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What is happening when I sleep?

Hello. A brief background: I am a 43 yr old female. I injured my back about 20 months ago, while shoveling asphalt millings at my home. Since that time, I've tried every conservative tx there is to avoid surgery, from chiro & PT to ESI (x5) & rhizotomy (x2). I've also just completed a package of sessions in Traditional Chinese Medicine (included acupuncture, homeopathic injections, cupping, & moxibustion), which I wish I had tried sooner because I think I am too far gone at this point. Recent MRI showed "significant worsening," which I am guessing is due to an unstable L5. I say "guessing," because the neurosurgeon who diagnosed the L5 instability told me that it can make an existing herniation worse, but also said I should "exhaust all non-invasive measures" first. So here I am, with a herniation that has changed from 3mm to 9mm at L5-S1 (central/left paracentral) effecting the thecal sac, compression of S1 nerve root, "moderate to severe narrowing if the left paracentral aspect of the spinal canal," & "narrowing of the proximal left neural foramen." MRI also says "Modic type degenerative type signal changes at the endplates," but doesn't say what type (I.e I, II, or III), so I don't know what that means. My dependence on a cane is increasing, especially first thing in the morning & then later at night. My question is this: what is happening when I sleep? I mostly do not move during the night because it causes pain. When I get up in the morning, the pain is nothing short of pure hell & I can barely walk on my left leg. Last night was the worst! I got up at about 4am to use the bathroom & it felt like I had been attacked with an ax to my lower back and left leg! I usually sleep on my side, with a pillow between my knees or on my back, with a pillow under my knees. The pain is always excruciating when I get up, but why? My back & leg have been at rest, so why is there such an increase in pain? I can understand the increase in pain in the evening & later at night, if I have been up & around (trying to work as long as I can & I have a young child at home), but don't understand the middle of the night & morning level of pain. I'm scheduled to see neurosurgeon on 8/19 for consult. I've been calling to check for cancellations, but am told 8/19 is the soonest available. Most days my pain is never lower than a 7, but frequently hits a 10 late at night, first thing in the morning, moving from sitting to standing, getting in/out of car, or just slightly shifting my weight the wrong way while sitting or laying. If something brushes the back of my thigh or just under my buttock, it triggers severe pain in buttock, hip, and length of leg to foot. Also started to have pain around ankle and bottom of foot. Lately, I've started getting stabbing pain like a cord is wrapped around upper thigh & through groin area. Anyone have any ideas or suggestions? Thank you, in advance, for any help or insight you can offer.
8/28/14 Discectomy, Laminectomy, Foraminotomy L5-S1
9/15/15 Surgical Debridement of infected surgical incision & drain seroma; wound vac applied
10/21/14 L5-S1 Osteomyelitis & Discitis; 10/23/14 Bone & Tissue Biopsy = MRSE


  • My guess would be osteoarthritis. When you lay or sit in one position for an extended period of time you get stiff and it hurts like h---. If you have enlarged facet joints they cause the arthritis in the joints of the spine, I know this due to my own personal experience. I pray you get some relief soon. I have been struggling since 2011 and am still trying to get some relief.
  • sandisandi Posts: 6,343
    edited 08/12/2014 - 4:53 AM
    until next week, you may want to ask them to put you in a short notice cancellation list.......I know you said that you have called repeatedly about getting in sooner but it is worth a shot.
    As far as the worsening symptoms go when you are laying down, and then attempt to get up the shifting of the vertebra is probably the cause. Even laying straight at night is going to tighten the muscles, then when you attempt to sit up and or stand, the vertebral alignment shifts.
  • Thanks Worried & Sandi for your replies. I had asked previously about a short notice cancellation list, but they said all I can do is call on Monday mornings to check for cancellations. The dr has a great reputation, but the front office staff are not very helpful. Not sure if I have what would be considered enlarged facet joints, as that has not been mentioned to me before. I do know that last rhizotomy was mid-March & facet nerves at L3-L4, L4-L5, & L5-S1 bilaterally were burned, so I am surprised at the severity of the pain I'm having, which seems to be getting worse every day. Thanks again for your help & I hope you both find relief soon as well.
    8/28/14 Discectomy, Laminectomy, Foraminotomy L5-S1
    9/15/15 Surgical Debridement of infected surgical incision & drain seroma; wound vac applied
    10/21/14 L5-S1 Osteomyelitis & Discitis; 10/23/14 Bone & Tissue Biopsy = MRSE
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