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Old 02-23-2007, 01:56 PM   #1
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ErikaB HB User
Spondy Newbie


Hi All,
I thought my inability to lay flat, bend, sleep, walk stairs, and exercise was due to a 7 year old knee injury. 2 days ago I was diagnosed with spondylolesthesis...Saw the xray of the out of line disc, which my chiropractor had also shown me 6 months ago, but was unable to correct. In retrospect, this first began 10 years ago when I was lifting dead weights at the gym. Of course, my OS is at one of the leading spine surgery and research centers in Northern California. Has anybody had any success with physical therapy, back brace, acupuncture or other and seen any positive movement or healing of this condition as a result of alternative therapies?
I'm hoping there is an alternative to surgery...and /or a way to gain better obility so I can loose the weight that my condition has caused before I even consider surgery.
I, holistic me, am completely freaked out.
Thanks,
ErikaB

 
Old 02-23-2007, 02:05 PM   #2
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Re: Spondy Newbie

Well I would start off by not going back to a chiropractor, sorry my opinions and I know opinions are like but holes everyone has them.

But if you have spondy and your vertebrae are activley moving I wouldn't do anything that could possible worsen your condtion. Did they tell you what grade you have? I can understand why you thought it was a knee problem. For along time my legs/feet even vaginal pains kill me more than my back.

Do you know what degree it is and if its stabilized or still actively moving? If you have a fracture or crack in the pars?

We all are a little different, my case is severe deg disc disease and in the end phases of that my vertebrae has started slipping I am grade one. I have been fighting the degenerative disc disease for along time and not finding relief so mine is combination. I am 37. I am getting ready to have fusion, but ofcourse that is a last resort.

Usually with most back problems they try injections, therapy and with spondy I've read bracing as well. Ofcourse the stronger your core the better for your back anytime. Yet when we hurt our backs its harder to keep our core stronger atleast it was for me.

Did they say if you had any disc problems as well? Just wondered if so since you were weight lifting.

I wish you the best and you will find so much support here and welcome....I hope you find some relief and answers. vette

 
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Old 02-23-2007, 02:09 PM   #3
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Re: Spondy Newbie

Yvette,
Thanks for your response...I'm waiting to find out if that darn disc is moving or just out of place. The knee was injured and so that's why I didn't think it was my back. According to the doc, there probably was a fracture, though the MRI is next week. You are right, the Chiro said she could not help and she is also a physical therapist, I appreciated her honesty.
What a fiasco.
I will keep reading these boards and updating on my condition...at least it feels good to know I'm not alone.
Thanks Again,
ErikaB

 
Old 02-23-2007, 02:19 PM   #4
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Re: Spondy Newbie

spondy is when the vetebrae is moving...disc is seperate. Well there are a few kinds of spondy one is sponyolethesis spelled wrong ofcourse where the vertebrae is or has moved or shifted or still is. That's the one I have. The other is I believe a crack...not sure. There is alot of information on the net about it, but we can't post websites here.

Good luck with your tests and in the mean time take it easy. The one safe thing you can probably do is walk...as much as you can.

You are definitley not alone, and can find all kinds of support here. I never even had cyber friends before..and now they are some of my best friends in the whole world.....welcome!! The one thing I know for sure, is its hard when our friends and family don't truly understand our pain, here we all understand.

 
Old 02-23-2007, 06:05 PM   #5
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Re: Spondy Newbie

I just found this forum and it is very informative.

I've also been to a chiro. They might be good for some spinal issues but not this one. It is a waste of time.

Depending on the degree of slip, a good exercise program designed by a Registered Physical Therapist who specializes in spine issues, can help.

An MRI can give a lot of information. You may or may not need a disc-o-gram. The MRI is a piece of cake. The dis-o-gram is not fun.

I was told that surgery is not an emergency unless you have bladder or bowel problems. If this happens, I was advised to go to the ER. Surgery is for the relief of pain, so I was told. Depending on other spine issues, it may or may not be effective. The surgeons I talked to said fusion surgery was indicated for me (L5-S1) but due to the condition of L3 and L4, the odds of pain relief is questionable. So far the only thing that is keeping me sane is Fentanyl patches and Percocet from my pain management doctor.

Last edited by Jack24; 02-23-2007 at 06:08 PM.

