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Newly Diagnosed - Lots of Questions

Hi All,

I have been experiencing varying levels of low back pain and some right leg numbness for 6+ months. Pain is made much more extreme by standing still for any length of time. Sleeping has also become a problem - I can only lay for 4 hrs max, then the pain becomes to extreme to sleep through and I have to get up and walk or stretch before I can go back to sleep. If I curl into a ball it does help. Leaning forward is the only way I can control the pain once it begins. My job entails mostly standing and driving an average of 1500/2000 miles each month. Standing longer than 5 minutes has become so painful that it began impairing my ability to do my job. So after hoping for a muscle strain and trying to ignore the problem, treating with heat and NSAIDs I went to the chiropractor about 3 weeks ago. I am a 37 year old female, I am extremely active - working out daily and am physically fit. The Chiro took had me do some flexion tests and took X rays. No problems with any of the flexion tests, in fact bending forward is the only way I can find any relief from my back pain when it exacerbates. Chiro assured me he could take care of the problem, but pointed out that L5 showed some degeneration on the X Ray. At that point I requested a consult to a neurosurgeon. My mother has congenital spinal stenosis, that began in L5 - she had her 1st surgery at 28. Her mother also had a lifetime of back problems. I am seeing the same Neurosurgeon who has been treating her, as I thought his familiarity with the family history would be beneficial.

MRI Results:
At L3-L4 - Minimal disc dehydration. Minimal diffuse disc bulge and facet arthritic changes causing trace thecal sac compression.

At L4-L5 - Disc Dehydration without loss of height. There is diffuse disc bulge and ligamentum flavum thickening causing mild to moderate thecal sac compression. Minimal bilateral inferior recess narrowing

At L5-S1 - Disc Dehydration without loss of height. A tiny annular fissure/tear is noted. There is a minimal diffuse disc bul

I have an appt. with the neuro on March 25. I saw the Chiro 3 times - each time the pain was worsened by the manipulations. I went from only really hurting when I'd been standing over 5 minutes or driving for an extended period to constant low level, dull pain. After the 3rd manipulation the pain was much worse upon standing and at rest. So I called my GP to see if she could give me something to help until my appt. with the Neuro. My GP (whom I've been seeing for 14years and have never asked for any kind of pain medication or seen for much more than well checks) treated me like a criminal. She read the MRI and said it was completely normal for someone my age and she saw no reason for the Neuro consult. She said I would be the healthiest patient he's ever seen. She prescribed a Steroid dose pack - which has helped and finally gave me Tramadol after I told her how much Naproxen and Tylenol I was taking every day. While I can still feel a dull ache and standing still continues to exacerbate my pain - I am able to sleep at night and have been able to work again.

So I guess my main concern is of course being scared - I have spent my entire life watching my Mother live with debilitating pain and problems from Stenosis. She has now had 8 surgeries, none of which have really been succesful. My GP made me feel totally belittled and like a drug seeker for even coming to her office. I do realize some degeneration is common in the late 30s on and most people do have some bulging discs. Am I panicking for nothing - is this a normal MRI for a 37yr old of normal weight? I kept the neuro appt. - told my GP that is why I carry insurance, so I can see who I need to see.

What are your thoughts? Opinions? Am I overreacting and just running scared.


