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Mri Lumbar Spine

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39 year old female suffering with sever back pain more intense since Oct. 06. FYI I did brake my tailbone as a teenager 13 or so yrs. old.

MRI LUMBAR SPINE
There is a transitional vertebra at the lumboscracral junction. For this examination this will be designated as S1. An abdominal radiograph series from 11 May showed 6 nonrib bearing lumbar type vertebra with the lowermost vertebra having a prominent left sided transverse process that forms a pseudoarticulation with the sacrum. If surgical intervention is planned close attention to the lumbar levels is needed.

Signal within the vertebra and spinal canal is normal. Disc signal is preserved with the execption of desiccation at the L5/S1 level. The cord terminates at the L1 level.

L2/3: Normal
L3/4: mild posterior element hypertrophy is present. This does not produce any significant central or foraminal stenosis.
L4/5: Mild posterior element hypertrophy is present. No central canal or foraminal stenosis is seen.

L5/S1: A disc bulge is present that is more prominent to the left. Facet Joint hypertrophy is present. The combination of disc and fact arthritis results in moderate stenosis for the left L5 nerve root. Mild foraminal encroachment is produced on the right.

IMPRESSION:

1. TRANSITIONAL VERTEBRA AT S1.

2. DEGENERATIVE DISC AND FACET JOINT CHANGES AT L5/S1 THAT RESULT IN MODERATE FORAMINAL NARROWING ON THE LEFT AND MILDER RIGHT SIDED FORAMINAL STENOSIS.

O.K. if anyone can help with this it would be greatly appreciated. As I have no insurance and the next specialist I go to needs to be the place that I need to be. Pain Management vs. neurosurgeon????????
My symptoms have been lower left and right sided back pain; seems to be worse on left side and butt and hip numbness.

Thanks to all who reply.
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replied June 22nd, 2007
Extremely eHealthy
Here is my advice to you. Back surgery is risky and expensive. It is also not 100% guaranteed. If it were me, I would see about getting and epidural steroid injection with a selective nerve root block and get into an intense physical therapy program. If that fails, then perhaps surgery might help, but I would not really consider this unless I had progressive symptoms in my lower extremeites after a long trial of conservative treatment..
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replied June 22nd, 2007
Thanks for your reply, have you or do you suffer from back problems?
I guess, it's going to be expensive either way I go huh. I just want something that is going to address the pain, as it has become unbearable. I take Percocet 7.5 which really isn't helping.

Anyway thanks for your reply.
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replied June 22nd, 2007
Extremely eHealthy
I do not have back pain. I work with a physicain who does non-operative spine care, and I have worked in ortho and neurosurg for the past 15 years.
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replied June 23rd, 2007
Active User, very eHealthy
Mri Spine
lisa....I have degenerative disc disease but am much older than you. I have tried everything and nothing really works 100%. I had to go on full-time disability from work two years ago because of the pain and spasms.

I do believe it's unusual for someone your age to get ddd unless you have had a severe injury of some type. Maybe the trauma of the tailbone break is just now showing up because you are aging and your discs are beginning to compact with a lot of sitting and also gravity.

The discs dry out as we age (that's my problem) and the discs compact pinching the many nerves that surround the spinal column. It's not a pleasant thing to contemplate for the future. I also have numbness down my left side like you.

No one who doesn't have ddd can even imagine the pain....Not even your husband, parents, bf or even your doctor. I have tried almost everything in the past 7 years (injections, nerve blocks, heavy pain meds, etc.) with little success.

Just because some of those options did not work very well for me does not mean they wouldn't work for you. I have been to three different pain management doctors and each recommended different approaches. I will warn you that none of the procedures are very much fun to go through.

Now I am trying massage and acupuncture but have not had enough treatments to get relief yet. I have heard that spinal stretching might help ease the pressure on the discs but I have not tried it yet. Surgery was not indicated for me (specifically, disc fusion was not practical). I can explain in detail any of the procedures, even surgery, because I have been throughly briefed on them or have gone through them.

I am truly sorry that you do not have insurance because that means you could be facing scary expenses. My wife and I estimated that the surgery alone for the fusion would have cost us $5000 out of pocket with insurance.

