I’d like to apologize in advance for this long-winded post….but I’m asking for input so I might as well give you all the info, right? here goes….
About two years ago I began having a dull nagging pain deep in my right butt cheek/lower back. I figured I was sleeping funny or the mattress was going bad. It would better some days, worse others. after a few months, when I realized I couldn’t stand more than a few minutes at a time, I finally when to my general doctor. He poked & prodded and I asked him if this is something I should go to a chiropractor for. He said he felt around and didn’t feel anything a chiro could fix. Fine. He ordered me to get xrays and sent me to physical therapy. I did physical therapy for a few weeks…until things seemed to get worse.
Somewhere around this point I was told to get and MRI and was given the name of a neurosurgeon and an orthopedic surgeon.
The report on my MRI reads like this:
L1-L2: There is no canal or foraminal stenosis.
L2-L3: There is no canal or foraminal stenosis.
L3-L4: There is no canal or foraminal stenosis.
L4-L5: There is no canal or foraminal stenosis.
L5-S1: There is bilateral pars defects and mild to moderate facet hypertrophy with mild anterior listhesis of L5 on S1. There is disk desiccation with unroofing of disk material and superiorly directed disk protrusion with an annular tear, overall spondylotic disease burden causes mild bilateral foraminal stenosis with mild compression of the exiting right L5 nerve root within the neural foramen by a combination of the hypertrophied disk and facet material. There is no canal stenosis at this level.[/SIZE][/I]
So I met with the neurosurgeon, he took one look at my MRI and said ‘oh, yeah, you’re going to need surgery – it’s inevitable’. Well, I practically ran out of his office.
I went to the orthopedic guy and he told me I may need surgery but he wanted to try less evasive methods first. He told me to get epidural injections. At this point the pain was traveling down my right leg, and there was occasional tingle in my foot. After I went to my 3rd injection – with minimal relief – I snapped, came to my senses and said to myself ‘what the hell am I doing? This isn’t [I]fixing[/I] anything – even if I DO get some relief’. Meanwhile, a few people said I should really give chiropractic a chance. So, I called my orthopedic guy and asked his nurse if I could talk to him about seeing a chiro. She said ‘make an appointment’. I explained I just want to talk to him – ‘make an appointment’. Well, I can’t wait a month just to talk to him…so, I made an executive decision and made an appointment with a chiro.
The chiropractor looked at all my info and he was the first person to finally tell me ‘you have what’s called spondylolisthesis’. Yay! A name for this madness! He said they treat many people like me with good results. again, willing to try anything, I jumped in. each visit they did a quick manipulation, and stimulation and started giving me stretches to do. I started getting some range of motion back. But still, that pain and tingling was still there. after a few weeks, the chiro decide to try traction. what a scary day that was. After a few sessions with traction, I did see some relief. But it came with a price. If the traction was too intense, either my hips would hurt, or my lower back would kill me for a couple days. But if the traction was ‘just right’ I’d have some relief. So, I started asking about an inversion table. I asked both docs at the chiro office seperately what they thought and both said the inversion table would help. So, when insurance ran out on the chrio visits, I bought an inversion table. I use it for 5 or 6 minutes each evening. I have to be careful, just like traction, if I go too long or invert too much – it’ll hurt me for days. If I do it ‘just right’ – it’s helps.
Also, about 3 months ago, I started doing more intense core excersizes & stretches. Everything I read said ‘strengthen your core’. If anything, this has helped with getting more range of motion back, and has definitely helped correct my posture. But still, the pain. The leg pain and tingle
So, now it’s a year later. Some days I feel like the excersizes and stretching and inverting helps. Then some days I just wanna lie on the floor and put myself in position that doesn’t hurt and wait for the next day. I’m back to thinking I should get surgery. I met another orthopedic surgeon the other day. He said I’ve taken all the right measures and I’m at a fork in the road. I need to decide. When ever they start talking about rods, and screws and fusion – I go blank. it's overwhelming. I can’t wrap my head around it. ….then a couple days pass, and I’m lying on the floor thinking, ‘if rods & screws will fix this – CUT ME OPEN NOW!’ he said that because i'm only 40, i'm not overweight, and i dont smoke, that i'm a good candidate. that i'll recover quickly.
I need input. I need advice. Anything. i'm trying to find someone who has the same problem as me...or something close. but that is on the other side of this. that can give me advice.
i'm only 40 and havent done the the things i love in 2 years...fishing, tennis & playing with my kids.
i forgot to mention - it wasnt until talking with the chiropractor that i recalled falling flat on my back while ice skating with my family that might have set this off. that was two years ago, right about the same time when this all started.
