After 8yrs of on-going severe pain and MRI's am considering surgery

[terria34]

I was in a car accident in 2000 and that was when my back problems started. I've worked as a server in restaurants for over 13 yrs. After the accident I've been in severe pain ever since. I hardly ever get a break from the pain. Maybe 2 days a month I can get directly out of bed without being in severe pain. I have been on narcotic pain medication on and off since 2000. The only reason I deal with the addiction stand-point is because they make life bearable by taking the edge off of my pain. I'm sick of living this way and am opting for surgery. I've recently had to quit work all together because the increasing episodes of debilitating severe pain is keeping me from being mobile 75% of the time. I'm currently looking into surgery for relief. I'm a 34 year-old female, I'm not over-weight. I have a 16 month-old son that solely depends on me and I can not even pick him up without being in awful pain.
My MRI summary report states that, The MRI of the lower spine demonstrates Degenerative disc disease and disc desiccation at L4-L5. There is annulus disc bulging from L3-L5 and facet arthropathy from L3-S-1.
What type of treatment wouild I benefit from, if any? And what are my chances of ever leading a drug-free and pain-free life?

[terria34]

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[terria34]

I promise, those will be the last "technical" questions I'll ask you. I know you are a busy man.
Thanks

[terria34]

Hi Doc,
Wow, I didn't think I would get another reply from you, I'm delighted and as always, do appreciate it. Yeah, my son is cute, since he is the center of my universe; I always post this picture when I post one. I have it on my posts at my school also. I'm a very proud Mama! They are so awesome at this age.
Anyway, onto the subject. This was going to be my last epidural series, I just do not reap enough benefits from the procedure to continue (I hate needles). I just was wondering if facet arthopathy indicates facet degeneration or stenosis? Is it true that MRI's are only 30% correct, and are genuinely not concidered in diagnoses? And what tests should I be pushing for to determine what exactly is wrong with me? I wouldn't dought the % rate of the acurateness of MRI's because some Doctors that have looked over my films and reports, act like it's not a big deal. Believe me! It's a HUGE deal when it affects EVERY aspect of my life. I've had an EMG that showed  conciderable nerve-damage, I do not want to go through that again.

[paindoc2006]

Terria34:

If your pain is truly facet joint pain then you would benefit from facet joint injections, not epidurals and no, that is not the same as trigger point injections. Radiofrequency procedures are for people that get only short-term relief from steroid injections. The good thing about that is that you do not get any steroid in the procedure. Too much steroid can cause the bones and tendons to deteriorate so you do not want to have more that 3-4 steroid injections in one year. Disc replacement surgery is still very new and its long-term effects are not fully understood. It is not something I would jump into. A full evaluation with a discogram is something you would need to do beforehand do even determine whether the disc itself is the problem.   Cute kid by the way, I have one that is 18 months old as well!! Good luck.

[terria34]

Hello Doctor,
This is Terria34, I appreciate you taking the time out to read my post and give your feedback. I know that being a doctor has to be a very busy life-style, and again, I do appreciate you taking time out of your busy life to respond to me. Anyway, to my point. I've tried series of 3 epidurals ( I'm in the middle of a series right now). They provide some relief for the next day or two after the procedure, but then the pain comes back full force. I participated in physical therapy for 3 years. It helped me stay "limber" and increased my range of motion, but I had to stop because I think I was doing some of the excersizes wrong and it was starting to add to my pain instead of helping it. I still do several of the stretches every morning to "get going". My current Pain Doctor told me not to do these if it hurts, which it does, A LOT, even with my pain meds. But, I do not see any other way to keep myself functioning for my sons sake. If not for him I would probably confine myself to my bed so I do not have to deal with the pain of everyday living. The things that everyone takes for granted, like getting dressed or even bending over to retrive something I've dropped, becomes a pain staking venture. Are Facet joint injections the same as "trigger point injections?" I've also have had them on and off over the years. I've never heard of radio-frequency procedures. Does the constant epidural steroid injections going to hurt me in the long run? What do you think of the new surgical procedure called "Degenerative disc replacement"? I am seriously looking into that. I probebly need to look into the phyciatrist specializing in pain management, because I am truly "at the end of my rope" mentally and physically. I've recently filled for social security and that is a long drawn out fight, that is weighing on me. I know the screening has to be this intence and gruelling, or else every tom, **** and hairy would be collecting just so they do not have to work. But I've been a hard worker all my life, but am in the position where I just can not anymore.

[paindoc2006]

dear terria:
i am sorry for your predicament. i am a pain physician on long island, new york and i see patients with your condition all the time. there are so many new interventional treatments for pain that i would recommend you try if u havent already before considering anything surgical.  these include epidurals, facet joint injections, radiofrequency procedures, spinal cord stimulations, etc you need to see a pain specialist preferably a physiatrist who specializes in pain. i see many patients who have the surgery and do well but many also do not so it is a last resort! good luck!