Seeing a back specialist Monday

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couchtater
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   Posted 9/18/2010 6:40 PM (GMT -6)   
I'm seeing a back specialist on Monday who also has a Physical Therapist on staff. I was told last week my constant off and on back spasms was due to Digenerative Disk and Facet disease and Endplate Marrow Degenerative Signal. mad
 
I was wondering what is a visit to the back doctor like? Also, does Physical Therapy hurt much? How often do they require a person to see a PT? confused
 
Right now I'm not in much pain due to a soft brace I bought. When I'm on my feet for a long time without the brace I hurt something terrible.
 
I don't want to be on medicine all the time. I have many drug allergies so I try to avoid anything that's not tried and true.
 
Another question...
If a MRI report says "No significant Spinal Stenosis" does that mean there is some Spinal Stenosis, but it's not bad yet??? smhair
 
Sorry for so many questions. This is all new to me and I tend to obsess over the little things. rolleyes
Joy

White Beard
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   Posted 9/18/2010 9:32 PM (GMT -6)   
Joy
 
Yes that is pretty much what it means. But as we age just about everyone gets some spinal stenosis, some more than others, but usually everyone has a little of it.at different places in there back, but usually it is not enough to interfere with the spinal cord and cause pain or problems. It is a narrowning of the spinal canal  that can cause pressure to be put on the spinal cord or some of the nerves that comes off of it. It is usually caused by a bulging disk or a herniated disk, or oseophytes, which are bone spurs. Physical Therapy can do allot of things to help you with your back pain, and they might even have you do special exercises for your back to strengthen your back muscles to help take the strain off of your vertabra. They also use hot packs and ultra sound, both are usually very comforting. Age and  heredity are two biggys when it come to back problems, and also doing things that strain it allot. Improper lifting and that type of thing, that most everybody does!
 
Joy I wish you luck with your appointment with your back specialist monday!  I hope it all works out well for YOU!
 
White Beard
Moderator Chronic Pain
After spending nearly 22 1/2 years in the USAF, I retired in Sept, 1991. I then went back to school and became a licensed RN in 1994, and I worked on Oncology and then a Med Surg Unit, I became disabled in late 1999 and was approved SSD in early 2002!-- DDD, With herniated Disk at T-12 and L4-5. C5-C6 ACDF in Sep 2009, C6-C7 ACDF in Mar 1985, Osteoarthritis, Ulcerative colitis, Chronic Pain, Fibromyalgia, Complex Sleep Apnea, and host of other things to spice up my life!(NOT!) Medications:Oxycontin, Percocet, Baclofen, Sulfasalazine, Metoprolol, Folic Acid, Supplemental O2 at 3lpm with VPAP Adapt SV I am White Beard with a White Beard!

couchtater
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Date Joined Jul 2009
Total Posts : 14475
   Posted 9/19/2010 7:33 AM (GMT -6)   
Thank you, White Beard. I'd love to get this pain knocked out. I've dealt with what most people would call a "3" on the pain level for over 20 years. It's always there and to me it's tolarable. I wake up at level "5" every morning, but it fades down to "3" after an hour.
However, everyday for several weeks at 11:00am, I've been hit with spasms of a "10". I'll be walking along and one would hit me. It's all I can do to keep from screaming out in pain and collasping on the spot. I have to grit my teeth and hiss. My students will stop and wait for me until the wave passes enough for me to proceed. The pain will continue in waves until I can get home and put my feet up. Since I bought this soft brace the spasms are fewer and take longer to hit. I'm able to get through a school day with less pain.
I keep having this odd feeling in my left leg, a kind of numb tingle. It's like your leg fell asleep but it's at the end of waking up, but some tingle is still there. Is this familar to anyone? Sometimes it feels like it's dragging a little.
Joy

Screaming Eagle
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Date Joined Sep 2009
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   Posted 9/19/2010 7:56 AM (GMT -6)   
Hello couchtater!

