Never ending back pain

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Codester
New Member


Date Joined Oct 2017
Total Posts : 8
   Posted 10/8/2017 5:09 PM (GMT -7)   
My back pain history all starts about 16 years ago, when I was 16 years old, due to a ski injury. I overshot a very large ski jump and compressed my back horribly. Due to fear of bankrupting my parents, I never got it checked out.
From there on out, it has flared up anywhere from 4 to 10 times a year. Sometimes I can go months feeling great, and out of nowhere, I'd throw my back out by putting my shoes on in the morning, or sneezing, etc..
about 12 weeks ago, I had an episode that was worse than I ever had in my 16 years of dealing with this pain.. I broke down and got an MRI done. The MRI showed that I have 5 bulging discs from L2 and down, with L5 and S1 ruptured with an annular tear.
The pain that I experience radiates severely in my hips and low back. I do not have numbness or tingling down my legs, nor do I have symptoms of foot drop. It is so severe however, that it is completely debilitating and makes it nearly impossible to walk or stand for any period of time. My job requires me to be very active, and I do not want to be on light duty all season..
The last doctor that looked at my images suggested getting a shot, which would require an epidural. I am pretty resistant to getting it because of the fact that it might work, but it might not.. and even then, it might only work for a short period of time.. is there anything that would "fix" it long term?
I have had very poor luck with them to even prescribe me anything to help manage my pain. They have prescribed me Meloxicam and zanaflex, neither of which help with the pain. They do however help me sleep through the night, which is extremely helpful. Most nights I only get a solid 2 hour chunk of sleep before I wake up and have to adjust because of my pain..
Thanks for listening..
Any suggestions?

Post Edited (Codester) : 10/8/2017 6:12:23 PM (GMT-6)


skeye
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Date Joined Mar 2008
Total Posts : 3051
   Posted 10/9/2017 2:03 AM (GMT -7)   
Hi Codester,

Surgery (most commonly, a microdiscectomy) is an option, but most surgeons will not touch you until you have tried and failed all other more conservative options (epidural steroid injections, physical therapy, time, etc), even if your pain is pretty severe. Usually the only exceptions to this are if your bladder/bowel function is compromised (that is considered a surgical emergency), or if you have a foot drop or other progressive weakness. If you look at the statistics, somewhere around 90% of people with herniated discs will see improvement in their symptoms on their own without surgery, and actually, with no intervention at all, if given enough time (this is likely what has happened to you in the past, given your history of multiple "episodes" with your back). I also would not discount epidurals right off the bat. Yes, some people get no relief or very temporary improvement in their symptoms (days to weeks) from epidural steroid injections. But other people will get up to a year or more of relief from a single epidural. You don't know until you have tried it, and it really isn't a big deal to have it done.

I do understand your concerns and fears all too well, as I have been dealing with the same thing, myself, for the past 10 mo. However, speaking from experience, even surgery is not a miracle fix. I had surgery for my disc (also at L5-S1) in June, after I failed all conservative therapy (among other things, I did have a foot drop in one leg). The first week was great -- had significant relief of my symptoms in one leg, and moderate relief in the other -- but by 10 days post-op, all of my pre-op symptoms had returned in both legs, and were actually even worse than before surgery. Two more surgeries later, and I'm still really not much better than I was before the first surgery. I'm only 5 wks out from the last surgery, so I'm hoping that things will continue to improve with time, as the inflammation from so many surgeries starts to subside. However, sadly, failed back surgery is not all that uncommon. Actually, it is so common that it is it's own syndrome! Some people do great, but many others, not so much... Not to mention that once you go to surgery, there is no going back (i.e. even with microsurgery, you are compromising your spine to some degree, and also potentially introducing some level of instability -- both of which can lead to future problems down the line).

So, while I would recommend consulting with a neurosurgeon for sure, I would also advise you that despite the pain, it really is in your best interest to pursue all the conservative therapies that you can first, and only consider surgery as a last resort!

Skeye

straydog
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Date Joined Feb 2003
Total Posts : 15150
   Posted 10/9/2017 7:12 AM (GMT -7)   
Hello & welcome to the forum. I am not sure what type of dr is treating you, whether its your PCP or a specialist. Regardless, the conservative approach is what any dr will offer including specialists. Skeye gave you a run down on different modalities used along those lines. I too, suggest seeing a board certified neurosurgeon for a consult. There are no quick fixes unfortunately.

Take care.
Susie
Moderator in Chronic Pain & Psoriasis Forums

Codester
New Member


Date Joined Oct 2017
Total Posts : 8
   Posted 10/9/2017 1:07 PM (GMT -7)   
Thank you so much for your reply Skeye.
I will be moving forward with scheduling a shot at the soonest date available. I have about 5 weeks off before my seasonal work starts again. The only Drs that I have seen are a PA who then recommended me to a specialist. I had an appointment scheduled with a really well known doc, but he was on vacation on the day of my appointment and I saw his assistant instead.. :-/
I do understand that the episodes do get better with time, but these episodes are becoming more frequent and cause much more pain than they have in the past.. From reading and researching, it seems that there aren't many long term, permanent fixes to solve my problem. The last thing I want is to have to find a new job..

