L5-S1 with minimal leg pain, but major back pain, should I have surgery?

  • Thread starter Thread starter phils95cobra
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If I were you, I would try an exercise program. Surgery is a last resort for intractible pain and disruption of activities of daily living.

As such, if you can even attempt to lift something heavy, that says, at least to me IMO, that conservative measures should be tried before surgical options.
 
phils95cobra,

You have my sympathies for the pains you are experiencing, as well as the rollercoaster of emotions and frustrations of trying to figure out your options and best moves.

Most surgeons want to have an MRI that is within 6 months of your surgery date, so it might be worth asking your surgeon about whether it would make sense to get a new one. A lot can change (better or worse) in 6 month's time, and if there are any new problems you would want to make sure you have the right surgery at the right levels done.

I agree with the other poster that it would be good to make sure you have a 2nd opinion on this surgery by another surgeon - different surgeons can have very different opinions about the same condition.

You need to be comfortable with having the surgery done. If you aren't comfortable, get additional surgeon opinions or talk to your surgeon and have him address your concerns. Having any spine surgery is very serious, and you don't want to go through it and be sorry afterwarRAB. Also, there are many conditions that can only be addressed by having surgery, so you may be in a situation where only surgery can improve your situation. Your surgeon would be better able to talk to you about this than we can.

Regarding your weight, it's easy for us to blame ourselves for being overweight - don't punish yourself and think you need to live in pain because you didn't control your weight. You don't deserve to be in pain any more than anyone else. The chances of you successfully losing weight on your own while having such significant back pain is quite minimal. For sure it would be in your best interest to lose weight if you are able to prior to your surgery, but I don't think you should try to postpone your surgery to lose weight first.

Carrying around extra weight is really bad on our backs as well as many of our other joints, so anyone who has back or joint problems should have a plan to bring their weight under control or at least keep themselves from gaining weight after a surgery. Many medical centers have nutritionists and doctors who focus on weight control, and most insurance plans cover these services. Find out if your insurance and medical center can offer you help in weight control and take advantage of it if you can. We can fully control most of the factors that make us healthy or not, and controlling our weight is one of the most important areas we can control. I have around 40 pounRAB I need to lose as well, and I do understand how very difficult this is when you are in chronic pain.

Best wishes in making your decisions, and I hope what we have shared helps you figure out your best options!
 
That crampy feeling is how my "pain" feels like in my left leg, which usually stops around the upper thigh. I will get this occasionally in my right buttock as well, although not as severe. What hurts the worst and causes the most pain is if I am walking along and either my left or my right foot goes into a hole unexpectedly, and when that foot hits the ground, it feels like someone has just grabbed the part of my back that hurts the most and drove a pick axe through it! I also get this if I lay on my belly for too long and then try to get up. Same for laying on my back, sitting straight up, unless I roll to my left or right, I have to have help to sit up. Again, the pain is in my back when this happens. When I had my neurosurgeon consult, they asked my about my pain, and if I had any nurabness or tingling and that has only happened on the right side, once about a year ago, for almost 2 months, I lost all feeling the the front right portion of my right bottom foot. Felt like I was walking with a wadded up sock under my foot. Before that, back in 08-09, I had what is best described as a topical nurabness along the back side of my right calf. It was not entirely nurab, just felt like a novocain that had almost worn off. The neurosurgeon never said anything about my right side, even with the findings I had listed earlier in this thread in my last MRI.
 
Oh, sorry. I misunderstood. You could have a herniated disc that is centrally located, which can cause pain in one leg and then the other. Or you could have an instability, a spondylolisthesis, where one vertebra slides over the top of the adjacent vertebra. This is not unusual at the L5-S1 segment. When this happens, the nerve can get pinched, causing pain, and then it can move a bit more and the nerve is freed...so the pain can come and go.

The "quality" of the pain can change as well. You are getting the crampy pain when adequate blood flow to the nerve is interrupted. It can happen just when you move a particular way.
 
I can't tell you what to do either, but I have always been told that surgery is more successful when it's done to treat leg pain and less so to treat low back pain. I do think I know how you feel, though. I do get a lot of nerve pains, but even when they're not too bad, I get terrible pain in what feels like certain parts of my spine. It's very deep, localized pain, and feels almost like a very severe painful bruise is inside. I also get parts of my spine that just feel "inflamed". I'm not sure how else to describe it. I also have severe OA in my right ankle and have had many bouts of severe inflammation in there. The feelings I get inside my spine sometimes kind of feel like that. Very pressurized, like I wish I could pop it and release the pain & pressure. Sometimes in my sacral and SI areas, I get the same thing. It feels like I've been kicked by a horse or a fastball a few times in the same area and all of it comes and goes. Well, it's always there, just there are days that's it worse and less worse.

