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It's been a while

AnonymousUserAAnonymousUser Posts: 49,321
edited 06/11/2012 - 8:39 AM in Lower Back Pain
Hello everyone,
It's been quite some time since I've posted last. A little about myself :

L3-4 partial annular tear posteriorly
L4-5 focal full thickness annular tear posterolaterally on the left associated with a disc herniation in the inferior neural foramen
L5-S1 full thickness annular tear posterocentrally and to the right of midline associated with a disc herniation with right S1 nerve root encroachment. This is associated with a disc bulge. There is mild neural foraminal encroachment bilaterally.

I've tried every conservative approach available to help with the low back pain. I finally saw an awesome spine doctor who recommends I have a microdiscectomy. I'm not really sure what to do. I still get around OK and work everyday although I do have chronic pain. I also have tingling in my left calf and foot. I am up for a promotion to the investigations bureau at my dept. and think that I may have to decline because of the back issues. I am so down about the whole thing. Thanks to all for listening and for all the insight you provide on this forum.


  • So sorry to hear what you are going through. It must be very disappointing to have to make such a big decision. I hope you get the promotion but understand why you would have to turn it down.

    I got my license to sell life, health and accident insurance 3 months after my surgery as I was doing very well. I was hired to work for Mutual of Omaha and so excited to be a part of that company. Then things took a turn for the worst and I had to decline the position. I never got a chance to even sell 1 policy. I've been on disability ever since.

    I hope that things work out for you and that if you do have surgery, that you heal fast and are able to accept that promotion at a later time.
  • Thanks for your response Ming. These are very tough decisions, At my Dept these types of promotions don't come by very often and if I decline then they will just move along to the next candidate and that will be that. It's a tough pill to swallow and it's something I've wanted for a long time.

    On a positive note my Doc is very competent and was recognized by castle conelly as one of my tri state area's top doctors. I am very happy with his treatment thus far. I just hope he could help me.
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  • of surgery unless you are risking permanent nerve damage. Surgery holds no guarantees and some are even worse afterwards. But if you are risking permanent nerve damage you may want to follow your docs advice sooner rather than later. Good luck and please keep us posted.
  • I wouldn't say that I am an advocate for surgery either. I think that's what has me in such a quandary. I've read many post op posts that were horror stories. But, like you point out, there is also the possibility of permanent nerve damage so...what do you do?

    My pain isn't so debilitating at this point that I can't get up and go to work everyday but, I also have pain and some tingling all day long. Can I tolerate it for now? I would have to say yes but for how long? I really don't know, I'm very much down about the whole thing. I miss being active and I really miss running. As I'm sure it has with most here, it is really affecting my job and just when opportunities are coming my way. I'm also in the Reserves and I will have to get out next year because of this. Sorry if I sound like I'm whining, I've always been a hard charger. I guess that's why this has me so down. Thank you all for listening.
  • Can you give a bit more details of "every conservative measure" if possible?

    This board is loaded with folks who have tried just about everything possible so they may have some additional ideas. Also what type of Doctor is recommending the surgery?

    Also you have quite a bit going on in that lumbar area. Did the doctor tell you exactly how he was going to do as you have several issues.

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  • Hey js,

    Ok so I'm not quite sure what precipitated the whole back problem. anyway i first noticed the back pain in 2005. i went to a chiro and got no results. back then I didn't have the tingling in the calf or foot just some burning in the glutes. I explained that to my doctor and he suggested I see a colleague of his who was a pain management doc. I had an mri and found I had some herniations as well as some facet issues. We went ahead with a series of epidurals which helped me but I was still having some discomfort so the doc did some facet joint blocks. a that helped so i had a rhizotomy (sp). I felt pretty good for quite some time after that. I had aches now and then but not bad. sometime in late 07 I started having back pain again but this time the burning in the glutes was worse and it went down the leg to the foot. I went back to a pain management doc and had the mri again. Herniations were worse so we went with epidurals again. I was still having pain so she also ordered a discogram which showed what I described in my previous post. I also had another set of facet blocks and rhizotomy done. my pain management doc said that there was nothing else they could offer me that surgery could be my next option. i went to see an ortho that specializes on spinal surgery had another mri and an emg done. the emg showed that there was an issue with the nerve in the left leg and what he concluded that for now we relieve the pressure on that particular nerve which is being irritated by l4-5. I know I have a host of other things going on to include the facets and some arthritis. Thanks for listening js

  • I think the only avenue I haven't taken is to see s physiatrist. I'm not sure that with the injuries that I have that that will help but I also don't know everything that a physiatrist offers. I guess it's something to consider
  • You definitely did do all the right things and it would seem exhausted all the PM could do and with the spinal specialist recommending surgery this would seem your next course of action.

    I am usually not an advocate of surgery but given all you have posted and the chronic pain I would probably have the surgery. Also the later MRIs showed that you were getting worse. If there were signs of improvement I would say even if the pain is still there I would still hold out with conservative approach.

    Now that you explained the doctor is trying to focus on the irritated nerve it makes sense. I would just worry given all the other issues would that be enough. But it is a logical approach and makes sense.

    I would ask question though to the doctor.

    1) What is the likelihood that now I have permanent nerve damage that this has been stewing for a while.

    2) How long for recovery?

    3) Last I would ask the likelihood the chronic pain would stop. Just freeing the nerve may not be enough and it will take time.

    Last I would also see an NS to get one more opinion and if you feel the pain is not that bad but I would see another PM and maybe physio. This really comes down to the amount of pain you are in as it seems your current PM has no further answers and your meds are not working.

  • Hey js,

    I don't remember asking about permanent nerve damage but I did have an EMG done and from what I understood, there was definitely some nerve issue but it didn't seem that bad. Also my tingling in the calf and foot isn't real bad, it doesn't prevent me from walking or getting around but I do feel it all the time. I do not want it to become a permanent issue that's why the consideration for surgery

    I did ask about recovery time and doc said that it's different for everyone but for this type of procedure he likes his patients to be out of work for 6 weeks and then start PT. He said that people have felt great after 2 or 3 weeks and gone back to work depending on what type of work they do but, he still wont order the PT until after 6 weeks.

    I also asked if the chronic pain would stop and he said that there are other things going on in my lower back so we would have to take it one step at a time so he wants to start by taking care of that particular area and moving on to the next if need be.

    In the end, I guess I need to do something before i do enough damage do need a fusion. I may need one anyway 5-6 years from now but if I can avoid it for a while I'd like to. Thanks js
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