my buttocks/hips/legs. An MRI was done done of my hips/pelvis and showed mild inflammation for which I had more injections. The pain has continued and I was told again only option is surgery. Two options were given one through my stomach and inserting fake disks (again I don't know the technical or medical terms for any of these!) or through my back and putting metal pins and a type of cage. The only problem is that I have these 3 black disks and he have little hope of relief or a "cure" as they wouldn't be able to operate on all three - it would be "chosen" which one or two after a discography. I was unsure about these surgery options so have been to another neurosurgeon who has said that he can see minimal signs of an annular tear but can see a slight disk herniation and repeated the ddd and black disks which is where he said the problem lies in terms of treatment. He has now referred me to see a pain specialist and the physio will come with me to this to put together a plan for me.
Basically I just feel confused by all of this! I can't work (didn't go back after being off for another injection) I find it difficult to go food shopping or anywhere else that needs walking round. I am still walking funny and very slow which drains me! I don't know whether I will always be like this, whether I will find a treatment to ease the pain and then I can go back to work, whether I should just have surgery and then see what happens and if I'm still in pain then nothing lost (except half a year of my life!) all in all I'm just confused!!!
I take cocodamol and ibroprofen (can't take any stronger pain killers as they make me sick) I can't excersize due to pain levels...I can't even walk far. I have an aching pain in my back if I sit too long (15 mins) continuous pain down my hips and thighs. Sometimes I have shooting pains down my thighs and sometimes down to my ankles. Sometimes I have cramping shooting pain across the left side of my lower back. More recently I have been getting a tightening type pain higher up my back that can make me feel like I'm winded and can last 15 mins - usually when I am walking (or trying to!)
I have never been very good with pain and so I have questioned whether I am just being a wimp and should get on with day to day things through the pain but have been told that the injections should have stopped this and the pain doesn't match with my MRI's

I'm not sure what I'm expecting in terms of a reply to this...but here I am!
Thank you


  • http://www.spine-health.com/forum/announcements/spine-health-announcements/welcome-message-resource

    First, I'm sorry that you are in pain.......but there are a few things that you might want to read and learn about. DDD ( or black discs) is a normal occurrence in human beings over time. Anyone over the age of 21 or so is going to have some or many discs that show signs of loosing their hydration. It is a natural process since the discs don't have their own hydration system. There are degrees of degenerative disc disease, and at your age, it is most likely very, very mild.


    An annular tear is a tear in the fibrous material that covers the disc.....from what your doctor said, he can see minimal signs of one....http://www.spine-health.com/ask-a-doctor/back-surgery/treatment-options-annular-tear

    Some of the pain that you are experiencing may be muscular, and physical therapy may improve it over time, however, it is normal for the pain to increase a bit, until you get those muscles working again.
    Muscle relaxers might help to ease some of the muscular related pain, and I would avoid allowing anyone to manipulate your spine.
    Rest is good for a very short time, but the worst thing that you can do, is to lay in bed or sit too long......walking , in moderate amounts is the best way to avoid aggravating your back . Stretches and other excercises provided by the physical therapist , and perhaps investigating different types of injections , and other therapies would be my suggestion before considering surgery. You want to give all of the other options a fair trial before undergoing surgery, if it is at all possible. Seeing another surgeon for another opinion might be a good idea as well.
  • Thank you for this. I am seeing the physio and pain specialist next week for a plan to manage the pain. At the moment if I am struggling I will lay on the floor for around half an hour (unless I fall asleep!). Obviously this is not possible if I am out although I have been very tempted to whilst food shopping and whilst in town once! I'm also worried - will I be able to get back in to work. If I find something to manage the pain now will I still have to keep having time off if it flares up or if I have to keep having injections?
  • It depends on how severe or not that your ddd is.......most cases of ddd can be managed with conservative measures, meaning physical therapy, injections as needed or recommended, regular excercise, and of course stretching and strengthening.
    At your age, if the condition is mild, it may flare up from time to time, but with the proper conservative treatment, and using over the counter remedies to manage an occassional flare up when it first occurs, you should be able to resume living your life .
    Anti inflammatory medications may be needed once in a while to ease any inflammation but other than that, you can manage the symptoms with a few modifications to your activities, such as not doing things that you know might cause it to flare up.
  • dilaurodilauro ConnecticutPosts: 9,839
    Sandi is correct.. Only the most severe cases of DDD will require surgery.
    Most of the time, approved exercise programs and over the counter NSAIDs can help manage DDD.

    I've been dealing with DDD and various stages of spinal stenosis for over 25 years now. Sure there are times it gets to me, mostly in the morning, or getting up after sitting a while... But for the most part I have managed it.

    You have youth on your side, so that approved exercise programs will probably be more involved than for someone my age.

    Personally, I dont see the need for injections, but thats only my opinion, your doctor is the only one you really need to listen to. Over the years I have had so many different types of spinal injections but never for DDD. The ESI's can help with herinated discs. But its hard for me to say what is your biggest problem The herniated disc or DDD?
    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
  • I guess I am stuck at that point as no one has done any physical therapy due to my pain level. Also at the moment I can't work out what makes it worse or better (apart from laying down or being asleep!) have you been able to work whilst dealing with your problems? What does ESI mean? That's what I've been told too, it's not clear what is causing the pain so could operate on a black disk and it I wasn't where the pain was coming from!
    I've no idea how severe it is but I have been told that the injections should have done more than they have and that my problem lies in the fact I have problems with three disks in that area
    Thank you!
  • that contains a steroid, and lidocaine, and the injection is commonly used to treat and reduce inflammation and swelling. Sometimes the injections work and at others they don't......Some doctors prefer to repeat the injection at least one more time to see if there is better results using a different approach.
    There are all types of spinal injections, depending on the problem that the doctors are trying to treat, so if one type of injections doesn't work, they may suggest another.
  • Has anyone suggested trigger/pressure point injections? I've had both types Lidocaine & Botox with steroids & if I ice straight after they allow me to start exercises & stretches to manage the problem of muscle spasms. I'm talking about the 'simple' injections that they do straight into your muscles not the more complicated, guided ones around your spine.

    I've been dealing with a variety of different spine problems over the years. When I'm at a stage where it's hard to figure out what's causing my pain levels I've found that using the really concervative things, TENs machine, trigger injections, massage, airomatherapy, medications (all at the same time) to manage the 'other' (muscle, inflammation etc) pain...followed by physio, physical therapy, aqua etc. has made it easier to get to the root of the underlying pain. I hope this makes sense?? ;-)
    Sometimes my reactions to the core pain are actually more debilitating that the damage itself. Sometimes managing the damage makes all the other pain go away but if your specialist can't be completely certain of what the pain generator is it could be best to manage the symptoms first.

    Sometimes they use the other injections as diagnostic tools. My doc always says that something that doesn't work tells him just as much as something that does. I would never have surgery until the pain generator has conclusively been identified. Surgery should never be guess work!
    Osteoarthritis & DDD.
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