How do you describe any leg pain you might have? I have had pretty severe back pain for the last two years but no leg pain. Lately, Iíve noticed a kind of pain in both legs and butt like you get the day after a hard workout, only I havenít worked out. 3 years ago, I could easily do a squat with 115 lbs multiple times. Now I can barely do a squat with just an envelope from the mailbox.
The gauntlet of CTs, MRIs and disc-o-gram show the following: I have isthmus spondylolisthesis at L5-S1 Grade 1-2, with stenosis of the foramen bilaterally and all the other stuff that goes with isthmus spondylolisthesis. L3-4 has asymmetrical bulging annulus into the left foramen. L4-5 there is circumferential annular tearing with annular bulge in the midline into the left foraminal region.
I have consulted three surgeons, 2 ortho and 1 neuro that said surgery was indicated, but voluntary. This was before the leg thing. All three said fusion of L5-S1. One ortho said expect to be back later for fusions higher up. Iím scared to death of surgery, but would love to get off these darn narcotics. Plus Iím self employed. We have insurance but my business couldnít take me being away 4-6 months.
Hello Jack -- I'll try to describe my leg pain. The pain originates in my lower left lumbar area, sort of wraps around my left hip and goes down the outside of my thigh, down to my knee. It is a shooting pain, and it is constantly throbbing. As I sit here typing, it is like a electric current - on, off, on, off... I sometimes massage my thigh to try to relieve it -- but of course, it doesn't really. It's funny that you mention not being able to squat -- I can't either, and I end up leaving things on counters rather than squatting down to put them away.
My lower back has always had problems but when the leg pain started, I went to an ortho surgeon, who said I had a bulging disc that was compressing the nerve between L4-5, which apparently runs right down the area I described above. I had a diskectomy but unfortunately, it did not work for me. The pain came right back.
I have been told by a top spine specialist and a neurosurgeon that there is nothing they can do surgically. The discs are all too degenerated to do a fusion, and it could make the situation worse. I believe a fusion would put pressure on the other discs, and since mine are all bad, that's why they won't do it.
I know exactly how you feel. The doctors say the surgery MIGHT help you, but no one's gonna guarantee anything....so you don't know what to do. Especially if they're indicating you'll need additional fusions in the future....I understand fusions are MAJOR surgery with a long recovery time.
Well, that probably didn't help you much but at least we can share "leg pain" stories. :-) Good luck with whatever you decide.
Different discs will create different nerve pain. I had L4 to S1 replaced and fused.
I had pain in my left butt cheek that went down my leg. On a good day, I felt like it was a sore muscle from a hard workout (I ran track in college and I used to be very athletic so I know the difference in muscle pain/burning). On a bad day, it throbbed like a bad toothache down to the bone. I had alot of tingling and occasional numbness in the heel of my foot and my big toe. Keep in mind, the back pain can also be causing muscle spasms which will irritate the nerves. It got to the point I walked the floors for days because of the leg pain and thats when I knew I couldn't fight surgery any more. I didn't want to risk permanent nerve damage and that is still up in the air.
"One ortho said expect to be back later for fusions higher up." This is a risk of having disc fusion. Because the disc is fused and no longer mobile, the discs above it will have to do the work of the disc that is fused putting additional wear and tear on those discs. It can cause discs above it to rupture as well. Many people never have another problem after a fusion and others (like me) have additional problems.
Its going to come down to your pain tolerance level. I have a high tolerance but my whole spine issue (neck and back) has definitely taken a toll on my pain tolerance. I did EVERYTHING prior to surgery, physical therapy, injections, exercise, weight loss, you name it. I had to give in because the pain became unbearable for me. You know your body, listen to it
Jami, thanks for that great description of the way spinal fusions work and the effect on the other discs. Now I know why 2 of the 3 surgeons didn't recommend it for me.
I can tell you (and Jack), that if the 2nd and 3rd opinion would have been spinal fusion, however, I probably would've done it. My quality of life has suffered greatly, and there are so many activities I can no longer do. I guess I was hoping for a miracle....and was stunned when I was told there was nothing they can do.
I get varities of different pain, just to make me feel crazy lol - Sometimes sciatica pain...last few months almost constant needles shooting pains that move around but love to stay in feet and groin area.
I am getting ready to have fusion this week. I have done alot of research and it isn't uncommon for other discs to overcompensate and have problems, this is why I have chosen to find a different line of work. We are self employed as well, and know what you mean. My hubby has to keep working...hopefully being able to work alot during my recovery, not the same as when you work for someone else...we understand all about that.
With me the choice to go for it, was after I had tried everything else, sick of living on pain meds that quit working after you get use to them, and kept getting worse and worse even after a year off work, then my legs went way down hill....and for me..I just decided its my only hope of getting better, so I want to take it. I have read that fusion for spondy is 97 percent succesful over a two year follow up.
I wish you the best in finding answers to your problems....not a fun club to have to join up for.
When I first began having problems it would simply be in my thigh. Very painful - felt like bone on bone. Then a couple months aftewards I began having shooting pains down the back of the calf around the ankle bone. When I would turn my right foot the pains would shoot down to the ankle bone.
I dealt with this for over 2 years before my GP referred me to a spinal surgeon. He ordered those lovely epidural injectiosn which greatly increased that stabbing shooting electrical shock pain. Now it went thru the right buttock, down the right thigh, down the back of the calf into the ankle.
We moved forward with the laminectomy.......pain increased, legs began jumping and now the leg began giving out on me.
Next we tried a selective nerve block........the deep cramping pain in the legs began - severe pain that you could scrape me off the ceiling. Nerve pain went thru right buttock, down the right thigh, down the back of the calf, into the ankle, along the right side of the foot, across the toes into the big toe. Leg giving out spradically especially after driving when I stepped out of the car.
