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Old 11-16-2007, 08:34 PM   #1
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Chronic back pain

Hey all! I recently had CT scans done of my cervical and lumbar spine. The results are listed below. Any and all advice would be helpful. The pain and discomfort have started affecting my everyday life style.

Findings:

1.) Reversed cervical lordosis
2.) Degenerative changes at the C4-C5 levels
3.) Broad-based disc protrusion at the L4-L5 with significant foraminal stenosis.
4.) Moderate amount of free fluid in the pelvis may be related to physiologic etiology. Findings could be better evaluated with MRI.

 
Old 11-16-2007, 09:26 PM   #2
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Re: Chronic back pain

Well it looks like you about to be headed for an MRI to be more conclusive of some of their findings.

C4-5.. are not normal, but doesnt note anything going on there. Probably just aging there (aka degenerative disc disease). It's not a disease.. it's a condition that happens to us all.

L4-5 you have a disc bulging along with stenosis (which is where the nerves that run through that area are being squeezed), which is likely causing you quite a bit of pain at this level.

I have no idea what is meant about the pelvis and the fluid present there.

The cervical and lumbar regions are often treated separatey and your doctor will work with you to learning more about you and decide which is most important to treat first and go from there. Since your cervical is not really noteworthy, I am guessing the lumbar region is going to take priority in treatment options.

Welcome to the board and keep us posted
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"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
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A Success, but still improving!

 
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Old 11-16-2007, 09:39 PM   #3
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Unhappy Re: Chronic back pain

Thanks for replying to my post! I've been researching the internet and some of the information is quite misleading!

So, in response to this. I'm only 23....should I be having this many problems? I've never injured my back or caused any trauma to it. Which my primary care doctor says is very odd but not rare.

What are the possible treatments for my problems? I know that an MRI will show more in depth....which is scheduled for next week, but I'm still curious as to what my options are? I've been having alot of stiffness and pain throughout the past year or so, but more recently in the past 3 months. My primary care doctor has referred me to a Nuerosurgeon to get an expert opinion but in the mean time he has put me on some pain medication that makes me sick to my stomach! It helps the pain but cause nausea! I'm a mess!

 
Old 11-16-2007, 10:02 PM   #4
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Re: Chronic back pain

I understand. I was only 18 when I herniated my first disc.

This can happen to anyone at any age. While you are young and this mostly effects the vast majority later in life, it still effects some much much earlier. And there is often no trauma to bring this on either. Like other health issues, this is often a trait that is handed down in families. You might check to see if loved ones have had back issues along the way, just for knowledge.

Since you are working up to a holiday next week, I would get in contact with your GP and let him/her know that the medication is making you very nauseous and ask if they can give you an alternative. There are some I just can't take at all, it makes me hurl within minutes of taking the stuff. Such as ultram, ultracet, percocet, etc. I have to take a light-hitter pain med, known as Vicodin. It works best for me and it doesnt make me sick to my tummy at all, and I am not woozy from it and can function during the day. For some, this stuff just isn't strong enough to control the pain.

More likely they will try and control internal swelling, which is a normal mechanism of your body to surround areas in trauma to help protect. So you will more likely be given some medications to help get that under control, which will more likely relieve some of your pain.

Also, they will probably want to do injections at those sites as well, to accomplish the same goal, but also sort of lubing those areas and hopefully bring you some relief. They work for some and others not.

The stenosis mentioned, the only thing I know of to relieve stenosis is surgery . Stenosis is narrowing of the spinal canal, which is where our nerves run through. When stenosis is really bad, they can go in and literally drill out the opening to free up the nerves and hopefully resolve the stenosis.

Your disc is also bulging. That could actually heal on it's own and for many doesn't require surgery. But it takes a long time for it to heal on it's own, if it happens at all. A 2 year timeline is often thrown about.

It took mine 15 years to quit hurting. I was young, had no insurance, and other than a few times of seeing the doc for severe pain, I just learned to take care of myself and it just quit hurting after all that time. I was even told not to have children as they thought my body would not able to carry them. Im a tiny person and I was told I might lose them or myself. And this was all about my back.. nothing else. BUT, I didn't listen, have to grown kids now. It was hard through the years for me when they where small in carrying for them during flare ups.. but I made it through and so did they, fully loved and cared for.

4 yrs ago I blew out l4/l5 moving heavy furniture out of a 3rd story apartment, and I was very fit at the time; body sculpting, etc. So it can happen anytime.

The neurosurgeon is a good choice. Another is a spine surgeon. Not all neuros strictly work with spines, so ASK this one when you meet with him/her. Write down questions you have beforehand, so you won't forget to ask them. These types of docs are very cerebral, so don't be suprised if the one you see has a lack of personality or bedside manner. This is not often their specialty. But at the same time.. get your questions answered. You want a clear understanding of what is going on with your back, an understanding of any treatment plans being offered, and also.. what comes next if the current treatment plan doesnt yield success.

Walking is good for you. It strengthens your back. Are you having any issues walking?? When do you hurt, what brings you relief if any, and what meds/dosage are you on?
__________________
"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!

