Lower back pain for 10+ yrs Mri results I'm confused

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hi everyone I'm hoping someone can help me understand my results as my gp wasn't very clear explaining them. 

 

10+years ago I injured my back at the time dr said pulled muscle so I carried on working it got worse and I ended up hobbling round and dr's then said I had trapped my sciatic nerve. I had physio exercises and traction which made it hurt over the time frame I've not been without pain but I have a high pain threshold so just got on with things. 2 natural labours later whilst in labour with my son 1.5 years ago I said my back had gone (really sharp pain at the time) since then every time I've been dr's I've been told bones soft from labour and that was it. Over the time frame I've had physio many times and don't see any improvement.

I finally had an Mri done and my results were: 

preservation on of the normal lordosis. Normal vertebral alignment and canal volume. The l5/s1 disc is degenerate with end plate changes. L3/l4 are normal. At l5/s1 there is a diffuse posterior disc prolapse displacing theca and the transmitting s1 root but no marked compression. No compressive lesion identified elsewhere. Normal conus and palaver table soft tissues.. 

Gp said that she can refer me to physio or orthopaedics but thinks physio first but my choice. I'm unsure after failed physio if this is the right route first for me.

Yesterday I vacuumed the house did a bit of ironing etc and I'm in agony today I can still move around but it's a constant pain with occasional sharp pains. Majority of pain is located in my lower back and bum. 

Has anyone any experience in the same situation? Can someone explain in simple terms what is wrong? Xx

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  • Posted

    Get to a good Ortho surgeon to get the MRI read to your properly. Sounds like you have a herniated disc at the first vertebra L5/S1. This is the first disc I had surgery on. Do you have pain into your calf and foot at all?

    The surgeon will give you options, if you have tried the Physio numerous times and pain meds are working then look at the options he/she gives you. They may suggest Pain Clinic which I'd have thought your GP would have already suggested.

    Good luck, just don't take no for an answer and push for everything you want.

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  • Posted

    Hi there,

    Sounds like everything okay except for L5/S1 which is basically near base of spine. L stands for lumbar and S stands for sacral. I too have a central disc bulge of this disc and it is also very thin when viewed on MRI scan, becomes dehydrated and whilst there is no permanent nerve compression you can still get nerve root irritation, I have no end of issues with muscle spasm in my lower spine, in fact I have just changed to a diff. muslce relaxant to the one I have been taking most of last 9 years I have been plagued with this ( the two discs above this level are also affected in my spine but to a lesser degree ), it's is not unusual to see facet joint degeneration either, due to the pressure put on the spine in the area.I have always been refused surgey on basis that scar tissue can cause problems too, and I have a 50:50 chance of success at best, so I have always been referred to pain clinic. I would ask your Gp for a referral to your nearest good Pain Clinic, they are anaesthetists that have then done extra training in pain management, this in conjuction with physio can be helpful in many cases. I take hard core pain meds, slow release morphine having got used to tramadol and the likes over the years, but best keep those in reserve unless you cannot function due to the amount of pain / muscle spasm, then take drs advice ....try to stay active, swimming, pilates, and aqua aerobics in kderation are all good for keeping core strong too.....I have never been offered a solution, at best we manage my pain etc as well as possible....

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    • Posted

      Why have they never offered you a solution to your situation after 9 years?? I've had two decompression surgeries and only last week had a two level Anterior Lumbar Interbody Fusion of L4-S1. Surgeon confident that he's fixed my pain issues, and so far he's correct. I'd fight till you see someone that'll give you a resolution to your pain instead of just piling in the meds. I've been on MST, Morphone Patches etc etc and all the nerve painkillers going. Off the strong ortho meds now but will continue with the nerve ones as I have nerve damage from previous injuries. Don't take no for an answer.
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    • Posted

