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Old 04-28-2005, 06:31 PM   #1
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Question Bulge disk...what is usual treatment?

What do Drs usually recommend with a bulged disk????? Left toes numb...left leg feels asleep, like it will give out. Shoulder blade pain, horrible sciatic pain (both legs). I have an appt on 5/16 with a spine dr. I really need help physicaly and emotionaly......
What questions do i ask?? I have talked to many people who have said that pt only prolonged the pain. I just want it GONE. I want to be able to take care of my animals, clean house, laundry, ride in a car without wanting to die because of the pain.....
I really need to know what to ask the Dr??? I know that i do NOT want cortisone injections, one of my best friends has cushings disease, and i have a cat that has addisons disease (from cort) . I have seen the emotional and physcial changes the cort has on my friend, and i will NOT have it.

It seems like i am talking to all of you more then my family at this point...last night, my husband asked me when i planned to start painting the walls....

Thanks once again for listening.



nean

Last edited by nean612; 04-28-2005 at 06:41 PM.

 
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Old 04-28-2005, 07:29 PM   #2
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Re: Bulge disk...what is usual treatment?

Oh my gosh, nean....your husband asked you when you are going to start painting?? Holy smoke, he really doesn't get it does he? I am so sorry.

In your case the disc is obviously putting pressure on nerves, and most likely the idea of surgery will come up. Possibly a laminectomy, or discectomy. And it is probably the best and only way to get better. Be sure to ask lots of questions about the type of surgery he recommends (if he does) and let him know you aren't interested in PT. Honestly, I doubt that PT will help, but some dr's feel they need to try that before going on to something invasive.

In the meantime, I suggest you let your family SEE your pain. Hold your back, walk stooped over or bent to the side, groan and moan if you have to. But for heavens sake, they need to understand that you are in a lot of pain and cannot be doing physical work right now. Can you tell that subject gets under my skin?

Anyway, nean, good luck with the appt; let us know what your dr. recommends.

Carol
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Old 04-28-2005, 08:10 PM   #3
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Re: Bulge disk...what is usual treatment?

I am dealing with the same thing as you. My left foot is numb and tingly. The back of my calf hurts and the muscle doesn't want to work. It's hard to walk because of the muscle pain and it just is not responding. My husband keeps coming home from work and will make jokes like did you mow the lawn today? Or did you get the laundry done? It really makes me mad when he says that even though I know he's joking. I mean if I was in a wheel chair would he still say those things. I cannot do those things so why would he joke about them it's really cruel I think. I limp when I walk really bad and go really slow and moan sometimes but he thinks it's funny to say those things. I know exactly how you feel. I have another MRI scheduled for Saturday. I hope to get some relief soon also. I am sorry you are feeling so bad I really can understand that feeling. It's hard physically and emotionally. I am just exausted after a few hours of being awake sometimes.
I hope you start getting better.

Kari

 
Old 04-29-2005, 02:06 AM   #4
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Re: Bulge disk...what is usual treatment?

Carol & Kari
Hello,
Well i had a "melt down" when he mentioned the painting.....I told him that i was thinking more along the line of a trip to the ER. My neighbor took me grocery shopping today.....i had dog food, cat food, cat litter, 2 five gallons of paint along with a bunch of the other ususally stuff to carry in. I talked with him and asked him to please meet us at the house to help. By the time we got home he had already left to go get a car part......then it started to rain. So here we are (she has a bad back too) unloading all this in the rain. The groceries were in the back of the truck, so we didnt have much choice. To me getting the house cleaned is a victory. So i feel that it is only a matter of time before my back goes.......The ride home (45 minutes) from wallyworld was brutal enough. Our mower is being fixed, and it will take me 4-5 hours to mow our yard (3-4) acres. That is if i can take the bouncing of it..........We do not have any children......taking care of our animals is sometimes a chore in its self...specially if the larger one is pulling on the leash (like if she sees a squirrel). Oh, and 2 of our dogs got into a fight..it was a dominance issue fight.. so no dogs got hurt...but guess who is pulling the 60lbs dog off the other one???? (while i am screaming for help).......
Can i call that PT??? So its 3am....my back (between shoulder blades)/ and sciatic are on fire...but hey i got 5 hours of sleep.
I think that i am going to start to keep a journal........so when i do see the spine dr, i can give him some idea of the activity/pain....etc....i more then likely will be too chicken to give it to him, but like posting here, it lets some of it out.
I think that if we all move to the carribean and play with dolphins all day it will cure us...

take care...hope everyone has a good day today.

