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Old 01-07-2013, 09:03 AM   #1
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back pain can anyone help

hi can anyone help me plan what to do next ,
This is the letter i recived from my doctor telling me what the mri scans show i'm still in a lot of pain and not sure what plan of action to take please help .
You will recall that sufficiently by the compressive nature of his sciatica to blame it on his discs but in the cold light of day it is difficult to justify surgery given the complete lack of any root entrapment at l4/5.
whilst there is a synovail cyst on the right side at l3/4 this again would not explain his left side sciatica .
As you know on his secong visit to my clinic to my clinic i wondered about a far lateral disc a l3/4 but again whilst it is narrow it is not very convincingly surgical and the distribution of his pain is not in the of the l3 nerve root which is the compromised nerve root .
The only potentially surgical adnormality is a bilateral pars defect at l3/4 which could be the cause of back pain and a bit of facet joint degeneration in the context of the pars defect is slightly encroaching on the nerve root but not in a way that makes me enthusiastic about surgery .

 
Old 01-07-2013, 10:52 AM   #2
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Re: back pain can anyone help

Before commenting on the post a few things come to mind:

First of all what doctor sent you this letter explaining things? Was it your primary doctor or specialist such as an orthopedist or neurosurgeon? If you are not seeing a specialist you should be.

Secondly do you have a copy of the MRI report itself? If not you should have one for your records. I always get a copy of the report and the films as well for my records.

If you have the report many of us post the actual report here for others to read what the radiologist says in the exact languague. It is up to you as to whether you wish to post the report itself of not.

It doesnt sound like he is recommending surgery but hinting at possible issues. But I'm not 100% sure.

What are your symptoms? What is your pain? What affect is there on your daily living as to what you can and cant do.

I think we need a lot more information. Again it is your choice on posting the MRI report. Good luck

 
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Old 01-07-2013, 11:18 AM   #3
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Re: back pain can anyone help

I had a similar situation several years ago -- terrible, debilitating sciatic pain, but my MRI did not indicate any nerve compression. I had a fusion at L4-L5 for severe stenosis and spondylolisthesis, and that was supposed to resolve my sciatic pain...but after recovering from surgery, my sciatic pain was as bad as ever.

It took me two years to convince my doctors that there was still something compressing the nerve.

It appears that your doctor doesn't feel any of your issues are responsible for the sciatic nerve compression.

[B]The only potentially surgical abnormality is a bilateral pars defect at l3/4 which could be the cause of back pain and a bit of facet joint degeneration in the context of the pars defect is slightly encroaching on the nerve root but not in a way that makes me enthusiastic about surgery .[/B]

I'm wondering if this is the cause of your pain...mine turned out to be caused by my facet joints at L3 which were causing instability at this spinal segment.
If you are still in pain, I hope your doctor will continue to look for a cause. You could have a nerve block at the L3-L4 level to see if it temporarily relieves the pain...our bodies don't all work exactly as the dermatome levels are shown in textbooks!!

 
Old 01-07-2013, 11:28 AM   #4
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Re: back pain can anyone help

hi pebblebeach .
I dont have my mri scans i have had 3 taken and some xrays but heard nothing from last april when i had them taken ,the letter i put on is what the neurosurgeon wrote to my doctor and then sent on to me before i had the x rays taken .
the symptoms i have is lots of pain down my left leg and stiffness in my lower back, i can't touch my toes or tie my shoe laces and i struggle walking any distance with it . It is keeping me up at night and when i do fall sleep it will wake me up after an hour or so ,Thank you for your reply and help or advice

 
Old 01-07-2013, 11:33 AM   #5
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Re: back pain can anyone help

hi pebblebeach .
I dont have my mri scans i have had 3 taken and some xrays but heard nothing from last april when i had them taken ,the letter i put on is what the neurosurgeon wrote to my doctor and then sent on to me before i had the x rays taken .
the symptoms i have is lots of pain down my left leg and stiffness in my lower back, i can't touch my toes or tie my shoe laces and i struggle walking any distance with it . It is keeping me up at night and when i do fall sleep it will wake me up after an hour or so ,Thank you for your reply and help or advice

 
Old 01-07-2013, 11:45 AM   #6
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Re: back pain can anyone help

