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Just wanted to post some items of my current situation and see if anyone has anything similar or thoughts:

2.5 years ago the disc at L4/L5 ruptured as I bent over one morning. Worst pain I've ever felt. Had several months of back, shoulder, leg pain treated with PT, narcotics and eventually tried the drx-9000 treatment + chiro treatments for a year. Things today are improved but still not great.

After a first MRI (about 6 months after initial rupture) a surgeon said he didn't think my case could be fixed with surgery. So, things continued on with the chiro, increasing the exercise and manage with vicodins and muscle relaxers as needed.

So today, the biggest problem is if I have to stand still (in a line) or walk slowly, wait for an elevator or things along that nature, within a couple of minutes the pain starts in my left foot - radiates up my leg into my back and the right foot usually starts the same mess now and then. If I sit down or lay down for 5 to 10 minutes, the pain will usually go away and I can continue on (until pain comes again and I have to sit down again).

Some times I medicate prior to the onset of pain if I know I'll be in a line somewhere or more likely will have to stand around or do something that will trigger the pain and though the pain is dulled, it is still there.

A follow-up MRI which also included my neck (when they tried to determine why my shoulder was hurting so much) showed:

There is degenerative disc disease at the c5-6 and c6-7 levels with disc space protrusions. At the C5-6 level, there is cord compression from a central disc space protrusion. The exit foramina are patent. At the C6-7 level there is central and right sided disc space protrusion...

Anyway, the surgeon looked at the MRI for my neck (which now doesn't hurt and the shoulder pain hasn't been a problem for a long time) and said that he could fix with replacing the protruding discs with a donor bone and fusion and I'd be back at work 3-5 weeks later.

At the time I told him my neck wasn't the problem and it was still my back pain and I didn't want my neck cut open if there was no pain and no loss of control.

The 2nd MRI writeup of my back (sorry to type all of this but again, I am hoping someone has had similar / same issues): There is degenerative change seen throughout the lower lumbar spine. For this report, the lowest most well formed lumbar type vertebral body is called L5. There is degenerative disc disease at the L5-S1 with a tear in the annulus and a central disc space protrusion with some central nerve root compression. There is mild facet disease. The lateral exit foramina are judged patent. At the L4-5 level there is degenerative disc disease with diffuse disc space protrusion causing central canal stenosis and nerve root compression. The L4 lateral exit foramina are patent bilaterally. Degenerative change is seen in the lower thoracic spine with mild disc space protrusions at T11-12 and T12-L1 levels. The conus ends normally at L1. No fracture or subluxation is seen.

There was an area for "impression" which basically said no overall significant interval change from the 2005 MRI.

My primary care doc has referred me to an Orthopedic Surgeon at Georgetown Medical school that I see in early November and will see if he has any ideas or solutions to my present state of things.

In the meanwhile, again - does any of the above sound familiar to anyone or why the pain is so much worse when I stand still than any other time? If I am active and moving, then usually things are tolerable but if I have to stop and wait for a traffic signal or walk slowly through a grocery store, then the pain starts in my legs and travels up into my back and relief will only come if I can get off my feet - which sometimes I end up just sitting/lying on the ground where I am at if I can't find a chair close by.

Long car drives used to be a problem but either that part has gotten better or simply knowing about the issue with a pain killer before and a tolerance to pain, I've simply learned to live with it. Sitting at a desk is sometimes an issue if I stay in one position for too long with moving. Sometimes manual labor is an issue and other times, it is not.

The original surgeon I see said he would be willing to try a fusion on me or some other type of operation but didn't think it would be successful in my case and might lead to my being in worse shape and/or the need for additional operations.

Originally, my insurance was a not so great HMO so getting additional opinions and treatments were limited but I've changed companies with a better insurance plan so the primary doc told me while I've got the coverage, I might as well take myself down to Georgetown to see what their view is.

It's not like I am hunting for an operation - I just want the pain to go away and the fact that the first surgeon told me, 'I cut people open every day and most problems have a surgerical fix in my opinion but in your case, I don't think it will fix anything" does not fill me with much confidence.

thanks for any comments.

Alan.
Hi,

I know your symptoms well...its exactly how mine were a year or two ago...quick walking (from the off) was fine but queues, or walking at a slow pace were murder for me, most days, but not all. Mine progressed so that instead of being something that happened a few times a week, it was everyday, and the length of time shortened and eventually led to it being anything where I was upright or straight-backed...sitting upright, lying flat, walking fast or slow...I can't imagine wanting to try running! but I'm still fine if I sit curled up, lie in the foetal position, and I'm (well, until recently for reasons below) still pretty supple, flexible etc...I can (could) squat, bend,lift etc...as normal.

Moving along, I had an operation in April and another september and am still waiting for improvements. I've had a little (I can walk for 5mins instead of 2mins) but its nothing to write home about. Whether this is just a long recovery or a second unsuccessful operation is yet to be seen.

Anyhow, the symptoms are typical "claudication" which occurs from stenosis - narrowing of the spinal canal (where the nerves start) and/or foramina (where the nerves exit). In my case its from a big lateral disc bulge on one side, but its seems there are a few potential causes in your case...disc protrusions, facet disease (the facet joints get bony growths on them which narrow the canal and foramina). the reason its only when your standing is that when you're upright the back extends slightly and the spinal canal and foramina narrow, but when you bend over, or flex forward everything opens up to give the nerves room.

As for treatments its complicated...surgeons may be reluctant if there's a lot of problems at different levels...however, there's some on here, Baybreeze in particular, who had good results from surgery for stenosis. I'm still waiting to see...keep hunting for opinions because you shouldn't have to live with the pain! see another surgeon if necessary.

I never found a painkiller that worked...I'm sure they're there but I don't want to try anything that's going to knock me out...the idea is to control the pain so you can function again and if you're in a constant state of grogginess it kinda defeats the point. Like you, I'm not in extreme pain all the time, so while I have no life on my feet, I can at least be relatively pain free when I want...after reading some stories on here, I'm grateful for that.

Well, I hope I haven't rattled on to much and that you find this useful. The causes are a bit different I think in our cases but the symptoms are very similar. My gut feeling is that its not something to be solved by physio or painkillers and surgery may be your best bet, so it may be time to see another surgeon. Surgery isn't always 100%, but sometimes even 50% relief can make a big difference. Problems often recur with stenosis (the bony overgrowths grow back) but that can still take a while. On the other side, sometimes you can create more problems with knock-on effects on other levels, instability etc... these are all things you would need to discuss and weigh up in your own mind...

All the best for now,
Jinks





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