Ok, here is the situation. About six months ago I injured my lower back riding my bmx bike. This injury caused pain in my left leg and lower back. The doctor decided I had a slipped disc in my lower back and gave me valium as a muscle relaxer and hydrocodone for pain relief and lodine for anti-inflamitory. After about a month of pt, the injury got better, no more pain.
Now about a month ago I was sitting in class at my local university and my back all of a sudden started hurting again. Now I ride my bike to and from school in order to cut down on gas usage. It is about 1.5 miles both ways, but that isnt really important.
This second time I hurt it we went ahead and went for an mri to see what the specific problem is. I now know I have a herniated disc at l5-s1 and it is pushing in my sciatic nerve causing the leg pain. At least that is how it was described to me. My doctor then sent me to the neurosurgeon for treatment after seein the mri, as he is just a general practitioner.
The neurosurgeon has sent me to pt again, which ive been doing for two weeks, and also gave me a steroid epidural injection before pt. So far the shot and therapy have done absolutely nothing, actually the pain is progressively getting worse in my leg. My back doesnt really hurt much, but the leg is excruciateing, to the point I cant do anything but lay down.
I had to call the doctor 1 week after the shot to check in on mypain level. I told him it did no good and he said that I now have the option to go straight to surgery or try another injection. The thing is the injections cost me around 400-500 dollars, and I dont want to try something that isnt going to work again. As I could use this money towards the surgery.
All in all, im wondering if I should just opt for surgery now, or keep trying the pt and injections, ive had this pain for about 5 weeks and it is driving me crazy and making me very depressed, I just want to feel better.
you have just started down the road to pain relife. You have not doen much to mitigate the problem before surgery. I believe that 80% of the folks that are here as regulars would tell you to get a referal to a pain specialist and see if they can do something before you take the plunge into surgery.
Depending on where you live in texas, there is one of the finest back clinic/surgery centers in the united states called the texas back institute, they will be better able to read your mri and actually come up with a minimally invasive surgery that may help you, or simply treat you for pain and decide not to do surgery for some time.
It is not a normal protocol for a doctor to do one epidural and 2 weeks pt and say.... Ok your ready for surgery. You should be doing pt and injections for at least 6 months along with pain meds and muscle relaxers. If after 6 months you do not respond, you can than be looked at as a surgery candidate. This is way too soon!!!
it sounds like your doctor has sent you in the right direction as far as treatment goes. You have been doing all the normal steps when dealing with back problems like you have.
Here is the thing though...... 5 weeks is not along time. I know it may seem like it to you and I have been there myself several times with several levels of my spine, lumbar and cervical spine. Normally esi's are given in a series of 3 injections in a short period of time. Like you the esi's never did a thing for me. I do think you should try 1 more injection because you don't want to rush into spine surgery. You should try everything else first. The one thing you mentioned was back pain. Please understand spine surgery's are not done for back pain and the surgery itself may in fact give you more back pain after surgery. What kind of surgery is your doctor talking about doing? This is a very important part of you post. If it is a discectomy please know most people end up with another surgery after about 3 to 5 years.
You and I saw this at the exact same time and responded right together. It is amazing how in synch people can be when they deal with the pains we do.
You gave clearer instructions than I but I wanted to stress the point, dont let a doc do major surgery on you if you have only been going for 2 weeks, that would terrify me now, knowing what I know. The 2 years I lived in pain were well worth their time because now I am totally useless as far as doing hard work goes, I could at least do it before and know I would be ok. '
i am even more afraid of having a car accident now, my doc just had a patient that had one with the charite in and the disk snapped in half and dislodged into the superior ligimentum flavum about 1" it was protruding and of course the space lost all stability and form. Too much scar tissue to go through the belly and replace/repair so they h ave to go through the back, rip apart the artificial disk to get it out, use the bmp and cages and do fusion to try to repair what had broken.
There is no reason to rush to surgery, it will not get you back on your motorcycle sooner and in fact it may keep you from ever get back on again.
