Hello all - I'm looking for some suggestions/thoughts on what option(s) to try next for hip/leg/foot pain stemming from L5/S1 herniation.
A little bit about me:
I'm 32, problems started June 21, 2013. I bent over in the shower and felt a tearing sensation in low back, super intense back pain (ended up on floor, couldn't get up). I was a very active person - fitness instructor, worked out 1-2 times per day, ~16% bodyfat (I'm a woman), great ab/back strength. Saw the Dr that morning, no pain below knees so he called it muscle strain/aging. Breathing, walking, living was very painful until late Sept/early October of that year.
By 10/2013 it settled down a bit so started working out more again. Had another incident of searing/tearing type pain in low back, and went back to the "I can't move anything" type of feeling. This lasted several weeks, eventually faded, I went back to working out, and the whole cycle happened again, and again, or about quarterly until 3/2015.
In summer 2014, I gave up "class based" (bootcamp/aerobics, that type of thing) and started doing yoga, which often makes things worse. I also did ~3 months of chiropractic, no effect. By late 2014, starting a family was on the horizon so I went back to my Dr. Again, he said 'aging' and that an MRI would be a waste of $, so he sent me to PT. I saw the PT from 1/2015 - 5/2015. She suspected an annular tear. In April, we decided the treatment wasn't helping, pain had migrated to calves and left foot, back pain subsided a bit, and I went back to Dr who finally ordered MRI in 4/2015, results are copied below:
At L5-S1, there is a left paracentral extruded disc herniation. The herniated disc projects 6 mm posteriorly and 6 mm superiorly, deforming the thecal sac and displacing descending nerve roots on that side. The superior portion of the herniated disc may be an extruded fragment. The AP diameter of the thecal sac centrally measured 14 mm. There is no evidence of foraminal stenosis.
I saw a neurosurgeon, who said either surgery or injections were valid options. Since I am youngish, he thought injections might be worth a shot, but to I was welcome to call him back if they do not work. Since then, I had a interlaminar ESI on 6/3, which gave 2 weeks of relief, and 4 days ago I had a transforaminal ESI. I did not feel the same sensation of the nerve numbing/tingling this time that I did last time, so I'm afraid it will not work.
I'm wondering what to do if this last ESI is not effective. Lots of people who have surgery describe their pain as being around an 8-10 all the time, and I'm definitely not there. My pain levels vary quite a bit, and some days I don't feel horrible. Other days I end up crying in my car at lunch or leaving work to lay down. I'd say overall my pain levels are 5-8 in a normal week, with 5 being you can ignore it for ~30 min and 8 being in tears. I also have a lot of numbness down the outside portion of my left leg, and an increase in muscle spasms When the pain is worst, it's on the left side, but when it subsides I also feel it on the right.
I'm afraid if I go back to the surgeon, he'll tell me it's not that bad and I should have been able to deal with this, much like my regular Dr has told me several times. At the same time, I don't feel like I'm giving my employeer a fair shake either, b/c I'm definitely not able to put in (at a desk job) 100% effort for 40 hrs a week. I'd say I'm closer to 28 hours of productivity per week - not horrible, but far from ideal. I've basically given up the active life I once had and greatly enjoyed, so I don't feel like I can modify activities too much more to fix this.
Long story short, I'm 32 and would really like to have already started a family by now, and would like to find a way to resolve this sooner rather than later, but I'm worried my case isn't bad enough to warrant surgery, though nothing else has fixed it yet and I don't feel like doing nothing is an option I can live with. Any thoughts/suggestions of what to do are greatly appreciated. Thanks for reading. Welcome to Spine-Health
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