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Annular Tear
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Annular Tear

Hi,
I got hurt at work about 3 months ago while transferring a resident from w/c to toilet.  My Dr said it was a strain and we decided to try PT... didn't help much if at all.  Next he suggested I try an epidural steroid injection... didn't help, but the anesthesiologist suggested that I have an MRI done.
  
The MRI showed 3 discs that are bulging and an annular tear at L4-5.  Went to a specialist and he said that the bulges are negligible - that the pain is most likely coming from the tear.   He said they generally like to give these 6mo to a year to heal on their own. He also told me to be extremely careful because "Now that you have the tear it is easy to do further damage." then told me not to bend, twist or lift. My husband, 3 yr old son and 9 mo old son were in the room w/me.  I told him that I'm a nurse at a long-term care facility and asked him what I should do.  He said to squat instead of bend. He didn't even discuss pain management with me at all.  I am currently taking T3s, ultram and cyclobenzaprine for pain and it's not keeping the pain under control.

Now I'm not only in a lot of pain but I'm also scared that I'm going to have further complications.  I tried squatting instead of bending at work over the weekend and it just isn't possible... I'm giving meds and eye gtts, assessing lung and bowel sounds with people who are sitting in w/cs in tight spaces and not bending or twisting at work is just not possible. I ended up having to leave about 4 hrs into my shift on Sunday to go to the ER for pain management.

Should he have taken me off of work? How much danger am I in of doing further damage?  Do you concur with the idea that generally you should give an annular tear 6 mo to a year to heal on it's own?  Is there anything I can do or not do that would speed up the healing process?
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Avatar_n_tn
I forgot to add that the pain starts in my lower back and radiates down into my rt buttock and hip and depending on the day sometimes goes all the way into my ankle/foot.
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Avatar_n_tn
It sounds like you're dealing with a company doc, trying to minimize costs to your work comp. If you can't do your job without continued aggravation you can do your job (at least until you heal). Send your work comp adjuster flowers, get in good with them. They're the ones who hold the key to the gate of your work future and can make your healing time less stressful.

Remember, you can take up to 8 ultrams per day (50mg each). I would make sure that by 10 am you have 4 on board. Getting on top of your pain early with make your day better, plus sleeping well on those things can be tough, so getting them in early might help with that..

Annular tears are a nightmare. For me any stretching is aggravating.
Do nothing that pulls on the sciatic nerve. Let it rest. lie on your injury side, fetal position, pillow between legs. read a good book.
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Avatar_n_tn
HI

I am a RN and hurt my lower back pulling a patient up in the bed. I have two buldging discs, hernaited disc at L5 and tear at L4-5. I have been in the worst pain of my life! Pain starts in my right lower back and goes down to gluteal and my lower left leg burns with pain.It is most severe around my ankle and goes down to my big toe.I have been taking percocets, flexerol and had 6 epidural shots in the last two months and still no relief!!

i work for a nonunion hospital which means i am on my own. The doctor from the very first day said that i can return to light duty immediately after hearing about the intensity of my pain. He really didn't explain much and said that I don't need a surgeon. Just rest and pain control. It's been over two months, I've been doing everything right but I've gotten no relief. Today was first first day back at work light duty. I am in the worst pain of my life again. i am back to where I started. All my symptoms are back but worse this time. I have not lifted anything in two months and have been going to physical therapy. I don't know what else to do at this point. My worker's comp case is closed because i went back to work already. I am hopeless

amrit
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Avatar_f_tn
Hey, I am a 47 year old WF who has suffered with pain for about 75% of the year 2010.  My deal with the first pain started in my left thigh in March 2010.  I was diagnosed with Meralgia Parasthetica and started on Neurontin.  Let me tell you it was pure H--- until around August.  I was only given the Neurontin for pain.  I suffered so much, which in turn was wearing me out mentally.  So, in Sept. 2010, I had lower extremity edema probably from the Neurontin.  I weaned off the Neurontin and the edema got some what better.  Well, I rocked on for a few weeks and then the worst lower back pain started, which was only on the left side.  I really can't describe the pain because its not really muscle or skeletal, all I can say is it feels like a constant gnaw, irritation.  I saw my family MD and he ordered a MRI done of the pelvis due to the fact that maybe the LFCN was pinched.  I did have bad endometreosis on the left side so thats why we did the pelvis.  The pelvis was ok, but did show a bulging disc in L4L5.  So, I was given Percocet for pain and it helped, but right fully so, no one needs to take Percoet all of the time.  I finally went to see a Neurosurgeon and he ordered a MRI of the spine.  Got that done and it showed a tear in the L4L5.  So, he wanted me to do aggressive PT with weights.  I tried one day of this and oh my goodness it was terrible, needless to say I never went back.  I got another referral to another Neurosurgeon and he noted the tear.  I have received one injection this week and am scheduled for another one next month.  The first 2 days past the injection was ok, I really didn't have any pain in it.  The third day was awful and the 4th day has been a little better.  Im still taking Percocet but hating to take it due to the addiction part of it.  I have also been started on Lexapro, cause all of this caused major depression.  I have lost 9lbs in about 2 weeks.  Please help me and tell me if all Iam doing is right and if this will heal on its own.  Iam hopeless!!  Thanks!

Angie
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Avatar_m_tn
A slight bulging lumbar disc can causes a nagging pain in the back that comes and goes depending on your level of physical activity.  This pain is irritating from time to time and is well tolerated.  A more constant and worsening pain  in this same region of your lower back that you can't shake is most likely an annular tear.  This pain decreases dramatically when lying down, but as soon as you stand the pain is immediately present and gets worse as your level of  physical activity increases throughout the day.  Pain from an annular tear will usually magically disappear just around 6 months as long as you don't aggravate it further.  Once this pain disappears you can still easily tear the annulus again if you try to resume too much physical activity to soon. Walking, yoga, stretching and swimming are okay and even encouraged, but jumping, twisting, turning, lifting heavy weights, running and rigorous biking are out of the question.  If you tear the annulus again the pain will be back for another 6 months and if you herniate the disc than your life will have changed forever.  A herniation will lead to sciatica, leg numbness, and more back pain that may never fully subside, unless you have surgery.  Surgery doesn't always work, so avoid a herniated lumbar disc at all costs.  I know this personally, because I am living with a herniated disc at L5/S1.
Nine months post herniation I still have lower back pain and also numbness in my toes.  It is getting better but at a snail's pace.  I had 2 previous annular tears in this same disc that both healed in exactly 6 months, until I over exercised and caused a herniation.  I went back to my old routine of running and biking hills and paid for it.  I am trying to avoid surgery for now.  I take ibuprofen sporadically when the pain is strong, but too much ibuprofen I found causes my hair to fall out.  At least the sciatica is gone for now. I hope this information helps.
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