Welcome to the boards...sorry you are going through all this. I'm in a similar situation...I have spondylolisthesis, along with severe disk degeneration and a bad herniated disk.
What type of surgery did the doctor discuss with you? I'm wondering if a discectomy would be an option. It sounds like your nerve pain is what's bothering you the most, in which case if there is a way to remove what is irritating the nerve, that would probably buy you some time. A discectomy is a much easier surgery (i was in and out in the same morning, and back to my routine within a few days, with no lifting bending or twisting for a month). It sounded like from your report that you have disc material protruding out, which is probably part of the reason for your pain.
I did all the same things you tried, and nothing helped. I finally went for a discectomy/laminectomy back in 2005. It gave me relief from my pain for 4 years. Unfortunately I reherniated my disc at the end of my last pregnancy, and had a second discectomy in Feb 2010. That surgery helps tremendously the nerve pain. If there's a lot of back pain, that's a different story. At this point I am getting ready to schedule my fusion, because there's nothing else I can do and my quality of life went down the tubes. I'm also very inflexible due to the spondy, and my disc is a disaster (severely degenerated, desiccated, and narrowed, on top of being herniated for the umpteenth time).
Did the doctor go right to suggesting fusion, or did he give you other surgical options?
yeah, it's mostly nerve pain for me. at the 'pinch' (right buttock) it hurts (sometimes burns), on the right side of my calf it hurts - like it's being twisted, and the tingle in my foot scares me (aside from being super-annoying). oh, and deep in my hamstring it will hurt. really not much back pain. and i was having spasms, but i think the stretches, etc helped clear that up.
yes, he (and the other two docs i spoke to) all jumped right to fusion. no one mentioned this discectomy. but you've got my attention! is this done with laser? or am i thinking of something else?
thanks for the reply
Last edited by TingleFoot; 09-23-2010 at 12:14 PM.
Hi. I'm sorry you are having such a hard time of it. It sounds to me like you are at the end of your rope; you can no longer do the things you love, you have lots of pain, you've tried lots of conservative methods to "fix" yourself and it looks like things have only gotten worse with some mild relief in-between.
If you weren't crazy about the lst doctor you saw, I would urge you to find either an Orthopedic Spine Specialist (my preference) or a Neurosurgeon. It's possible that surgery is all that is left. I don't know why the chiro was so sure you have spondylolithesis but for sure you have a bad disc which is putting pressure on a nerve at the L5-S1 and that is causing many of the symptoms you describe. The annular tear (outer lining of the disc) is allowing disc material to drip onto the nerves....that material is caustic.
I hope you don't delay any longer. Nerve damage can become permanent if you wait too long to remove the impingement and thats no fun at all.
Good luck to you. And please let us know how you are doing.
Last edited by moderator2; 10-18-2010 at 10:25 AM.
Reason: huge quote
again, i appreciate the replies and feedback. i've kinda just been sitting back seeing where this goes the last month. that was my plan, with my two appointments coming up this week. i fully expected to meet the two surgeons again (second visit for each) and then decide who i'll let do it.
so, now i'm second guessing all this. i'm right on the cusp, i decided 'yup, i should do this'. now, im set back...not sure what to do.
between my chiropractor throwing out the 'oh, people wth spondy usually dont get surgery' comment...to, not being able to find anyone who's had the same problem to talk to directly....it's making it hard to decide. do surgeons give references? i wanna talk to someone wh's had it done (realizing they wont give me the name of someone they've botched).
the core excersizes helped take the tingle out of my foot. but that's where the improvement stopped. but, am i giving it enough time? no idea. the leg pain/numbness has shifted positions, it seems. and good days it's good, on bad days its BAD. it does make me worry about permanent nerve damage. that alone is enough to scare me into getting the fusion.
Last edited by moderator2; 10-18-2010 at 10:24 AM.
Reason: please do not post websites except as described in the Posting Policy
Exact same issue here. Excellent health and ran marathons 3 years ago, can't run to my mailbox now without upsetting nerves. I'm still active but the condition is extremely symptomatic, I can even do modified strength training with minimal negative effects. Some days are good and others are not. Once the epidural steroid injections wear off life becomes difficult and most activity stops and my overal mood is in the gutter. When the pain is bad its difficult to focus on life when your taking Hydrocodone and Skelaxin ever 4 hours. Also, I'm VERY nervous about surgery...
Spondylolisthesis is when one vertebrae moves forward over another below. No amount of injections can fix this though it can help the symptoms. No amount of chiropractic can fix this permanently as your vertebrae is no longer anchored and will continue to move based on daily normal movements and that will all cause repeat symptoms.
The important thing is to discuss with an Orthopedic Spine Surgeon or Neurosurgeon what Grade of Spondylolisthesis you have.