Codester
New Member


Date Joined Oct 2017
Total Posts : 8
   Posted 10/10/2017 4:25 PM (GMT -7)   
I just scheduled my appointment for next wednesday. I sure hope this works..
If a shot doesn't work, do people normally try to get another one right away? I've read that you can only get so many shots in a year? do they generally look at your MRI images and choose where to inject based off that information? How do they know where to inject?
I wouldn't say I have a phobia of needles, but I am a little bit apprehensive about this treatment. I've read that it may take 3-5 days for the injection to actually have results.. are there side effects I should be aware of? will it cause more pain initially? does the actual shot hurt?
Sorry for so many questions.. I have gone nearly 16 years dealing with the pain on my own, and I don't see doctors very often.. It's to the point where I can't take it anymore and need to do something..
Thanks for the kind advice

Codester
New Member


Date Joined Oct 2017
Total Posts : 8
   Posted 10/10/2017 5:16 PM (GMT -7)   
Another quick question.. how long after the epidural/ shot injection before I can drive home on my own? or is this something that I will need to have somebody else drive me home for?

skeye
Veteran Member


Date Joined Mar 2008
Total Posts : 3051
   Posted 10/10/2017 7:38 PM (GMT -7)   
Yes, you can only have so many a year due to the steroids. I don't know the number, but your doctor can tell you. Yes, they usually say that it will take at least 3-5 days for the steroid to start to work, but it can actually take as long as two weeks before you see any effects from the shot. If the first one did not help, or only helped partially or briefly, my doctor recommended doing a second. If the second did not work, then he stopped. Although I have heard that some doctor automatically recommend a series of 3... My doctor liked to at least talk to the patient 2 wks after each injection, and ideally see them in the office. As for how far apart the injections are, I had 2 epidurals done at 2 different levels & I think mine ended up being done about 2 months apart (although I got no relief from the first ones at all), but that was mostly because legistically, that was what I could do. But I believe you can repeat it as soon as two or three weeks after the first one.

Side effects are generally transient, and are typical of those of any steroids: flushing of the face, chest, felling hot, increased hunger or thirst, and insomnia. I experienced some flushing & heat for a few days, but that was all.

Definitely bring your MRI images & report with you with you, if you have them on a disc (if not, you might want to call the hospital or facility where you had your MRI and request a disc), as that will be how the doctor determines what level(s) to inject, and what approach to use. Then they use fluoroscopy (real-time X-ray) when they do the injection to make sure that they are at the right level/location.

The epidural is painful in that it is an injection, but it isn't too bad. Actually, you will really only feel the injection of local anesthetic (which burns fairly intensely, but briefly). After that, you should only feel pressure, and maybe some mild pain/tingling down your leg as the doctor injects the steroid. They usually talk you through the whole process. And yes, sometimes your pain can be a bit worse for the first 24 hrs or so (that happened to me with my first epidurals), but sometimes it also gets temporarily better for a few hours due to the local anesthetic, and then goes back to the way it was, or feels a little worse once that wears off, but before the steroid kicks in.

As for whether or not you can drive after, I would call the doctor's office ahead of time and ask. If they use any sedation, you will likely not be allowed to drive home. However, it seems that most docs don't use sedation for lumbar injections these days. However, you still may not be allowed to drive, as the injections can temporarily make your leg(s) feel weak. I was still always required to have a driver, even though my doc did not use sedation. You might also want to ask about whether or not you can eat or drink before the procedure. If your doc does not use sedation, it likely won't matter, but if he does use or offer it, then you will likely have to stop eating and drinking several hours before the procedure.

I think that answered all your questions...

Skeye

theHTreturns...
Elite Member


Date Joined Mar 2009
Total Posts : 19898
   Posted 10/10/2017 8:56 PM (GMT -7)   
be safe. get a ride. hope it goes well.

Codester
New Member


Date Joined Oct 2017
Total Posts : 8
   Posted 10/19/2017 3:20 PM (GMT -7)   
Well after all these years, I finally got my first epidural steroid injection yesterday. The actual procedure wasn't nearly as bad as I thought it would be. They gave me the injection between L5 and S1 and it took maybe 20 minutes total. The anesthetic shots were the worst, and even then they were just a mild sting.
The side effects I felt was a sort of crampy, achy pain that was localized to the injection site and my lower buttox. I felt mildly nauseous at night, but it may have been a weird combination of food I ate. And I had very bad insomnia, where I layed in bed all night, but I was practically awake the whole time. The pain got pretty intense at bedtime and I took 600mg of advil. It was hard to get comfortable, but my 3am, the pain diminished and I fell into a light sleep.

Today, I feel like it may have helped moderately. The pain is still there, but it is a different kind of pain. Hopefully as the week progresses it will feel better and better, but at this point in time, I have to say I feel better than I did before the shot.

Thanks for the encouragement! And for those out there considering this option, it is nothing to be afraid of trying.

pitmom
Veteran Member


Date Joined Jan 2015
Total Posts : 2152
   Posted 10/19/2017 3:52 PM (GMT -7)   
Glad to hear your procedure went well.

