Well, Screw That!

[menzies]

For the last couple of years I have been having Sciatica issues. Did the recommended stretches and those eased the pain. Over the past couple of months the pain has become constant. We are off on a South America trip in a couple of weeks so I decided to take myself off to Mayo and have them try and find what the hell is going on.

Not the best result. Meeting with the pain guy on Wednesday for some short term relief, hopefully to get me through our trip, and an appointment with the surgeon is already on the books for when we get back.

Between L5 and S1.

It sure sucks getting old!

 

[RT Firefly]

Greetings,
Mr. m. What am I looking at here? Is that a bulging disc causing a pinched nerve?

 

[Lou_tribal]

Come on, nothing that cannot be fixed with a shot of marvel mystery oil and some valves adjustment

L

 

[menzies]

Greetings,
Mr. m. What am I looking at here? Is that a bulging disc causing a pinched nerve?

Officially: "At L5-S1, there is a disc bulge with superimposed left lateral disc protrusion that abuts the exiting left L5 nerve root and traversing left S1 nerve root. There is severe left subarticular recess stenosis. There is moderate right and severe left neural foraminal narrowing."

I hate it when medical professional call it severe, especially surgeons!

Rum and coke for now. I hope injection for the next month, and then hopefully they can get in there with a razor blade and shave that dang thang off.

 

[bshillam]

Been there done that, got the shirt. Know your pain. Involved in a T-bone, spent the last year in recovery. Came to realize I have done as much as I can with the medical professionals. As one I have quoted recently, reached the maximum medical benefit. There really isn't a day I have that doesn't have some pain of some sort. I feel grateful I am walking!! I do have to remember to drink water as those disc are filled with fluid from the body. The other thing - don't lift weight. I have been limited to 25lbs. Such as life. Try reducing the weight you carry. Sorry you are going through this, everything is connected to the back - so much of what we do is dependent on our backs.

 

[RT Firefly]

Greetings,
Mr. m. I'm no doctor but I don't think they can shave a disc. As Mr. b noted, it's a fluid filled sac. Ever consider a chiropractor?

 

[menzies]

Greetings,
Mr. m. I'm no doctor but I don't think they can shave a disc. As Mr. b noted, it's a fluid filled sac. Ever consider a chiropractor?

Just into two months of the pain.

And just taking it one medical professional at time right now.

I am going to Mayo, so hopefully they know what the hell they are doing!

 

[Insequent]

I had that exact problem a couple of years ago. In my case it followed some hours of twisting sideways hand sanding teak trim on the flybridge windscreen base while sitting on the dash area.

Apparently swimming is good. I found bicycle riding beneficial. When it gets bad you lose nervous sensation. It can become incredibly painful as well, just about unbearably so.

The surgeon I saw had the same issue, and numbness extending to one foot to the point he always had to put his other foot in the shower first to test the water temp. He was not going to have surgery, and advised that more often than not it did not help.

But, after testing reflexes and strength he thought it possible that I had just pinched the nerve rather than sustaining more permanent damage. As such a guided steroid injection was suggested. That worked a treat. Not instantly, but steady improvement over a period of weeks. I'm very careful to ensure I do not pinch it again I can tell you!

 

[bshillam]

A bulging disc can not be medically treated through surgery. I would see a chiropractor if you haven't. For me it was Chiropractic care and acupuncture. Weekly and some weeks more than once. When I first started I was under so much pain standing, sitting, laying down it was all painful. I also experienced the loss of control/shooting pain on my left side, I had to use a cane. Do everything you can not to go into surgery. As some have already said, there may not be any improvement and you'll have months of recovery/PT.

 

[GFC]

I had Sciatica problems about a year and a half ago. Chiropractor fixed it. No more problems after about 6 or 8 visits.