Good luck, I hope you find something that works for you. The suggestion by sillyakchick makes a lot of sense and could solve your short-term pain. Percocet is the minor leagues of pain meds for back problems. Just wait until you get bumped up to oxycontin and morphine. They help with the pain but could end up screwing up your life.
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replied June 23rd, 2007
Dear lonestarguy,
Hey, thanks for your reply. I'm sorry to hear you have been through so much. I can't imagine having to live with this pain for the rest of my life. I go to the doctor Thurs. so I will post what he recommends. I have also been reminded of 2 motorcycle wrecks when I was a teenager, who knows maybe that didn't help matters. You wouldn't beleive the state of my health at my age. All the valves in my heart leak, aortic valve moderately, I take 5 pills a day just for my heart. I have arachnoid cyst in brain, with major miagraine with loss of vision. Digestive problems, it just goes on and on. My mom says if I keep it up I'll make it into some kind of medical book. lol It's funny to look at me you would never know all of these things are wrong, but life day to day for the last year or two has been living hell.
My dad had a stroke last April and passed away in Dec. 06, he was a big man and I could of got things irritated lifting him. He was a big man nickname "Round Man" about 265 lbs., and he lost all use of left side, no speech except for a few words. Anyway I took care of him everyday, so God love him and so do I he was worth every bit of it, if that did play a part of the back problems really giving me trouble since Oct. 06. that's when it just wouldn't let up and strong every since.
Anyway thanks for taking the time to reply. Lots of luck and best wishes to you and your wife.
Lisa
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replied June 24th, 2007
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lisa r....I am sorry to hear that your body is crumbling before your very eyes. It has taken me a few more years to get myself into such terrible shape. ha! ha!

Also remember that I am one of a select group who knows exactly what the back pain feels like. It is the worst pain I have ever had and that includes a bullet wound in war, four major operations, kidney stones, torn ankle ligaments, broken kneecap and various other broken bones.

Good luck on your trip to the dr. and let us know what treatment plan you choose. I do agree that surgery should be a last resort.

Chin up. There are people out here who hope you find relief.

lsg (rick)
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replied June 28th, 2007
Dr.'s Visit Cymbalta For Back Pain And Numbness ???????????
Hey everyone,
Well I just got back from the rehab doctor. He first wants to try injections and some physical therapy. The problem is I have no insurance, sooooooo this is a major problem. Also due to stomach problems, internal bleeding and so on, he also said there were alot of med's that he would like to try, but due to stomach problems cannot do so as most of them irritate the stomach, digestive tract. So that knocked out a whole list of med's that he would have liked to try. Meantime, I'm about to have a nervous breakdown listening to him and what he wants to do and how in the hell am I going to pay for this all the while telling me the injections may or may not help and I may have to have surgery anyway. What......of course I'm breaking down, thinking what am I going to do, I can't live like this much longer. He mentioned that there was one med. that he would try but he didn't have any samples and as he put it "there is no way I could afford it", you got to love honesty. Well he did have some Cymbalta samples, so that's what he put me on, said hopefully it will help with the pain and numbness??????? and help with my mood. Thanks Doc, I told him sit on this bed in my shoes and then talk to me about mood. It's not his fault I can just be such a smart ass sometimes especially when I'm hurting. (sorry) So he is going to write a letter for me with his recommendations, I am going to talk to the Indigent Assistance program at the hospital here, he said see if they will help with my treatment as I surely need some treatment. Asked if I had applied for Disability yet, I told him yes I am in the process of that, as he said unfortuntely time was not on our side when it comes to that, it takes so long to get the process done. Sorry for the rant session, but thanks for letting me go on if you've read this far. My question is has anyone heard of Cymbalta for back pain??????? If so did it work? Side effects? Thanks and best wishes to all.

Lisa
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replied June 28th, 2007
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Lisa....sorry everything is going against you right now. Having back pain and dealing with bureauracy is the worst. Try to keep a positive outlook because things might turn around.

I am taking cymbalta right now for my depression but I am not sure it does much for numbness or pain. For me the side effects are sexual, so if you don't have a penis, I think you are okay. It does seem to help with depression though.