      well I have had 3 orthopaedic surgeons tell me I am not the best candidate for surgery, it's not like I don't keep checking in with them....last thing I could have been offered was a spinal cord stimulator, but once again I am not the sort of candidate they usually go for and gave me a success rate of poss. 25% pain reduction at best...so I helf off for now. I have taken gabapentin and pregabalin but both have affected my short term memory long term, and I discontinued them slowly over a year ago, still got cognitive issues though. Yes, I do take zomorph and sometimes oromorph for the pain, and baclofen for muscle spasm, not saying it's perfect solution but we do what we have to under the circumstances, and apparently I am not a great candidate at present for surgery.....I've done steroid injection, physio, Mindfulness couse ( that was good ), and radiofequency ablation of nerve roots ( v painful in my case and helped for maybe 6 months or so )....9 years ago I was told I could look into disc replacement with a surgeon in Manchester, then 3 years ago I was told the best decision I made was not to pursue it then as the material wasn't strong enough and people were having to go back under the knife.....all depends on who you talk to !!
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    • Posted

      The surgeon who did my op on Wednesday was the Ortho guy who did my first op back in 07. He is superb. Tells you how it is and paint the picture black or white (yes or no).

      It sounds like you have similar issues to I had. I had Lumbar Lordosis, Lumbar Spondylothesis and DDD over 4 discs. S1-L4, L4/L3 is good and L3-L2 aren't good either. The lower two which have now been fused where done due to me not responding to medication, Physio or any other conservative treatments including injections, tens and acupuncture. I had a double discogram which was positive and this allowed him to pinpoint my pain and fix it. Time will tell if it's a complete success or not as I'm only 4 days post surgery but things looking good.

      Have you tried Amitriptyline or Carbamazepine for nerve pain? I take both and will continue to. Also take Diazepam to stop muscle spasms.

      As you say, you are actively seeking solutions or assistance with it. Keep going. It's a long road but it'll be worth it.

      Just to give you a figure, the op I had has a 85% success rate.

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    • Posted

      Interesting, yes my discs are L5/S1 worst, then L5/L4 and then L4/L3 started going. I did try amitryptiline, but I could not stand the side effects from it, so never found out if it was any good for pain in me, to be fair it is the worst TCAD for side effects, but in some I know at low dose works for pain,....I have been on diazepam for years, 2mg and 5mg, three times day for muscle spasm, but doesn't do a lot these day for me. I use a lot of heat patches when muslcs in spasm too.....there is soemthing called Tiger Balm in a patch ( cool version ) is wonderful, but mostly available in far east, although can get off Amazon although costly ! I currently have been swapped to baclofen 10mg, 3 times daily for muscle spasm after a horrific bout of nerve pain and muscle spasm 2 weeks ago that nothing would touch ( and I have strong meds ! )....
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    • Posted

      I had the opposite to you with the nerve pain meds. Pregabaline and gabapentine gave me horrendous side affects. I'm on 100mg of Amitriptyline at night and 300mg of Carbamazepine and it works. I still get pain but reduced. I also have no pain feeling in my right foot plus no jerk reflex and left thigh is pretty dead too. My kids find it funny that they can stick pins or needles in my foot and I don't feel it!!! Got a laugh sometimes! 😂😂
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  • Posted

    Re pain in buttocks, that is usually sciatic nerve, although in some cases can be SI nerve also. Tends to shoot down the leg to the foot, but not neccesarily same one day to next. Some days I lose feeling in parts of my foot, and get tingling pins and needles from it, other days it like a dagger going into your butt cheeks, other times it's like a pulling sensation down the back of the leg.....beware drugs that act on nerve pain I have been there and since come off them due to side effects ( long term ) - worth checking meds on here for a more complete picture if any suggested - I doubt whether an orthopaedic surgeon would do much at this stage, I would def. recc. pain clinic though and wait lists can be long to get an appt, so get a referral off your GP, they can direct you re meds, injection therapy, and can get you on specific physio programmes that are more targetted to your condition.

    All the best xx

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