narrowing of the l4/5 disc

i have been suffering back pain for about 7yrs now i was first diagnosed with a hermiated disc,after being told that it would get better in time,which i accepted,i continued working through daily pain  until last year when i had more intense pain,sometimes crippling,i have returned to my doctor to find out what has gone wrong,with the latest xray results showing moderate to severe norrowing of the l4/5 disc,although has now being diagnosed as a lumbar sprain(is this correct?)and i still have severe pain on waking up in the morning after broken sleep and now getting pins and needles down my left leg as well as alot of cramping in the same leg,not getting much help from my back specialist as he says it will heal over time,can anyone offer any help on this matter,as i am now losing quality of life as i generally stay at home now due to the pain, iam aged 35 and have plenty more life left and would like to live it pain free or close to it.any help apprieciated

[chadry]

Don't you just love some of the answers you get. How do they figure it will get better cause from what you are writing it appears to be getting worse. I suffer from low back issues myself and I am 46 and believe me I know what you are saying about the quaiity of your life changing. Try another doctor. Hopefully someone can give you better advice.
take care
Chadry

[High Noon]

I assume the latest xray is really an MRI.
I would get a second opinion- bring your latest films to another orthopedic surgeon for evaluation- not the radiologist report.

Lumbar sprain's generally heal within a few weeks. I can only asume that the back specialist does not see any root/nerve impingement with the L4-L5 herniation, which would rule out surgery. Most disc abnormalities do not cause pain- that ts why a second opinion is recommended.

That said with the pain so real, can you/have you any pain medication to help?

L4-L5 disc issues are very common for persons over 30.
Many back/leg pain is asymptomatic.
I would also recommend you reading a book by Dr. John Sarno on back pain- helped me ,

Good Luck

[jackyc]

thanks for your help so far,i have been given pain relief in the past but i dont like it that much as it tends to zonk me out and i feel tired and lethargic,my latest xrays are just that i have not been sent for a second MRI they are just going off my MRI from back in 2000 which shows the herniation and xrays done about six months ago,my orth surgen is the same one that i saw in 2000 and has the opinion that as highnoon says that there seems to be no root or nerve damage,although the radiolgy report reads: "there is moderate to severe narrowing of L4/5 disc space with marginal osteophyte formation.slight narrowing at L5/S1 may well be developmental. the higher disc spaces are well preserved" with a added note that reads "L4/5 spondylosis"

[gma2]

I had a discectomy on my L4-5 in 2005. Also, same year I had a right-side total hip replacement due to bone necrosis (no blood to bone= dead bone). I just had another 3-view xray of my low back because I am in so much pain. (which I had to talk my primary care doctor into which should never be) The nurse called and said I had a lot of changes in the joints and disks and that this is common with aging. (I am 53) I asked her if my surgeon was going to be called to read the report and she said I could do that if I wanted him to! It's crazy, I know, but I don't particularly want to end up in a wheel chair, so I requested my report to see exactly what it said. I got it just this week and this is what was on it.

1. Apparent mild dextroscoliosis...This means that my lower spine is bending (scoliosis) to the right (dextro) which causes my left side to droop (I tried asking him about why I'm leaning like I do but got no where.)


2. Diffuse osteopenia...This means I have low bone mass (osteopenia) everywhere (diffuse).


3. There is spurring and disk space narrowing with back and joint phenomena...This means I have bony growths (spurring); the spongy 'disk' between 2 or more bones in my spine are being squished so they get narrow (like if you squish a marshmellow) which btw is why I had the discectomy in 2005; and then I have the back and joint phenomena which basically means I'm in pain.


4. Spondylosis is present in two areas...This means there is spinal deterioration and deformity of the joints of the vertebrae (joints in the spine).


So...with that said, all this is happening (if you know a little bit about the spine) at my L3, L4, L5 and S1.


L=Lumbar S=Sacrum. (The L5 rests on the S1)  So, picture yourself leaning your left shoulder down, right waist/rib area up and out. My spine is like that all the time...not normal...and I never had this until a couple of years ago, so...TA DA it equals pain! And, at least for me, my neck, shoulders and legs are affected also due to this.

I'm calling my surgeon after the holidays. We patients have to get so much more involved in our 'results' now and not just take their word for it, like "It's okay you have pain because gee, you have a bad spine thing going on there!"

And there is no such thing for me (or anyone with low back pain) as "quality of life". This pain stops you from doing the simplest of things. I used to love to dance, and play with my grandkids, and worked (I'm now on disability) and loved my job, but could no longer do it well. I have to have a stool to rest one foot on to take the pressure off my back just to do dishes. I cannot walk any distance any longer. I had a blood clot behind my left eye in 2003 which made me permantly blind in that eye. I now have panic and anxiety attacks and I never leave my house except to the doctor and now that it has snowed I cancelled my last therapy (for the agoraphobia and anxiety, etc) appointment too. Pills, pills, and more pills. Bills, bills, bills and more bills.

I hear all the time to change doctors, but it gets really old when you do that. I find they are all similar in that it is harder and harder to get them to understand and rarely do they call you directly with the test results - it's a back-and-forth multiple call thing with the nurse. It's exhausting and...when you are in pain, you do not need any more aggravation. But, I'm seriously considering changing. I've been with this one since '99 and if my daughter goes in with me, all my questions are addressed; if she doesn't..."We won't have time for all this today" comes out. I just put that together on this last visit when I went in alone. (She always takes notes on what he says to help me remember everything - that might have something to do with that)

I can truly say "I feel your pain" and I don't envy you. I just wanted you to know there is someone who 'gets it'.