4 weeks out from spinal fusion now - ocassional foot pain and some deep cramping pain. The remainder of the sciatia pain has disappeared. YAHOO!!
Man it sound's like your back is wacked worse than mine..I don't know what kind of buisness you run but you should get that back taken care of before you end up worse. No PT is going to help you and injection's will only numb the area. I'm not sure how long you would be off work ,but I would say atleast 3 months ATLEAST ! I feel bad for you because the small buisness people get the shaft all the time..Forget the squats to. The only time your gonna squat is when you go to the bathroom from here on out .
Hey Jack... I am a long time back pain sufferer (20 plus yrs) that started with my 1st hernaition at S1-L5 when I was 25. My 2nd occurred around 35 (actually felt the nucleus squirt from the S1-L5 disc again!) and after the pain subsided months later was left with numbness & tingling on the outside of my calf and 2 out toes of my right foot (24/7).
My last herniation (Feb '06) was easily the worst at L5-4 created additional numbness, pressure/pain & tingling in the right leg/foot and now on the front of my thigh, outside calf & across the big toe of my left foot.
I have some nerve damage (sensory) & muscle atrophy (confirmed by EMG) on my right leg & pain in my right ankle & foot that is about a 3 out of 10. I can usually control the pain with a daily rx nsaid & a 1/4 tab of lortab 500 at night to sleep.
The 1st neurosurgeon I have seen said I will need a fusion at S1-L5 & hopefully just a disectomy at L5-L4. He would like me to get more active to see if the back will fail again (ugh!) which I am slowly starting back into this week. I am also in the process of getting a 2nd opinion & trying to figure out what to do.
Hope this helps & keep talkin... take care... Dave!
Thanks for the replies. It is helpful and sobering information. Iím still trying to work my way through the psychology of how this has and will affect my life. I am a general contractor. I donít have to do any kind of physical work anymore but enjoyed getting out in the sun, and getting sweaty from physical work. Iíve always been physically active. It came home last summer when I went into a Baskin Robins to get an ice cream. The girl behind the counter was in a hurry and pushed my change at me. It fell on the floor. I canít get that low without getting on my knees in a praying position. The floor was sticky with spilled ice cream so I just left it. A small girl, about seven, saw this and picked up my change. I let her keep it but went out to my car and just cried.
Thankfully, I can still earn a living with the help of Durgesic and Percocet but had to drastically change my routine.
Sometimes I think I would be better off not knowing about the causes of my back pain. Seems like every doctor I see tells me a little more bad news. The first doctor I saw, a family doc, said he though it was a herniated disc. I know now he was wrong but wish he would have been right as it seems easier to fix in most cases.
Dealing with the pain is almost secondary to the transition to the disabled. Especially when most of my contacts havenít a clue what chronic pain is like. It is such an intrusive, personal, hidden, life altering event that no one can see. Trying to do what use to be simple tasks is rewarded with an increased in pain. I feel like a race horse with a broken leg trying to make it to the finish line. And like them, rewarded with a bullet.
My leg pain was what first took me to the doctor. I described it to her as bad cramping, like the cramps that wake you up at night. But the cramps were in the wrong part of my calf. I also told her that it was like having a large splinter jammed in my calf, one that I couldn't figure out how to remove. My upper leg burns and goes numb, in turn. It is only my left leg that is affected. After an MRI and a visit to a neurosurgeon, I have found out that I have congenital Pars Defect, Spondolythesis, and two bulging discs. The discs are compressing the nerve that is causing my leg pain. This is all new to me, less than two months now. I'm in Physical Therapy with small results. My leg pain is still the worst of my problems. I'm on the message board hoping to find some information.
Hey Jack , Most of us here was physically active before our backs gave out. Heck I was playing tackle football and other ruff sport's plus had a job doing labor work alot of lifting. It stinks when you can't even run anymore. When I have to get down to pick stuff up I learned to just get on my knee's , my knee's are ruffed up now , no need for knee pad's
Can't they fix a herniated disc without a fusion ?
Hope you get some sort of relief . Perc's and stuff isn't any good for ya for the long haul.
Hey Jack... sorry ur in this bad back boat... my wife calls me JFK cuz he had a horrible back thru his life.
Anyways... heres the question(s) you have to ask urself...
1) Is this going to get better over time? (for me... no)
2) Am I goin to do further permanent damage? (for me... a very good chance)
If I had been in pain for the last 3 years that requires significant amount of daily pain meds (ie 2-3 percoset, etc) and I started havin leg numbness, I would seriously consider surgery. I have not had severe pain (3 out of 10 in my right foot/ankle) since my last herniation (Feb '06) but I have additional numbness & pressure & I'm pretty sure it's gettin to be time since I don't want to have any more nerve damage.
You may want to get an EMG to determine what level of nerve damage has been done to date just so you know.
Take care & keep talkin... Dave!
PS: Also you have to look at your age... I'm 48 & I'm not sure I want to wait til I'm in my mid 50's or 60 to have this kind of surgery done since I'm still pretty strong & healthy.
Actually, I'm on the backside of 55, i.e. pushing 60 hard. We all have a complicate decision that is not cut-&-dried. My family practice doc and my pain management doc tell me at my age it wouldn't be unreasonable to take opioids for the rest of my life. The way I figure it, I can always come back to them if surgery doesn't work. I have just about decided to go with the surgery but I can't for about 8-10 months due to business concerns. The joys of being self employed.
I never thought I'd wish to be older but paying for my own health insurance I sure wished I was 65.