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Old 04-13-2004, 11:00 PM   #1
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L4-L5-S1 HB User
36 Years Of Pain Coming to a Conclusion

I'm 52, extremely fit and have had back pain for 36 years. Laid up in bed for days sometimes and other times functional to one degree or another. The pain has been constant for 10 years only varying in severity from 3-8 on a 10 scale. Take oxycontin several times a year when its 7 and above. Otherwise Darvocets 1-2 a day.

I ride bikes,hike,spin, weight lift and do 700 situps every other day. It kills me to walk in Costco on the concrete floors for more than 30 minutes.

If I do nothing, it actually seems to get worse than if I exercise.

I do my activity / workout and generally spend the rest of the day on my back with a pillow under my legs.

The pain seems to be getting more intrusive and its time to make some decisions. I was advised by a UCLA neuro and and Loma Linda nuero to have a double body anterior fusion with titantium cages 5 years ago. I put that off in the hopes that the artificial discs would be available and do the job.

I have just had another MRI / Xrays and consulted with a MD who is advising the SARNO mind-body connection therapy.

I meet with Dr. Peppers at Scripps next week regarding 2 level Pro-disc surgery.

Here are the questions.

1) do I continue to keep on keeping on in varying degrees of constant pain? This can and does make me depressed and not a whole lot of "fun" to be around for the wife and kids / friends.

2) give the mind-body thing a try?( non-invasive and very little downside) ..I'm leaning this way ..

3) go for the double pro-disc (If I'm still a candidate) ?

I'm curious if anyone knowledgable out there can interpret the findings below and give me some idea of prognosis over the next 5-25 years if I do nothing????????

Thank you for your consideration of these issues.

l4-l5-s1

Here are the particulars:

1.Spondylitic changes (1<) of the lumbar spine with posterior disc bulges and degenerative changes of the facet joints resulting in mild to moderate/severe neural foraminal and lateral recess encroachment at multiple levels of the4 lumbar spine.

2. L2-3:Mild right and mild/moderate left neural foraminal encroachment.

3. L3-4: Mild bilateral neural foraminal encroachment and moderate bilateral recess encroachment.

4. L4-5: Right asymmetric broad based posterior disc bulge measuring 5mm in ap diameter. anterior effacement of the thecal sac. There is moderate right lateral recess encroachment. There is moderate/severe right and moderate left neural foraminal encroachment. Mild degenerative changes of the facet joints.

5. L5-S1: Right asymmetric broad based bulge measuring 5mm in greatest ap diameter. Mild degenerative changes of the facet joints. Anterior effacement of the thecal sac. There is moderate/severe right and mild left neural foraminal encroachment. There is moderate/severe right and mild left lateral recess encroachment, also Disc material mildly contacts the transiting right S1 nerve root.

T12-L1: Broad based posterior disc bulge measuring 3.6 mm in greatest ap diameter. There is mild efacement of the thecal sac.

L1-2: Broad based posterior disc bulge measuring 3mm in greatest ap diameter.

L2-3: Broad based posterior disc bulge measuring 4.5 mm in greatest ap diameter. mild anterior effacement of the thecal sac. mild right and mild/moderate left neural foraminal encroachment.

L3-4: Broad b ased irregular posterior disc bulge 4.5 mm in greater ap diameter. Mild anterior effacement of the thecal sac. mild bilateral neual foraminal encroachment. There is moderate bilateral recess encroachment..

 
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Old 04-13-2004, 11:48 PM   #2
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MollieR HB User
Re: 36 Years Of Pain Coming to a Conclusion

700 situps???? I wouldn't be able to move for years if I did that, but I guess you are used to it. I had fusion L4, L5, and S1 in late January and feel much better but not sure my new hardware could stand up to your workout schedule. I use the treadmill, walk outdoors, recumbant bike, but I try to protect my vertebra from anything I think will trigger that terrible pain now that I have been "fixed"

 
Old 04-14-2004, 07:56 AM   #3
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Re: 36 Years Of Pain Coming to a Conclusion

Mollie,

I started to do ab work 5 years ago when surgery was reccomended. The doc said to strengthen abs.

It is great to hear you are up and about after surgery.

I'm functioning, but in constant pain.....I want the pain to end and still be able to function...........

Maybe thats asking too much?????