I was thinking the very same thing as to how we think so much alike. :) that is why I asked you to join us at sab.;) I have to say I love reading you post brian. You always have very good advice to give others. "coastie" is another member who I love to read. I look forward to seening you on sab. I know you are busy. Thank you for all you do here for these members. :wink:
I am on there I just don't know what to do over there. Most of the topics I like to read about are already really well written and basically closed not because they are locked but the "admin" hawgged all the info sharing space and so I don't feel I can add good info.
I may be missing the part where there is active discussion, I will hop on there in a minute. I am home all day because we are having a hurricane day. (alberto)
Hey hey hey now brian. I am the admin there. Hahaha I am 100% sure you have plenty to add there. You just don't know it. I feel you would be a great assit to the family. I promise to make you feel at home. ((((brian))))
I aam there as tamadrummer too. I am reading the article in the fm forum about "you don't look sick" and the ms something or other winner that left divorced her hubby and left the kids and lived in her car for 11 months.
It really disgusts me when I read about how many real people out there suffer from tremendous pain and no one ever understands and they all think we are nothing but a bunch of liars.
Pain is real and millions of wonderful people are devistated by pain each day. Depression is probably the worst part of pain because you just feel so useless to the world.
This is why I post as much as I can on these types of forums and also try to discredit as many of the crap alternative "natural" or "organic" methods as I can. All they do is make people hurt worse if they truly suffer from real biological pain.
I caught you there and posted to you in chit chat. ;)
as you have seen before you and I both work on this and I agree with you on this subject 100%. I think we work well together.
this is why I post as much as I can on these types of forums and also try to discredit as many of the crap alternative "natural" or "organic" methods as I can. All they do is make people hurt worse if they truly suffer from real biological pain.
check out the picture section as well. :) you will see my mug there. Hehehe
it really is hard to try to get others to understand the pain we live with when others can't physically see our pain. Some will never understand unless they are in the shoes we live in everyday. It's hard enought to live with the pain and then we have to always defend or get others to understand what we go through. :(
Thanks for the advice guys, some answers to your questions.
They are planning a minimally invasive surgery, the doc said they have a 98% success rate and 2% complication rate, the best of any other method of back surgery. He said he will not be removing the entire disc, just he herniated parts of it. The main reason he is going sooner than later is I had the pain about 3 weeks before even seeing the doctor. Now I am also getting leg drop, my foot has started to tingle, and I dont have the power in my left foot that my right foot has. He is scared of nerve damage because of the extent of the herneation. Also, im sure its been said before and im sure all of you guys believe me when I say 5 weeks is a long time to be in the amount of pain I am in.
What medicines should I ask him for? He is open to what I think should be done for treatment as well, to a degree. It seems the hydrocodone is not nearly as effective as it used to be, he has also recently given me methocarbomol, but it makes me feel really lightheaded, and I dont like it. Before this he gave me ibuprophen and darvocet, witch are about as effective as drinking a glass of water against my back pain.
As your doc said, yes the surgery has a 98% success rate. Great, that number is not being told to you in truth. What that means is, 98% of the folks that undergo nucleoplasty/idet do not have further complications caused by the surgery. That does not mean that 98% of the people are cured and no longer have pain.
Again, go to that link I posted for the texas back institute as well as to www.Spineuniverse.Com and look for as much info as you can find.
Surgery should always be a last resort and you have not been in treatment long enough for anything to work. At florida spine instutite they made me go 6 months between procedures and I started with a series of esi's x3 and then did that 3 more series before we went to nucleoplasty. That did not work and it was another set of 3 esi's and repeted that process 2 more times before they decided to do the major surgery. In december of 2004 I under went artificial disk surgery praying that my pain would stop. Nope it didn't.
