Back and leg pain.

Edited , 6 users are following.

I have suffered with back problems for the past 20years which over the last 7/8 years have gradually got worse.

It started of with pain in my lower back which was helped by regular trips to a Chiropractor.

This allowed me to continue walking with my local walking group.

Bu slowly over the past 7 years the pain has gradually worse with pain in my lower back, down my right leg plus bot feel are numb.

I had an MRI scan November 2015 which showed problems at L5/S1 which causes moderate stenosis compressing the L5 nerve root.

Feb/2016 had a nerve block injection, this had no effect.

Pain management tried Pregabalin and Gabapentin, both did not help.

Pain was so bad now that I could only walk comfortably for 10mins, therefore walking group came to a stop.

Had a private consultation with a spinal consultant who made his own diagnosis of the MRI scan, which was that degenerative scoliosis was producing narrowing @ L4/5 and L5/S1 plus grade 1 spondyolisthesis @ L4/5 level. He suggested a lateral recess decompression surgery which I had December 2017.

Result being that the surgery made no difference and the specialist said that I would have to learn to live with it!

Have tried living with it but GP sent me for a further MRI scan June 2019, followed by another nerve block injection, which also has had no effect.

GP now also says that I will have to live with it.

The pain is slowly getting worse sometimes stops me sleeping.

What should I do know??

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  • Posted

    I would persevere with your consultant and try more nerve root blocks at different levels. I had 4 nerve root blocks with no positive results and no pain relief. The last 1 at level 4/5 didn't give anything positive except I couldn't walk afterwards. That was enough for the consultant to say well we either do nothing or try surgery at that level. My husband and I decided if that was only option we had to try. Surgeon found not only was disc touching nerve but facet joint was also squashed on it. Nothing showed on MRI scan and medics didn't know where pain was coming from. I've been free of pain now for 15 months and off painkillers for the sane time.

    Bottom line for you have more nerve root block injections at different levels to try and establish where pain is coming from.

    Hope this helps.

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  • Posted

    Roy - So sorry to hear about your problems. Many of us have been in the same situation and can sympathize. I agree that you should probably try more and varied kinds of injections, and definitely don't be shy about being on strong pain medications, including various opioids. I'm also surprised that gabapentin didn't help, since you clearly have neuralgia - did you give it a long enough time (or strong enough dosage) to give it a fair chance? I've been on it at varying strength levels for years and while it doesn't eliminate pain, it definitely can take the pain (of neuralgia, but not other kinds of pain) down significantly.

    A couple of other things you should google and talk to your specialist about. The first is a Radio Frequency Ablation. It is a fairly simple procedure (not much worse than getting a spinal injection) in which they slide an electrical wire down through the needle and burn a lesion onto your nerve root, which cuts off the pain signal to your brain. It can be effective for 6 to 12 months (after which the lesion heals), but it can done again and again for years if it is effective.

    The second option is something called a spinal cord stimulator. I actually have one in me and it helps (the model I have is called a Nevro HF10 but there are other models and companies). They essentially implant a battery pack in you with electrical wires that are threaded up both sides of your spinal cord. They give off very small electrical charges in key areas that can block all different types of pain signals. And you are given a remote control after implantation so that you are in charge of the power level. It's a very minor procedure to have it implanted (similar to a cardiac pacemaker).

    Good luck and don't give up - there are more solutions out there beyond just drugs, injections and surgery (not that I am against any of those, but for when those fail...)

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  • Edited

    I have had two decompressive laminectomies and three fusions in the past six years...all from playing hockey for 45 years (plus add a metal knee and metal hip). I too have gone to chiropractic for sciatica issues and have been very successful with that. The one time it didn't help (nor did injections), the pain was caused by a bone spur crushing my sciatic nerve root at L4/L5. My neurosurgeon did the laminectomy and also shaved back the calcified disk at L5/S1. Woke up to zero pain; the remaining discomfort took less than a week to resolve as the nerve inflammation subsided.

    I would suggest seeing a neurosurgeon to get this addressed properly. A few years after the laminectomy, pain returned that required a TLIF fusion of L3 through S1 with spacers, rails and screws. Took a while to recover from the op including a few months of outpatient rehab work but I eventually (~6 months) felt waaaay better and subsequently had no pain from my lower back area. You may also want to find a neuro with experience in the XLIF (LLIF/OLIF) procedure as that one requires only one overnight in the hospital and no brace or rehab. I had that done at L2/L3.