L4-L5-S1

 
Old 04-14-2004, 01:31 PM   #4
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carol632 HB User
Re: 36 Years Of Pain Coming to a Conclusion

[COLOR=Sienna][FONT=Garamond]Are you seeing a spine specialist? Have you discussed your exercise regimen with him? It seems to be pretty strenuous considering the shape your back is in. I think that I would cease the spin and weight lifting and the sit ups. Long walks at a brisk pace would help keep your back muscles strong.
I really do urge you to discuss it with your surgeon...

As for the mind over matter (sarno) most of what I have read is negative..wouldn't it be lovely if we could just heal those bone spurs, ruptured discs, bad gall bladders, with our minds? I guess it wouldnt hurt to read the book, but I have not heard one person who agreed with the concept.

You have bulging discs all up and down your spine...at L5-S1 you have disc material touching the nerve root...thats a pain generator for sure.

You definitely need a good spine specialist; then get a second opinion and maybe even a third. I am going to bet that surgery will be the foremost treatment offered. With so many bulges, you are looking at multi-level fusion in the future....at least that's my take on it.

I hope someone more knowledgeable about reading MRI's will come along soon to give you their opinion.

Take care.
Carol[/FONT][/COLOR]
__________________
2 lami's, 3 fusions
bone spur removal
cerv. fusion, 1 level
morphine pump

 
Old 04-14-2004, 05:49 PM   #5
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footsie HB User
Re: 36 Years Of Pain Coming to a Conclusion

Carol, you may not have a great back, but your vision must be somethin' else! I really want to read your valuable posts. Could you go one or two points larger? .

Jamie

 
Old 04-14-2004, 08:26 PM   #6
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Re: 36 Years Of Pain Coming to a Conclusion

Carol,

I've seen the top neuros at ucla and loma linda.......

The spinning / cycling / ab-work were reccomended by them........

And your take on the findings is exactly what they have been reccomending........

Its just that the fusion results seem to be problematic at best and gruesome more often than not......

Although I've got constant pain... at least I can still get some exercise / outdoor activity which brings me pleasure....

I'm only 53 and love the outdoors.... I don't think I could handle a failed back surgery that caused more pain and problems than I currently have and precluded me from the outdoors/activity for the remaining years.......

I see Dr. Peppers next week about the double pro-disc adr and am hopeful he can give me some optimistic prognosis...

The fusion guys have said at best its a 40-70% chance at improvement and they only consider that during the first year... after that ...the adjacent segments start to go(which mine already are) and the pain becomes almost identical to before surgery after the 4th year......

Not great....not great at all.......

I'll keep you posted and thanx again for your input....

L4-L5-S1

 
Old 04-14-2004, 11:44 PM   #7
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injured betty HB User
Re: 36 Years Of Pain Coming to a Conclusion

[QUOTE=MollieR]700 situps???? I wouldn't be able to move for years if I did that, but I guess you are used to it. I had fusion L4, L5, and S1 in late January and feel much better but not sure my new hardware could stand up to your workout schedule. I use the treadmill, walk outdoors, recumbant bike, but I try to protect my vertebra from anything I think will trigger that terrible pain now that I have been "fixed"[/QUOTE]

The optimum number of crunches (sit-ups are not good for you) is 500 per day and can be broken up throughout the day. Doing these on a exercise ball is the way to do them without hurting your joints. Don't forget your obliques on each side.

If you don't do workouts that involve the abs, then you are not helping you back. Your lower back has no support beyond your abs. Rock hard abs are not only for looks, but for a healthy back.

Also, if you don't do the upper, middle, and lower back stretches (can be found on the net) your back will literally harden up, get stiff, and you are back to square one with pain.


I learned the hard way,

 
Old 04-15-2004, 08:37 AM   #8
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Re: 36 Years Of Pain Coming to a Conclusion

Moonlight,

you are exactly right..... the exercise ball is great for ab work.... All my crunches are done with my legs up at a 90 degree bend on top of the ball / bench / held in place by my lower abs......

Obliques are done usualy with one leg's ankle crossed over the others kneecap while that leg is bent. I lift my shoulders up and rotate so the opposite elbow touches the outer edge of the crossed knee cap.................

I use the roman chair for back extensions to balance out the front abs.... never hyperextending...........

In addition I do some leg raises on my back with the hips elevated on a towel or on my sides and combine those with oblique crunches..................

