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    Old 05-24-2011, 01:32 PM   #1
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    Don't know what to do

    Hi all! I haven't been on these boards in a while, and I was never a regular poster, but I'm at my wits end and not sure what to do. Here is the story, as I know it.

    I had an MRI done about 2 months ago. Summarizing, it said that I have two broad based disk protrusions (L2-L3 and L5-S1) and a foraminal protrusion at L3-L4. At L3-L4 I have mild facet arthrosis and ligamentum flavum thickening with mild left foraminal stenosis. I have "abudant epidural fat" leading to stenosis at L5 and they have called it clinically epidural lipomatosis. I have mild central canal stenosis and bilateral recess stenosis at L5 causing some nerve compression at that level in addition to hypertrophic facet arthrosis and bilateral pars defects with grade I anterolisthesis with no change in flexion or extension (shown on a post MRI X-ray).

    I've had nerve conduction studies that all came back normal. I've been to my GP, a neurologist and yesterday a spine surgeon. The spine surgeon said I was too young for a fusion (35) as I would just have to have additional fusions later, and that since I wasn't experiencing any foot drop, it really shouldn't be an option anyway.

    What I am experiencing is excruciating pain in my lower back. I cannot sit for any length of time, walking is almost definitely out of the question, although I do occassionally "suck it up" and do a little walking, but I PAY for it later. I have been working from home since early November. My pain does radiate into my buttock, but it doesn't go completely down my leg. I do have some tingling, burning and vibrations in my feet. I do have some minor hip pain, which the neurosurgeon said could be part of my issue, and he sent me to aqua-therapy.

    I'm taking 500mg of Vicodin twice a day (which doesn't control my pain, but my GP is handling my pain medication and refuses to give me any more or anyting stronger) and 600mg of Neurotin 3 times a day (that just makes me sleepy). I now have permanent damage to the skin on my back from too much time on the heating pad, and can't even use that for fear of doing further damage.

    I just don't know what to do. Pain Management is not available to me as I don't have insurance but a non-profit helps provide me with health care within their system. The neurosurgeon did say I could go into a pain management clinic and they could do a diagnostic test to determine if the nerve root is the issue and then burn some smaller nerves. It's $90 just to walk into their door, we just don't have that kind of money right now. My husband can't work because he has to do all of the things I can't (picking up kids, laundry, floors, etc). Any thoughts you may have would be greatly appreciated. Sorry for the novel!

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    Old 05-25-2011, 08:19 PM   #2
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    Re: Don't know what to do

    Did I do something wrong?? I'm not sure why 91 people have read my thread and I have not even been offered a "welcome to the board"...was there something offensive with my original post?? I thought after reading through the threads that you all were a great and supportive group...please let me know what I did incorrectly??

    Last ditch effort,

    Hope Laughs

    Old 05-25-2011, 09:35 PM   #3
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    Re: Don't know what to do

    First, welcome. I can't answer why you had so many reads but no answers but for me, I just read this so I will do my best to try to help with suggestions.
    A disc protrusion is just simply a disc bulge. This would be at L2-3 and L5-S1. All this means is that the disc is slightly outside the normal rim of the vertebra. Not a big deal.
    The foraminal protrusion? I'm not sure what that is, but if you meant foraminal stenosis- this means that the disc is slightly in contact with the L3/4 nerve root. The mild foraminal stenosis means that the disc which appears to be in contact with the nerve root is slightly displacing /impinging the nerve root. You also have some mild facet arthritis at L3/4. As we age, we may develop some arthitis in the facets ( this is where the bony part you can feel creates a joint (one on each side of the bony protrusion you can feel) and keeps the vertebre in alignment. The thickened ligamentum flavum is one of the ligaments that run in the posterior and anterior of our spinal columns.
    The mild central canal stenosis at L5-S1 comes from the canal area where the nerve roots come down from the spinal cord is mildly compressed.It also appears to be compressing to some mild extent the nerve roots at exit at the L5-S1 level. Most probably due to the clinically ? epidural fat. At L5, it has slipped slightly forward over S1, due to a break in what is called the pars articulis ( that bony protrusion you can feel running down the back of your spine). Whether or not this is an old break or a new one , it isn't clear from your posts. The slippage ( also called a spondylolysthesis) is graded by a percentage. A slippage of 25 % or less is called grade 1, grade 2 is over 25%-50%, grade 3 is 50%-75%, and grade 4 is 75%-100%. A hypertrophic facet joint is what I described above to you, but it just means that the bone has thickened over time, due mostly to stress on that facet.....since yours is bilateral- it means both facet joints at that level.
    Since the spinal neurosurgeon didn't feel surgery was necessary at this point, your best bet is for you to get into a pain management clinic either at your local hospital or low income clinic have them as well and talk to them about the pain you are having. I would also check into some of your states' resources for uninsured , low income families. All states have to have something in place now to help those uninsured to get insurance, some at no cost to the family. Do you have family close by, or good friends who can help you look after the smaller children? Or older children who can pitch in by lugging the laundry baskets to the washer and dryer for you? When my younger kids were smaller, we made a game out of them helping mommy fold laundry together and we got things done that way. He can always find a night time job to help with the bills and sleep during the afternoon or evening once the kids are in bed so that you have some other options for help around the house.
    There are injections that the PM doctors offices can do , work toward finding better medication combinations to help manage the pain better so that you can take on more responsibility for child care and household tasks as well. PT , excercise and time will all help to manage the pain, ice, rice in socks, heated in the microwave and heating pads all might help as well. The rules for using ice and or heat are 15-20 minutes on and at least that long off. Never, ever leave ice or heat on for more than that, otherwise you can find yourself getting a nice burn , and both ice and heat can cause skin and tissue damage.
    The good thing is that you don't appear to have much , if any signs of nerve damage, which is the criteria for surgery. So, hopefully,with some time and treatment by the right doctors, things should get better for you.

