Spinal stenosis; SI joint

[FaithfulMom]

I’ve been struggling with low back pain and sciatica for almost two years.  I've missed a considerable amount of time at work because driving and sitting hurt like crazy.  There was some mention of spondylolisthesis (L4-5) on an MRI, but primarily degenerative disk disease and arthritic findings.  I drive 2 hours a day and work at a computer-oriented job.  Sitting causes much pain.  I took 2 months off and underwent a serious physical therapy program.  Got marginally better, mostly in the ability to manage the pain.   Walking and activity usually lessened the pain.  Two days after return to work, the pain was back full force.  About a month ago, we were threatened with a Category 4 hurricane and my husband was out of town.  I spent hours moving things upstairs and loading other things into the car (up and down the stairs for hours).  We were spared the wrath of the storm, but a few days later, my back, buttock and leg pain sky-rocketed.  Walking is now excruciating.  Sitting and prone is best.  I’m 52 and don’t know how I will manage the rest of my life with this pain.  My mom also has DDD (with spinal stenosis) and has had cervical and lumbar laminectomies.  She did fairly well after both.  From all of my reading, I know that spinal stenosis is likely and that surgery is probably my best option at this time.  I REALLY don't want a fusion, though.  My questions, if a laminectomy would help, how unstable does the spine become because of the removal of that bone?   Could the SI joint also be a primary issue in my pain?  Anatomically, that’s where it hurt the most prior to this latest development.  If so, is there ANYTHING that one can do to strengthen or “fix” problems there (SI joint)?  Also, I am becoming more and more “flexible”…i.e., my hypermobility usually causes my doctors to think that I have a great range of motion ( I can flex forward and touch the floor)…and thus they don’t take me too seriously.  Could there be something hormonally that is causing lax ligaments?  
I want to be pro-active with this.  I don’t want to be old…so young!  And...between hot flashes and excruciating back/butt/leg pain...I am about ready to call it quits.  I'd appreciate any words of advice or direction.

[Kevin Pho, MD]

To answer your questions:
1) It is possible that the SI joint may be the cause of the pain.  If this has been determined to be the case, you can consider a referral to a pain clinic for SI joint injections.  Steroids would be injected to decrease the inflammation.

2) I am not aware of a hormonal cause that would increase joint flexibility.

3) If spinal stenosis is a concern, a pain clinic or visit to an anesthesiologist can be made to determine if epidural injections would be helpful in pain relief.  

If this is not feasible, then a referral to a neurosurgeon can be considered to discuss surgical options.

These options can be discussed with your personal physician.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
http://www.straightfromthedoc.com

[FaithfulMom]

The results of the recent MRI says moderate to severe spinal stenosis due to degenerative disc disease and grade 1 spondylolisthesis.  Also a 7 mm cyst further contributes to the stenosis. Has anyone here had a cyst involved in the diagnosis?  I don't want to go the steroid injection route.  After two years, I'm ready for something more permanent than temporary relief.  Can anyone share any similar experiences and/or words of advice??

[bird lady]

I had back surgery a year ago am still having so much pain.  I had L4, L5, S1 decompression and grade 2 Spondylolisthesis at L5 & SI.  A decompression with bone fusion and instrumentation was done.  I wore a brace for 3 months.  Tried to go back to work for 3 months but had to finally quit a job I had been on for 25 years.  I have regained some strength in my legs and have only made it up to walking 1 mile a day but am in a lot of pain while doing this.  For about 5 months or more, I have had foot pain across top of right foot, ankle and down to big toe with a stinging/burning in the toe at times.  Saw an orthopedic about 2 weeks ago and he doesn't think foot pain is coming from back surgery.  This leg was the one giving me the most pain before surgery with sciatia pain.  I can't ride in a car for much over 15-30minutes without the sciatia hurting on both sides.  I was told after my sugery that 3 nerves on both sides were released with main one being the sciatia and that they were very inflammed but not necrotic.  I go back to my Neurosurgeon on 11/22 and really don't have anything much good to tell him.  This foot pain is hurting my walking which I badly need to do to lose weight and gain more strength in my back.  I knew before I had the surgery that I only stood maybe 80% help "if I was lucky" were my surgeons words but I never expected to hurt worse than before surgery. As you can imagine, I am quite depressed as this has been, I think, the worst year of my 57 years. Anyone out there with similar problems, I would greatly appreciate hearing from.  
Thanks, Brenda

