Hello, this is a long post, but it should give a description of my mom's back, from beginning to the next apointment this wednesday (to see what doctor thinks of latest tests).
In 1997-1998, my mom lifted a box and that started her life of back pain.
** my mom wrote the following, that I've edited a little **
February 2000, a neurosurgeon diagnosed my back problem as a vertebrae slipping out of place. In December 2000, the L4 and L5 disc ruptured and surgery was performed. Fusion was done with cages at L4-5.
During 5-6 months after surgery, pain was still there, but seemed to be getting better? Doctor cleared back to normal activity, but still taking it easy.
At this point… pain started to get worse.
October 2001, saw a Pain Specialist and started prolotherpy treatments to strengthen back muscles in L4-5 area. This prolotherpy treatment went on for 12-14 months.
Pain continued at high levels and continue to take Vicidon. Pain Specialist suggested I see a surgeon to make sure fusion was solid.
Saw new surgeon, we did a disco-gram, milogram and CT scans. Test indicated pain was in the fusion area.
A second surgery was performed in Feb. 2004. The surgeon took out the old cages from the front and put in new cages form the back. We used BMP to promote bone growth.
Had physical therapy for 4 months starting in May 2004.
Pain is worse and in September 2004, went to a Pain Management doctor, who suggested that the pain might be coming from Facat joints in the L4-5 area. He did steroid injections. Pain was gone for 4-5 hours, most likely due to the lidocain, after it wore off, the pain came back. We did steroid injections for 3-4 months… but stopped as it was not helping.
We did HiFrequency radio wave treatments to burn the nerves in the facet joints. There were 3 rounds of these radio wave treatments, but saw no improvement. The pain was still getting worse.
We went back to surgeon and he ordered a MRI, Myleogram, discogram and CT scan. After these test, surgeon had 2 different doctors stating: the fusion is probably not fused.
However, the surgeon stated, “I don’t know how it cannot be fused”.
Surgeon would not do surgery again, as he could not find any specific problem, but told us to come back in 6 months.
The pain is getting worse.
We tried acupuncture for 6 weeks and saw no improvement.
We tried Botox injection and saw no improvement.
The pain is getting worse.
We did a Bone Spect Scan, CT Thoracic and Lumber Spine without contrast on Sept 2007. The following is the results:
Bone Spect Scan Findings:
Comparison is made to a CT of the thoracic and lumbar spine performed earlier today. Normal activity is seen throughout the thoracic spine. In the lumbar spine, there is a mild activity seen bilaterally corresponding to a L4 pedicle screws. There is no abnormality seen in the screws on the CT. Combines findings suggest normal postoperative appearance. There is linear increased activity seen along the inferior aspect of the two interbody disc spaces. There is a fragmented ossification and the osteophyte formation seen along the anterior-inferior aspects of the metallic L4-L5 spacers on CT. No other abnormalities are seen in the spine. Arthritic activity is noted along the superolateral aspect of the right hip.
1. Focal activity along the anterior L4-L5 disc space. There is osteophyte formation and fragmented ossification in this distribution on the CT. This likely represents ongoing degenerative process
2. Otherwise normal postoperative appearance from L4-L5 fusion.
3. No scintigraphic evidence of lesion in the thoracic spine.
4. Arthritic activity in the right hip.
CT Thoracic and lumbar spine without contract
1. Stable postoperative appearance at the L4-L5 level.
2. Stable minor protrusion of disc material at the L3-L4 and L5-S1 levels. No selective nerve root involvement.
3. Medium-sized, left posterolateral T7-T8 disc herniation. No selective nerve root involvement.
4. No significant canal or foraminal narrowing at any level.
Pain description, overall since beginning:
Since after the 5-6 months after the first surgery, pain has been going down hill, slowly, steadily getting worse with time.
In general, lying down is the only thing that really helps. So, it makes sense that after sleeping, the mornings are the best for the pain. As the day and activity go on… the pain starts to get worse.
Taking drugs, they help in that they mask or make the pain tolerable, they do not make the pain go away.
Besides the last few months, pain is less in the morning, worse any other time. Now, as of late, pain seems to be bad all the time.
