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Back pain L5-S1
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Back pain L5-S1

hi, i'm a 24yo male. I've been having lower back pain for about 5 years now. And my doctors have given up, "We tried all that we could have done."

Recently I've started noticing other things and not knowing if they are normal,

-  When I'm reading a book in bed, is it normal to feel fatigue, strain, discomfort  in my lower arms and shoulders?    
   (after about 7-9min.) -  I'm on my back, elbows resting on bed, hands up(holding book)
-same when I'm on my side reading a book. - arm that's on top is about horizontal, resting on body & holding book

After all this time I'm beginning to doubt if this is something normal, That I've had all my life, of something related to the chronic pain problem... ( in which case, it's not just my lower back)
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1001737 tn?1324503515
If this is an irregular feeling, it could for instance be worth looking into things like fibromialgia (fibromyalgia) for example.

Other info:
At this time, I'm taking 2x 10mg targinact /day just to get me out of bed & some minor thing around the house.  (targinact=10mg oxicodone - 5mg naloxone)
December '10 I had surgery (ALIF L5-S1) but that didn't help.

The pain is there 24/7, and is worsened by the simplest thing that I do.
sleep = about 4 hours /night.
pain to my legs:
- 65% L-leg / 35% R-leg nagging pain (above knee), + nagging pain from shine to to top of my feet.
- Sometimes muscle weakness (when walking collapsing through my knee (but not to a point where i would fall))
- Laying on my back for more than 40min. =leg falling asleep, tingling.
- ± 20x /day shooting pain in my sphincter (??english??)
- If i would try to work or stand or sit for 4hours or more = more paine, vomiting (from pain) and few times loss of conscious.

Thanks all, help & info is appreciated!
1001737 tn?1324503515
1928494 tn?1324553793
Back injuries are commonly reported after truck accidents, car accidents, motorcycle accidents, and the majority of premises liability cases. One of the reasons back injuries are so common is because of the length and complex function of the spine. Prevention is best option. Avoid picking up heavy objects placed below your knees, Keep your back straight and Stay in good physical condition. Reduce daily sitting time, Get up out of your chair every 30 -40 minute and Participate in light to moderate exercise at least 3 times per week. Thanks.
First aid training Toronto
1001737 tn?1324503515
thank you for your feedback.
These are all vallid points to prevent, the question is more about how i could be helped now.

even after 20Mg of exicodone / day i:
can't lift heavy objects
can't be active for more then a few hours
   (not just work, also hobbies, going to the movies, etc.)

THE MAIN QUESTION WAS: does anyone recognize him/herself in this situation / symptoms.
i'm beginning to doubt certain feelings (fatigue, strain,) that i had way longer.
And if those feelings are not normal, then my back problems are not the underlying problem but one of the symptoms!

Because doctor are done looking for causes or fixing me,  they are thinking about implanting a morphine/ pain pump.

And i would like to avoid this at all costs.
1331804 tn?1336870958
Have you had an MRI scan of your cervical, thoracic, and/or lumbar spine?  I think it is important to know precisely what is causing your chronic pain so that it can be treated effectively.

In the United States, many physicians try opioid medications along with adjuvant medications (e.g, anti-convulsant, muscle relaxer, anti-depressant) together along with epidural steroid injections and/or trigger points injections, accupunture, accupressure, deep tissue massage, chiropractic, and/or physical therapy.  

The best way to adminster opioid medications for relief of chronic pain is by prescribing two different types of opioid medications: long-acting (e.g., fentanyl transdermal, MS Contin, Kadian, OxyContin) and short-acting (e.g., Oxycodone IR, Percocet, Morphine IR).  The long-acting opioid medication is taken on schedule and continues to work between 12 - 72 hours.  The Fentanyl patch lasts between 48-72 hours and MS Contin/Oxycontin lasts for 12 hours, and Kadian lasts 24 hours.  If you have what is called "breakthrough pain" after taking the long-acting opioid, you would take an immediate release opioid such as the targinact.  

There are also several minimal invasive surgical techniques that require very small incisions and the bulging part of the disc that is impinging on a nerve root can be extracted, thereby reducing pain.

Spinal Cord Stimulators (SCS) and Interthecal pain pumps are a last resort effort to reduce chronic pain in the US.

1001737 tn?1324503515
Thank you for your reply!

I had all sorts of scans from chest to pelvic area.
They tried all sorts of things, from epidural to accupuncture, numbing nerves...  After long search they fused L5-S1 (ALIF) and removed the disc. didn't help.
They now say that "Sometimes we fix the problem but the pain stays, and we don't know why"
"We tried normal things and even things we didn't really have faith in"

So, they stopped searching for causes and sent me back to the pain clinic.
They told me that "All that is left is to treat the pain, and even that is limited."

In the past i've been on all sorts of meds (as you mentioned above)
Paracetamol     -    Myolastan
Diclofenac        -    Epsipam
Cymbalta         -    Redomex
Tramadol 400Mg+
Fentanyl patches up to 50µg
And now Oxycontin 20Mg every 12Hr.

So they say all that remains is SCS (they don't have much faith in but willing to try)
or Pain pump implant.

My hopes are still on some underlying problem they missed and is treatable or fixable.
1331804 tn?1336870958
Well after reading your last post and re-reading your other previous posts, it does sound like you have tried many different things including surgery which didn't help with your pain.

I didn't see on your list of medications Gabapentin (Neurontin) or Lyrica (Pregablin).  These medications are very effective at treating nerve pain and many times nerve pain is not well treated with opioids, muscle relaxers, anti-inflammatories, etc.  Have you tried Gabapentin or Lyrica?  If not, I would definitely discuss these types of medications with your physician and see if you can give them a shot.  In the US, they are anti-convulsants used off-label for nerve pain.  I have a lot of nerve damage in my thoracic spine and nothing worked for that type of pain except Gabapentin.

I have read many posts from people that have had the spinal cord stimulator implanted and the feedback has been pretty neutral.  There are people that LOVE their SCS and feel like they have regained a part of their life that they thought would be lost forever.  And then there are others, that didn't get much pain relief or none at all from the SCS during the trial period such that they didn't go forward with the permanent SCS.  I think given what you tried, the SCS or intrathecal pain pump may be of great help to you.  

Lastly, I am not sure how many of the meds from your post you have been on at one given time but I know that out of my 6 medications for pain, neither one would work very well by itself.  However, when all 6 medications are taken together, they help quite a bit for my pain.  So if you haven't tried many meds together yet, you may want to see if you can try 5 or 6 medications simultaneously to see if the effectiveness is increased.  There are also medications that come as a patch or ointment that either reduce inflammation (volteran) or act as a local anesthetic by blocking pain signals being sent from the painful area to the brain (lidocaine/lidoderm).  The one I have used in the past is lidocaine, both as an ointment and as a transdermal patch.  They have been effective at taking the edge off of my pain.  The ointment lasts 2 hours applied directly to the skin and the patch lasts 12 hours.  You can get the ointment to last longer if you apply it under Tegaderm, which is an occlusive dressing that is made by 3M.

I am so sorry you are in so much pain and I wish you the very best on this journey.  It is a journey and it can take quite some time to find the right fit.  

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