For people with Grade 1 often injections can help as they are less invasive and will help decrease symptoms if they work.
For people with Grade 2-3 often the best treatment is a fusion. The fusion anchors the moving vertebrae to the one below (or above it) so the moving vertebrae (spondylolisthesis) .
At Grade 4-5 surgery is virtually mandatory to avoid permanent nerve and spinal cord impairment.
You can start at Grade 1 and gradually it can get worse to the latter grades. In my case I though I had hip pain one day during college and it was Grade 2. Since no amount of non-invasive treatment would permanently correct the problem I opted for surgery and had a quick recovery. I'm unique in that I have very loose ligaments and tendons so I get additional levels of problems and have neck, knee, foot and thumb problems as well.
Your MRI does indicate anterior listhesis. Spondylolisthesis shows in two forms. Anteriolisthesis when the vertebrae moves forward, which is the most common and posteriolisthesis when the vertebrae moves backward which is not often.seen. So perhaps the NS and OSS you saw didn't explain using the exact term spondylolisthesis but the MRI shows that as a finding.
Grade 1: 25% of vertebral body has slipped forward
Grade 2: 50%
Grade 3: 75%
Grade 4: 100%
Grade 5: vertebrae has fallen off level below.
After 10 years of suffering gradually worsening pain I finally had a spinal fusion on July 7th of this year. Even though the recovery is frustratingly slow I can already say it was the best decision I ever made.
I too had spondylolisthesis along with a few other issues and over the years I have tried everything in order to avoid surgery. I was treated by an orthopeadic surgeon who was excellent. She advised fusion as opposed to other surgeries as she believed anything less would have resulted in further surgery in a few years time.
I have been unable to do any form of excercise for the last two years and at my worst had to call an ambulance as I was unable to get out of bed! I have permanent nerve damage in my right leg which is irreversible.
People are right when they say you notice the difference as soon as you wake up - I couldn't believe it and kept waiting for the pain to start - it never did! That said fusion is MAJOR surgery and you should think long and hard before you make any decisions. Mine was a one level fusion of L5-S1 which sounds like the same area you are having problems.
Again I am otherwise healthy so the prognosis is good (35 at the time of surgery). I start hydrotherapy next week as my hamstrings have contracted and I am not looking forward to it - I get the feeling that the surgery was the easy part and the rehab is going to be hard work after being inactive for so long.
If you do have the surgery good luck and remember that it will take a long time to recover which can be very frustrating. There is a wealth of information and advice on this forum and I found it invaluable when making my decision. Let us know how you get on
[QUOTE=scmtx;4612204]Some days are good and others are not. Once the epidural steroid injections wear off life becomes difficult and most activity stops and my overal mood is in the gutter.[/QUOTE]
isnt this horrible. when my alarm goes off, i lay there a minute with anticipation wondering what kind of day it'll be. when i swing my feet out of bed - i'll know. i've had to apologize to my wife a few times about my demeanor. 'sorry, this isn't [I]me[/I] - you know that, right?'
[QUOTE=SpineAZ;4612279]I'm unique in that I have very loose ligaments and tendons so I get additional levels of problems and have neck, knee, foot and thumb problems as well.[/QUOTE]
can you tell me more about this? because i've had issues with my shoulder, ankle and thumb joint - all on the same side (right) as my spondy symptoms.
...i'd hate to think i'm unique too.
[QUOTE=Ruth9901;4612365]After 10 years of suffering gradually worsening pain I finally had a spinal fusion on July 7th of this year. Even though the recovery is frustratingly slow I can already say it was the best decision I ever made.
If you do have the surgery good luck and remember that it will take a long time to recover which can be very frustrating. There is a wealth of information and advice on this forum and I found it invaluable when making my decision. Let us know how you get on[/QUOTE]
sounds like your on the up side of this. that's awesome. i wish you a great recovery.
i know it'll take time. lots of time. but, after suffereng for two years...i'm willing to wait out recovery.
i still havent decided. when i met the two surgeons a couple weeks ago. the first said i've tried everything i could, i've taken the right steps - now it's up to me to decide and that i should call him when i'm ready. the second practically threw me out of his office (in a nice way) and said 'you arent ready for surgery'. the problem was i wasnt crawling on my hands and knees begging to be fixed. i was having a good day that day.
those were both orthos. i'm meeting a neuro in a couple weeks for a 4th or 5th opinion. she's was highly recommended from a friend of my dad.
For me all I can say is all my life my ligaments and tendons have been over flexible. This caused me to have my foot bunion surgery at a young age as the tendons and stuff around that joint just give out. Same with my knees and spine. Nothing specific they have diagnosed me with but has caused me more problem sin my 40's (currently 44)
You guys are awesome! Although it sounds insensitive, I am glad to see that I am not alone. People that haven't gone through this really can't sympathize.