Thanks for listening

nean

 
Old 04-29-2005, 02:13 AM   #5
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Bionicwan HB User
Re: Bulge disk...what is usual treatment?

Hi Nean,
Sorry for the pain your in. Glad your soon seeing a Dr!

Carol's post echo's my advice and comments to the "T" I think keeping a journal is an awesome idea. Not only does it let you place some of your feelings and frustrations on paper it will be an invaluable tool to use in describing a "Day in Your Life of Pain" to the Dr.

Good Luck and please keep us posted
BionicWitch

 
Old 04-29-2005, 03:18 AM   #6
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Re: Bulge disk...what is usual treatment?

Good Morning BW,
What do you think of this part of my mri result???? Midline soft tissue edema in the superficial subcutaneous tissue of L1 thru L4 (something I cant read) levels. I have a bulge at L5/S1........ When I got the results the wicked NP gave them to me, and said i need pt....shouldnt a DR decide that (ok i am over that....almost) I have an appt with a spine dr 5/16. Any thoughts??? The way i read it is there is swelling/inflammation above the disc, so is this adding to pain, or is the L/S problem causing it....Chicken or the egg question i guess. Could inflammation in this area also cause pain in back over kidney area that wraps around to just below my rib cage?? I will add it to my list of questions for the Dr. Just wondering what your thoughts are.

Hope you have a good day......

Thanks for your help!!!

nean

 
Old 04-29-2005, 03:31 AM   #7
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Re: Bulge disk...what is usual treatment?

Midline soft tissue edema

indeed means just what you thought swelling (edema) and probably substantial inflamation.

and your right, the bulge is probably causing this. You could hold off on the PT until you see the specialist .... and see if he agrees? and I'm sure this could be why you have the pain in the area you describe.

I'd take things easy, RESEARCH, RESEARCH, RESEARCH and consider ALL conservative treatments available before considering surgery (if it's suggested) with the RIGHT treatment and if the disc is still just bulging, conservative treatment could help you very much! You should ask the doc about taking a NSAID or perhaps some steroid therapy, this would help the inflamation.

Good Morning to you too!
I hope you have a gentle pain day
BionicWitch

 
Old 04-29-2005, 04:35 AM   #8
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Re: Bulge disk...what is usual treatment?

Hello Bw

3 years ago, I was diagnosed with what Dr F thought was shingles, it was a burning pain that wrapped around my left side.....well it has never gone away....I have had 2 other drs give their opinion, i have had acupuncture many times, treated with tons of herbal stuff, i have had xrays, 2 abd ct scans w/o contrast, bloodwork, urine tests...all normal. I have been on vioxx, celebrex, bextra, taking advil & tylenol and 3 different antidepressants (which is another drug i WILL NOT take) .. One Dr said costochronditis (and wanted to treat with cortisone injections.....I will NOT have done) another Dr said splenic flexure (gas trapped in the intestine...i have had no gi signs), but i have told him that i cannot get up out of bed in the am without hubbys help..(thats if i sleep thru the night...the sciatic usually wakes me up and i got to move to the couch with pillows under legs )...my back is really stiff and sore..... this is the current dr who finally ordered a mri on my spine.........I have complained to each and everyone of the above drs about sciatic pain. He put me on vicodin es for "bad days", ultraset and xanax for stress and sleep (this was 1 year ago)........About 4 months ago the ultraset started to make me nausous (sp). So i started to take more of the vicoden..talked with the dr about it (I didnt just do this on my own).....which i think i have probably developed a tolerance to...........when i went to get the results of the mri & refill the meds his np treated me like a junkie....and she would not refill ANYTHING!!!! I still have some left...i have a 50 minute drive to that office..i wish i would have brought my bottle and showed her i still had some left. I have talked to other people who have seen this np, and left feeling like they were a pia for her to have to waste her time on. Yes there are times that it takes 2 to get the pain under control. I guess after 3 years and finally a reason for this pain....i just want it gone. I am sick of taking pills......and i will NOT have cortisone injected, or by pills. I am a reg vet tech (retired....since the 1st of the year, because of the above "wrapping" pain, hoping that "taking it easy", and less stress would help) I have seen the side effects of dogs, and cats on steriods. I have a cat with addisons disease caused by steriods. One of my best friends has cushings disease. I just have a bad feeling about it.

