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Pain for the rest of my life?

I'm only 28 years old, and somehow managed to nearly completely herniate my disc between my L4-L5 (may have something to do with having degenerative disc disease and lumbar stenosis, but almost a complete disc herniation at my age?). Timing was rather awkward, and by the time I was able to have an MRI, surgery was emergent as the herniation was practically obliterating my spinal cord. I was experiencing weakness and numbness in my legs and feet, and severe pain in my buttocks and legs. Both the spine surgeon and the neurologist expressed their astonishment at the size of the herniation (the worst either had ever seen), and that I was still able to walk, or at the very least didn't have Cauda Equina Syndrome yet.

I'm currently 6 weeks post-op, and my legs feel great, and the numbness is beginning to ebb away. However, I'm starting to feel pain in my lower back with the slightest movements. The doctor explained to me today that there's virtually no padding between the vertebrae now, so they're basically rubbing against each other when I move. He said that losing weight and strengthening my core can help manage some of the aggravation, but that I will basically be dealing with back problems for the rest of my life now.

Maybe I should be grateful that I'm not paralyzed, but that seems like a rather ominous prognosis to have to look forward to for the rest of my life, one that I know will only get worse with age. Are there any other reasonable options to help manage this a little more proactively, so I don't have to live in chronic pain?


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    What kind of surgery did you have? If it was a discectomy, then I fail to understand if the disc was in that serious a condition, they didn't do a fusion at the level , to increase the space between the discs?
    If the vertebra were almost bone on bone, inserting a cage and restoring the disc space, and fusing the two levels together would have made the most sense.
    Depending on the type of surgery you had, and the recovery, you may or may not experience some residual low back pain, that may be related to the muscles. Strengthening your core muscles, regular excercises, stretches, all can help to ease muscle tension, and the use of muscle relaxers can help as well.
    6 weeks out is far too early to tell you that you will continue to experience pain, or what your ongoing status will be.
  • I had a lumbar decompression. I don't completely understand how this works...I do understand that a herniation is where the soft interior of the disc leaks from a rupture. So I guess if most of the disc herniated that the disc itself is sort of "deflated". But the doctor said quite plainly that there's no longer very much cushioning between my vertebrae, and the bones are likely to press against one another. At my two week checkup I had zero pain. It was the first time in YEARS. This pain started a couple of weeks ago, and compared to my lower back pain previously where it was difficult to sit for long periods and I had a quite obvious muscular ache when I tried to use the muscles in my lower back, now the pain occurs mostly when I walk or try to stand or anything that maybe jostles my back in the slightest bit, and it's not just that ache anymore. It's a sharper pain that's resonating from a centralized point right in the middle of my lower back.

    I'm assuming he didn't do a discectomy because the procedure was actually emergency surgery just to get the herniation away from blocking my spinal cord.

    Here's what happened. Basically I started off with serious lower back pain when I started seeing an Orthopedist. I've been in chronic pain for years, but had never had it that bad before. I asked if I could do some therapy to help learn how to manage it, so that's what I did for a few weeks. Then on a Sunday I woke up in such acute pain that I was just ugly sobbing, and had to wake my mom up (she and I live with and take care of my grandma) to try to do something to help me. She got me some Ibuprofen and ice and about an hour later I managed to get out of bed and she took me to the emergency room. By Wednesday my symptoms had completely changed to the leg pain, weakness and numbness, and no longer any pain in my lower back. I had already scheduled a lumbar epidural for Thursday because I was still in pain despite the therapy, and I was starting to get concerned about some upcoming traveling I was looking forward to. I called to try to talk to the doctor about the change in my symptoms, and was just told that the epidural should still help, so I went ahead with it. Then Monday I flew to Sacramento for a work conference, where it became abundantly clear that walking was incredibly difficult due to the weakness and the fact that I no longer had fine motor control in my feet. I used wheelchair assistance in the airports, and rented an electric wheelchair to get around at the conference. Walking did get a tad easier by the end of the week (I had to return the wheelchair at the end of the day to the convention center, but tried to do as much walking in the evenings so I could enjoy myself with my colleagues). I flew home on Saturday, had a follow-up after the epidural on Monday, at which point the doctor ordered an MRI because it was really the first time I got to see him since my symptoms had become so serious. I had the MRI late afternoon on Wednesday, and got a call around 11:00am Thursday morning, about 5 hours before I was supposed to depart for a trip for Ireland that despite my difficulty walking, I was still going to go to, damnit. But the doctor made it quite clear that he was really worried, based on what he was seeing in the MRI, that if I had gotten on a flight like that, that I would likely become paralyzed from the pressurization and swelling. After reviewing the MRI, you could see where a large, oddly shaped mass just took over the space where my spinal cord was. He said it was the largest disc hernation he'd ever seen, and that it needed to be evacuated immediately, that it was just a matter of time before I did start showing signs of possibly permanent paralysis. I was admitted to the hospital that night, and surgery done the following morning.

