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New to the Whole constant back problems
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New to the Whole constant back problems

Im just trying to figure out what the right corse of action would be , From all yall experience people out there
heres the story........
Ive had back problems for about 5 years now.  but usually it would only be after being active for a period of time , But i would get intense pinch like pain down my but and leggs and every 6-8 mopnths ide have a flair up (so to speak) it would hurt  mildly all the time for a coouple days then go away , Saw a chiropractor briefly , Was told i had phase 2 degeneration , He guessed due to a fall as a child or something...I was young and he was expensive so i never completed my treatment(that was 5 years ago).just delt with the pain given it was only during being activley or labor intensive.....about a month ago i got one of my flair ups , and it just got worse and worse to the point where just walkin would cause intense pain down the back of my butt and legs , i went to a doc , he said bulged or herniated disc , gave me pain meds and steroid anti inflamitory , Itook about 6 days off from work ,But im still in pain , Not exrusiating pain , Just constant tightness and uncomfortabillity and sharp/burning like pain. standing , walking , even laying down ,  Sleep is becoming affected .(going on a month now)..If im on my feet more than 20-30 mintutes the sciatic like pain comes again , Never has it hit me this quick and stayed this long
had an Mri perfomed, no bulges or herniations found I will copy and paste the impression ..............
Apparent bilateral pars interarticularis  defects at L5-S1 with
significantly hypertrophic facet joint changes at this   level.  Otherwise,
unremarkable. (what does this Mean?!?!?!?!)
My pcp told me that i had a slipped joint , there was nothing that could be done about it and he is refering me to pain management ...I dont really have a high opinion of my pcp , i had just recently started going to him , and he does not have my confidence ,   My main problem is i have no insurance and am self paid,
Has anyone else had experience similar ?? pain management is expensive,
Ive been told by several pain management is the good thing to do , And others have told me that i should go see an orthopediast ............!!!!  what do i do .both of which are outragiously expensive.Im only 28 years old btw    :( im too young for this .....

Thank you everyone , any advice would be appreciated.
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1322157_tn?1279660281
I thnk....the pars defect (can eventually lead to spondylosis which is kind of like degenerative disc disease (DDD). Everyone gets this as we age, some of us get it earlier than others. Think of it like arthritis. And it can cause back pain.

I also think that initally, the pars defect is treated with rest and a brace - but because you have been suffering from this for 5 years, perhaps your injury is not stage 1. Maybe your pars defect has been there a while and now the facet joints have developed bone spurs (see below). This would account for your pain that emulates at herniated disc.

Regarding the wording on your MRI report: significantly hypertrophic facet joint changes - (from the website: http://www.painspecialiststx.com/procedures/facet_blocks.htm )

"Patients with facet joint problems in the low back will present with low back pain. This pain usually does not radiate down past the knee. Depending on the studies anywhere from 20 to 50% of low back pain is caused by the facet joints (with the other main culprits being the discs and the sacro-iliac joints)."

"If a facet joint develops severe spurring (facet hypertrophy) it can narrow the foramen that is the opening for the nerve root that leaves the spinal cord. In this case it can cause pain shooting all the way down to the toes (sciatica). In this case the patient's complaint is similar to disc prolapse and sciatica."

This sounds like what your pain is stemming from.  


However, If your PCP said you had a slippage, this is called: Spondylolisthesis

It can also be a progression of the pars defect. Did your MRI report mention anything else other than what you wrote? I don't see where your report mentioned this and your PCP (who you said you do  not have a lot of faith in) may have assumed or misdiagnosed this problem.

I am not a professional (lol), just someone who has read up a lot on back pain since I have suffered in pain for so many years and had more than one surgery on my back.

What will your pain managment Dr do? Probably some injections to help ease the pain. Possiibly pain meds and may recommend PT..They can also do an alblation (I do not know anyone who has had this - but you might investigate this if the other methods do not work). who knows. But the right course of action is always conservative. If they recommend injections, personally, I would try them. For many, many people, they help. Surgery is always a last option. But my advice is to try everything else first..

Keep us updated!!
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1322157_tn?1279660281
Check out this website to explain your diagnosis. http://www.medcyclopaedia.com/library/topics/volume_vi_1/p/pars_interarticularis_defect.aspx


It also has another name: (also called spondylolysis)

You level (L5)  is the most common site for it to occur.

Hope this helps you a little.
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Avatar_f_tn
that did help ty , But now im confused ...it said a brace and rest is common treatment , Why am i being sent to pain management ???  wi ll theydo that for me , im having to wait 3 weeks before my pain management appt ???  im just really confused , every aspect of my life is being affected right now , and im prolly just scared ,
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1322157_tn?1279660281
I thnk....the pars defect (can eventually lead to spondylosis which is kind of like degenerative disc disease (DDD). Everyone gets this as we age, some of us get it earlier than others. Think of it like arthritis. And it can cause back pain.

I also think that initally, the pars defect is treated with rest and a brace - but because you have been suffering from this for 5 years, perhaps your injury is not stage 1. Maybe your pars defect has been there a while and now the facet joints have developed bone spurs (see below). This would account for your pain that emulates at herniated disc.

Regarding the wording on your MRI report: significantly hypertrophic facet joint changes - (from the website: http://www.painspecialiststx.com/procedures/facet_blocks.htm )

"Patients with facet joint problems in the low back will present with low back pain. This pain usually does not radiate down past the knee. Depending on the studies anywhere from 20 to 50% of low back pain is caused by the facet joints (with the other main culprits being the discs and the sacro-iliac joints)."

"If a facet joint develops severe spurring (facet hypertrophy) it can narrow the foramen that is the opening for the nerve root that leaves the spinal cord. In this case it can cause pain shooting all the way down to the toes (sciatica). In this case the patient's complaint is similar to disc prolapse and sciatica."

This sounds like what your pain is stemming from.  


However, If your PCP said you had a slippage, this is called: Spondylolisthesis

It can also be a progression of the pars defect. Did your MRI report mention anything else other than what you wrote? I don't see where your report mentioned this and your PCP (who you said you do  not have a lot of faith in) may have assumed or misdiagnosed this problem.

I am not a professional (lol), just someone who has read up a lot on back pain since I have suffered in pain for so many years and had more than one surgery on my back.

What will your pain managment Dr do? Probably some injections to help ease the pain. Possiibly pain meds and may recommend PT..They can also do an alblation (I do not know anyone who has had this - but you might investigate this if the other methods do not work). who knows. But the right course of action is always conservative. If they recommend injections, personally, I would try them. For many, many people, they help. Surgery is always a last option. But my advice is to try everything else first..

Keep us updated!!
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Avatar_f_tn
no that was the only words used on my mri report , .only other words were obtained withouth gandolium..Thats what i was trying to figure out , My guess is the pcp is a dumma**  hahaha   Thank you very much for yourhelp and ure research. Ive been researching for hours on end and havent been able to find what u found ,it helps me understand a little better ...and my pain does stop at the knee , so i guess my wording was incorect ,.So thank you very much , Im wondering if a second opinion would be needed  before pain management begins ??  Hmmmmm  decisions decision but ty again , My pain management appt is set for the 23rd so i guess i will find out then
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