Well once again thanks for listening!!!!!!!
nean

 
Old 04-29-2005, 10:42 AM   #9
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et318 HB User
Re: Bulge disk...what is usual treatment?

Nean,

I am sorry to hear about the unfortunate run on Cushing's that you have encountered. Your low back and leg pain likely has alot to do with that L5-S1 disc. I think that trying some PT is worthwhile because you are unable to do as much as prior to the onset of severe pain, you need to maintain some conditioning. By the way, what you do at PT should be within reason given your pain and physicial limitations. A good therapist can handle that. If you ever had to have surgery, one of the biggest roadblocks to recovery is generalized deconditioning of the body. In other words, reduced muscle tone and overall strength. It is like starting from square -4 instead of square 1.

I don't know what to say about the cushing's fears. The injectable corticosteroids used today are a far cry from the old "hydrocortisone" that epidurals and a multitude of other injections were performed with. These newer agents are tolerated well and their doses are well understood. Given your MRI findings, I think that you are basically painting yourself into a surgery corner by not being willing to look at some of the conservative options that will involve injection. They work for some and not for others but surgery is also hit and miss, especially lumbar surgery. Just look around at the other posters on this board.

Good Luck!

Ed

 
Old 04-29-2005, 12:33 PM   #10
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injured betty HB User
Re: Bulge disk...what is usual treatment?

ET318:

The shots are the shots. They are all steroids and it is the steroids that cause the problems. There is a lot of information out there in regards to the steroids and the damage caused by them. You might want to take a look at the on line publication, The Burton Report, in regards to the shots. There are certainly some scary side effects and the cons out weigh the pros. I would not allow anyone to give me a steriod shot ever again. I would opt for the oral steroids before I would allow them to do the shots, and they are just as bad.

The shots were never meant for the spinal area.


 
Old 04-29-2005, 12:41 PM   #11
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Re: Bulge disk...what is usual treatment?

Well said Ed.

I understand your hesitating on TOO much or too long of a course of "steroids" but there are so many variables of meds and courses of treatment. IF your back gets to the point where surgery is offered as the only other alternative or IF your pain gets to be where you think the only alternative is surgery and practically welcome it (believe me, your BODY will tell you whenthis time comes)I hope if if either of these times come.... you do as Ed suggested and research what is available and used in spinal diagnostic and pain treatments.

I wish you well
BionicWitch

Last edited by Bionicwan; 04-29-2005 at 12:43 PM.

 
Old 04-29-2005, 01:31 PM   #12
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Re: Bulge disk...what is usual treatment?

I try not to get involved in discussions regarding The Burton Report.
Charles Burton is definitely a "thinker". The only problem is that he cannot get a room full of other neurosurgeons to go along with most of his very unusual opinions. When they don't they are all labeled as unethical. I find it very hard to believe that the ENTIRE medical profession is in unison looking to destroy the spines of america. Are there people who will treat in a self serving manner? Yes! Are their physicians who are allowed to practice in specialties where they do not keep up with current standards? Yes!

I am not trying to say that Dr. Burton doesn't have some valid points but there are many of his "theories" that are not born out by valid long-term peer reviewed studies. They have also not been born out in my involvement with thousands of chronic pain patients. Do I think there are too many spine surgeries occurring without adequately defining what the true problem is? Yes! Do I think there are under trained physicians attempting to performed specialized interventional pain procedures? Yes!