    So that might be why he didn't go ahead with a more involved procedure like a discectomy and fusion, but why that's not an option now if a fusion would help alleviate the bone-on-bone issue I have now, I'm unsure.
  • Sorry to hear about this terrible pain you've endured. I've had five herniated discs myself so I feel some of your pain. My personal opinion is to seek non-surgical options by talking to your doctor. You mentioned losing weight. Are you overweight? What's your diet like? Do you smoke? Smoking has been linked to back pain. Eating a healthy diet and keeping a healthy weight also can help ease the pressure on your spine too. I would strongly recommend taking supplement vitamins such as Fish Oil pills, Vitamin D, Glucosamine Sulfate and Magnesium. Those will help with the inflammation and will reduce pain over time. Glucosamine Sulfate was proven in a double-blind placebo controlled study to work (recommended by my spinal Dr.) and Fish Oil pills have been widely publicized about their health benefits.

    A fusion might alleviate the bone-on-bone issue, although fusions tend to only have a 50% success rate. I've confirmed this with multiple surgeons I've spoke with who advocated against them (and these guys are surgeons!)

    Have you looked into Platelet Rich Plasma (PRP) therapy? Or stem cells? Neither one is covered by insurance, but is something you might want to consider because it's cheaper, safer and the worst thing that can happen afterwards is that it doesn't work. To me, a fusion surgery is high stakes gambling: you might actually end up worse afterwards, but of course, discuss this with your doctor because I am not one. I have three friends who had fusions and the results are quite mixed: one has nearly no pain, one still has intermittent pain and his back goes out from time to time with trouble sleeping and the third is completely miserable, on a lot of pain pills and is about to have his 3rd surgery. Again, I'm not a doctor, so talk to yours about what options you have, including the non-surgical ones.

    Never quit and never give up.
  • I really appreciate having options. I guess the trouble I'm having now is the fact that my doctor basically gave me none, and just told me that I'm just going to have problems for the rest of my life. I've not looked into any other options yet, but now you've given me a list of a few to check out, so thank you.

    I am overweight, and have been all my life, but I've also been relatively healthy as well. I've always been active, and have tried to eat properly (I'm not even a fan of sweets or fried or fatty foods), I just have an eating disorder where I tend to overeat a LOT. I've actually lost over 20lbs in the past 3 months, which I started trying to do before my trips to help me feel a little better. I've never smoked. This pain prognosis is just really hard for me to swallow, because I am so active. I have a very busy and active lifestyle, and I do a LOT of traveling between work and pleasure. I feel like this is going to really put a damper in things, and already has. It's quite depressing.
  • Rossonero. I really agree with the message of your post but my research on a couple of the things you mention have yielded different findings so I just wanted to throw them out there (I hope you don't mind)

    Plasma Rich & Stem Cell spine treatments were something I really looked into. I had a consult in Texas. They were talking about injecting my discs. This 'therapy' is like having a discogram again & again & again. If you research the risks of discogram you'll see it does carry risks. My extensive research could find any positive outcomes but I did find a couple of people who ended-up having emergency fusions. I've decided not to go ahead with it now. I'm pretty desperate so as this becomes more common & I have more to base my choice on I might change my mind. It's an expensive, very painful option that does carry risks. I've been warned against it by my surgeon & PM. There could be the option of trying it around the bones but there's not great promise with that in spines. I have distructive arthritis with a lot of inflammation. I've been advised against that too.