Pain level. My mom has a very, very high pain threshold. I could only imagine when my mom says it hurts… it’s MUCH worse than you or I could tolerate.
Exercise. My mom does not really exercise at all. Well, she is very, very active, but this activity is running her shop. She works all the time. Is on her feet all the time. And I believe she wears crappy shoes (not supportive).
Nutrition. My mom’s diet over the years is not a good one. Its better as of late, but eating a well balance meals is NOT her thing, much less eating correctly throughout the day. I bet her eating healthy habits are extremely lacking when compared to the average person. Oh, my mom is very skinny.
To sum it up…
We need a solution to rid my mom of back pain. Something that works. She has tried many, many things. Has seen many, many doctors.
I know some of the problems stem from her lifestyle habits (work too much, rest to little, not treating the body correctly) HOWEVER, the last tests show problems????
If the test are correct, they may or may not be, BUT if they are….
What can we do?
I’m looking for people who have been in her shoes, done what she has done, experienced what she has experienced…. And who finally found a solution.
I’m really, really hoping that there is a solution out there in this world… one that will work/fix my mom’s back.
Obviously, as much as a solution could solve her back pain, we also need to fix her unhealthy lifestyle. Right now, it seems that we are not sure if the egg or chicken comes first. Does the back fix the lifestyle or does the lifestyle fix the back?
Thanks for your help, knowledge, experiences, ideas, and prayers
Well Hi Larry. You have certainly found the right board to post your mom's issues and talk with others like her that have chronic back problems.
Unfortunately, there is no miracle cure of fix to your mom's back or anyone else's I'm sad to say. There is just still so much they just don't know about the back and the nerves even with all the technological advances that have been made. They still have such a long way to go.
Your mom's fusion could or could not continue to be part of her problem along with other spinal changes that were evident on the impressions. Surgery does not offer a guarantee to riding of our back pain. It's just a ray of hope.
Your mom's issues are also not uncommon and if you continue to post here, and I hope that you do, you will chat with many here that have been in a similar position as your mom and give you their stories and what they are doing about it or how they are coping.
A proper diet/nutrition is very important to helping get the most of our bodies and especially when we have health problems. Sugar and/or carbohydrates lead to swelling which places more pressure on things then without these. Proper vitamin and mineral intake along with balance of water is also essential for proper bone maintenance and muscle contraction, etc. So eating right is ALWAYS a good thing.
A supportive and cushioning shoe is very important to have and maintain for us back pain sufferers. A good cross-training sneaker is a good idea, but there are lots of others out there that fit this bill well too.
I know she has seen many surgeons, but it never hurts to get another opinion. Doctors are all different and so are their ideas and approaches. Hopefully one will be able to help find the source of your mom's pain and either rid of it or at least control it much better for her.
Keep us posted on her.
"believe in the beauty of your dreams"- E. Roosevelt
L5/S1 bulging @ 18, now 46; still there (but no pain)
Fusion at L4/L5 Apr -2006
Solidly Fused Nov-2006
A Success, but still improving!
Welcome and I must say you are thorough. It's nice to see your trying to help mom. I have been in chronic pain since 1998 so I know how you & your mom feel. It's a hard life with pain in it every minute. I admire your mom for not giving up. I am disabled with failed back syndrome, they can't "fix" me. I have DDD, arthritis, stenosis, lordosis & splondylilosis. My problems are all in L4-S1. My vertibra are secured with rods, screws & cages in the grade 2-3 spondy (one vertibra is almost 50% moved forward) They cannot put in back into place due to 4 surgeries causing too much scar tissue and to remove any scar tissue will just generate more.
I would love to tell you that there is one wonderful fix out there waiting around the corner for your mom but I'm not a dr. so I won't even begin to diagnose your mom over the internet. I can say that your mom is doing just what she should be doing. Going to the dr. until she finds help. I went to so many dr.'s from 1998 to 2003, in 03 I found a dr. that finally diagnosed me but it was too late then. We decided to try the fusion even tho the chances were very slim for me. I am somewhat better after 4 fusion attempts but I did not fuse either not one of the 4 times. I have a very small bone growth but not enough to be fused.
I'm so sorry your family is going thru all of this, you must be a strong man emotionally to still want to help your mom. I kept searching until at least 2-3 dr.'s all have the same opinion then I could say with confidence that I tried to the best of my ability.