Please seek a second or even third opinion. A doc that is that ready to do surgey, even what they consider to be minimally invasive, would have me scared to death. Just because it is minimally invasive doesn't make it a minor surgery. The risk vs. Reward really needs to be weighed.
first off you are so welcome. Thank you for giving us more information about your situation. My guess the minimally invasive surgery your doctor wants to do is a micro-discectomy? I had 2 micro-d's of the lumbar spine l4-s1 (2 levels) prior to my fusion. The first micro-d lasted almost 5 years to the day before I needed a second one. The second didn't last long at all. I do not for one min. Regret having the micro-d. The least invasive the better. ;)
I am guessing you meant to say drop foot and not drop leg? That would be a very good reason to look at surgery quicker. It is great that your doctor is worried about nerve damage. You sound like you have a good one there. ;) is the doctor you are seeing a neurosurgeon or an ortho? My surgeon is a neuro. And in your case I hope your's is also because of the nerve involvement.
You are right many of us can relate to weeks of pain being way to long.
When it comes to medication.... I personally don't like to suggest anything as I am not qualified to do so and feel only your doctor should deal with those kinds of question. That is just my personal opinion.
I would like to invite you to check out the link I posted in my other thread. The link is to another support/message board. I am a firm believer in that the more information one can get the better.
Please keep us posted and ask if you have more questions. We are happy to try and help.
I very much believe in what .Tamadrummer said, I live in chronic, intrctible pain 24/7 I have had surgeries that did not help that much, I am not trying to tell you what to do or not to have one but everyone I have talked to that has had one said that they hurt more with the after effects of the scar tissue and the arthritis. I hope you do get a second opinion! I hope that you have someone there to help you after surgery. I am not a dr but I wish you all of the best of luck. Keep us posted as it sounds like you have made up your mind to go with it just be sure to write all of the questions down that you have for the dr so you will not forget!
I do have to say I am one who is in way less pain after all I have been through. My surgery's were successful in respect to the reason they were done. There are many who have been helped by surgery. I do not push surgery as brian has stated and I fully believe,..... Surgery should always be the last form of treatment. It is best to get more then one opinion when it comes to surgeons. It is always a very good idea to hear from several people who have had surgery on message boards, in person, and including former patients of the surgeon you will use to see how they are and what they thought of the surgeon and the staff.
I don't think psilo357 has made up their mind at this point.
Much thanks for all the help, I need it in my decision making. You are right, I have yet to decide wether or not the surgery is for me. I am married, and my wife will help and support any decision I make.
Imshirl, the doctor I am seeing is a neurosurgeon, actually one of the more prominant and well respected ones in the state. And also he is saying micro-discectomy is what I will have if surgery is the route I go. I dont know if people like dropping names around here or not, so I will keep it private for now, but will tell or link to his site if it helps.
The main thing he is worried about is the nerve damage, and is why he reccommends the surgery. I have talked to a couple of his other patients as well, both had surgery and both have had outstanding results. One man is overweight and has had mulitple back surgeries. He said he never felt as good after surgery until my doc finally worked on him. And it was about 4 years from his last surgery. The other person on talked to was a female and had her injury playing softball. She finished the surgery six months ago and was worried she would never be able to exert herself in the ways she is used to, but she says that there is 0 pain and she is already playing softball again!!
This is mainly what I want, as I am a bmx freestyle rider and demand quite a bit from my body. For more info I am 22 yrs old and in great shape minus the back injuries. I dont use drugs, or drink, and am very active as a father of two and a working husband. Which brings me to the point of why pt may not be working as well, at work I have to stand up for hours on end, 6-8 hours a day to be exact. And there is no possible way for me to take off of work, as my family must eat and live, you know.
Im definately going to give it the full run on the therapy and im going to attempt the second esi (logic tells me this is epidural steroid injection, correct?).
I have read much information on my injury on back.Com and a few other resources. I will check out your links. My doctor does not recommend attempting accupuncture and really urges not to go to a chiropractor, as they can do mor damage than good a lot of times, im just so confused as their are so many options??!!
Thanks for all the help again, it would be much harder without yall
Okay, new news, the disc has only gotten worse, not better. I have now had 2 esi's and been in therapy for 5-6 weeks. I went to the doctor today and we have decided to go ahead with the microdiscectomy. My surgery is scheduled for july 3 and he said the procedure itself is only about 40 minutes long, but I will be in the hospital for a few hours. He also said I will be able to go home the same day. Im nervous but ready for the pain to stop.