When to seek surgery for relief??

[backtomyselfoneday]

Hey folks. I will try to keep this as short as possible, but bare with me.
4 years ago, I was using an ab/back machine at the gym. The kind where you bend forward into it, and your front, or abs, push the weight forward. Did this for a few days, until one day, I got up, and could barely move. My back was absolute toast! Everthing I did hurt, getting up, walking, bending over was nearly impossible.
A week or two went by, hoping it would heal by itself, but no luck. To speed things up here, I has an MRI done 3 yrs ago, which showed a herniated disk, and 2 or 3 other bulging disks. Signs of DDD too, but I know That's common. I'm 29 and in good health now.
Both the neurosurgeon and orthopedic dugeon said no surgery for now, try physical therapy, stretches, chiroprator, etc. During PT I had ultrasound stuff done, as well as some electro therapy stuff. That didn't help at all after 2 months of going twice a week. Then we tried epidural injections, had about 3 or 4 of those done over a year and a half. They actually made things worse!
So, here I am now, 4 years later, with lumbar pain so severe I want somone to stab me! Also, I have sciatica, which began on my right side, but now is worse on my left. Its pain that goes from my butt to my thigh/knee, and sometimes to my foot. I can't sit for more than 5 mins, then standing bothers it, so I'm always in a battle to attempt to get comfy. The pain keeps me up most nights since I can't get comfortable. Along with the pain in my butt and legs, I get numbness that comes and goes and weakness too... Like sometimes I feel like my leg will just give out on me.
So, since I'm young, I know they don't like to operate, which I understand. But I'm at the point now where I feel like I've tried all conservative measures, and have been coping with awful pain for 4 years! My Dr wants me to try lumbar facet injections, which I suppose I will try... I've tried everything else, right?! I'm also thinking that things may have changed in over 3 yrs, since my last MRI. I'm getting to the end of my rope here, and I've come to terms that I will probably always have some pain, but at 29, I shouldn't have to carry a cane to ensure my balance. Does anyone agree to that?
My PCP said, "no, we don't like to operate for disk issues usually, espwcially at your age, but when the nerve is involved, then we are more likely to think about surgery." well, I'm not looking forward to surgery, but I am looking for relief. If it would help me a little, I'd do it in a heartbeat!
Does anyone have any input/thoughts on what I'm going thru? Does it sound like surgery would help or no? I've even got numbness in my fingers sometimes, which may or not be related.
Thanks in advance guys! Sorry it's a long a$$ post! Much love.
Meg

[helenlegs11]

If you are after a nerve scan you need an MR Neurography scan or an EMG. Google both. Every neurosurgeon is always hung up on spinal issues, but the sciatic nerve is the longest nerve in the body and can be entrapped in the buttock by the piriformis muscle. Their grey areas are all areas other than the spine! !
Check out piriformis syndrome (PS)   It is sciatica, which you demonstrate with the symptoms described, but from another location. Always remember, especially from trauma injury (lifting etc) you could have both PS and disc/spinal problems.
You Tube Dr. Aaron filler for more info on PS and MR neurography.
The only person who knows if their herniated disc pain is worthy of an op is you . . .can you continue with that pain or not. . . .
I had a microdisctecomy 8 years ago and have never regretted it.

[squirtatious]

In my mri, it showed significant bilateral root nerve compression due to severe bilateral foraminal stenosis caused by spondylolisthesis. Inasfar as I know, mri's do show root nerve entrapment, maybe a few cases may be missed, but the majority does show it. Standing mri's are by far the most accurate.

[backtomyselfoneday]

Thanks again for your thoughts and advice! You guys are the best! I'm thinking at this point that I've really exhausted most of my conservative options. I've been tolerant and open-minded thru this all, but enough is enough already! What I want, is for them to diagnose the problem and attempt to fix it. Like I said, I'm not hoping for a surgery, rather, I'm looking for something to help fix me.
My biggest fear (or one of them) is that I'm consistantly having weakness/numbness in my legs, and from all the research I've done, That's not a good. Sign. If they could give me a magic pill to take, and all things would be normal, I'd try it in a heartbeat. I'm ready to get/feel better, and honestlyan sick of the pain.
Doed anyone know if any and all trapped nerves will show up in an MRI? 3 years ago, when I had my first one done, it only showed a herniated Disk, and some bulging ones. It didn't seem like my doctors took them real serious.  I'm at the point where I almost don't care about any after effects such as scar tissue. I've finally accepted the fact that I will never be pain free, but I want to at least live as comfy as I can, without the fear of falling down, etc. Can the doctors see/ read everything on the MRIs to see exactly what's going on, or is there a gray area?
I'm just trying to understand I'd I'm a good surgery patient, or just try the opain management docs. To me, it seems like putting a bandaid on the issue, but I'm open for suggestions! Thanks AGAIN guys!!

[Kalvin]

I was about 5 years older than you when I had my L4-5 fused, I went through about 3 years of just living with it and having similar treatments as what you've had, I never really thought of surgery as an option, I naively just assumed I'd get better. I let it go to the point where I could hardly walk,  was in horrible pain and couldn't work. My surgery was done shortly thereafter to prevent permanent damage, I had no choice. My recovery was long and hard because I let it go so long. At 6 months I was a lot better, but it took almost a year to fully recover. The good news is that I haven't had a single problem with my low back since. No adjacent segment disease or anything.

Your in a difficult situation,  pain wears a person down and going to these various doctors appointments has to get old. I know several people that have had successful back surgery and I know plenty that haven't. Its a big gamble.

A couple of things, I don't understand what your PCP is saying about the disk issues? He's right, surgery isn't that successful on disogenic back pain, but if you have sciatica, pain down your leg into your foot and numbness, its being cause by nerve compression not by the disc. Actual it is in a sense, you probably have a disc herniation impinging on a nerve root. Its called radiculopathy. If you have one these MRI's where there's multiple problems at multiple levels, surgery might not help you. But if you have a specific identifiable problem that correlates with your symptoms the outlook is generally good.

In my opinion, these surgeries are not good for non-specific back pain, if they can spot a big disc herniation or bone spur pressing on a nerve root and your symptoms correlate they can go in there and take care of it and in most instances you be fine. I don't know what to tell you accept that if your pain is to the unbearable point, you probably need to consider surgery, if not keep going with the conservative stuff and maybe something might help. And get some other opinions.


Take Care

[squirtatious]

Have u tried chiropractic treatment?