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Neurology (Expert Forum)
Re: Back Pain
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Re: Back Pain
by CCF Neurology MD:NT, Jan 01, 1995 12:00AM
Posted By CCF Neurology MD:NT on December 19, 1998 at 17:03:01:
In Reply to: Back Pain posted by RM on December 10, 1998 at 10:53:50:
Hello:
I have been very frustrated concerning an ongoing back problem. Any
thoughts from you here would be appreciated. An MRI shows slight
disc bulge at L5, S1. The doctors do not think this is of any
significance, but my pain all stems from that area in my back. It
initially was only back pain but has since moved to my right calf.
The pain in the right calf is livable but there. All pains go away
when I lie on my back, on a hard surface.
However, my initial back pain was severe and did not allow me to sit
for almost 2 months without pain killers. The severe pain
has subsided but 6-7 months later I am still unable to take
my back out of the neutral position, in other words I can't
arch my back at all. An injection into the epidural space at L5, S1
really helped but has since worn off, and NSAIDS don't decrease
inflammation enough to arch my back. It's almost as if I am
trying to stretch a rubberband and it just won't stretch far
enough to allow me to arch my back. Actually bending aggravates
it to a point it gets worse the next day.
I have researched herniated disc's and I know I am not a candidate
for surgery. I have been doig PT twice a day for the last
4 months. This has helped but I feel as though I have made
no gains in the last 2 months. Should I sign up for the
frequent injection plan, I'm only 31, I should have improved by now,
right. I had a second MRI thinking the first one did not show what
I thought was a severe herniated disc, but it still only
revealed a slight bulge at L5, S1. What do you suggest for someone
who is not a surgery candidate but still has the problems I have.
Thanks,
RM
Dear RM:
Seeking another neurological (neuromuscular) and another neurosurgical (back surgery) opinion, preferably from specialists at a major academic center near you, may be a practical first step. Despite two negative MRI scans, it is possible that you have significant nerve root compromise that may be identified by tests such as EMG and even a myelogram-CT scan. Contrarily, it is possible that your pain arises not from nerve root compression, but from disorders of some other spinal structures, such as facet joint or disc degeneration. Although these latter disorders are somewhat controversial ones, specific treatments for these can be quite effective in some cases.
If neurological and neurosurgical experts again do not have any specific tratment to offer, the most practical option is to seek the help of a pain specialist. Modern-day pain therapies are very effective and you may even be able to return to an almost normal lifestyle.
In Reply to: Back Pain posted by RM on December 10, 1998 at 10:53:50:
Hello:
I have been very frustrated concerning an ongoing back problem. Any
thoughts from you here would be appreciated. An MRI shows slight
disc bulge at L5, S1. The doctors do not think this is of any
significance, but my pain all stems from that area in my back. It
initially was only back pain but has since moved to my right calf.
The pain in the right calf is livable but there. All pains go away
when I lie on my back, on a hard surface.
However, my initial back pain was severe and did not allow me to sit
for almost 2 months without pain killers. The severe pain
has subsided but 6-7 months later I am still unable to take
my back out of the neutral position, in other words I can't
arch my back at all. An injection into the epidural space at L5, S1
really helped but has since worn off, and NSAIDS don't decrease
inflammation enough to arch my back. It's almost as if I am
trying to stretch a rubberband and it just won't stretch far
enough to allow me to arch my back. Actually bending aggravates
it to a point it gets worse the next day.
I have researched herniated disc's and I know I am not a candidate
for surgery. I have been doig PT twice a day for the last
4 months. This has helped but I feel as though I have made
no gains in the last 2 months. Should I sign up for the
frequent injection plan, I'm only 31, I should have improved by now,
right. I had a second MRI thinking the first one did not show what
I thought was a severe herniated disc, but it still only
revealed a slight bulge at L5, S1. What do you suggest for someone
who is not a surgery candidate but still has the problems I have.
Thanks,
RM
Dear RM:
Seeking another neurological (neuromuscular) and another neurosurgical (back surgery) opinion, preferably from specialists at a major academic center near you, may be a practical first step. Despite two negative MRI scans, it is possible that you have significant nerve root compromise that may be identified by tests such as EMG and even a myelogram-CT scan. Contrarily, it is possible that your pain arises not from nerve root compression, but from disorders of some other spinal structures, such as facet joint or disc degeneration. Although these latter disorders are somewhat controversial ones, specific treatments for these can be quite effective in some cases.
If neurological and neurosurgical experts again do not have any specific tratment to offer, the most practical option is to seek the help of a pain specialist. Modern-day pain therapies are very effective and you may even be able to return to an almost normal lifestyle.