To answer your first question on what you're first visit might be like,.....well we won't know for sure, but he will probably put you through some sort of movement test, and ask you several questions while doing so.

The PT can be uncomfortable, as they will want to push your muscles to the limit and give them a good stretch. It is very common to see these guys 2 to 3 times a week at first. Then, when you have been given the proper instructions for stretching to do at home, they may see you less often, as long as you are doing your homework assignments they give you.

If you are not seeing much improvement after several weeks of PT, then an Epidural may be suggested to you. A person can see quite a bit of improvement from this, but then again it will not help everyone.

Are you taking ibuprofen for inflammation? Many Dr's suggest this as well, along with the PT. Is the back specialist you are seeing a surgeon?

Take care,

SE wink

couchtater
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Date Joined Jul 2009
Total Posts : 14475
   Posted 9/19/2010 8:24 AM (GMT -6)   
I don't know if he's a surgeon. I saw his ad coming home one day and his name stuck in my head because of it sounding kind of odd.
When my MRI said what it said I started to go to a regular doctor for the usual pain meds and muscle relaxers. Then I remembered his name and decided it was time to see a specialist. I don't like ibuprofen because it slows down my already slow digestion. :P
Joy

Alcie
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Date Joined Oct 2009
Total Posts : 4978
   Posted 9/19/2010 10:16 AM (GMT -6)   
Hi Joy -
My rheumy says not to wear the brace because it allows your back muscles to deteriorate. We need to do the PT to strengthen them, which keeps back pain from becoming a vicious circle of pain causing us to stop exercising and lack of muscle strength worsening posture and causing more pain. I use the brace when driving over an hour, to keep the pain from getting so bad I can't function.
Alcie
 
 

White Beard
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Date Joined Feb 2009
Total Posts : 3689
   Posted 9/19/2010 10:50 AM (GMT -6)   
Joy
You said in your post:(" keep having this odd feeling in my left leg, a kind of numb tingle. It's like your leg fell asleep but it's at the end of waking up, but some tingle is still there. Is this familar to anyone? Sometimes it feels like it's dragging a little. ") this sounds like you might have nerve in your lumbar region that might be being irritated or having some impingement or something! Yes you definitely need to have this checked by a back specialist! Alcie is right about the back brace, I just would not wear it all the time, but just when you really need it. Definitely talk with your Doctor about using it.   Does your leg ever just go out on you when you walking? or do you have allot of charlie horses in that leg?  Just becareful!!! You really do need to get your back looked at by a specialist. 
 
I wish you all the best!
 
White Beard
Moderator Chronic Pain
After spending nearly 22 1/2 years in the USAF, I retired in Sept, 1991. I then went back to school and became a licensed RN in 1994, and I worked on Oncology and then a Med Surg Unit, I became disabled in late 1999 and was approved SSD in early 2002!-- DDD, With herniated Disk at T-12 and L4-5. C5-C6 ACDF in Sep 2009, C6-C7 ACDF in Mar 1985, Osteoarthritis, Ulcerative colitis, Chronic Pain, Fibromyalgia, Complex Sleep Apnea, and host of other things to spice up my life!(NOT!) Medications:Oxycontin, Percocet, Baclofen, Sulfasalazine, Metoprolol, Folic Acid, Supplemental O2 at 3lpm with VPAP Adapt SV I am White Beard with a White Beard!

Retired Mom
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Date Joined Feb 2010
Total Posts : 1753
   Posted 9/19/2010 11:08 AM (GMT -6)   
Hello Joy,
 
I logged on specifically to tell you about your leg symptoms and noticed that WhiteBeard had done exactly that.  The information the people on this site can give is amazing.
 
Also, concerning the brace.  My neurosurgeon, my PT, and my other Dr's ALL told me NOT to wear my brace any longer than possible after my fusion surgery.  I believe it was Alcie who mentioned about the muscles.  You DO NOT want to weaken any of your muscles.  You will certainly need to have strong muscles if they have to do fusion to stabalize your back.
 