 
Old 02-23-2007, 06:36 PM   #6
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Re: Spondy Newbie

[COLOR="DarkOrchid"]HI Erika,
Welcome!!! You will be so happy that you found this place, I thank God every day that this board is here, with people like you who know first hand what it feels like to suffer like we do. I agree with Yvette, walk, walk, walk, it's the best, safest thing you can do.

I have a grade 2-3 spondy at L4-S1, I have had 4 fusion surgeries in the last 3.3yrs. They could not "fix" mine because it took yrs before they diagnosed me properly by then it was BAD. Then the first fusion failed, the screws became loose (hubby had a ball with me having loose screws, lol). They removed the hardware and added more BMP, after about 5 months post op the vert. started moving again, back in we went from the back, then 4 days later from the front. That was a lil over a yr ago. No fusion yet, I have hardware securing the vert. at a grade 2-3 spondy with no fusion. They could not put the vert. back into place because of the tremendous amount of scar tissue from the previous surgery's. I'm 45 and I'm on about 20 pills a day to help with the constant pain I am in 24/7. From the looks of things so far this is as good as I'll get.I'm now diagnosed with failed back syndrome, I have permanent nerve root damage effecting my left foot & leg.

I'm not saying all of this to scare you but to impress on you the importance of finding a good DR. from the start, to explore ALL of your options, get a second & third opinion BEFORE you make any decisions for treatment. I learned from experiance, I'm here to help others learn from my experience not from their mistakes. Many Many people with your condition get fixed and go on to live perfectly normal lives, dont' let what you read on here discourage you from whatever treatment is the right thing for you. The people on here are the exception to the rule, over 80 % of back surgeries DO work. We are the lucky ones, well not lucky physically, but lucky we found each other on here. I know when I get online that my friends are gonna understand if it's a bad day and if it's a good day too. I know I have to give back to this board too, like helping newbies like you, like having that shoulder to lean on so to speak when others on here need help thru a rough spot.

I hope your MRI turns out ok, take yorutime reading on here, you will learn alot. Ask questions and most of all weigh ALL your options before you make any choices.

Good Luck & God Bless

Carol[/COLOR]
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Old 02-24-2007, 10:39 AM   #7
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Cool Re: Spondy Newbie

Thanks mamakitkat and Jack24,
Your reponses help alot. Right now, I have mild Spondy with L5 and S1 and L3 & 4 involvemnt which mostly affects me lying down and mobility...Like most of us, I was an athlete, weightlifter, backpacker, bike rider, hiker.

I do have incontinence, bowel involvement, which I know makes this the pars defect and gives me the most cause for concern...to young to be poopy. My pain is localized in my lower back...though my right leg is weaker and stairs are a challenge. Walking distances is impossible, though I do get out and hike with my dog 2-3 times a week in the park on soft trails...the beach is out of the question as the sand is too unstable and I come home crippled.

It mostly bothers me at night and I don't take any meds...to afraid to wreck my stomach lining, though do take ibuprofen occassionally when it's too crazy bad. I was thinking of purchasing a bed like a Tempurpedic which is supposed to support the spine....any thoughts on that?

My gal at Nordstrom gave me these hard heel/half shoe inserts that keep the spine aligned and they have been a miracle for me in my business shoes. Check them out if you can.

Thanks for reccommending that I find the best care...I'm with one of the best Spine centers in Northern California which does provide the alternative options before going for the surgery, like Osteposthic medicine, acupuncture, physical therapy, bracing etc.

My plan, right now, is to do the physical therapy to strengthen systems....let's hope my orthodpedist agrees. I've been afraid and almost unable to do the situps and exercise required to strengthen the back and stomach on my own. Every time I attempted, with water aerobics, eliptical, treadmill, machines...I became a mess and ended up at the Chiro. So some professional phisiatrist help will be surely welcome. I'd like to strengthen back and stmach to drop the weight my condition has helped me put on, well before even considering surgery, which seems imperative.

I read about these braces, orthoses, which sound horribly frightful. Hard plastic braces...oh no!
I'm just coming to realize I will never return to my former active self and must learn to manage my life with this new found disability. Though having lived with this now, for years, undiagnosed...my pared down lifestyle is already a given.

