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multiple herniations
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multiple herniations

Hopefully a long story shortened up:

History of low back pain 15 yrs. Got better once then took a job that was labor intensive (before I give into the pain I was lifting about 60,000lbs/day at least 10 hrs a day, 30-70lbs at a time). Have had 3 more episodes of debilitating back pain. Last 2 are linked.. Hurt at work out for a month then back to work and it never really stopped hurting from then on, gradually worsening symptoms, (not slow onset but many small debilitating episodes).  Last June gave into pain went to GP. Did PT with no help, then MRI (read below).

I have 2 kids to support so I have been trying to hang on to work, but with the one set of restrictions (20lbs,90 minutes/day), was enough to get me fired for not being able to do my old job and coincidentally I was denied my claim for workers compensation all in the same week,(the insurance carrier for WC sent me to a so called IME who said my herniations were not caused by or aggrivated by bending over all day lifting 30 tons? 17 years of schooling and he waists it destroying peoples lives for money what ever happened to the oath? ).  I managed to get part of my old job back after begging the doctor to raise my restrictions back to 40lb/3hr so that my family and I could "eat".  It's going on a year and I haven't rely seen any improvement. I hurt less now but I'm not lifting tons a day bending all the time. Any time I do anything relating to the back, examples: wash dishes, clean bath tub, walk a lot or stand still for more than 15 minutes my back will cramp,butt on right side hurts, sometimes my legs will go partially numb,or needle and pin me, below knees. Sitting for more than 10 minutes causes my right leg to get numb from crotch to knee cap. Some loss of feeling in crotch when doing certain exercises. Maybe a symptom not related but I also seem to have a problem emptying my bladder all the way and stopping and starting...

Also, if I lay on my right side to go to sleep, a large portion of  my left leg will go numb. When I lay on my back, my right leg will go numb. And to make sleep interesting, I have also acquired a set of bad shoulders from that line of work which makes it almost impossible to sleep om my left side. I told my doctor this and he said that "bed rest" shouldn't hurt anything. I asked him again, "even if things are going numb?" got same answer.

My doctor seems to be ready to call this MMI. I still wonder if I should live with this or get back surgery of some kind. My question is this:

Is it really OK to just go to lay/sleep in a position that makes my leg/s go numb? If this is done for a long time will it "kill" nerves or something permanently?

MRI of the lumbar spine

The vertebral bodies demonstrate normal stature and alignment. Disc space narrowing with – disc dessication (desiccation) L4 identified in fine-S1. End plate Modic marrow changes at L5-S1. The conus is normal with the tip at L1-L2 level.

L3-4 disc space minimal broad based bulge.,

At L4-5 there is a moderate sized broad based central disc herniation; mild facet hypertrophic change. There is no foraminal encroachment. prominent posterior fat continues to mild canal stenosis.

L5-S1, there is a central and left paracentral disc protrusion/herniation there is asymmetric extension laterally towards the right; moderate facet hypertrophic change. no canal stenosis. There is minimal inferior right foraminal encroachment. bilateral spondylolysis also noted .No listhesis.

IMPRESSION: Disc herniation L4-5- smaller central protrusion/herniation at L5-S1.
L5 spondylolsis – there is no acute marrow edema change.
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8 Comments Post a Comment
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847433_tn?1243013252
mike,
Does your orthopedist know about your numbess and the urinary problems you are having?  If he doesnt, than you should get to see him/her immediately and have him r/o cauda equina syndrome, which can be caused by a large central lumbar herniation.  Basically the nerves lower down in the spine where there is no spinal cord is called the cauda equina (looks like a horses tail) basically bundle of nerves that control  function like bowel and bladder, walking etc.  If these nerves get compressed and especially since your are experience some bladder difficulties you MUST have you doctor look into this immediately, as you can possibly end up with permanent damage. Cauda Equina Syndrome is considered a medical emergency, call your doctor and look it up.