Last edited by Justoneofus; 11-16-2007 at 10:07 PM.

 
Old 11-16-2007, 10:18 PM   #5
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Re: Chronic back pain

That information that you gave me has really enlightened my thoughts! Thanks!

So, in other words...the disc herniation could potentially heal on it's own? You said that the time frame was a 2 year window...to be honest, I don't think that I can bare it that long!

My GP thinks that I am having sciatica. My left leg tends to get a throbbing and very painful sensation throughout it. It's not a constant feeling though, it just happens on occasion. But when it hits, I'm down! I am limited to what I can do. I cannot sit or walk for long periods at a time.

I'm allergic to Celebrex, so I cannot take that. My GP had been giving that to me along with Skelaxin for inflammation. The RX that I'm currently on is Hydrocodone 10/500 q. 4-6 prn. I've noticed that if I eat about 15 minutes before I take the medicine my nausea tends to dimenish somewhat. I definately cannot take it on an empty stomach. I've noticed too that lately I've been getting an itchy sensation all over my body...no hives or anything, just itching! Is that normal? My GP said for me to try this medicine for a couple of days and if it doesn't help, he would switch me to Oxycodone?? Even though the Hydrocodone does relieve my pain, I think that I am allergic to it and may need something different. Do you suggest anything? It's all confusing to me...I just want something that works or at least helps until I can get in with the specialist!!

 
Old 11-17-2007, 02:49 PM   #6
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Re: Chronic back pain

You are taking what I am taking and those combos work the very best for me. Do you have a sulfa allergy? celebrex has this property as well as other medications. What little left on the market celecoxibs that are out there, most all have sulfa in them. I took this because it worked best for me as an anti-inflammer, but it made me very loopy, probably due to the sulfa in it. I have not taken celebrex for well over a year now.

You need to take note of the itching. I get this with the percocet, darvocet, etc. If you are itching on the outside, imagine what might be going on inside the body. I am truly experienced on allergies.. I have MANY and several are deadly in nature for me.

Being "allergic" doesnt not necessarily mean you cant be near something or ingest it either. The question is what does the item do to you. Is it minor, is it not. Just be watchful of this, and I am always very leary of this when it comes to medications.

Anti-inflammers more often lead to tummy upset. It's always advisable to eat some starchy food when taking medications, (unless directly advised not to) such as a piece of bread, crackers, etc. It also will get the medication absorbed faster into your body in doing so.

Skelaxin is not an anti-inflammatory, but a muscle relaxer. I prefer it, but it's not as potent as some others out there. Many like this for day and something stronger for night. I like it for both.

Hydrocodone is Vicodin. You are taking 10/500. The "10" is the pain reliever (I believe mostly codeine) and the other "500" is tylenol properties it has in it. This also has some anti-inflammatory properties, but used for pain. They also make this in a smaller dose which is 5/500.

Oxycodone is basically percocet. It's a much stronger narcotic medication, but it might be what you need to balance things. It's worth a try. (This stuff I react to big time.) But it's worth a try to find if it works for you. But I would definitely eat something when taking this med too.

More likely your specialist will take a conservative approach, give you meds, possibly steroid injections (which by the way are less harmful to your body than oral steroids) and try some physical therapy and time to see if you improve. I know you dont know if you hold out that long (meaning letting it heal on its own), but you may not get get the choice, as surgery is truly a last resort.

Most all humans will experience disc bulges throughout their lives, but often experience low grade back pain (rather than the chronic back pain level) and it subsides over time or flares up from time to time. Then for those that this scenario goes further, then medical intervention is needed, to include surgery for some.

Surgery will never be an guarantee of solving any pain coming from the spine. It helps many, but some are even worse off then before surgery. With all the technological advances out there today, there is still so much they still don't know about the spine, the nerves ,and the signals sent from the brain, etc. They do the best they can, but they still have a lot to learn.

Please keep posting and let us know how you are doing.
__________________
"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!

Last edited by Justoneofus; 11-17-2007 at 03:04 PM.

 
Old 11-17-2007, 06:55 PM   #7
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Wink Re: Chronic back pain

I've never been officially tested to see if I have an allergy to Sulfa, but I work for a General Surgeon and that is a common allergy that we see in patients. So, there might be a really good possibility that I am.

I think that alot of my discomfort is coming from my back muscles as well as the actual injury. Sometimes I'm so stiff when I wake up that I compensate throughtout the day and it causes my muscles to retract. I go to a massage therapist twice a week for a good back rub! I love going to her...it really does help relax me.

I'm going to call my doctor on Monday because this medicine is making me itch terribly! I can't stand it...but, I have to take it because it helps ease my pain. Thank goodness!

I'm curious as to what my actual options are. I've heard that physical therapy usually isn't that effective for most patients with back injurys. Is this true? I don't want to have surgey and I'm looking for the most non-invasive treatment plans. Someone had mentioned a technique of nerve "burning" to me....do you suggest this? I'm just trying to get an idea of what I should expect....

Thanks again!!

 
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