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Old 12-14-2011, 03:40 PM   #1
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Question Back pain need advise

Ok so here is the history. Will try to be brief. had horsebackriding accident fell into fence fractured my l1 and lots of bruising. Left butt cheek went totally numb. 2 nights in hospital and 3 months in brace. Have had horrible back pain ever since. Have done pt and then started getting lower back pain especially when I bend forward. One am was pouring a cup of coffee and both legs went numb and they felt like they did not even belong to me. Was afraid to move. It finally went away the whole erperience only last maybe 2 min.

Scared the hell out of me went to pain dr and ordered another MRI. Had that done the day after thanksgiving. Pain got so bad I stayed on the couch for at least 5 days. Was having to take my vicoden 10-325 every 4 hrs and it would still not get rid of it. Just made it tolerable. Was hurting to even walk at that point. MRI results at l5-s1 there is a high signal at the posterior margin of the disc compatible with annular tear. Broad based disc bulge with small central disc protrusion. There is ligamentum flavum thickening and facet hypertrophy. No evidence of spinal canal stenosis. No evidence of significant thecal sac or nerve root compromise.

I then had the epidural steroid injection. It helped some but wore off after a week and a half. Just had another today which is two weeks from last one. The dr does not seem to think this has to do with my accident. How can it not? My butt is still numb and that is right below the disc that hurts. Now he is talking about an emg. I think he is as confused as I am.

He doesn't seem to think that the disc tear and herniation should be causing that much pain. My feet kept going numb and have that pins and needle feeling alot. I am getting very frustrated with the whole thing and he is making me feel like its all in my head. Im at loss and would love someone else's opinion. Thank you in advance

Last edited by Susieq1234; 12-15-2011 at 04:22 AM. Reason: Wanted to change title and fix some typos

 
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Old 12-16-2011, 11:19 AM   #2
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Re: Confused over it

I see I told you had to find your thread...but never looked to see if anyone had responded to your questions. Sorry for the delay.

What has transpired since you made this post? Have you had another epidural steroid injection? Any change in your pain?

Are you seeing a fellowship-trained spine surgeon? If not, I would suggest you make an appointment for a consultation, and to see what is going on now.

I would assume your crash has something to do with your current pain and the disc issue at L5-S1. I'm not sure why the doctor thinks there is no correlation or that an annular tear cannot cause a lot of pain. Many patients would disagree on that one!

You could also have pain coming from the face joint at this level. Something is compressing one of the nerves coming out of that spinal segment. Look at a dermatome map and you will see how the L5 and S1 spinal nerves innervate the leg and foot.

Please update your post and we'll try to give you some constructive suggestions.

 
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Old 12-16-2011, 11:56 AM   #3
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Re: Back pain need advise

I would say that a annular tear in it's self is painful as he!!.. I had a severe tear at the l5-s1 and DDD, only a smaller central disc protrusion. I had severe sciatica and it was from the annular tear mostly. The doc called it chemical radicular pain. Smae as true sciatica from nerves being compromised. The 1 thing I would worry about being u fell like u did is that u may have injured your SI Joint. This can hurt like he!! and hard to confirm. Images don't always show a whole lot. I can tell u that I had a fusion to fix my DDD and annular tear and it helped some but has increased the pain in SI Joint to a point it's excruciating. I will now be having that joint fused next year. But I will say annular tears small or large are very painful. Your Facet joints or SI Joint may be a lot of your issues IMO.. Good luck!!

 
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Susieq1234 (12-17-2011)
Old 12-17-2011, 04:59 AM   #4
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Re: Confused over it

Thank you for responding. I had esi on Wednesday and it's hard to tell. Thursday was good but friday it was hurting. We will see what today holds. As far as the dr, the one I'm seeing now is pain management. I had a neurosurgeon right after my accident, he just blew me off when he decided I did not need surgery. I would really like another opinion but having trouble fining a "spine specialist" in the area. Would like one that does nothing but spinal problems....im glad others feel like its from my accident also. I had never had back issues before that. I'm only 40 and a hair stylist. Im on my feet all day and can't afford to change careers at this point in my life but the pain is getting very old.... I'm also convinced that I could have possibly broken my tailbone at the same time but once again the drs kinda just blew me off on that issue. Still have tremendous pain there and numbness on the top left side of my behind. As far as is joint goes he has already considered that and I have alot of the symptoms. Get sharp shooting pains in the left side of upper thigh groin area. Which were REALLY intense and frequent after I fell. They have subsided but still have occasionally but not near as painful or intsense as they were. Thank you again for taking the time to read and respond to my situation. It is very much appreciated

 
Old 12-17-2011, 11:07 AM   #5
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Re: Confused over it

If you are anywhere near the Clearwater area, I can give you a suggestion. In general, I would suggest you look for a fellowship-trained orthopedic spine surgeon rather than a neurosurgeon for your particular issues. Most doctors or the clinics they work for or hospital system will have a website that shows the doctors' training and education. The fellowship is of particular importance because it is what tells you that the orthopedic doctor has additional, specialized training in the neck and back, and you want to be sure that the medical practice is limited is issues of the back and neck, and nothing else. The doctor does not also replace hips or set broken bones. Also, you do not want a sports medicine doctor.

They should be willing to provide a proper diagnosis and suggest a series of conservative treatments. Only after all conservative treatment modes have failed should the doctor suggest surgery (unless of course, it is obvious from the very beginning that the problem is so severe that nothing but surgery will help).

Being on your feet all day is something that is brutal for someone with your issues. I hope you are at least wearing really well-cushioned flat shoes. Heels are terrible for someone with back problems. Could you get one of those gel mats that are advertised in the shelter magazines (and used by chefs, etc.)?

Whenever anyone has any type of impact crash, it seems almost inevitable that he/she develops arthritis in the facet joints, and sooner than it would happen with normal aging. The facet joints are paired with each vertebra and are joints that allow us to bend and twist in the spine. I wouldn't be surprised if you have some degeneration going on in at least one or two facet joints. And along with this, you usually find some other degeneration going on, too.

I hope the ESI will provide some relief for you.

 
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