Hopefully, you will get long lasting results. Mine have varied from a whole year to only a few weeks. I'm about due for another set.
multiple surgeries for rotator cuff both shoulders with residual chronic impingement syndrome, ulnar nerve transposition, carpal tunnel release, multiple wrist surgeries, multiple herniated discs, tarlov cysts, whiplash, bursitis of hips, grade 5 right shoulder separation and torn labrum, ovarian cysts, fibroid tumors of the uterus

Codester
New Member


Date Joined Oct 2017
Total Posts : 8
   Posted 10/31/2017 10:55 AM (GMT -7)   
Follow up of the treatment 12 days later:
I felt like the pain for the first 3 days after my shot was getting better. The pain wasn't completely gone, but it felt "different". Now, 12 days later, it feels as though I am back to square one.. The pain is almost always constant, and I especially feel it when I bend over or sit.. No pain down my legs, but excruciating pain that radiates all in my hips and lower buttox.. I'm looking for a physical therapist that's local, and now I need to schedule a follow up with my doctor to see what the next plan is..

Codester
New Member


Date Joined Oct 2017
Total Posts : 8
   Posted 11/15/2017 8:37 PM (GMT -7)   
I visited my Dr for a followup. The outlook for me is grim.. Bulging discs from L2-L5, and the bottom two have small tears that are leaking. He said that since the ESI wasn't effective for me, he doesn't think it's worth trying that anymore. He also said that I'm not a very good candidate for surgery. He told me that the best thing I can do for myself is to develop my core to reduce my episodes of my back going out.. The best way to do this would be swimming or cycling he said. He also was very reluctant to prescribe me anything for the pain, and was about to walk out of the room, when I asked him if he could prescribe me something to help me sleep. He prescribed me a bottle of 100mg Gabapentin, which he said should help. I haven't taken any yet due to the fact I have an extreme head cold right now and I am taking mucinex, and I am unsure of the reaction it would have with the medicine.

Raew64333
Regular Member


Date Joined Sep 2017
Total Posts : 33
   Posted 11/15/2017 10:52 PM (GMT -7)   
No problem new member.. I am new too. Keep posting..

Raew64333
Regular Member


Date Joined Sep 2017
Total Posts : 33
   Posted 11/15/2017 10:56 PM (GMT -7)   
I can tell you from my experience there is Neurosurgeon that will give you honest opinion. Call Micheal Chang in Sac.. I have good results . I am old!

Raew64333
Regular Member


Date Joined Sep 2017
Total Posts : 33
   Posted 11/15/2017 11:04 PM (GMT -7)   
Don't give up hope. Not all docs agree. May need to change to different Neurosurgeon. Call Michael Chang in Sac. I did not have any hop till he did my 4 level neck surgery. I am having great results at 2 months post op. Would recommend him to anyone. I am 67 had no hope before him !

Codester
New Member


Date Joined Oct 2017
Total Posts : 8
   Posted Yesterday 11:12 AM (GMT -7)   
I appreciate the recommendation for your doctor, but living in Alaska makes it very difficult and expensive to travel, not to mention needing to take time off work.

My pain is a constant 3-5 on the pain scale. When I have an episode it jumps to 10 and stays that way for about 2 weeks as it gradually diminishes back to a 3-5.. My sleep has been largely affected, and I can only sleep for 1-2 hours before I wake up and need to re-adjust in bed to get comfortable.. It's affecting my wife's sleep as well because I keep waking her up all night.. What do you guys recommend for helping sleep?

Since the doctors are so reluctant to prescribe pain medication, Kratom has been my saving grace and really helps to reduce the pain and stress..

straydog
Forum Moderator


Date Joined Feb 2003
Total Posts : 15150
   Posted Yesterday 11:51 AM (GMT -7)   
Codestar, even though you have multiple levels of bulging discs, that does not mean you are a candidate for surgery. I applaud your dr for his honesty. A good surgeon would have done as your dr did. Without cord involvement & nerves being compressed, appreciate his honesty. By all means do what he has suggested to strengthen your core muscles, that is very important for people with back issues.

Look at the age of your mattress on your bed. If it is several years old, replace it. If you don't have the funds to do so right now, put a thin sheet of plywood between the mattress & box springs to firm it up. Look at your shoes that you wear. Invest in good shoes & try to have 2 pair to switch out every other day. I need a lot of support & spend a fair amount for my Brooks tennis shoes. Never thought in my wildest I would ever spend this kind of money for shoes, it makes a difference.

Now about the Gabapentin, go to Drugs.com & check out the interaction with medications. It gives a detailed list. I use Tylenol PM, without Tylenol in it, its called Sleep Time. I went from sleeping 2 hours a night to 8. A friend of mine was on sleeping pills for 13 yrs & her dr cut her off cold turkey. She uses this all the time. If you are a side sleeper, put a pillow between your knees, it takes pressure off of the back. In the mornings when you get up, do gentle stretches, I have to do this several times a day. You have to keep moving your body, its tough don't get me wrong.

Keep asking questions, we will try to help all we can. Take care.
Susie
Moderator in Chronic Pain & Psoriasis Forums
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