I shudder to think what problems I would be having right now if my abs were not in the shape they are.....

L4-L5-S1

 
Old 04-15-2004, 10:46 AM   #9
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Racharina HB User
Re: 36 Years Of Pain Coming to a Conclusion

L4-L5-S1
I am 37 soon to be 38 and I have L5-S1 herniation. I had hemilaminectomy/discectomy on 7/16/03. It has been 9 months and better post surgery but I am still struggling with a lot of pain. I don't know how you can do 700 sit ups, lift weight every day. I could barely walk prior to surgery. Pain was excruciating!!! Now that I feel better I am back doing sit ups (only about 5 minutes which they are probably 4 sets of 15 repetitions, perhaps little more, and not everyday. I walk about 45 minutes when I can, but I swim a lot! Swimming is the only think I can do with no pain.

I do notice however, that if I don't work out I seem to have more pain.

I honestly feel this will never heal, I will be in constant pain always, no matter how many surgeries I have.

One day I was having an MRI and I was hopeful cuz I thought by having my surgery I would be fine. I mentioned to the Dr that was doing the MRI and he told me: "It will never be the same, you will always have pain, I had surgery myself years ago, and I am still struggling". Those words stayed in my mind... and now I see why he said that. Not to bring you down or anything, but I wish I could find some one that puts me out of my misery for sure.

[color=red]-[b]R[/b][/color]
[size=-2]-Back Problems since 08/25/2001
-3 Nerve block injections (helped first couple of months, then would wear out)
-Changed insuranse from [i]Kaiser[/i] to [i]UH[/i]. Kaiser gave me the run around all the time.
-Saw new NS under new insuranse. 5 days later: Had hemilaminectomy/discectomy on Right side [i]L5-S1[/i] (07/16/2003)
-03/2004, feel better 50% but still have pain EVERY *@#$%&!! day.
-I am 37 will be 38 on 06/13 [/size]

 
Old 04-15-2004, 12:48 PM   #10
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Bixby HB User
Re: 36 Years Of Pain Coming to a Conclusion

I'm 35 and I'm also fit. I've been suffering from back pain since I was 14 years old. I also can't walk thru a mall with out breaking into a cold sweat due to the severe pain I feel in my lower back. I've been living with this sensation for 16 years...

1st. off I'd knock off the 700 sit-ups every other day. Sit ups are terrible for a person with back pain. If you go to a gym that has an up right leg raise rack start doing those instead. For those who don't know what one is, it's simply a rack that you climb up onto support your body weight with your elbows and forearms, your back's supported by a pad. Your legs dangle and the object is to lift your knees to your chest. If your advanced you keep your legs locked at the knees and extend them outwards to a 45 degree angle and slowly let them back down. It's a great work-out.

Before I'd go under the knife I'd find a reputable Chiropractor in your area and have him take an x-ray. I did a couple of months ago and I'm extremely happy that I chose to. 1st off your x-ray is taking in a natural standing position. Unlike an MRI or an x-ray taken at any surgeons office.

After the x-ray I chose to give this reputable chiropractor a chance and have some adjustments performed on my back.

Before he took my x-ray I told him that I had an MRI taken not to long ago and I know what's wrong with my back. I then told him that the conclusion of the MRI was bulging - degenerative disc's with bone spurs on my spine. He simply looked at me and said, Joe - everyone suffers from bulging degenerative disc's. I was in my normal, decent pain, about a 6 on your scale I guess so I went ahead and started my adjustments.

I must say my back was tender in the beginning. The key was to put ice on it for 5 min.s every hour as soon as you can after the adjustment until the pain subsides.

I went 4 times the first week, 3 times the next 2 weeks, 1 time every other week for the next month and now I'm only going once a month now for maintenance. He tells me after a couple of months we can reduce that down to every other month or as needed.

I can't tell you how happy I am that I chose to go to a chiropractor... Spring has arrived and I've spent hour's out in my New England yard cleaning up my acre of land from the messy winter we've had. I come in after heavy session in the yard, take a shower, and feel almost no back pain! Last spring I suffered immensely after every yard work session.

I told my Chiropractor after my last visit that I can't believe what he did to me! He fixed me.

The x-ray cost me about $60.00 and each visit cost me $35.00 I'm into it for about 350.00 so far. (my insurance doesn't cover Chiropractic treatments) A small price to pay to keep off an operating table with an ambiguous outcome...