    The second one is a little thing. I used to take glucosamine & condroitin. It was recommended by English doctors. It's no longer supported because its failed so many placebo studies. It was found to be less effective than placebo in one of the main research findings. It's completely harmless to my knowledge so if anyone thinks it helps why not carry on taking it? I'm finishing up my stash & then I'll decide if I'm going to buy anymore.
    I take the other suppliments you mention. Magnesium seems to make the most difference to my pain levels. I find a hot Epsom salt (magnesium) bath is an effective part of my pain 'rescue' routine.
    Osteoarthritis & DDD.
  • I am so sorry you are in pain! From what I've read here, if it were me I would look into a second opinion. Many doctors have thrown the book at me because they feel like I'm 'never going to get better'. I was discouraged just like you. It is a terrible feeling. I decided to find new doctors and holy cow did that make a difference! Yes, I still have pain, but I have hope! I have learned so much about my back and about myself over the past few months just by seeking other opinions.
  • Thank you, Sunny. I think my plan for right now is to do what my doctor told me (exercise and weight loss) coupled with some of the vitamin remedies mentioned above. I'm starting PT next week to get help with finding safe exercises to help build my core strength. The pain is not unbearable right now, but I know that it can get worse with time, and to hear that there's nothing that can be done about it is not kosher with me. Frankly that just rubs me the wrong way to hear from a doctor, so when the time comes, I will go somewhere else. At the very least he could have said that in the future there would be more options, not just that I'll have to deal with this for the rest of my life.
  • Okay, I understand a bit more now. It sounds like you had what is called a Cauda Equina emergency. This occurs when there is a herniation or other compression of the area where the spinal cord ( thecal sac) is positioned in the lumbar spine. Compression of those spinal nerves can result in permanent injury if left too long. It is a surgical emergency to relieve the compression on the cord/spinal nerves contained in the cord.
    It may be that because of the massive size of the herniation, that the objective was to
    remove the compression first, and that since then the disc has collapsed. If that is the case, then a fusion may be recommended in the future, or they may decide to allow the two vertebre to fuse together naturally, assuming that there is no nerve root compression from that happening.
    The pain and other symptoms may improve over time, as your body heals, and you were very lucky that your surgeon was able to remove the compression of the cord in a timely manner.
    If a fusion is recommended, he can insert a cage into the disc space, and bone graft, which would fuse the two vertebre together, making it one solid bone.
    If I can answer any thing else for you , feel free to pm me.....I have Cauda Equina twice, so I know what it does and can do.
  • I personally have herniated discs in my lumbar, and due to other problems I cannot get them repaired because it is more of a risk than actually trying to fix them would be. Due to this I have had to find alternatives to help with my pain and I myself have found that hot showers or baths with Epsom salts, along with muscle relaxers helps me quite well. However, I also take very strong pain medications too. But I was told that losing weight, due to the fact that I am a little over weight, would help. Also, I was told that due to the location in the lower back where the herniation's are, as well as the fact that in my case all of the discs in my lower back are fused together, basically, "crushed" together, that over time as I got older my pain would get worst and I would have more problems for life. I can not say in your case this will be true for you because I am not a doctor, however, I can tell you from experience dealing with things similar, since I am 27 and have been dealing with these problems since I was around the age of 12, that for myself, as much as I did not want to believe what I was told would happen, problems for myself have gotten worse as I have gotten older and the pain of course has gotten worse, and as much as taking muscle relaxers and hot baths and trying to, as hard as it is, to work your core muscles in your back and belly when a person is in unbelievable pain, that is really the only thing in my personal experience that has helped, well those things and like I said in my case I also take very strong pain meds. I hope that what ever happens in your situation that it all works out well for you and that you can stay as positive as possible, because it is my experience that the more down I get about my problems the worst the pain is due to stress.
  • So 7 weeks out, I've had my initial PT workup and was given homework to do since last Tuesday, and I'm hurting even worse right now than I was before my surgery. Granted I could barely walk due to weakness before my surgery and was still in significant pain, but now I'm feeling sharp pain in my lower back and in both of my hips. Standing up and moving pretty much at all are all agony. I just took a pain killer and muscle relaxer and I'm laying on a heating pad, and right now the pain has de-escalated to a dull roar. I don't tolerate narcotics very well as they make me extremely fuzzy and lethargic, so it's very rare that I go so far as to take anything for the pain.
  • I am constantly in pain. But my doctor suggested this new product which has helped ease some of my discomfort on the toilet. I purchase it on amazon a few weeks back, its called the "Raised & Easy Access Toilet Seat" by Royal Kare. They also have a website @ www.RoyalKare.com.
    It has really helped me in the bathroom, I highly recommend it.
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