missy
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667923_tn?1266738793
Dear Mike and Missy,
     I can't believe it,someone who's having exactly the same symptoms as I am.Only difference is they can't find anything wrong w/my MRI's.I don't underatand? The only thing they can tell is that they can't see behind my plates that I have in my neck surgery.That tells me something though,I think my problem is behind those plates.I had a C5 diskectomy Feb.'06. I cant get any relief from from my meds,around 50 per.After surgery I had a series of 3 nerve blocks and the third one,the doc hit something bacause I jumped on the table.It was enough to have me lift my head out of that hole to ask,"What was that?"The doc studdered as he said,"friction".Have you ever heard of it?
I don't know what my problem is, but somebody's got to find it.I can't do anything..I pay dearly for it. Just reaching or bending.I sat in the floor tonight to find some paperwork and I drifted off to sleep and so did both my legs.It was horrible.MY left leg was so numb,it felt somewhat like a peg leg or that it had been sharpened by a pencil sharpener.My right leg was so numb that I couldn't put any pressure on it. I was leaning up against the bed w/my back at the time when I fell asleep.I have trouble w./staying awake and falling asleep.I don't sleep right,maybe 2-4 hrs. at a time. Pain wakes me,usually 90 per.of the time,and I was generous.It is hard as I say to do anything. I can type some and it takes me time. My writing is terrible now(only 5%strength in rt.and 20% in left.I have numbness that I have found on my face above my lip,that space between your lip and nose.Also, I was crying and I didn't feel the tears running down my face. I just felt them in the corner of my eye. I am so scared to what this. I just hope and pray that it is something that can be treated or cured for that matter. My face on top of every thing has blisters,really large boils that are flat and I looked it up and it was postherpetic neuralgia.I compared all the boils and came up w/PHN,so I realized that it also causes pain,numbness,paralysis(neurological problems). I am leaning to having PHN because I waited to late after the blisters appeared. I don't know... that is why I compiled all this, so somebody could help me in some way.I just wished that I could find an answer to what is debilating.
                                                 Thanks again for listemig to me,  Karem          
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847433_tn?1243013252
hi,
sorry to hear of all you problems.  You sound like you have a mix of alot of different things going on.  My comments were to Mike due to his specific symptoms.  Some of which included: numbess in the groin and difficulties with urination along with several lumbar herniations specifically central. A large central lumbar herniation can compress cauda equina nerves and cause syptoms (symptoms) such as he has described.  the only reason I commented on his post was due to the urination difficulties which if not addressed by his physician could cause long term problems

You should see your ortho or neuro or whoever you see and explain all of your symptoms exactly as you have here.  Dont dx yourself you will only get yourself scared.  Good luck, hope things get figured out soon.
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Avatar_n_tn
I have mentioned the bladder issue but I haven't been checked for prostrate problems either,(I am 42 yrs old). This has been going on for a long while maybe 4 years or so that I remember. All the lifting that I do now which is in upwards of a 1/3 or 1/4 of what I used to do doesn't seem to make bladder symptoms any worse. The only thing that does is diphenhydradramine hcl that I take sometimes to get to sleep. I'm going to bring up CES with my doctor at my next appointment.

Thanks much for your time but my question remains tho:

Is letting my leg go numb for hours while sleeping in that position or being bed ridden going to "kill" those nerves or will they just come back to normal if I get out of that position?

Mike
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847433_tn?1243013252
mike,
i cant answer whether you would have permanent nerve damage with anything position you sleep in, im not a doctor, i am a nurse but these types of problems are not my area.  I am here like everyone else because of spine issues. I have 2 cervical herniations and 1 lumbar herniation.  

anyway, if your bladder issue has been going on for that long you should also ask your primary care physician about seeing a urologist if you have not already done so.

the medication you mentioned for sleep is just benadryl, but alot of medication no matter how benign it may seem can often cause urinary problems, just keep asking questions and seeing the proper specialists to address all your issues.

Do you have a WC attorney?  If not get one, there is no upfront cost to you.  I am in a WC situation as well, its awful, but would be worse without an attorney.

Also have you been to an ortho or neuro?,  chiro, taken any medications for any of your symptoms?  You need to start from the beginning before going to surgery.  You should be seeing a specialist.
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Avatar_n_tn
Been to therapists and all that 11 months worth. I just had my Dr. setup a appointment with a neurosurgeon to see if I should pursue this farther or try to live with what I've got. All I know is that my Dr. is saying that I'm capable of lifting certain amounts of weight and sitting 5 hrs standing 5 hr etc. But that also, is uncomfortable after a much shorter period than he is suggesting. To get social security and the likes you must be unable to work period, well I can work but I pay for it every day that I put in.

I hired an attorney a while back...  WC is supposed to be a "no fault" system, you get hurt, you get fixed and at the same time the employer cant get sued. But now that the WC carrier has dropped the claim shouldn't I be able to sue the employer??? Nope cant do that. How fair this system is.