Good Luck!
Your to young to be suffering the way you do!

- Bixby

 
Old 04-15-2004, 12:58 PM   #11
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Racharina HB User
Re: 36 Years Of Pain Coming to a Conclusion

Bixby:
Good for you!!!!

 
Old 04-15-2004, 05:51 PM   #12
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L4-L5-S1 HB User
Re: 36 Years Of Pain Coming to a Conclusion

Bixby,

Thanx for the advice... Sorry to say I've seen more than 15 chiro's over the last 30 years.... I was in business with most of them and know the profession very well...........

Adjustments don't hold at all for me... less than 30 minutes......

Thanx again....

L4-l5-S1

 
Old 04-15-2004, 11:59 PM   #13
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injured betty HB User
Re: 36 Years Of Pain Coming to a Conclusion

Bixby,


Best advice that I heard in a long time. The first line of defense in back care should be manipulations.

L4-L5-SI:

If you can't keep an adjustment, that usually means *lax ligaments*. See Prolotherapy treatment.

 
Old 04-16-2004, 09:12 AM   #14
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TomL HB User
Re: 36 Years Of Pain Coming to a Conclusion

My situation is very similar to yours.
I have had back pain for about 36 years. I am 58 years old.
I was diagnosed with grade 1 splondo at L5-S1 in my early 20's. Although there was not much more slipping the past 36 years I finally had to give in and underwent L5-S1 fusion 2 years ago. One year ago I was fused at L4-L5. The doctor thought the reason I had problems at L4-L5 was because of the problems of L5-S1 for all those years.
I have been extremely active my entire life, when I was not down with back pain. I have been a runner for over twenty years, usually averaging 25 miles a week with plenty of 10K and half-marathons.
21/2 years ago my back and leg pain were bad enough that I could no longer run or continue my active lifestyle. That's when I decided I needed the surgery.
Leading and inactive lifestyle didn't seem like much of an option since my father had his first heart attack at 42 and his family history was full of males dying early from heart disease.
I was in excellent physical shape before my first surgery and I believe that really made a difference after surgery.
It has been 14 months since my second surgery over that last two years. I have really dedicated myself to spending this year getting as strong and conditioned as possible, I think that is the only way I will be able to lead the active lifestyle I prefer.
I do a couple of hundred crunches a day using a ball, just like you. I go to the gym every day. I use the captains chair, just like you. I try to do the circuit every day, spin twice a week, 1-hour aerobic step jam twice a week. On days where I do not spin or do aerobics I walk on the treadmill for about 40 minutes at 15 degrees of incline. I ocasionally use a stepmill for stairclimbing. I also walk about 20 miles a week outside when the wheather permits.
I still have some issues from the surgery. I have good days and bad days. The surgery has really created some problems that were not there before the surgery. I have lots of pelvic issues since the surgery. I have a problem in one SI joint and I am working on it with pilates and other exercises.
I am only able to do the spin class for half an hour because I get a numb right foot.
I don't know if I was any help to you, but I wanted to let you know that there are successful surgeries. It sounds like you have educated yourself very well and that is important.
I would suggest that you learn as much as you can about the transverse abdominal exercises. My therapist has a MS and specializes in lower back and pelvic problems. She certainly taught me how important the trans-ab is to your back. She has taught me turn on that muscle whenever I do anything physical. I had a very difficult time learning to contract that muscle and keep it contracted when necessary, but I am convinced that it is very important for a healthy back.
I will be glad to answer any question you may have.
Good luck.

 
Old 04-16-2004, 12:01 PM   #15
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L4-L5-S1 HB User
Re: 36 Years Of Pain Coming to a Conclusion

Tom L,

Sounds like we have a similar story........

I understand you had the surgery when the pain kept you from doing what you love.......

You are currently doing a similar exercise regimen to myself with pain...... What is your pain like on average, after the surgey, from a scale of 1-10?????

The reason I am asking Is maybe I should continue to endure the pain until surgery is an only option????

Cycling/spinning feels that best to me because it opens up the lower spine (I am bent over from the waist) and it as no impact... The eliptical is very good as well.....

Can you explain the location and function of the trans-abs?? are they the obliques??

Thanx again.....

L4-L5-S1

 
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