My pain started in my legs and feet over 10 years ago. My first round of doctors said everything from 'Welcome to middle age' to 'I can't help you, but here is a Handicapped Parking permit'! More than one 'specialist' said that my pain was imaginary.
Over the years I have seen Neurologists, Chiropractors, Pain Management Specialists, Physical Therapists, etc, and nobody had any answers. After 9 years of absolute misery, my daughter recommended that I go to see the Ortho Surgeons at the medical school she is attending. What a blessing!
After a couple of Xrays and MRIs, they found I had major L5-S1 slippage and a nasty bone spur in my hip. I had the hip surgery in April and now I can walk without a cane for the first time in years! I am going in for the L5-S1 cage/screw surgery in December and that has me worried. I am concerned about how much time it will be until I am able to do simple things like drive my daughter to school or go to the grocery store. I know that everyone is different, but I am hoping that there is a common answer to this question.
I too have the current issue of going off at the mouth when I try to get out of bed in the morning. If I cough or sneeze, I see lightening and stars and other things that you might see in a cartoon. I know that the spine surgery is my only option at this point, but I am terrified that I will be an invalid for a long period of time during recovery. Any advice?
I don't know if you have read any of my threads or messages but I am having my surgery in a week finally. It has been 10 years of agony and about 5 surgeons, 3 pain specialists and several GP's but finally I was happy to go with this surgeon. I know my disc at L5-S1 is almost non-existent and L4-5 has a tear and is black in the MRI meaning there is no soft centre any longer I am not sure of the condition of the facets but this neurosurgeon came up with the plan I envisioned when I was shown the mri by one of the surgeons.
The lower vertebrae will be separated then fused with an implant and the next disc will be removed and replaced with a flexable disc replacement. I know of other people having success with the replacements and if it will help give me some flexibility, hopefully that will stop any damage to the next level over coming years. But I also realise my back will never be like it was in my 30's and I plan to change my life completely. No more shovelling, jumping, lifting weight, etc. I will not damage my back any more especially for someone else's benefit.
I had to change my spiritual and emotional life completely when I gave up drinking and smoking at 40 years old and I am able to change my physical behaviour now at 50. Along with my exercise regime. I will have to spend lots of time on nice quiet walks and regular swimming. I will not be doing any of the physical exercise I grew up with in my outdoor field of work. Concreting is out along with building and motorcycle riding.
So I am expecting a big change so I will need emotional and spiritual support or I won't change anything. I believe it will take a lot of relaxation as well. So I don't expect to be working for a while until I am healed up properly and if it takes 12 months or 2 years well that is what it will take. I am planing on giving it my best shot. Lucky I like music Ha. I will need something to stay sane.
25-Nov-2010: ALIF fusion L5-S1. 9 years of Chronic lower back pain. Nearly 18 months of pain across my upper pelvis, through my butt and down my left leg into my foot. Sciatica relieved by surgery.
I had a spinal fusion in 2009 when I was 22 and it was the best decision I have ever made. I was in constant pain with no relief. I also sought the help of a chiro with no help. Finally they x-rayed me and found a pars defect that had lead to grade 3/4 spondy. I had 4 screws and 2 rods put in. I have some range of motion limitation but nothing that really effects my everyday life. I have normal back pain when I overdue it but by the next day its gone. You need to find a surgeon you trust. I am a surgical technician by trade so I know how important it is for a patient to trust their surgeon. It will make everything go much better if you do.
i havent been by in a while...but i think i have an update.
i've decided i can no longer live like this. i can no longer wake up every morning wondering what the day will be like - pain-wise - before i swing my legs out of bed. i can no longer ask my wife & kids to bend over and pick up the simplest of things for me because i'm afraid to. i can no longer avoid going for walks or bike rides. i can no long suffer while sitting at my desk at the office. i'm done.
i've found a neurosurgeon who i trust and who's highly recommended from a family friend - who says she's changed his life (for the better).
i've tried it all (i think) for a year now. PT, injections, core exercising (helped a bit), chiro.
i'm a good candidate for fusion - so i'm told. 41, in good physical condition, not overweight, never smoked. i'm prepared, mentally, for a long recovery. the boss says me working from home won't be a problem.
so...unless someone here has a REALLY good reason for me to not do this, speak now!!
and again, i havent been by here in a while, so thanks to everyone for the replies. and [B]jstanley[/B], thanks for the encouraging words.
edit: oh, hey [B]jstanley[/B], i see your in OH too. can i contact you? email or something? just wondering if weve seen any of the same docs, by chance.
Last edited by TingleFoot; 01-27-2011 at 07:31 AM.