The pain and "spasms" you describe are fairly clear to me from my own personal history.  Fusion stopped the nerve pain (kind of like electrical fire and 10+ pain shooting at the same time) immedately, so it was considered a success by the neurosurgeon, however, the bones did not fuse the way they were supposed to and back pain is a constant problem for me now. 
 
If you are recommended for surgery, please don't jump with the first surgeon they recommend unless that person is the absolute best in the field.  Fusion surgery is nothing to play with and can forever change your life.  Of course, a damaged/pinched nerve is certainly life altering too! 
 
Not everybody has problems with fusion surgery.  Many are a success, however, because this is a chronic pain site, there are more of us (statistically) who did not have successful fusions than the average person.
 
Best of luck to you!
 
(By the way, there is absoulutely no way to know what the apt will be like until you get there....I've found every "spine specialist" to be very different in approach and in procedures.....and it's the same with PT)
Retired Mom

spinal soldier
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Date Joined Dec 2009
Total Posts : 687
   Posted 9/19/2010 11:31 AM (GMT -6)   
hello, how are ya, Alcie and Whitebeard hit the nail on the head on two points: the brace does more harm than good in the long-run. your core stabilizer muscles are disengaged when it's on so they turn to mush. that in turn will make your problem worse fast. then the tingling/numbness in your left leg is a indication of a nerve involvement or radiculopathy. the spasms you are having are probably a symptom of the underlying problem. some "back-specialist" just see operation tattooed on your forhead and make sure you have a sure diagnosis before you start letting a PT manipulate your body. i would try to get a second opinion from a neurosurgeon. if you don't like taking any meds. you still can use things to reduce the inflammation such as: MSM [methylsufonyl-methane] is a sulfur compound with potent anti-inflammatory properties, evening primrose seed oil contains GAMMA-LINOELIC-ACID [anti-inflam.], quality Ginger capsules, bromelain [enzyme in pinnapple] is potent anti-iflammatory, turmeric, and for normal nerve fuction and nerve healing the B-vitamin Inositol and Choline can help. Calcium in the form of calcium chealate and magnesium in form of mag. chealate [make sure at least 1000IU of Vitamin D with it for absorbstion] can promote healthy nerve function calm muscle spasm and can help sleep. if you would like i would like to see your MRI report? best wishes: NICK
L4,L5,S1 bilateral Laminectomies, Foraminotomies 2002
L4-S1 PLIF with instumentation 2008,

current Rx: OxyContin 60mg 2x, Dilaudid 8mgs [brand] 4x p.r.n. brk., Phenergan 25mg 3x prn nausea, Lyrica 75mg 2x,Adderall 20mgs 1x A.M., Soma 350 mg 3X, Relafen 1000mg 1x, Klonopin 1mg H.S. or prn anxiety Supplements: CO-Q10 100mg, Vitamin D 2000IU, Fish-Oil1000mg EFA, B-Complex50 3x/day, GABA 750mg

couchtater
Elite Member


Date Joined Jul 2009
Total Posts : 14475
   Posted 9/19/2010 12:16 PM (GMT -6)   
I'm allergic to sulfur so I can't use MSM. I'm on thyroid meds so I have to avoid certain natural remedies, too. I've heard fish oil has anti-inflamatory properties.
I'm going to ask the doctor for some more natural ways to help me.

I take the brace off every night to sleep. Yesterday I put it on long enough to go to work for a few hours and go shopping.
When I woke up this morning I was hurting so I put it on for a couple of hours. I'm sitting here at the computer without it. I hadn't wore it since 11:00 today.
I want to get rid of it so bad. I'm willing to listen to the PT and do my exercises. I need to lose some weight to help the stress on my back, too.
 