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    Old 05-26-2011, 12:14 PM   #4
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    Re: Don't know what to do

    hi, im sorry to hear your in so much pain and not getting answers. i have a lot of similar aches and pains as you and like you im still waiting on answers 10 yrs later. im due to see a neuro surgeon in august, iv had 2 mris but they cant find anything to fix, they think i have a lot of nerve damage along with bilateral sacroiliitis and degentrive discs. i have a family too and find it very hard my husband cant work either because i cant be left with the 2 small kids (1+2) on my own. i live in ireland so our medical services are different but i have free medical care but it means a 2-3 yr waiting list to get to see anyone. i dont know much about the results of your mris i just wanted to say hello and let you know im here to chat if you need too i know how hard it is.have you had any cortisone injections or an epidural, these can help people for weeks to months at a time and if you do get relief they can be done up to 3 times a year i think. iv had them but i was unlucky they made me worse. i see your having trouble with the heating pad have you tried using ice for 20 mins then heat for 20 mins, you can do it several times a day and always put a cloth around the pad to prevent burns. have you seen a physical therapist, i know its not easy when you have no money but is there any medical help available to you. im sorry i dont have any answers but feel free to chat anytime, take care, shelsers

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    Old 05-26-2011, 01:48 PM   #5
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    Re: Don't know what to do

    Hi, so sorry you are having to go thru all this pain. I been dealing w/ back pain since 2000 so I kinda understand. Pain Management is my first thought but w/o the insurance I totally get it. $90 to get in the door is cheap but if you have to have injections there's more $ there.

    I know where I live there is a major hospital where you apply for help and then you can get into orthos, pain mgt, etc. (VIrginia) So maybe call social services and see if there's something you're missing out on with that? Just grasping at straws here.

    Ice is my favorite. Heat will inflame the discs most of the time and is usually just for muscles but do use a towel and limit it. If you can get your hands on a cheap brace at a drug store to help you out sometimes that would be helpful but don't wear it all the time (weakens your core muscles).

    I didn't see where you were taking any NSAID (Anti-inflammatory) that may help as well. There are some cheaper choices out there.

    Have you considered applying for disabilitly? It would take a good while but ya gotta get started somewhere.

    I hope I helped some and again so sorry for your pain, I deal with it everyday but am significantly older (55).


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    Old 05-26-2011, 02:10 PM   #6
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    Re: Don't know what to do

    Hope n laughs I can relate to your situation. I am too at a point where I need to continue to get treatment but funds are running out. My problems started 6 years ago. Extreme lower back pain with radiating leg pain lost time from work steroids,physical therapy, numerous epidurals, diskectomy, spinal cord stimulator, cervical spine surgery, lumbar fusion and now 6 years later unable to return to work, limited functions at home life is no bowl of cherries. Medicines of little help at this point as your tolerance develops you need to be careful for abuse even though without them it is there is no relief and you can try the ice n heat etc. Now at this point denial from SSDI, LTD insurance too, I am still fighting for my health and for my rights. Don't give up! I hope for everyone who relates to this May God Bless you. My 2 cents.

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