 

[RT Firefly]

Greetings,
Mr. m. I've had back/sciatic problems in the past that have been alleviated by a chiropractor. Took me about 3 different practitioners to find a good one. First two I had to have "adjustments" on a weekly and sometime bi-weekly basis for months. Third one, went to two appointments and done. She also used acupuncture. Now whether or not it was the chiro or the accu, I don't care, it worked for me.



NOT trying to talk you into anything but my and others anecdotal experiences (above) suggest this form of treatment DOES work. One problem is most MEDICAL doctors do not recognize chiropractic as a viable form of treatment. I tried physio and exercise and that didn't do any good.



Bottom line is what have you got to lose? The LAST thing I would try is surgery.


Really hope you get some relief.

 

[Russell Clifton]

Two years ago I had to cut a cruise short because of so much pain in my left leg. Had a steroid injection and the relief was almost instant. Really have to be careful now. Two weeks ago I dragged out the Honda portable generator to run the old fuel out of it. Had to pull many times to get it started. Could hardly walk for 3 days afterwards.

 

[HopCar]

I screwed up my back with a 4d battery.
A good chiropractor gave me some quick relief but not long term.

I went to a Neuro surgeon who prescribed physical therapy. I expected him to push me to surgery but he didn’t. He said I’d tell him when I wanted surgery. The physical therapy really helped.

I also have a bad disc in my neck and I make kidney stones. My back, neck or kidneys can put me in horrible pain at anytime so whenever I leave home for more than a day I carry some strong pain meds just in case. I figure that if I have to see a doctor who doesn’t know me he may be reluctant to prescribe the good stuff I really need. Tylenol doesn’t do ****.

 

[BruceK]

Officially: "At L5-S1, there is a disc bulge with superimposed left lateral disc protrusion that abuts the exiting left L5 nerve root and traversing left S1 nerve root. There is severe left subarticular recess stenosis. There is moderate right and severe left neural foraminal narrowing."

I hate it when medical professional call it severe, especially surgeons!

Rum and coke for now. I hope injection for the next month, and then hopefully they can get in there with a razor blade and shave that dang thang off.

Movement of the spine due to bending etc usually occurs between the L5 and S1 vertebrae,so it`s often the site of wear and tear. Including disc protrusion, where the disc protrudes out of the space where it is intended to sit, as a kind of shock absorber, between the vertebrae.
Stenosis is narrowing or restriction, maybe due to bone overgrowth, and takes away space for nerves to sit nicely. Once you have protruded disc pressing on nerve roots, you likely get referred pain down the leg, maybe including foot and toes, and areas of reduced sensation to pin prick testing etc,identifying those areas can tell you the spinal level it is coming from.

From your comment"shave that dang thang off" the idea might be to open up the spaces again by removing bony overgrowth.

I know lots of people love chiropractic, but I`ve seen people who had neck pain, had chiropractic manipulation, and immediately developed pain down the arm, pointing to a disc condition not present pre manipulation.


Dr. C Edmund Graham here had a technique injecting scientifically prepared paw paw enzyme into swollen protruding discs, which shrank the disc back towards normal size.


I`ve an old disc protrusion at L5-S1 contacting the nerve, and more recently sustained a crush fracture of L1. The L5-S1 clinical picture was so apparent to the neurosurgeon he never wanted a CT scan, the one done for the L1# showed it,and was no surprise. I avoid surgery for it by regular swimming.
My imperfect "knowledge" about this area comes from personal experience and from years ++++ of,as a lawyer, regarding back conditions: reading medical reports,researching from textbooks, talking with medicos,talking with claimants, taking evidence, and importantly, correlating medical reports and personal histories. I`m not sure if I`ve helped or hindered and happily defer to anyone with real expertise.

 

[menzies]

I had both an MRI and an EMG. The spine doctor who ordered them scheduled me into the pain guy for a shot before my trip. She said the shot usually lasts a month, but in some cases settles the nerve for a longer period so long as I don't do anything aggressive to restart it. She also said their surgeons are very conservative. She booked the surgeon for when I get back so that I was on the schedule and wouldn't have to wait if things did not improve.
She didn't have the write up when we met, only the images. So I emailed her last night asking if her approach has changed after getting the report.