  • I think you made a wise decission to keep your neuro appointment. You do have a family history of back issues, you are concerned because of the pain, you have tried some conservative treatment (chiro which was probably not the right treatment for you, but the surgeon might be better able to sort that out). I do think/hope there are still appropriate conservative treatments that can you some needed relief (physical therapy, aqua therapy, even ESI injections which sound bad but aren't and do give people lots of relief). It is true that our spines usually decline with age, they don't just "heal themselves". I think you are wise to try to get some control over it BEFORE it gets so far you can't work or enjoy life. Although I respect your MD's suggestion that you do not need to go to a specialist, in the end, your concern/pain should warrant a consult at minimum. Plus clearly your GP was unable to solve your pain. It was unprofessional and callus for her to say that about your being the healthiest patient he's ever seen. I'm also very sorry that you were treated that way over pain medicine. If you have NEVER asked for something like that in 14 years, then you'd think your GP would be happy to write a medicine to help with pain/sleep temporary until you could turn your pain over to the surgeon or to a pain clinic. Hang in there... You are doing the right thing to get the consult. Let us know how it goes!
    33yo mom of two. My surgical history...preadolescence scoliosis, kyphosis, and a hot mess.... 5 spine surgeries and lots of items added I wasn't born with (titanium, peek, surgical steel). Guess cremation is out. TSA loves me.
  • Thank you AllMetal, I appreciate your taking the time to answer my concerns. I know I am more than likely overly concerned, but I also know that my pain levels are increasing and interfering with my daily activities. I was completely taken aback by how I was treated by my GP - and I told her as much. I started with the Chiro, hoping to treat the problem without medications. I had used the same one several years ago when my cervical spine was messed up after 3 wrecks in 6 months. He did a great job and isn't one who wants you to come back 3x week for life. I also like that he is willing to recommend 2nd opinons with medical providers and refer you on if he thinks it's in your best interest - my referral to the neuro was given by the Chiro. I am intersted in hearing what the Neuro says - he interprets his own MRI results and has requested the disc - be intersting to see if he sees the same thing as the Radiologists. I am not really interested in surgery if at all possible to avoid. I much prefer to find other ways to to help treat and control the pain. I have read some about aqua therapy and certain yoga exercises that can make a difference. However, at this point I'm going to wait until after my appt. with the Neuro to do much. The Chiro did want me to continue seeing him and I may go back for massage and the tens unit - but I'm not going to let him manipulate again until I talk to the Neuro. I took my 3rd dose of Prednisone today and I can tell a differance. I am hoping once I finish it maintains and I don't bounce right back to where I was before.

    And most importantly I am going to be looking for a new GP - I work in the medical field, I have been a good patient and have never given her any reason to treat me the way she did. Even when I went in with a questionable fractured hand I turned down pain meds for prescription naproxen.
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  • I have nothing against chiro, I think the right chiro who is well trained can really be a huge benefit to people with certain types of pain, and it is a conservative, non surgical option that I'm glad we have. However, just like you wouldn't be seeing a gastro doctor for your spine, I do think they are spine issues a chiro should NOT address and I think you are smart to wait and discuss this with the neurosurgeon first. I think the massage and TENS unit would still be safe and could give you some relief as you wait. I'm glad the prednisone is helping and I do think you need to find another GP.
    33yo mom of two. My surgical history...preadolescence scoliosis, kyphosis, and a hot mess.... 5 spine surgeries and lots of items added I wasn't born with (titanium, peek, surgical steel). Guess cremation is out. TSA loves me.
  • i too am a 37yr old with a recent history of back problems. your mri sounds very similar to my initial results. i would advise keeping all your traditional medical appts eg neuro & gp. but ask them about using alternative medicines in conjunction. they may conflict and give you more problems. talk to all your practitioners, ask as many ?'s ask you can, be open to all treatment options, then take time to decide, dont rush into anything. especially if u are in pain - rushing just to try aleviate your symptoms. you can read my history in my recent post titled cauda enquina syndrome help.
    v boardman
  • backache99backache99 Posts: 1,313
    edited 03/11/2013 - 11:08 PM
    i know what your mother is going through i am now 46 and have had back pain since i was 30 i was lie you very fit and active .i am now crippled with intractable spinal pain following 3 major spinal operation and many years of painful pain clinic procedures ..you may be experiencing pain now and i am sure you feel bad about it and you life is it as good as you want it to be .BUT trust me it gets so much worse .i am so bad with pain that i can't wear normal clothing i need to wear shorts as i can't stand anything on my legs due to over sensitivity and damaged nerves .i have had 3 operations and the last one was ALIF that a fusion where they go in through you stomach ..that was 14 months ago .i now spend my life on my recliner taking pain killers oxycontin and oxynorm i sleep for 2 hours a night and i am in awful pain 24/7.my advice to you is see a spinal consultant and get some medical photography done ..from what you have said your back is not as bad as you think it is ..thrust me it can ..and most likely will get a lot worse hold of on surgery for as long as its safe to do so then make sure you have the best operate on you ..you in for a hard time ..read as much as you can about procedures and feel free to ask any questions many of us are long standing back patients with years of knowledge and will help if we can
    good luck
    1997 laminectomy
    2007 repeat laminectomy and discectomy L4/L5
    2011 ALIF {L4/L5/S1}
    2012 ? bowel problems .still under investigation
    2014 bladder operation may 19th 2014
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