Thanks for your post and questions and all...we are made to feel like idiots and that's not right.You are right to be concerned and you are right in thinking this isn't right, because it isn't.

[gma2]

May I ask why you think disc abnormalities do not cause pain? Because, they do.

Also, you said "Many back/leg pain is asymptomatic." Pain is a symptom, so I don't understand that either. She states "pins and needles" and "cramping" ...also symptoms.

Asymmptomatic means there are no symptoms.

Jackyc definitely has symptoms according to her post, and it is related to the Lumbar-Sacral area because she stated "severe narrowing of th L4/5 disc with marginal osteophyte" and "slight narrowing of L5/S1 and that the higher disc spaces are well preserved. L4/5 spondylosis.

Osteophyte is a bone spur.

Although it may seem helpful, if wrong information is given, it is as bad as being given a wrong diagnosis.

I agree with you that the actual films should be taken to the specialist. Most specialists won't even consider seeing you without them.

I worked in the medical field for 30 years. I know that doesn't make me an expert, but I do know quite a bit about what I write before I write it. Research is my middle name. Plus...I am experiencing this as well. The terminology in Jackyc's post and my own are so similar, it was eerie; I knew I had to let her know what it all meant. She asked for help. I hope I did.

I try to help by letting people know NOT to let this go. It gets worse. She is 35 as she stated and I do not want her or anyone else to take a chance of ending up like me. Even at 53 I am too young to be walking around using a walker (which I do) or my 4-prong cane (which I also use).

Kind regards.

[High Noon]

You are correct in that I erred and should have used the word idiopathic, I think that is correct term.
Meaning that pain cannot be confirmed as definitely being caused by certain factors. That is why on this forum you hear of persons who have MRI/CT scans and the doctors say the results are not conclusive or show little and yet people have real pain.

Studies done since the early 1990's on people show persons in their 30's, 40's and 50's with disc abnormalities who experience no back or leg pain.

In the case of the poster her doctors did not see anything sigificant enough to recommend surgery.

[alinpain]

i just had lower lumbar fusion in my l4 l5 ,im out of pain and walking again,i had same thing going on in my right leg,pain knumbness,couldnt walk,you name it,my surguey was on oct 26.
god bless-al

[gma2]

That's ok. I didn't mean to dis on ya or anything; it's just that I wanted to correct it for Jackyc. The holiday season will soon be over and I am taking action. If my surgeon says the results don't justify surgery, I will go with that (I do trust this Dr.) however, the pain is real and to make a long story short my body is toxic with all the meds I take due to other health issues. I am seriously considering homeopathic alternatives. I'm not done researching all that. One thing everyone can do that is helpful in the long run (and short for that matter) is request all your medical records be sent to you. I have all mine from every doctor, hospital, rehab after surgeries, etc. This is so helpful. If you don't know medical terminology, find someone who does to walk you through it. When years go by, they discard records. I found that out the hard way with my daughter who had meningitis when she was 2 - we tried to get the records (thinking they would be on microfiche because it was 23 years ago BC -before computers *smiles*- but no go; she has been and is experiencing many 'brain' difficulties and the Mayo Clinic wanted to put her in a study and without those records they may not now-I did have journals, datebooks, etc from over the years with details, so with that info I wrote up a letter and sent off to her doctor - lets hope that will suffice. Anyway....got going here, sorry. Thanks High Noon for understanding.

[gma2]

Congrats on feeling better! Continued good health!

[gma2]

Where are you? Are you getting help? Please let us know. You are in my prayers and I cover four states with my prayer requests. LOL So....you're covered in that area. Back down to earth...let us know ok? We are here for you.

[alinpain]

thank you

[chiari2]

Well, I am no expert on what has been said here, however I have become an expert on my own symptoms and the narrowing of the spinal canal is connected to pain, it depends on the level of stenosis you are encountering. Stenosis is generally congenital unless it is caused by bulging or herniated disks. For example, I have stenosis at C5-C6 with disk herniation to the point that it is flattening my spinal cord. I also have stenosis in the Lumbar and Thoracic regions. I have also been diagnosed with Chiari Malformation type 2. All of this in one diagnosis was a bit overwhelming, yet relieving at the same time. It proved that I wasn't going out of my mind and my problems were real. I am still awaiting my neurosurgeon appt at Duke University. It goes without saying that I am a very happy individual (sarcastic tone).

There are a few approaches to resolving stenosis, it just depends on the level of severity and what is causing the problem. In alot of cases PT resolves it, but with severe stenosis, surgery is almost always recommended.

Best of Luck!

[anca288]

It is funny how physician think that your pain is all in your head and you are a drug sicker; however. I have pain that I want to take a gun and get it offer with it  I am only 30 years old , but because of my seizures my L4-L5 has mild disc space narrowing . There is calcification of the L4-L5 disc posteriorly and broad –based posteriorly disc protrusion and they sad that I also have mild spinal stenosis and trace atherosclerotic , classification is see in the right internal iliac artery . I am in pain every day and I can’t even get out of the bed not play with my 11 years old son. However, you know how it is they are not the one in pain so they do not really care