I just did my "moving" xrays and am waiting for my MRI appt. You guys are so positive and it means alot to me...just a place to vent where I don't sound like an "old lady" or a winging complainer.

Keep in touch all.
ErikaB

 
Old 02-24-2007, 11:03 AM   #8
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Re: Spondy Newbie

Just to be clear....spondy is when the vertabrae is slipped...not the disc. I hate to state this as fact as I'm not a doctor, but it's not something that can be corrected without surgery. You can try to control the pain in various ways, but the vertabrae won't go back to the correct position.

I have spondy at L5-S1 with the disc between completely degenerated. I'm almost 34 and will be (unless I change my mind) having PLIF on May 21st.

I agree with Yvette...stop seeing a chiropractor. You could do more harm then good with a chiro and spondy.

Your condition sounds very severe...even compared to me. I can walk a couple miles everyday. I can walk on the beach. I don't have incontenence. I do take pain pills though. I suffer when I do too much bending and lifting. I'm just tired of the pain and need to proceed to the next step as I have a 20mo daughter who needs her mommy to be healthy and able to take care of her.

((((((((((((BIG HUGS TO YOU))))))))))))))

 
Old 02-24-2007, 11:09 AM   #9
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Re: Spondy Newbie

Hey Jack,
I love your direct approach to our issue!...I have the same condition as you...you must have been an athlete like me.

I'm counting on the physical therapy well before considering surgery. Though my condition is definitive, it is not advanced though I do have the bowel invlovement and am not too encouraged on how my orthopedist will responde. I'm a big believer is healing myself, and believe if I stregthen my muscles supporting the lower back, it will make a difference...Perhaps I am a cockeyed optimist.

I think I have a high pain threshold and just deal with it...it mostly bothers me when I sleep/lying down.

Keep in touch, I haven't gotten my full diagnosis.
Did you have, or will you be having surgery? When were you diagnosed.
Thanks for all,
ErikaB

 
Old 02-24-2007, 12:52 PM   #10
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Re: Spondy Newbie

[COLOR="DarkOrchid"]Hi Erika,
You sound like you have a plan and it sounds good, here it comes, BUT whenever a incontinence problem exists it is a very severe problem and usually needs surgery ASAP. It is much better to start out slow with less invasive treatment and hopefully before you get to the surgery option one of those treatments work. I have never heard of anyone with incontinence that was able to fix it without surgery. I'm on your side and hope that you can find relief with out surgery but please don't dismiss surgery if your dr. wants to do that soon, most docs din't jump right in to fusions unless there is a very very good reason, as you said your too young to deal with diapers.

I will be praying for you, good luck.

God Bless

Carol[/COLOR]
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Old 02-24-2007, 01:13 PM   #11
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Jack24 HB User
Re: Spondy Newbie

Erika,

An interesting fact relayed from an orthopedic surgeon was that Ishmic Lumbosacral Spondylolisthesis (a stress fracture of the spinal isthmus) usually occurs as a teenager, especially in contact type sports like gymnastics, wrestling, football, etc. but can be an isolated event. The supporting ligaments and muscles keep everything in place for a time, then the vertebra slips over time. This is when he thinks mine occurred. The trouble with high school athletics is the participants think they are indestructible.

Also of all our spine parts, L5-S1 is the most poorly design. If you look at it on x-ray you can see that this would be a trouble area. A good reference site is "Spine Universe", you can Google it.

I'm now in my mid 50's and had no trouble until about 2 1/2 years ago. I've seen a physiatrist, 3 rounds of PT, as well as the above mention procedures. I started narcotics about 15 months ago through my Pain management doctor. He seems to think I'm a poor surgical candidate. His opinion is a little tainted as he sees a lot of failed surgeries in his office. A neurosurgeon pretty much said the same though he did give me a 75% chance of some improvement ranging from a lot to very little. He gave me a 25% chance of being worse. An orthopedic surgeon said I could expect 80-90% reduction in pain. This sounded great but the former didn't sound to good. Recovery would be 4-6 months before I could return to work. This would take planning since I'm self employed, i.e. no work no pay.

If I were you I would put off narcotics as long as possible but if you do have to take them don't feel guilty or ashamed. In order to be pain free on narcotics I have to be zonked. I'm to much of a control freak to see how anybody can enjoy it, plus I can't work and be a Zombie. Drugs take the edge off but don't alleviate all pain. There are many unpleasant side effects with opioids as well.