BTW, the EMG? What an awful test!

 

[High Wire]

BTDT, L5-S1 on the left side TWICE 11 years apart. First time was a 10 mm bulge that would not go away. Second time was a bone chip got in there aggravating the nerve. You will have to get the 3 epidural injections first. Surgery is the last resort. Choose a Neuro-surgeon not a tennis elbow guy. If they nick the sciatic nerve you loose feeling in your leg or foot for good. The pain relief was amazing. So there will be some loss of function after surgury which of course varies with the individual. For me, when I walk, at 3/4 mile exactly my left leg will start tingling. By a mile it will start to go numb. Sit down for 10 minutes and everything resets back to normal. I can live with that. Oh yea, beware of the opioids. Besides the addiction danger, they give you heck of a case of constipation!
HopCar and Bshillam said it. When it hurts to walk, sit, try to sleep, drive a car, you will be begging for relief.

 

[folivier]

I've had back pain for too many years to count. And I fear I'm getting closer to surgery on my L4-5 with a torn disc. Been going to a pain doc (anesthesiologist specializing in pain management) for 15+ years for steroid shots and nerve ablations which work for a few months. Last summer I tried CBD ointment and it has worked better than other topical ointments. I also use a TENS unit when the pain gets bad enough. As they say "I feel your pain".

 

[diver dave]

HW has that right about the surgeon. My brother is a back neurosurgeon. He fixes a lot of ortho hack jobs.

 

[BruceK]

EMG is an odd test! It measures the speed signals move around the body, which can tell if there is a nerve impingement. Very odd to see a foot moving without you telling it to.
I`ve seen surgery reports where fragments of disc are removed, but a disc is not the same all the way through.There is a softer center,which can extrude if the outer surface gets herniated, that spells real impact on nerves.
Like some others here,you can have a base level of discomfort which increases rapidly when you do something which annoys whatever is amiss. Like helping lift an 8D, when my left outer/lateral toes numb off, but it recovers. I went through a year of nasty sciatica,now essentially resolved. There is a method to relieve it short term, lie on your back on the floor, hips bent 90 degrees, knees bent 90 degrees with lower legs across a the base of a chair. Instant relief, for me at least.
I may not be a fan of chiropractic but I am a fan of physiotherapy. Though I think these days the distinction is blurred, especially with "manipulative physiotherapists".

 

[Datenight]

I had a Laminectomy in July of 2010 at age 53. It changed my life. Back pain had been an issue since my early 20's. Our family has long been a beliver in chiropractic therapy and I was a regular patient. Despite regular treatments and exercises nothing was helping that summer. It was my chiropractor who suggested the neurosurgeon.

I was supposed to see the surgeon at the end of the month but the pain got so bad I called and got in two weeks early on a cancelation. Heavy pain medication made no difference. After a short exam, seeing the right leg with drop foot and unable to straighten up the doctor suggested surgery the next day. As I could not walk it sounded good to me.

The operation was outpatient! I could not walk going in at 2:00 p.m. and walked out at 9:30 p.m. The pain was gone other than soreness at the incision site. My entire right leg had almost no feeling which took about 18 months to come back due to nerve damage. Right foot still has numbness in the toes but does not affect day to day living.

It has been almost 10 years and my back is better now than it was 20 years before the surgery. For me it was a life changer. I wish you the best and hope if it goes to surgery yours is successful as mine was.

Rob

 

[ktdtx]

There are surgical options but surgery should rarely be the first option.


https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/lumbar-disk-replacement

 

[menzies]

There are surgical options but surgery should rarely be the first option.


https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/lumbar-disk-replacement

Nope, not now. Maybe not ever!

They ain't doing that!

