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L5S1 Posterior Herniation, Foraminal Narrowing and potential facet joint issue

MathesonMMatheson Posts: 1
edited 06/15/2017 - 11:26 PM in Lower Back Pain
Hello everyone! First time poster. Some background to start. I'm a 31 year male expat living in China.

I've been experiencing lower back pain since April of 2015. My injury occurred while running on a treadmill. I felt a brief, sharp, stabbing pain. Localized, no radiating pain. I was originally diagnosed with a mild muscular strain, given a week's course of anti-inflammatory drugs and recommended acupuncture - which I begrudgingly tried without improvement. The pain remained but was bearable; limitations being, inability to run, jump or move too quickly in general. After 2 more months of this without change, I visited a second orthopedic in a different city. He requested a CT scan which confirmed a very small posterior herniation at L5S1, with some disk degeneration at L4L5. A month later, an MRI would confirm his diagnosis. He prescribed more anti-inflammatory drugs and rest. I didn't experience any change but again, I could walk without pain, sleep relatively well and swim, sluggishly at best. Sitting for short periods was also bearable. And standing seemed to be the most comfortable position. What remained was a small spot of pain in the centre of my lower back. The vertebrae also felt tender to the touch.

Things took a sudden and egregious turn in November of 2016, when, while showering, I felt a sharp stabbing pain at the L5S1 begin to radiate all over my lower and thoracic spine. It was excruciating and required immediate medical attention. I was taken to the local ER. I couldn't walk without extreme pain. It would take a couple of minutes to walk a couple of meters. However, no position provided any real comfort. Again, the doctors gave me some painkillers and a course of IV steroids to be taken over 3 days. I remained in bed for 4 weeks with little to no movement, save for going to the bathroom. After this sedentary period, I returned to work and moved around gingerly at best. 

By early January 2017, I was able to walk with a degree less pain but my original condition had certainly worsened. In February, I began, for the first time, to experience pain in my buttocks and hips. The pain at this point was perpetual with no relief found in any position. I'd describe it as a growing, dull, ache with occasional shooting pains down the left leg and some mild numbness in the left foot. By mid March, it was near impossible to walk - akin to the November 2016 breakdown. Having recently moved to a new city, I saw a new orthopedic who recommended an new MRI. This latest MRI confirmed some change to the herniation (only 7mm L5S1 posterior herniation) and increased narrowing of transforaminal canal. The doctor recommended rest and anti-inflammatories, claiming the condition wasn't too serious and a full recovery would occur within a month.

Things didn't quite work out that way, and having taken one week off work, I returned with limited ambulation. Sitting, standing, walking and even lying down is difficult now. I sleep about 3-4 hours intermittently per night if I'm lucky. My employer has kindly allowed me to use a yoga mat next to my desk for stretching and lying down. I take advantage of this everyday because sitting and standing for 9 hours is tedious and painful. I began a physiotherapy program in March which ended after 12 weeks(recently). There was little to no improvement to my condition. We experimented with flexion for the first 5 weeks and then transitioned to extension with almost no change to the original pain level. I continue to stretch my psoas muscle daily along with child's pose stretching. Has anyone with similar symptoms had any success with this treatment path? If so, would you recommend any helpful exercises?
I haven't been out socially since early February of 2017. This community abstention hasn't helped. I feel like my condition worsens with every passing week.

Yesterday, at the suggestion of a new orthopedic, I received my first Medial Branch Nerve Blockers. She believes my facet joints are locking and causing a lot of pain in conjunction with the herniation. There were a total of six injections along both sides of the spine. Anesthetic and steroids were used. I don't feel any different almost a day later, but I'm aware of the slow acting nature of the steroids so I'm keeping some room open for the hope of mild improvement to my symptoms.

I know that was a lot of information to digest, but I'm interested to hear from anyone who finds themselves in a similar situation, either pain-wise or timeline-wise. I've recently, looked into an Endoscopic foraminal disectomy. Has anyone had any experience with this sort of treatment? I'm desperate at this point. I tear up at the thought of going out for dinner, a walk in the park or a six hour night's sleep. If you have any questions, feel free to ask. Any advice would be appreciated.
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Comments

  • Hi Matt,

    According to your description of injuries, I have more or less the same injuries. I now live in Canada and am trying regenerative medicine but prior to that I was living in Shanghai's xuhui district. I lived there for three years with a disc herniation and here's what helped me the most.

     I went to a traditional Chinese hospital  - they call them zhongyi (中医)and saw a doctor there that massaged me every week.  He treated me with deep tissue massage, acupuncture and cupping. In addition, he made me do some physio work to strenghten my lower back and glutes.  The massages were brutally painful but they helped a lot.  I also went to mangren anmo (Blind Massage) two to three times a week after work to relax my back and that helped keep me function and off pain. The time commitment bothered me at first but then I started bringing my kindle and reading while getting massaged. It helped a lot. 
  • Also, do explore other alternatives than surgery. There's PRP etc that may possibly help you. 
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  • memerainboltmemerainbolt IndianaPosts: 6,057
    Hello Matheson

    Welcome to Spine-Health

    Please click on he Welcome link below as well as the System Tutorial for more information.

    Welcome to Spine Health

    All new members should take the System Tutorial 

    As far as time wise and pain, yes I've been through the same thing. Over 4 years of trying anything and everything (beside surgery) to find a little relief to get my life back. But you can't give up. If this does not help let her know as ask for other options.

    Hang in there and keep us posted.
    Sandra
    Spine-Health Moderator
    ---------------------------------------------------------------
    Please read my  Medical History
  • Thanks everyone. I've looked into PRP - the efficacy of the treatment doesn't seem too strong. That said, I'll give it a shot if it's available here in China. Sellaia, did you try PRP in Shanghai?
    Thanks for the recommendations. Unfortunately, massage tends to make the condition much worse.

    I don't feel much of a difference since having the medial branch blocks, but it's still only day four.
    Having the facet joint issue, along with stenosis and the herniation makes it difficult to balance flexion and extension exercises. I never know which path to take. From what I understand, stenosis requires flexion and posterior herniation needs extension. Any advise on balancing the two without hurting oneself?
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