Lower back problem

[Sarge]

Recently had an MRI read to me and the Dr said That the fluid in three of my lower discs had leaked to the inside of the disc not the outside. Dr also stated the discs were dried up (disc desicration was what I thought she said). This is causing unbearably severe pain down right leg to toe, sometimes left leg, precededed by numbness and partial paralyzation. I also have constant pain in lower back and right/left hip. I have been seen at physical therapy regularly for ten weeks (excercises for lower back, traction, electro stimulation, etc.) with no improvement other than an education on how to contract my lower back to hold it together when I stand. PT has been unable to localize the pain. The PA seems reluctant to refer me to a specialist, she recommends further conservative treatment possibly injections of some sort to the back and a continuation of medication (tramadol/etodolac). I am a U.S. Paratrooper of 19 years active duty and am no stranger to pain but this is too much. I've been placed behind a desk which only aggravates my back twice as much. Is there some sort of surgery or treatment that would help my situation and allow me to continue my job?

[CCF Neuro[P]-M.D.-RPS]

Dear Sarge:

Sorry that your having back pain.  Sounds like your profession has likely contributed to your back problem.  Disc degeneration is quite common, yet the fix for the symptoms of the degeneration-pain- is elusive in many cases.  Surgery can help in some cases, in some cases is does little, and in some cases it worsens the problem.  There are some very good rehab places in the military, one is in San Diego.  I would see if a rehab specialist might have some recommendations.  Then a visit to the pain specialist might also help matters, as you don't want to continue in pain, but also not be addicted to opiates.  The last ditch effort is surgery.  I do hope that your able to locate a good rehab specialist and get a good evaluation.  If they recommend surgery, then it is likely warranted.  

Sincerely,

CCF Neuro MD

[MBMRCS]

Dear Sarge,

From my expieriance there are no successful operations for back pain.  HOWEVER, leg pain caused by a slipped disc or lumbar canal stenosis (tightening of the boney canal the nerves run through) can be successfully treated with surgery in the majority of patients.  If leg pain is your main complaint, or weakness/reduced range of walking, you should see a neurosurgeon.  Pleasebarein mind that these will do nothing for your back pain, and can even makeit temporarily worse.

Dr Thorne
MB MRCS
Neurosurgery Resident, London UK

[Tedily]

Sorry to here about back and leg problems.I have had L3and L4 disk problems often for 30 years. 1999 I had an MRI and wasn't interpreted completely.I had the back pain and legpain at same time.Had two epidural blocks or injections at L3,4 locations. Got much better for six weeks each time.Went to neurosurgeon out of town and he said I have spinal stenosis and this is what Dr.Thorne was telling you about.I had surgery by a board certified orthopedic SPINAL surgeon in Chicago.I have no more leg pain and my disks are doing much better.Remember now that the surgeon didn't touch my disks, he took lamina bone out of canal to make room for nerves and this gives disks more room for healing if I do something to make them protrude toward in side of canal. If you have epidural block and pain leaves for six weeks and comes back down your leg you need to be checked for spinal stenosis. You may however have more severe disk problems than I have other than stenosis.If you have stenosis it will only get worse and only continual relief is surgery.There is a fine webb site at San Francisco Spine Center or Institute in Daly City,CA.Experts on new and redewing failed back surgeries.The best I've seen so far.Good Luck Sarge--Ted

[danielle]

Did you ever think of Deteriative Disk Disease? My husband has all the same problens and that was the diagnosis the doctors gave him. The pain will also come and go for him. This is going on two years and all they can do is rehab. They say that you can do sergery but it is a disease and they will come back in another disk. They also said the the injections could help him, they could do a nerve block. Just a little thought. Maybe bring it up to your doctor.
Danielle