After about 2 years of fighting the pain and it only getting worse, I had to be treated for depression. At one point I was thinking about the ultimate answer. Unlike some body parts, you finally have to give into a bad back.

I still haven't decided what if anything else to do. If surgery had a more favorable prognosis, I go for it. The drugs are working somewhat but with an abreviated lifestyle I am having a hard time adapting to. I am able to work but can't lift over 15 lbs. Driving/riding in a car is tough too.

Unlike some here, I have had an active, good life which I'm thankful for. It is still tough to look into the future and see only pain.

 
Old 03-03-2007, 11:39 AM   #12
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Re: Spondy Newbie

About 8 months ago I had an MRI because of sciatic pain. The radiologist report said that I had two mildly bulging disks. The orthopaedist who I saw said that I was not a surgical candidate, and he prescribed a conservative course of treatment.
On my quest to get rid of the daily pain, over the past 8 months, I went to physical therapy for two months with no success; I had 10 sessions of acupuncture over a period of a month and a half; I had 12 sessions with a chiropractor who specializes in deep tissue massage and adjustment. No relief: So I went to a physiatrist. Over a period of three months she did trigger point injections into my leg then; an epidural; an SIJ injection; and 3 facet joint injections (under guided fluoroscope). They were all ineffective.
Out of sheer frustration in still not feeling any progress, last week I took my MRI's, my x-rays, and all of my related medical reports, to an orthopaedic surgeon, a spine specialist, who only deals with spine issues. (He has been my son's best friend for years (from medical school). I hadn't consulted with him before because he practices in a distant city.)
He reviewed all of my records, my MRI, and x-rays. He said that I do not have bulging disks. I have spondylolisthesis. (He showed it to me on my x-ray and MRI. It was very apparent to me.) My L-4 vertebrae had moved forward. The facet joints on the back of it (for lack of a better description) are pressing on the spinal canal, and therefore pressing on the nerve that runs though the canal. That's where my pain is coming from.
He said that the trigger point injections were useless, and the three steroid injections had been injected into the wrong spot, so of course they had been ineffective.
So for 8 months, I've been dealing with the wrong diagnosis.

Here is my understanding of the stages of spondylolisthesis: The 4 stages seem to be defined by the amount of the 'misalignment' of the vertebrae; the number of vertebrae affected; and the patients ability to 'deal with' or 'manage' the pain.
Stage 1: Basically OTC meds are effective to relieve most of the pain. (That's where I am. His instruction to me: Carry on with your life. He said in stage 1 a lot of people find relief from core strengthening exercises, and walking exercise. He also said that the vertebrae could not be put back into place without surgery.)
Stage 2: Prescription meds are needed to relieve pain.
Stage 3: If prescription meds don't help, they try an epidural.
Stage 4: If the pain is very severe even after an epidural, then surgery may be indicated.
Incontinence is serious at any stage, and ought to be reported to your physician.
That's my latest update. I hadn't posted on the back board in a while.

 
Old 03-03-2007, 11:44 AM   #13
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Re: Spondy Newbie

About 8 months ago I had an MRI because of sciatic pain. The radiologist report said that I had two mildly bulging disks. Based on that report, the orthopaedist who I saw at that time, said that I was not a surgical candidate, and he prescribed a conservative course of treatment.

On my quest to get rid of the daily pain, over the past 8 months, I went to physical therapy for two months, with no success; I had 10 sessions of acupuncture over a period of a month and a half; I had 12 sessions with a chiropractor who specializes in deep tissue massage and adjustment. No relief. So I went to a physiatrist. Over a period of three months she did trigger point injections into my leg then; an epidural; an SIJ injection; and 3 facet joint injections (under guided fluoroscope). They were all ineffective.

Out of sheer frustration in still not feeling any progress, last week I took my MRI's, my x-rays, and all of my related medical reports, to an orthopaedic surgeon, a spine specialist, who only deals with spine issues. (He has been my son's best friend for years (from medical school) . I hadn't consulted with him before because he practices in a distant city.)