[Pain Lady]

I'm so sorry to hear you're in worse shape than before the surgery. My pain gets so bad sometimes, I do think about it, though the last Pain Dr I saw said he wouldn't recommend it. I have severe arthritis in both SI joints, several lower vertebrae, and now it's in my hips. I've been working, but have used more leave than I earned (govt employees can carry over), so I know it's only a matter of time before I have to retire. What are the Drs giving you for pain?

For years I've been making do with muscle relaxers and Darvocet. My GP finally gave me Percocet and that helps more than anything. In addition to the arthritis, I also have fibromyalgia, and when both are in flare, I just want to give up. But then I have good days and know that's not an option. Just know you're not alone out there. We are many.

Ann

[Pain Lady]

PS the radio transmittal Therapy (RTF) buys me a little relief. I go again tomorrow. I'm in bad shape tonight. Hope you get better. Ann

[cjplus9]

I'm so glad I found this forum. I feel so alone and "different" with my spinalstenosis, arthritis, degenerative vert, etc. I've been on disability for years and I'm only 61 now. It does a number on my depression and to top it all off, I now have diabetes. The point I'm trying to make is that hearing you all share your own pain can at least ease my aloneness with mine. I'm considering getting the injections again. I didn't like the way they made me feel years ago but I'm getting desperate. Does anyone know the name of that medication they inject you with? I've forgotten. Thanks. cj

[tlw1975]

I thought that I was alone. I'm 30 and feel like I'm 80.  The pain can be so bad that I want to cry.  I currently see a Arthritis and a Pain doctor.  I'm living on pain killers and muscle relaxers.  I cannot sit lone periods of time with out have to getting up.  And when it rains....I'm done....I hurt so bad.  They are call arthritis of the SI joint.  I haved 4 injections and pt, nothing seems to be working.

[atrueoriginall]

Could any Spinal Stenosis sufferers here please tell me if you were ever diagnosed for GERD also and placed on any of the following meds?  

omeprazole (Prilosec)
lansoprazole (Prevacid)
pantoprazole (Protonix)
rabeprazole (Aciphex)
esomeprazole (Nexium)

[AncientHolyOrder]

I would like to answer the last post in reguards to the GERD. I have been on Protonix for many years now. I never connected the possibility of these conditions being connected. I have tried many herbal formulas to stop the inflammation and recently I have found Bromalain which comes from Pineapple Enzyme by a company called Good and Natural. I take 600mgs three times a day and it has helped considerably. I also have been on Morphine for over 6 years now, it was my only method of being able to work.  I also have late stage liver disease so shots for me are out of the question. I have been working all this time and everyone is correct about the endless pain. I must sit and stand all during the day. I also have been forced to change my eating habits and during my research I found many foods contain such an acidic formula that maybe we cannot heal due to food issues.
Well my life depends on how I eat, work, live, and walk. So maybe together we can all find a solution to this crippling disease. I totaly believe its in the food. Email me at ***@**** if you want to order and try some Bromelain.

[josephr]

My wife had HORRIBLE sciatic pain that got in the way of her everyday functions.  We were worried that there was nothing to be done until we found a really good reflexologist.  Less than 15 minutes and the pain had disappeared.  When it recurrs, less than 3 minutes to eliminate all pain...he taught her how to do it on her own.  It may be good to see a reflexologist, but here is a link that we use: http://www.winnipegreflexology.com/2006/02/relieve-sciatica-pain-do-it-yourself.html
The whole site has a few other helpful things, but mostly hard to understand unless you've been to a reflexologist before. (www.winnipegreflexology.com)

[BeaAnn]

A related discussion, Confused was started.