I wish I knew what to tell you about the road without insurance because I have always had it and most times did not even know how much the procedures cost. The doc is also right about disability, it takes a long, long time to be approved.

My heart goes out to you and I wish you luck.

lsg
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replied June 28th, 2007
I knew I could count on you to reply. THANKS, it helps to know somehow knows how you feel. Yeah, I'm with you given my situation he is probably buying time with my "mood" until we can find out which way this thing is going to go. I cussed at him when he said Cymbalta, but he swore it would help me rest and help with the pain and numbness, along with my mood. I did kind of lose it, but you know it has been one thing after the other for over a year, my blood pressure was 180/103 this morning. I told him pain, because of the 5 pills a day I take for heart failure my blood pressure should be good, but he also noted some swelling in lower legs, mentioned I should go back to heart doctor to address the blood pressure and swelling issue. Yeah, just what I need another bill at a specialist office.

I also taking Percocet which is not much of anything when it comes to this pain. I told him it would be cheaper to just die and plant my butt, haha but I did wait until after he had already mentioned the Cymbalta. He had a good point when he said that would be true with anybody with on going medical problems, guess he put me in my place with that one. 39, 39 Man I can't beleive I am falling apart at this age.
Well I'm guess I'm in luck on one thing; no penis, so lots of good news there. Ha Ha. But my sex drive has been gone for a while anyway, who feels like that when you are always in pain. lol

Thanks for your time
Lisa
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replied June 28th, 2007
Oh yeah I forgot to tell you my best friend also suffers from degenrative disk disease, and guess what her doctor gave her yesterday, (different doctor than I saw) Effexor. I was surprised at that one, but oh well I guess that's a new trend in treating back pain, or maybe they are just trying to help us cope with it.

Lisa
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replied June 28th, 2007
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lisa....I am here to help and a shoulder to lean on (only don't lean too much because I have a bad back). Ha, ha.

It does bother me that your blood pressure is so high. I don't know much about your heart problems but I imagine you feel like you're juggling and it's becoming harder to keep the balls in the air.

But, before we plant your butt at 39, let's at least see if we can't get you into your 40s. I won't lie, you have a myriad of problems and no insurance. Life seems crappy and you have not had any good news lately.

I just got through kicking a four-year addition to hydrcodone and life is starting to turn around. It can happen for you too. I googled the effexor and found out one of the side effects could be HBP, so it might not be your best option. So Cymbalta could change your mood and, remember, it takes up to a month before you start to see if it helps.

I hear you about the sex drive because mine was nonexistent when I was on the pain meds. Luckily, it has returned and viagara is very effective.

All I can say is to hang in there because it can get better with several procedures you can try when you can afford it.

Let me know whassup. lsg
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replied June 29th, 2007
Extremely eHealthy
Hi Lisa;

What a difficult situation you are in. Cymbalta is a unique anti-depressant, in that it can treat physical pain caused by depression. Now always the cause of back pain, obviously, but when you are in pain, you get depressed which causes pain which makes you depressed...you probably get the picture here. There are some free medication programs that can help you get medications if you can't affor them.. Whgat was the medication? I can send you a pm of the site to go to to look for the meds and download the forms.
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replied June 29th, 2007
Hey sillyachick,
He never told me the name of the medication, I guess he felt there was no need. However he is getting me a letter together with his recommended treatment, I'll call and see if I can find out what he was talking about.
I talked to 5 people that I know and they all said don't do the injections, each one of them said it didn't help them and even made them feel worse in some cases. These are all people that I know, so I was wondering what are the side effects or dangers of the injections?? They have me scared to do it; if the financial side of things work out for me.

Thanks for your reply.

Lisa
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replied April 12th, 2008
back pain
Since no one really has an answer for back pain, most integrated spine centers start with the safest treatment and gradually work toward surgery.

1. Medicines (non-steroids)
2. Physical therapy
3. chiropractic or osteopathic manipulation
4 Steroidal oral meds
5. Steroidal spinal injections
6. other weird pain clinic interventions that are akin to Voodoo (IDET, percutaneous disc suction, nerve stimulators...)
7. surgery


Buttermere
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