    In January of 2019, I blew out L1 so two months ago, I had a double XLIF at T12/L1 and L1/L2. After the close, they flipped me over and inserted the rails to support the XLIFs and attach the new upper rails to my existing lower ones. I'm now fused T12 through S1. Any residual pain is due to dead core muscles that support my back. It will take some time and work but all the original pain is gone.

    See a gifted neurosurgeon. Something is wrong in the L4-S1 area that needs to be addressed. My bone spur did NOT show up on the MRI so my doc just went in, found the spur and fixed the problem. You should not have to live with this pain.

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  • Edited

    Injections, maybe...but that is addressing the symptom rather than the problem. I've had a couple, as well as laminectomies, pt, chiro, and all the rest. I even had a spine doc that was doing a medical spine eval on me tell me that he doesn't "believe" in MRIs and sent me home with a sheet of instructions on how to meditate. All because I have an inherited disc degeneration disorder. My first fusion was cervical, second was thoracic, both fairly urgent. I have to get up the nerve (excuse the pun) to do the lumbar fusion and hopefully will walk again. You will probably need lumbar fusion. But what I now know and can pass along: get a THOROGH medical spine eval done at a spine center. That clinic will be able to refer you to a good neurosurgeon. If you don't feel like you are being thoroughly evaluated or taken seriously enough, you probably aren't. Don't be afraid to move on if you start to lose confidence in your surgeon. You have a right, as the consumer, to expect excellent care, every time. And when it comes to matters of spinal nerves, only excellence can be accepted. Blessings to you! Praying that you find permanent relief.

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    • Posted

      Yup...sometimes the only fix to the source of the problem is spine surgery. I would suggest a neurosurgeon with experience with the XLIF (LLIF/OLIF) procedure. Instead of the TLIF where they go in from your back and use rails and screws, the XLIF incision is on your side. A General Surgeon does this part while moving "stuff" out of the way. The neurosurgeon takes over with a clear path to your spine.

      The Neurosurgeon takes over and inserts a tool that makes the job easy. First, a drill to clean out the offending disk. Next, he/she inserts the XLIF device. They might try a few different ones to see which one matches the best with the anatomy of your spine. Once the chosen one is positioned between the vertebrae, the neuro uses and Allen wrench (yes...a real Allen wrench) to EXPAND the device like a car jack when you get a flat tire. This increases the space between the vertebrae, relieving all the pressure on the nerves at that location .

      Some devices just go up and down while others can be expanded in different widths both anterior or posterior. This can help in maintaining the proper curvature of the spine. Once done, screws are inserted to hold the device in place. Finally, a small bone graft is taken from your hip, crushed into a powder and injected into the middle of the hollow device to start the bone fusion itself. Neuro then removes all the tools; the general surgeon does the close.

      Result: All your pain is immediately gone. One night in the hospital, no rehab, no brace, instant recovery. Yes, you have to treat your back well (lifting and weight restrictions for a while). This has been my "miracle op" when I had stenosis caused by the narrowing of L2/L3.

      Search YouTube for "Globus LLIF Technique" for how the surgery is done and then "Globus ELSA" to see how the device is inserted, and adjusted (the supporting "cage" is optional). Two GREAT animations. Note: The XLIF can be done in TWO vertebral spaces in the same op. Any more levels than that, and the doc will do a typical TLIF/ALIF with rails and screws...with all the attendant pain and rehab.

      Hope you can get the XLIF...or better...that your condition is caused by something minor like my bone spur so the doc just needs to clear out anything pinching the nerve and you don't need a fusion. MRIs can be inconclusive on the spine; that's why a CT Myelogram with Contrast is the "gold standard" test for seeing the spine in great detail. Get one done! Hoping for you that this is an easy fix!!! Here's a picture of mine at L2/L3...

      image

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  • Posted

    Thank you all for your encouraging posts, I will tomorrow be making an appointment with my GP and see if I can have a further injection and other possible ways forward.

    Thanks again.

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    • Posted

      Seen GP today and he suggests I try a course of Gabapentin 300mg three times a day, so will see if that helps, hope I have no side effects.

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