He reviewed all of my records, my MRI, and x-rays. He said that I do not have bulging disks. I have spondylolisthesis. He showed it to me on my x-ray and MRI. It was very apparent even to me. My L-4 vertebrae had moved forward. The facet joints on the back of it (for lack of a better description) are pressing on the spinal canal, and therefore pressing on the nerve that runs though the canal. That's where my pain is coming from.

He said that the trigger point injections I'd had, were useless; and the three steroid injections had been injected into the wrong spot, so of course they had been ineffective.

So for 8 months, I've been dealing with the wrong diagnosis.

Here's my understanding of the 4 stages of spondylolisthesis: The stages seem to be defined by the amount of the 'misalignment' of the vertebrae; the number of vertebrae affected; and the patients ability to 'deal with' or 'manage' the pain.
Stage 1: Basically OTC meds are effective to relieve most of the pain. (That's where I am. His instruction to me: Carry on with your life. He said in stage 1 a lot of people find relief from core strengthening exercises, and walking exercise. He also said that the vertebrae could not be put back into place without surgery.)
Stage 2: Prescription meds are needed to relieve pain.
Stage 3: If prescription meds don't help, they try an epidural.
Stage 4: If the pain is very severe even after an epidural, then surgery may be indicated.

Incontinence is serious at any stage, and ought to be reported to your physician.

That's my latest update. I hadn't posted on the 'back board' in a while.

Last edited by judyswrite; 03-03-2007 at 11:46 AM.

 
Old 03-03-2007, 12:23 PM   #14
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Re: Spondy Newbie

Erica,
I'm sorry that I didn't see your post earlier, but have been really busy and not on the boards a lot lately. My daughter was born with congenital spondylolisthesis. She actually just did a 30 minute presentation on spondy, the different kinds - congenital, traumatic ... My daughter knows them all. They there are different grades from grade 1 - 4. When she was diagnosed she was a grade I, less that 25% slipped, and really didn't have any difficulties. The the slip increased so did her symptoms. She was now a grade II at 33% slipped. When your slip is at grade III you have a slip between 50- 75% off and grade IV is greater than 75%.

First her pediatric orthopaedic dr tried rest from all of her athletic activities. She was 14 at this time. Unfortunately that didn't seem to help. She was able to get relief from the heating pad and taking Aleve. When this didn't help he put her in three months of pt, three times a week. It helped build her core muscles which helps with back problems, but it really did not take her pain away. After that she continued to work out on her own at the Y.

No about 10 months have passed and her dr still doesn't like that her symptoms haven't gotten any better. So he suggests surgery. That blew me away, surgery for a 15 year old. So of course I researched everything that I could and sought two other opinions. He was great by actually getting us in to see one of the drs quickly. Well all drs agreed surgery would help her symptoms, but one suggested bracing first.

Of course I canceled her surgery date and she wore a hard tlso brace during all of her waking hours for three months. Again, it did little to relieve her pain and we were now trying prescription meds, but had to keep changing as things were being pulled off the market. After bracing there was six more weeks of therapy to rebuild the core muscles that she lost from no use. Her dr explained they they do not give epidurals to pediatric patients. So here we are at 1 3/4 of a year and still things weren't getting better. In the mean time an mri was done and it was found that she was also born with stenosis. So I gave into surgery for her.

So this is just her course of action. She did have a two level fusion 20 months ago and is pain free now. Even with a fusion there are as many ways to approach the surgery as there are surgeons. Each of these three surgeons would have done a different approach to get the same results. I know she isn't typical of all on this board, but she was only 16 and was very lucky. But we certainly did try two years of non-surgical means to help her before giving in to surgery. Quuality of life ended up being our issue. She did not have the life of a normal teenager.

Good luck at your appointment. cas

Last edited by caszyman; 03-03-2007 at 12:30 PM.

 
Old 03-03-2007, 03:16 PM   #15
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Jack24 HB User
Re: Spondy Newbie

Judyswrite,

According to my doctor, the degree of pain does not correlate with the amount of slip except maybe in Grade IV. Other factors that can affect pain are the condition of any remaining disc tissue, the condition of the facet joints and other things I can't remember. He said he has seen people with grade III that had no pain. Some lucky folks have actually had the vertebra fuse together by Mother Nature, God or their own bodies. I wished I could be one of those.

 
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