Spinal soldier,
My report said:
No suspicious marrow lesions.
L3-L4:mild facet hypertrophy
L4-L5: Mild facet hypertrophy and tiny disk bulge. No significant disc herniation spinal stenosis or foraminal narrowing.
L5-S1: Mild facet hypertrophy and small disc bulge. No significant disc herniation spinal stenosis or foraminal narrowing.
impression:Degenerative Disc and Facet Disease of the Lumbar spine above most Affecting L5-S1 where Endplate Marrow Degenerative Signal may account for Focal pain.
No significant Disc Heriation Spinal Stenosis or Foraminal Narrowing.
 
 
Thank you, folks for your opinions and tips. I'll try to avoid using the brace tomorrow.
Joy

Post Edited (couchtater) : 9/19/2010 1:43:18 PM (GMT-6)


spinal soldier
Veteran Member


Date Joined Dec 2009
Total Posts : 687
   Posted 9/19/2010 1:43 PM (GMT -6)   
if your still in a painful situation and the brace helps you should probably wear it until your diagnosed and get with the physical therapist. if your like some herbal teas or extracts, the herbs; alfalfa, boswellia, catnip, chamomile, fenugreek, feverfew, and rosemary have anti-inflammatory properties and some like chamomile and catnip are tranqulizing. have a great afternoon.
L4,L5,S1 bilateral Laminectomies, Foraminotomies 2002
L4-S1 PLIF with instumentation 2008,

current Rx: OxyContin 60mg 2x, Dilaudid 8mgs [brand] 4x p.r.n. brk., Phenergan 25mg 3x prn nausea, Lyrica 75mg 2x,Adderall 20mgs 1x A.M., Soma 350 mg 3X, Relafen 1000mg 1x, Klonopin 1mg H.S. or prn anxiety Supplements: CO-Q10 100mg, Vitamin D 2000IU, Fish-Oil1000mg EFA, B-Complex50 3x/day, GABA 750mg

couchtater
Elite Member


Date Joined Jul 2009
Total Posts : 14475
   Posted 9/20/2010 6:48 PM (GMT -6)   
Saw the back doctor today. After pushing and pulling and poking me to death she determined that any movement of my pelvis causes me pain.
I start seeing a PT next week.
She gave me predinose and amrix.
Joy

Screaming Eagle
Forum Moderator


Date Joined Sep 2009
Total Posts : 5005
   Posted 9/20/2010 7:11 PM (GMT -6)   
Hello Couchtater!

Did this back specialist take a peek at your MRI? Also I was wondering if you by chance sleep with a pillow under your legs if on your back or in between your legs when laying on your side? It may help to try this.
Lets hope the PT works for you, and it will be important to do any homework they give you as well. Make sure you give it a good effort.

So is the pain in your pelvis or your back when you rotate your pelvis?

Take care, and good luck with the PT.

SE wink

southviewgirl
Regular Member


Date Joined Sep 2010
Total Posts : 64
   Posted 9/20/2010 9:07 PM (GMT -6)   
Though a lot of people have responded already. I thought I'd add my two cents. I've been to back doctors since I was 7. I have stuff going on with my back something fierce. When visiting back doctors, or orthopedic surgeons, they do a physical exam, and a family history, along with your medical history, possibly xrays, depending on if they have those in the office or not, some do, some don't. They may order more tests as well.

I'm new to the group, but I can help answer lots of questions as I've had 20 surgeries so far, spinal fusions for scoliosis, staph infections, hardware removal, SI joint fusions, and pelvic surgeries.

Best of luck to you at your appointment.
We must be the change we wish to see in the world.
Mahatma Gandhi

southviewgirl
Regular Member


Date Joined Sep 2010
Total Posts : 64
   Posted 9/20/2010 9:22 PM (GMT -6)   
Forgot to mention the PT. Physical therapy is different for everyone, depending on your needs. They are very good at making sure you are comfortable and not doing too much to cause pain. Every physical therapist is different in their approach as well.