I agree with the last poster. Get a copy of your MRI and get a second opinion. They should have made a followup apptmnt with you and not just sent you a letter with a bunch of medical jargon in it that you can't understand. I was told for years that I had an issue with my SI joint (by several doctors) when in fact all this time it was arthritis setting in not the SI joint. I used to feel that a Chiropractor was the answer instead of meds and pain killers. But last time I went I have to say I felt worse. I do yoga now and I feel alot better. Your body has this natural instinct to fix itself and if there is anything in your back trying to fix itself it will almost always result in muscle spasms which will make u feel worse. Im not a health care professional and am only going on my own experiences. Its a horrible thing to have to live in pain like that. Go online and look up some of the yoga stretches you can do. Do them before you get out of bed in the morning and let me know how it works for you. Most of them I couldnt do at first but stretching yourself more and more everyday helps to get you more flexiable And those endorphins flowing (which is a natural pain killer). Doing them on the floor is best but I have a firm bed and if I get on the floor im affraid I wont be able to get up. Yoga is also helpful for your balance as well so as you grow older and less stable Yoga can prevent you from taking falls. I don't want you to think I am some crazy person talking about Yoga but you have to give it a try. Its good for the mind and spirit as well.

 
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Old 01-07-2013, 11:46 AM   #7
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Re: back pain can anyone help

Pidge:

Here are my thoughts. First of all I have had spine issues since 1988. Since that time I have been thru the following spine surgeries:

-- 1994 lumbar surgery for herniated discs;
-- 1995 cervical surgery for stenosis;
-- 1997 lumbar surgery for "flatback syndrome" which required Harrington Rods;
-- 2000 cervical surgery for "kyphosis" which required Harrington Rods from C3 to T4
-- 2006 Spinal Cord Stimulator implanted for pain control;
-- 2011 spinal cord stimulator removed wasnt helping me any longer;
-- 2012 "Trial" Intrathecal Pain Pump for pain relief;
-- 2013 This Friday permanent implant of Intrathecal for pain control.

One thing I learned over the years, first I never thought I would have this extent of back issues.

But just a recommendation, it is a good idea to have (1.) the MRI films for your records; & (2.) A copy of the radiologists report.

I recommend this in the event that you seek other opinions this way who ever you see they can view the MRI/CT films themselves and also see what the radiologist wrote in the report.

I have almost ALL of the reports/films.

I think you need to clarify with the neurosurgeon as to what the issue is causing your pain and if surgery is NOT being recommended then what course of treatment does he feel is warranted. Does he recommend pain medication/anti-inflammatories. Does he recommend any physical therapy? You need to address the issues and what the appropriate treatment is for you.

 
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Old 01-07-2013, 11:58 AM   #8
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Re: back pain can anyone help

i have a long body pillow and I lay on my side and tuck the pillow partially under my body where it creates a kind of wedge. You are not completely laying on top of the pillow or laying completely on your side. This takes alot of pressure off of my back and allows me to at least fall asleep. I don't know if my other reply posted but I suggest doing some Yoga stretches. Those help me get out of bed every morning. I don't have the same thing as you do but I have arthritis in my back and have found yoga stretches and a firm mattress make me feel at least 40% better. No matter what is going on with your back you are going to have muscle spasms which is your bodies way of trying to fix the problem. If you do these Yoga stretches in the morning you have to trust me that you will feel better. Go to youtude and look them up. Starting out you will not be able to do them as they demonstrate but you will get more flexiable as you continue. Dont force them just push to the limit where they are slighly uncomfortable. Yoga also helps as you age and become less stable in walking and standing because it helps you with balance. Its worth a try isnt it. Just try it for one day and let me know what you think.

 
Old 01-07-2013, 12:01 PM   #9
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Re: back pain can anyone help

Pebblebeach3 did any of these surgeries help you at all?

 
Old 01-07-2013, 12:44 PM   #10
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Re: back pain can anyone help

sure!!! Hi. I was a radiologic technologist for 18 years, AND am a back pain sufferer too. I have degeneration of the facet joints and foramen. The foramen squeeze nerves and cause pain and spasm and cramps when degenerated. If you want t know what is causing your pain and possibly stifle it for 8 months to a year, get nerve root ablations, also called rhizotomies. First you'll have to get nerve blocks there to see if the ablation will work. If the blocks work, they move on to the ablation. It is like a microwave cooking It melts the nerve tissue while the doc administers meds to control pain. It ends cramps , muscle spasms, and pain. You can actually try to get your body in better shape(before the nerve grows back) after the ablations are finished. If the surgeon hadn't screwed up my neck, *'d be a happy camper!I was thrilled before the neck surgery because my t-spine pain was controlled. They do this for the entire spine. They knock you out much more for the lower back. Due to the danger of lung collapse or interrupting the vasculature in front of the t-spine, they keep you conscious. yes, yikes! It works though!!!! Good Luck! kxray

 
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