Your mom is a strong lady too, to run her own place with all of this pain, I couldnt' imagine how hard that must be for her. I will keep your family in my prayers. I can't think of anything left to try besides the spine stimulator, it helps to block the pain feelings from getting to your brain so in essence your in pain but you don't know it. That is the only option left for me too, I have chosen to put that off for a while since I'm only 46 I dont' want to use up all my options so early in my life.
I hope someone here can be of more help than I have been, I did want to welcome you and commend you for searching for help for mom.
"Thru every dark corner is a door to a new light"
THANKS for the post, wishes, help and 'talking' ----
we got back from the DR today.
at this point, he can fix something if its broken, etc. He feels "structurely", all is well. Goes without saying --- some people can have the same back and be fine... others can have problems.
So, as I see it:
1) we got to change my mom's WHOLE lifestyle --- EVERYthing in, if it is not helping -- more than likely its hurting the back in some way, directly or indirectly. exercise, eating, mental happiness, etc. etc.
2) pain --- got to find a person who KNOWs, who DEALs, who UNDERSTANDs exactly what my mom is going through... someone who GOES out of their way to help make a differenence in the pain. Not some who will do their job... but goes out of their way to help. Does that person exist???? not sure.
I hope so.. hopefully we can find such a person.
3) the back --- if structurely, its all sound --- then maybe the first 2 items will eventually help/heal the back.
If there is a problem in the back --- get some other opinions, eyes, help with that.
so, I'm hoping posting the finding of the latest test --- one might offer some opinions Yes, I know... no one will diagnose over the internet --- i'm only looking for opinions and personal experiences, etc.etc.
this all sounds good, i'm talking good..... its a good plan, but
can my mom and I execute?
As I said to my mom, you are in a downward spiral. Its going to take a huge positive force to get out. Its going to take time. Its going to be hard.
Mom, I love you and WE ALL want you to get out of the downward spiral.
Glad to hear there's nothing "wrong" that is a good thing that they can't see anything that needs "fixed". But it doesn't help how she feels very much, I know.
I have to ask if your mom is in agreement with changing everything like her diet and so on. I agree that any healthy changes can only help her physically but sometimes it can damage emotionally if the person is not 100% in agreement about making those changes. Trust me, emotions contribute BIG time to pain levels. So if your mom is feeling pressure from others to make these changes and she doesn't really want it too, it may not be the best answer.
It sounds like your pretty close to mom, that is so great! but be careful, sometimes our helpful views can not be very helpful. I'm not saying this because I think it pertains to you but only to caution you that it does happen more often than not.
I have had times where my family, who is nothing but supportive, has wanted things for me that I didn't want and it really caused alot of tension for me. I really think whatever plan your mom does try has to be HER plan and she needs to be the one to decide that. I know you want to help your mom but this is a time where stepping back and just supporting her may be the best thing you can do for her. Any pressure from family & friends can possibly make things worse. things like the starment about the downward spiral can be a devastating thing to hear from someone. I'm sure she feels inadequate with this pain keeping her from feeling normal. People who suffer from chronic pain tend to suffer from depression and low self esteem and when others try to tell us what is best for us it can make those feelings even worse not better.
Sometimes NOT focusing on the pain is the best answer. I am with a pain management dr. now because I'm not getting better anymore. Perhaps your mom needs to find a good PM doc and see what is available to help the residual pain she has. From what I have learned with PM docs is that they focus on how to help you live with the pain NOT on how to "fix" you. When I go to my PM doc we discuss what is going on with me what my options are and then he lets me decide what we will or won't do. I have never been to him where I felt worse after the visit. Do I have pain still? YES, but it is not my main focus anymore, I take my meds as prescribed and I get thru the day.
My surgeon cautioned me before my first surgery that after surgery I will probably have some pain for the rest of my life. He said that no one has major back surgery and never has pain again.
From what I recall your mom has arthritis & degenerative problems in her back, that will not get better. Unfortunately there is no cure for those problems.
As I said before I am praying for your family. I hope that you find alot of info on here that will help you & your mom to deal with this.
"Thru every dark corner is a door to a new light"