Good luck to you!!
-We must be the change we wish to see in the world-
(Mahatma Gandhi)

*Scoliosis, Degenerative Disc Disease, Spinal Stenosis, Osteoarthritis, Loss of Lordosis, Endometriosis, Kerataconus*
*20 surgeries- 8 spinal including 6 fusions and 2 for staph infections, 9 pelvic including full hysterectomy, 1 knee for staph infection, 2 cesareans to deliver my beautiful children*

Alcie
Veteran Member


Date Joined Oct 2009
Total Posts : 4978
   Posted 9/21/2010 8:16 AM (GMT -6)   
Joy -
I've been through PT for my back several times, and it does help a little. It strengthens your core muscles. Just refuse anything that hurts. If it hurts it could be causing damage.

Prednisone is to reduce the swelling. I can't take it because it gives me a horrible headache in doses (20mg) high enough to do any good.

Amrix is cyclobenzaprine, aka Flexeril. BEWARE of it it you are taking tramadol!!! I got a really bad case of serotonin syndrome from that mix! Turned all red, sweating, couldn't control body temperature. It put me to sleep, which I liked - took it only at night. It helped a lot with my back pain - which was partly from muscle spasms. Just watch what you take it with!!

It would help to find out is what is causing the pain. Did the MRI show a bulging disk or any nerve impingement? Spinal stenosis is not the same thing. Spinal steroid injections helped me most - for a couple of years. Unfortunately that's a short-term fix. But surgery is a last resort - just like our stomach surgery. Same type of recovery and a bunch of new side effects. Try everything else first - for a long time, like a year or more!

With your sulfite (I think that's what you meant by sulfur - or was it sulfa??) allergy you should stay away from botannicals and herbal cures. Lots of them are preserved. Fish oil is in that category too. I do manage to tolerate the tiny krill oil caps, but have not noticed they do any good for my back, just hoping for help with cholesterol.

I lost a total of 40 lbs over 5 years and that helped a little. I did the no-carb thing for a couple of years, but only lost for a few weeks. Then I just ate smaller portions. Especially after our fun stomach surgery that was easy. Everything helps some!

Best wishes!
Alcie
 
 

couchtater
Elite Member


Date Joined Jul 2009
Total Posts : 14475
   Posted 9/21/2010 4:09 PM (GMT -6)   
SE, The pain comes from the L5-S1 area and sends shooting pain across my left butt cheek. It then shoots down to the left calf. That leg always has a numbing tingle to it. Walking, sitting, and leaning forward cause pain. If I'm laying down flat it hurts. When I get out of bed I have to roll out slowly and push up slowly or I "lock-up" and spasm. She did look at my MRI because I brought the disc copy I have. She sent me for 7 x-rays of me flexing because I complained of a "rocky" feeling in my back, too.

Alcie, It's sulfa drugs.

I've tried pillow between my knees, but it won't stay put because I'm a flip-flopper. I go from side to side trying to get comfortable. I have a semi-firm mattress with a 4 inch thick memory foam padding on top.

The Amrix is powerful! I took it last night 4hrs before bedtime like the doctor told to me. I woke up so groggy this morning. My vision was blurry beyond 10 feet and I couldn't get enough water. I've yawned alot today. I've got to take it again in an hour and I'm dreading the side effects. It controlled most of the spasms today except the major one that hit at 2:00 today. I was going to help a kid at the computer and I sat down next to him. Not thinking I leaned forward quickly and had one of the biggest spasms ever! I had to take a few moments to relax the spasm. It kept flaring for the next hour. I had to use a cane to walk my students out to the buses.
Joy

Chartreux
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Date Joined Aug 2006
Total Posts : 9661
   Posted 9/21/2010 4:42 PM (GMT -6)   
I sure hope your not on the predisone for a long time...seems like too strong of a
med to be given from a first appointment....I would say to look for another doctor as the ones on
the bill board and big ads are not always so good....I hope you can get some relief...
Lots of soft healing hugz..
Others will come by with better advise and I posted an answer about the ten unit on another posts, I forget sorry...
**********************************************
* Asthma, Allergies, Osteoarthritis, Spinal Stenosis, Degenative Disc (Lower Lumbar S1-L3 and Cervical C5,C6, C8 and T1), Fibromyalgia, Gerd,
Enlarged Pituitary Gland, Sjogren's, Ocular Migraines, mild carpel tunnel, ect.... "Would be nice if we could use the edit button in real life"...