 

[leeman]

You don't chose surgery, it choses you. In my case I couldn't walk or stand. The
cortisone nerve block actually made it worse. I was on morphine every four hours. You will know when you need surgery...you're not there yet.

 

[menzies]

You don't chose surgery, it choses you. In my case I couldn't walk or stand. The
cortisone nerve block actually made it worse. I was on morphine every four hours. You will know when you need surgery...you're not there yet.

How did it work out?

For both the pain release and the potential mobility decrease?

 

[Bacchus]

Depending on your success at Mayo you might want to check out Hospital for Special Surgery (HSS.EDU) in NYC.
They are tops in orthopedics and dont go for the knife as a first choice. I have had 2 experiences there and have met / talked to many people that have been to HSS and have never had a negative result or sentiment. NYC is not possible for everyone but if possible I really encourage folks check their success rate and ratings... they are impressive.
If interested in more info a PM best.
Hope you find a solution as I wouldn't wish back problems on my worst enemy.

 

[leeman]

How did it work out?

For both the pain release and the potential mobility decrease?

I walked out of the hospital the next morning. Mostly pain free, but had complications associated with this particular type of surgery. All good now, but some left foot numbness still lingering. They say up to two years. Possibly permanent. I can live with it.

I wonder if we do the procedure differently here? Mine was L4/5 and was minimally invasive. I have no clue if different surgeons have different approaches.
That might be a point of investigation.

 

[RT Firefly]

 

[BruceK]

I had a Laminectomy in July of 2010 at age 53. It changed my life. Back pain had been an issue since my early 20's. Our family has long been a beliver in chiropractic therapy and I was a regular patient. Despite regular treatments and exercises nothing was helping that summer. It was my chiropractor who suggested the neurosurgeon.
I was supposed to see the surgeon at the end of the month but the pain got so bad I called and got in two weeks early on a cancelation. Heavy pain medication made no difference. After a short exam, seeing the right leg with drop foot and unable to straighten up the doctor suggested surgery the next day. As I could not walk it sounded good to me.

The operation was outpatient! I could not walk going in at 2:00 p.m. and walked out at 9:30 p.m. The pain was gone other than soreness at the incision site. My entire right leg had almost no feeling which took about 18 months to come back due to nerve damage. Right foot still has numbness in the toes but does not affect day to day living.

It has been almost 10 years and my back is better now than it was 20 years before the surgery. For me it was a life changer. I wish you the best and hope if it goes to surgery yours is successful as mine was.

Rob

Great story,sounds like nothing would help but surgery, and it did. And as "day surgery"!
Reminds me of something I heard a number of times, if the nerve impingement is left too long the nerve recovery time can be longer or may be less successful.Putting off the inevitable can mean a less optimal result later.
I count myself lucky, years of nasty sciatica eventually settled. If I overdo it I can get back pain, even leg pain,toe and forefoot reduced sensation "pins and needles", occasional cramps, but it`s tolerable, especially considering how it was. If I was in the same condition as Rob above I`d opt for surgery too, I think he had all the indicators. He doesn`t mention the muscle spasm which goes with it where muscles spasm to protect underlying structures, and is severely painful with certain movements.

 

[menzies]

Saw the pain guy today. Going in for the injection into the space between L5 and S1 on Friday afternoon.

Glad to be doing it as it is getting worse. In fact we went to dinner at the club this evening and one of my friends took a look at me as I walked up and said "man, you look tired."

Non stop pain is bloody tiring.

 

[BruceK]

Saw the pain guy today. Going in for the injection into the space between L5 and S1 on Friday afternoon.

Glad to be doing it as it is getting worse. In fact we went to dinner at the club this evening and one of my friends took a look at me as I walked up and said "man, you look tired."

Non stop pain is bloody tiring.

That`s often when people opt for surgery, ground down by pain.
Sounds like fun. Some kind of steroid injection. Hope it helps, there is/was a limit how many of those you can have.