Despite the inadequacies of the system, we still have a strong contingent of compassionate and competent health care providers. Those that do not practice ethically need to be exposed and flushed from the system. This will only occur if their true victims stand up for themselves. The problem in that is that many pain patients are fearful that if they make too much racket that someone will label them with a title that will make it harder to get appropriate care.

 
Old 04-29-2005, 04:42 PM   #13
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Re: Bulge disk...what is usual treatment?

Not only is he a thinker, but he has the nerve to actually come out and challenge the practices that are being used today.

It is too easy for a doctor to look at someone in pain and say, *Hey, let's try the ESI's. The doctor gets his wallet lined with 100's of dollars for a few minutes of his time and usually no one gets hurt. Nine times out of ten no one is cured by the shots. If they are, the inflammation would have gone away by itself in the long run. I have been to docs who have the shots laid out and ready for pretty much anyone who says, *ouch*.

Back care is a huge business right now. Due to sedentay life styles, the current economics, and lack of knowledge about our bodies, back problems are one of the biggest health problems that we are facing today. So, a lot of doctors set up shop, hang out a shingle and progress in becoming either a PM or a back doc.

I am not saying that they are all bad. I am saying that if you corner a doctor and have a honest conversation with one, they will tell you that most back problems resolve themselves and that too much surgery is being performed at an expoential rate. There is a lot of money to be made in the field of back medicine.

Why treat snotty nosed, sick kids or the people with contagious diseases when you can set up a practice to treat only back problems? To avoid the pitfall of having to explain to the DEA why they are prescribing meds, they usually have formed some sort of relationship with another doctor, a PM. It is a symbiotic relationship.

What they don't count on, and they hate, is that the internet now exposes and educates people about health issues. Before the internet people did not take the time to find out about the meds they were given. They put doctors up on pedestals and did whatever they were told to do.

These days you can read all about the meds. You can research the ESI's. There are far more people who have exposed the shots than The Burton Report. Take a look at his references and foot notes.

Those shots were only meant to be used as a diagnostic tool. If the pain (inflammation) went away and didn't come back, then it was not a structural problem. If it didn't go away, or returned, then they moved on to the next step in the pain protocol. The insurance companies want the doctor to do what is the cheapest route. ESI's are in the plan. JUST SAY NO!!!!

 
Old 04-29-2005, 06:48 PM   #14
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Re: Bulge disk...what is usual treatment?

Having been involved in thousands of interventional pain injections, I can say first hand that a majority of that information is incorrect/erroneous. I really don't have to say anymore than that because I am not a casual observer nor have I lined my pockets with money. However, I have seen people improve significantly and avoid surgery.

I feel sorry for anyone who lives their life believing that there is a world wide conspiracy to do harm solely for the sake of earning money. By the way, I have been involved in procedures that were painstakingly difficult and long. To tell you the truth, a good PM doc gets paid not one more cent for that procedure then those ridiculous bedside ESI's that some of these untrained anesthesiologists are doing.

 
Old 04-29-2005, 07:06 PM   #15
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Re: Bulge disk...what is usual treatment?

et318,
So from your experience in seeing the injections first hand and how they help people. They really do work and help with pain. That is what I thought too. On this board it seems as so many people say they did not help them and then when I have talked to people in person who have had them they say it did help them. Would you say you have seen quite a few people with the numbness in the foot be helped by the injections? I am going to have an injection if it is appropriate. I have to wait and see what my MRI shows. I am on an oral steroid methylprednisolone right now and in just 24 hours it has helped a great deal with the pain in my calf and my back. I still have a numb foot but I still have 5 days left of the treatment. Last time I was on the oral steroids it got me walking again in just one day. It still hurt a lot but before taking it I could not even walk on my own. It was amazing how much it helped by the time I was done with a week of it. I was able to go back to work. I hope it works as well this time. I do not see any reason it will not.

Kari

 
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