********>^..^<********>^..^<********>^..^<********

couchtater
Elite Member


Date Joined Jul 2009
Total Posts : 14475
   Posted 9/21/2010 6:29 PM (GMT -6)   
It's a six day dose pack to calm the inflamation. I've been on it before for my asthma.

I've been on pain killers and muscle relaxers many times before for my back. She asked if I've been given predisone before for inflamation - Um, no.
I've been researching back treatment on the web and the Mayo clinic said sometimes it's used for inflamation, either injection in the spine or a pill. It's not uses but three times a year.
Joy

straydog
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Date Joined Feb 2003
Total Posts : 16008
   Posted 9/21/2010 6:45 PM (GMT -6)   
Joy you are right prednisone is given for back pain due to inflammation, they have been using it for years and years and it is perfectly safe as long as you tolerate it. It a steroid which is what is used in injections for the back. If you are having nerve pain and some of your symptoms fits that picture perfect the prednisone may really help you, I sure hope so. My sister had a pinched nerve in her back ans was totally miserable for a very long time. She got sick with pneumonia and was given a Medrol Dose Pack (steroids) for the inflammation in her lungs. She said she woke up the third day and realized as she was getting out of bed the back pain was totally gone. She had been suffering for over a year too.She said all day she kept expecting the back pain to return that this was just a fluke. To this day the pain has not returned. She says if it does she knows what she will ask to be given.

I sure hope you get some much needed relief.

Susie

couchtater
Elite Member


Date Joined Jul 2009
Total Posts : 14475
   Posted 9/22/2010 4:11 PM (GMT -6)   
Day one on the predisone...
No major spasms! A few small ones- very tolarable.
I was able to even bend down and wipe up kitty mess on the floor. I hurt a little afterwards, but it didn't last long.

I'm suffering from a very dry mouth from the Amrix, though. I've been drink water all day. :(
Not good for a person on two lasix a day.
Joy

Chartreux
Veteran Member


Date Joined Aug 2006
Total Posts : 9661
   Posted 9/24/2010 3:12 PM (GMT -6)   
Joy
when I posted I was concerned, cause I know you take pred for asyhma flairs..and
that your doctors all should know that so that you don't get pred toxicity..
and you probably do tell the doctor...so my answer was out of concern...
I hope your feeling better and that the pred is helping...
Straydog /Susie was right you could possibly get steroid injections...
but maybe up to date mri's would be a good start for your PM doctor
and don't let them push ya too hard with the physical therapy...
Don't let them do "the no pain no gain..."okay and I hope you have a good week...
(((((((((((((((((((((((((((((((Joy)))))))))))))))))))))))))))))))))))
**********************************************
* Asthma, Allergies, Osteoarthritis, Spinal Stenosis, Degenative Disc (Lower Lumbar S1-L3 and Cervical C5,C6, C8 and T1), Fibromyalgia, Gerd,
Enlarged Pituitary Gland, Sjogren's, Ocular Migraines, mild carpel tunnel, ect.... "Would be nice if we could use the edit button in real life"...

********>^..^<********>^..^<********>^..^<********

couchtater
Elite Member


Date Joined Jul 2009
Total Posts : 14475
   Posted 9/24/2010 3:37 PM (GMT -6)   
I had the MRI just a week before I showed it to the doctor. So it was very recent.
I'm having some spasms this evening without the brace, but I'm trying to give my back a rest from it. The doctor told me it was okay right now to wear it for the 8hrs I'm at work, but to take it off as soon as I get home. She said eventually I will be totally off of it after the PT gets working for me. If it hurts I'm going to tell them. I'm not one to believe in the "no pain, no gain" rule.
Joy
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