l5-S1 nothing helps can't sit or lie down any thoughts?

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jacksa

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I cant sit or lie down for a minute without severe pain in my buttocks groin area . When I stand and walk the pain subsides. When I first found out about the herniation from an MRI after over a year of having the pain and three cat scans I took advice from a chiropracter friend and went for treatment on a spinemed decompression table. I did 18 treatments with no relief. When I showed the DC the latest CT she pointed out the herniation.I am very upset the hospital didnt see it when they did the CT I will be looking at the first two when I get back from the treatment. If you look at the side view of the MRI the herniation is pressing about 3/8 to 1/2 of the way into the nerve column behind the spinal cord could that be causing cramping/pain in my buttock/groin area? I am so over the pain and inability to sit and relax or lie down I am seriously considering having an operation but do not know if there is anything else I can do to avoid it. Frontal view on CT shows that the vertebra are very close possibly bone on bone and no medication vicodin 750 anti inflamatories muscle relaxers epidural shots have given me any relief. In the last two days prescribed 15mg's of Morphine and Gabapentin hoping for relief. Clirabing the walls would be a good example of the pain on the 1-10 scale. I hope that there is relief and no permanent damage. Going to a spine center on Monday for a consultation.What are my options? I can barely stand driving in the car for 45 minutes this is a living hell. Please help if you have any ideas.
 
Hi, jacksa, and welcome to the forum, but I'm sorry you need us. Have you seen a neurosurgeon or an orthopedic spine specialist (my personal favorite) yet? If not, that's what you need to do. Is that why you are going to the spine center?

Do you have any leg pain or back pain or is it all in the buttocks? Since meRAB, injections, etc. haven't given you any relief, I think you would be well advised to seek the opinions of a couple of spine specialists and go from there. Have you been to a pain management specialist? If your spinal cord is being impinged on seriously, there might not be much choice other than trying to control the pain or surgery and surgery should be the last resort unless you have nerves being compressed.

If you have no pain anywhere else, then the disc might not be the problem. It could be SI joint problems, or facet joints.....the possibilites are almost endless.

Actually, you really should not be seeing a chiropractor at all without a complete diagnosis and talking about it with the specialist. They can really cause more problems than you already have.

I hope I have given you a bit of information. Please keep posting and letting us know how you are doing.

Carol
 
I am on Thursday hoping they can fix it soon.
Do you know why i would have the pain both when sitting and lying down?
 
Heights of lurabar vertebral bodies are maintained. The STIR sequence reveals no underlying bone marrow edema. There are generalized degenerative changes of the lurabar discs most marked at l5-s1. This is slightly indenting the ventral secal sac. Small focus of increased signal within the posterior disc at L5-S1 is in keeping with a small radial tear in the posterior annulus. There is no canal stenosis. The perineuronal fat is maintained in the lateral foramen. There is no compression of the dorsal root ganglion.
 
It's the lying down part that has me concerned. Usually, it's about the only place spineys can get relief is lying down. The disc material must be moving and pressing on a nerve.

I would see your surgeon and see if s/he would recommend a electro-myelogram (EMG) to check the nerve conduction in your legs to see which nerve is being affected.

Make sure you see a Neurosurgeon. Explain the issue of pain both sitting and lying down. Prepare a half page synopsis with bullet points before hand so you don't forget anything. Make sure you have a copy for the surgeon. It's actually impressed them to have a quick reference for their charts.

wb
 
Feel your pain have torn and herniation in l4/l5 and l5/s1. Just had a discogram, which is a test to see if pain is coming from disc and also dye is put into disc then a ct run to see how much damgage is really there, suppost to be more info than an MRI. I will get the results from my pain management dr this week then take to orthopedic in few weeks. Driving in a car sucks, sitting sucks, only able to lie down on couch and flip flop from side to side cuz i get pains in my legs. Sorry to hear about your problems. I am thinking surgery may be the route to go for me. Good luck to you
 
went to the orthopedic spine specialist and he wasn't very helpful he walked into the room and asked which leg of mine was nurab because he was sent into the wrong room then he complained that I didnt have a herniated disc about the quality of the ct scan/mri and was a jerk pretty much. I went to my general doc saw the physicians assistant and she saw the mri from a few feet away and said I have a herniated disc then it just so happened there was a neurosurgeon in the office once every 3 weeks and he just happened to be there so she took the films and said I am going to ask a neurosurgeon and came back and verified that I do have a minor herniation. I have an appointment to see another neurosurgeon on thursday. As far as controlling the pain I am on gabapentin and morphine and it doesnt seem to help much. Its been like this for a year and I am over not being able to relax or sleep soundly.
 