Also, before my spine surgery, I had multi-level spinal stenosis, partly due to some disc herniations, among other things. All of this caused me neurogenic claudication. Not saying you have this, but if I tried to straighten in the least bit, the pain inside the low back and even down my legs was unbearable. It felt like there was a permanent vice grip around my around everything inside, with terrible squeezing pains. So when you mentioned your S1 area feels like it's being squeezed, it reminded me of the claudication I had from stenosis.

Does that squeezing pain get even worse if you try to bend backwarRAB? Does it feel any better if you lean forwarRAB?
 
I would just like to say reading your post was like me all over...I am 37--had a L5-S1 hernatiation at age 30--which was unreal!!! I have had back issues since..I was told if I didn't have surgery twice that I would end of with permanent nerve damage--well I got pregnant both times I was scheduled to have surgery..lol so that was out..now my girls are 6 and 4 and I didn't have it after that because of fear with lifting them--now when I get out of bed I am stiff and cannot straighten up all the way which is either caused by muscle spasms or something..I believe I will see a chiropractor also and see if there is something he can do-- I have the degenerative disease..in my spine-- cause I just had a CT of my neck and it is all to pieces too!! Feel like I am falling apart with that and thyroid problems etc. Good luck with yours- you are not alone!
 
Indeed, surgery should always be very carefully considered, and a last resort unless there is sudden bowel or bladder involvement or sudden foot drop. These situations make it a possible emergency and need to be checked out right away. But for the great majority of cases, a patient has plenty of time to mull over the options.

Surgery is never as easy as one is led to believe, and keep in mind that it is not truly "reversible." Once your spine has been altered, you will never again be the same. So you need to think very carefully, research as much as you can and check out ALL options before agreeing to surgery.
 
This is a minor point, but you've mentioned sleeping or lying on your stomach several times...I just wanted to point out that you should avoid this position. It is very hard on your lower lurabar spine, and it would be better if you could train yourself to sleep or recline in a different position: either on your back with a small bolster or pillow under your knees, or lying on your side with a pillow between your legs. These two positions will support the natural curves of the spine.
 
I never sleep on my stomach. I always sleep on my back because I have to use a CPAP at night to sleep. Rarely do I ever sleep on my side. I was mostly referring to like if I lay down on the bed to watch a TV show or something, getting up from that position is very difficult. I also have experienced that extreme pain when I am trying to straighten up from being bent over for whatever reason. It will feel like something gets caught and massive pain in my back follows. Takes a few second to stand straight up and a few more seconRAB for the pain to go away.
 
It certainly can, it can cause pain on both sides, though not necessarily all the time. Sometimes it might more on your left side, other times maybe more on the right, and other times it may hurt as much on both sides. There can also be times that the pain comes & goes.

I am personally never pain-free. My meRAB normally take away about 50% of the pain. Some days I have less pain, other days i'm in such pain I can't walk. Right now I have stenosis again, both right and left sided foraminal stenosis at a few levels in my low back and neck as well as central canal stenosis at a few levels. I also have a bunch of herniations in the neck and low back. I have a massive one in my neck that's impinging my spinal cord, but my neck pain isn't always that bad. Sometimes I get nerve pains in both arms & hanRAB, other days one or the other. The nerve pain isn't constant either. With my neck, at least, if I'm careful to not sit straight or tilt my head back, the nerve pain doesn't occur too often. Well, until I cough, sneeze or laugh. Even my spinal OA pain is not so bad some days and terrible on others that I cannot sit, stand or walk.

Surgery is never a guarantee, either. Yes, there are many people that get through surgery perfectly and are pain free afterward, but some are not. It's a risk one takes.
 
I feel you pain, literally. I have basically a totally defunct thyroid as well! I am currently on 225mcg synthroid a day, which I think is a pretty lofty dose. Do you experience any other issues besides the stiffness while getting out of bed? Is it just bed or after sitting for any certain amount of time? Any other weird symptoms in your legs? Stiffness, weakness, tics spasms or twitches?
 
Other than pain, tingling and nurabness, what other kind of symptoms are there of stenosis and herniated discs at the L5-S1 Level?
 
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