Good luck to you also Missy.

Mike


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847433_tn?1243013252
I dont understand what you mean by WC "dropping the claim".  From what I understand they can say that you've reached "MMI" which I believe mean maximum, medical, improvement.  but you can appeal decisions and so forth.  Also there has to be some sort of settlement when the case is finished.  this usually takes a few years.  You seem to have quite a few herniations. I have 2 in my neck and 1 in my back and I know the problems its caused me.  WC will never make anything easy.  They will always try to tell you you dont need anymore tx, and they will always try to pay you as little as you can.  

You need a doctor who will be on your side and advocate for you.  In my case the insurance company denies everything basically even though my neck and back have been accepted into the case as a work related injury, they object to everything.  So my doctors will have to give testimony as will theirs and then the judge will decide.  In the mean time I still go to my chiro and ortho. and pain management and get tx.  You are allowed to received i believe what is considered "reasonable" ie. chiropractor.

Have you had epidurals?  they have worked well for my neck which is pretty bad herniations pressing on thecal sac of cord.  Lower back ongoing.  So my case continues.  They have paid me some money and paid for MRI's and my appts, but I have to fight for everything.  I think it is good to go to the neurosurgeon.  YOUR DOCTOR IS kind of making it bad for you if he's the one thats saying you can work, and lift etc.
Ask about the epidurals(steroids) they can be wonderful. Also have you had EMG done?

keep in touch, good luck at neuro and look into epidurals and EMG/NCV study? (test for motor and nerve problems)
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Avatar_n_tn
WC carrier sent me to their doctor, (a so called IME doctor better known as a hired gun for the insurance company) who said that all that lifting and bending over, (60,000lbs/day) the last 10 years had nothing to do with my herniations nor did it aggravate my "pre-existing disc degeneration" as he called it.

It's just damage control for the insurance carrier. He even went on to say that I am a likely candidate for surgery, this immediately following in the same paragraph mind you, that I should "treat my herniations with over the counter drugs", so that his WC carrier wouldn't have to pay for any medicine also lol! Then they sent my the denial notice stating that

Here's a couple of paragraph's from his report:

"None of Mr. _________'s treatment to date is related to his employment at __________ or related to any on-the-job injury at _______ . None of Mr. ________'s time off work or work restrictions to date are related to his employment at ___________. Mr. _______ has no permanent partial disability related to his employment at_______ or related to any on-the-job injury at_____."

"Regardless of causation, Mr.________ should manage his ongoing low back symptoms with self-administered conditioning program, self directed weight loss program, over-the-counter analgesic medication, and over the counter anti-inflamatory medication. Mr. ______ may ultimately be a candidate for low back fusion surgery due to his preexisting multilevel degenerative disc disease and degenerative facet disease of the lumbar spine, as well as his preexisting L5 spondylolysis. This surgery is unrelated to Mr.____'s employment at _________ and unrelated to any on-the-job injury at _______."

In 10 pages he must have said "unrelated to work " a hundred times, but hey that's what he's pay to do on behalf of the IC. My lawyer and I were thinking he was getting pretty drunk by the time he let out the line admitting that I may need surgery. Looks bad for him in court!

I did some research, he's got 17 yrs of schooling under his belt, now and orthopedic surgeon for about 20 years I believe. What makes a doctor of his stature do such a thing? MONEY can buy you happiness if you are an insurance company! What ever happened to the hypocritical oath?

Now, I do have a doctor or many, on my side, next a neuro surgeon on Jun 1 to see if he thinks I will benefit from surgery.

Oh, and I'm the one who keeps trying to hang on to a job. I have to beg the doctor now to let me work so that I can support my family. He wants me to be on really light restrictions but my employer wanted heavier ones,,, gotta eat and WC pooped on me so...

As far as epidurals go , no haven't yet , but if that nero says I have to have surgery then maybe I'll risk it first. I hate the thought of needles going into such a delicate area. What happens if they hit a nerve or worse the spinal canal?(i.e. the guy sneezes oops!).

I didn't mean to bore you with my aimless chatter sorry for that. I see that you are in pretty bad shape yourself. I'ts all we can do in times like these to try our best hope and pray,(a lot), that things will work out for the better. Either way, life goes on and we need to adapt the best we can. Keep me informed of your situation if you don't mind.

Wish you good luck and good health,
Mike


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