300mgs gabapentin 1 during day two at bedtime. Almost through the first bottle. How long does it take?
 
jacksa,

I'm sorry to hear of your problems. I actually have a very similar problem that I can stand (limited amounts of time) without severe pain, but can't sit at all and am in terrible pain when I lay down (regardless of position). I have had 5 spine surgeries so far including an L4/L5 fusion and left SI joint fusion.

If you aren't able to get answers soon regarding your pain, check into your SI joint. Most spine surgeons really don't know much about the SI joint, so you'll really need to do some research to find a knowledgeable doctor who knows about the SI joint.

It would be helpful as another poster mentioned to create a bullet-point half page or so that lists what causes you more pain, and what makes you feel better. Give specific examples.

Best wishes!
 
You should be getting some relief after a week or two. There are other nerve pain meRAB that are available if this one isn't giving you relief. Topomax and Lyrica are two of the others. OR you dose of the Neurontin can be upped.
 
I have a decent sized herniation at l5-s1 (16mm). I have a lot of pain sitting and laying down. I also have pain walking. I am getting some relief with Zipsor 25mg along with vicodin 10mg. I also have spondylolisthesis, severe disc degeneration/narrowing, and arthritis in that area.

Did your MRI come with a report? If so, maybe you can post it here and we can give you some feedback. The key is if the herniated part of the disc is still attached or if it's a free fragment. Before my last surgery I had a 20mm free fragment and anti inflammatories wouldn't touch the pain. There may be something else going on, like stenosis.

Hope you get some relief!
 
Have you ever heard of someone that could stand without pain but could not sit or lie down because of l5-s1 herniation?
 
Went to the neurosurgeon. Because of DDD and how close the vertebra are together he recommended that I have a fusion done on my l5-S1. Said physical therapy probably wouldnt help and the disectomy wouldnt either. They go in from my tummy and said its a two hour surgery plastic spacers titanium plate and screws to hold the plate in. I am scared but also know I cant live with this pain and nothing will fix it. He said he has done thousanRAB of these and because it is a single level fusion there is a 70% chance of no pain. He served his residency at UCLA and the surgery will be done in las vegas. No PT and a six week recovery is what he said. Never been so scared of something and counting the days until so I can get the recovery over and be in less or no pain.
Everyone says make sure you get a good doctor but really how do you know. I Googled him and it seems like he has a pretty good record but still scared.
 
Try laying down with a wedge under your knees to take the pressure off of your back and see if that will help. Also it takes time for the Neurontin to build up in your system to give good relief. How often are you taking it and what strength?

stay away from chiros and see a good neuro. doc.
 
Sitting and lying down cause pain standing relieves it. No meRAB seem to help. Noveraber 3rd is the date.
 
I have four epidural injections as well as a joint block. Nothing worked. I am currently seeing a highly recommended orthopedic in chicago ill. Thanks for the info, not sure where I'm headed but I think it may be the operating table.
 
Jacksa- For some reason, I didn't have much luck with Neurontin (gaba) many years ago. I did noticed that it increased my appetite quite a bit. I ended up trying Topamax as an alternative. It did the trick for my nerve pain.

wb
 
Jacksa-

We have similar stories. I've had surgery (laminectomy) at L3/L4 many years ago. A couple of years later, I had pain sitting down, but not standing up or lying down. I had herniated L4/L5 and whenever I sat down, my weight pressed the expelled disc material on to S1, causing the buttock pain.

I sleep with a lurabar wedge that takes pressure off of the lurabar.

I need to suggest that you see a competent Neurosurgeon as soon as you can. Besides surgery, there is a treatment called an Epidural Steroid Injection (ESI) that can be done to see if it will get you pain relief.

And the kicker to my story. It's been 7 years since my L4/5 surgery, and I reherniated the disc. I just had an ESI today at L5 and I don't have the buttock pain while sitting down. I know it will only buy me a few months, but I'll be having another surgery when it wears off. But I have time to make preparations.

Again, please see a Neurosurgeon asap to get help with this problem.

wb
 
I really hope the surgery fixes most of the problems. I am also having a fusion at that level but also a disc replacement on L4-L5. Mine is not until Noveraber 25 so I have a bit of waiting. My insurance doesn't kick in until the 10th, that's why the wait. I have terrible pain sitting and laying I have pain unless I have a wedge under my knees or a pillow between them on my side. I have a problem walking though because of the sciatic nerve. So I wish you luck with the surgery and hope your recovery goes well. Did you say you don't have any physical therapy after? I was wondering about that but I am sure I will need rehabilitation as I have been in pain for 10 years and my life is basically in my bedroom. I will need to learn how to exercise and hope I can loose some weight as I put some on over the 10 years. Good luck and let us all know how you are going.
Allan
 
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