Mysterious back problem

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Bryan12112

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Hey all,

I have a bad condition that no doctor so far has been able to help, or I think even diagnose correctly. The pain is getting so bad that pretty soon I'm afraid I will be unable to continue working.

It started three years ago. I was in class for about a month for job training and I noticed that it felt like my low back on the left of the spine was having a muscle spasm off and on. The spasms were very fast and subtle, but I have never had anything like this before. This pretty much continued for around a month. Well one day I was sitting in my car and I turned to my right to look behind me and I felt something that I knew was bad. It didn't hurt right away, but as I drove home it really started hurting. For about a week I was pretty much bed ridden and when I stood it looked like my upper body was shaped like an S. It was so bad that I went to a chiropractor and he thought I had scoliosis before he did x-rays.

I have had a few MRI's over the years and they all show the same thing. I have two degenerative discs in L-4, L-5, S-1. I have had epidural injections which have done nothing at all. The two surgeries I have had are a discogram and I went to a laser surgery center that went in and trimmed down any bulges and cleaned around the disc. Neither surgery has helped at all.

The pain has always been located in the exact same place, before and after surgery. It is in my lower portion of my back, just to the left of my spine. I have noticed that the swelling that I always get is sort of shaped like a crescent moon, starting at my spine and curves down to the left side just above and to the left of my tailbone. I have never had any leg pain at all, which everyone tells me is a good thing.

The two things that really make my back flare up are sitting and standing. I can only stand motionless for about 10 minutes before it really starts stiffening up and hurting. Starting to walk relieves the pain, depending on how long I have been up. Sitting is almost as bad. After sitting for about 30 minutes I can really feel it in my back. Since I have to sit for long perioRAB at work, this is a real problem. I have a radiologist friend of the family and he has seen all of my MRI's and basically said I have a slight bulge for my age, but what he can see on the MRI I should not be having this much pain. I am currently taking 200mg of Ultram a day, and two advil when I work, which helps somewhat, but I am still in pain. The only thing that really helps relieve the pain now is lying on my side.

Anyone have any ideas on what this can be. I am getting real discouraged that I can hardly do anything with my family and facing the prospect of not being able to work anymore, but no doctor so far has been any help to me.

Bryan
 
I AM sorry for the pain. IT's a miserable thing to have. I am certainly not a doctor, but you pain sounRAB like it is nerve related, especially with the bulging at those discs. Have you ever been on any of the nerve meRAB? Nuerontin, Topomax, Lyrica? All of these were originally made for seizures, with nerve pain control control being a secondary benefit. They all have their own side effects, but the pain relief outweights most of the side effects.

Have you been to a nuero back doctor? One who can help you figure out why the pain occurs? And have you tried accupuncture? It really was a benefit to me. I used it for a year.

I am sorry that I can't offer more help for you...but there are many folks on this board who will jump in with other sugestions. Good luck.
 
It could be an SI (sacroiliac) joint problem. There are very few doctors that really know much about this condition, so you'll need to do some heavy duty research to find a knowledgeable doc. You could contact SI Bones and find one of their trained surgeons in your area. Most spine doctors don't even know how to diagnose this problem. Find a surgeon who is trained on doing SI joint fusions and get evaluated by them.
 
Bryan,

I feel your pain.. My condition started like yours did and I was extremly frustrated.. I had a MRI and was refered to se a Ortho Spine specialist.. He looked at the films and said right away nothing looked out of the ordinary for a person my age (35) at the time.. MRI impression said only normal age related issues.. I was refered to a pain mgmt doctor who had me do therapyand not ant difference.. He finally decided to do epidural injections a series of 3.. No help. He tried to push narcotics down my throat until he could do facet injections.. About 9 months later he did 2 injections and then a radio frequency ablation and still no help.. I finally decided to go see see a Top notch group of neurosurgeons and he asked a ton of questions and then Had me do an uoright/sitting down MRI which shows the pressure u have when sitting and standing and seen him only 1 hour later.. This MRI showed I had Grade 4 DDD at l5-s1 and a central disc protrusion impinges the nerve root.. He was sure the DDD was there when the standard MRI was done it just didnt show up as well as the 5mm protrusion.. He said since the conservative treatments hadnt worked he would reccomend either a ADR or a PLIF which ever I would prefer and depending on insurance.. He then scheduled a discogram for dec 15th and CT to follow to verify that it was only that disc and the CT to check the anatomy of the inside of the disc to see what he would need to do in a surgery.. I am grateful he was so thorough and beleived that I had a painful problem and he would find out why.. I would suggest u see a neurosurgeon and 1 that will do every test available to get to the problem.. You may the same problem or a nerve conduction test may be done to rule out neuropathy.. I am not a doctor by no means just had the same problems u had and was beginning to think I would never find out.. The doctor is a blessing that I found by seeing more than one and doing alot of research.. God luck and I hope you find out the problem

God Bless,
jww
 
Bryan, I am really sorry for the pain you are going through. Lord knows all of us here can empathize with you.

It could be that you need better testing that a plain MRI.........such as a cat scan with contrast to beter show all the nerves etc. You will need to make an appointment with either an Orthopedic Spine Specialist or a Neurosurgeon with a spine specialty. These guys are the best at knowing which test to order for you and also at reading the results. They can then, depending on the findings, offer you a treatment plan.

Do keep in mind that surgery should be a last resort except in certain cases which might include nerve impingement. Also, let the dr. know that you have had no luck with steroid injections tho that could have to be with placement of the medication. Be sure to describe what causes the pain and where it is located along with the type of pain it is.....stabbing, shooting, cramping, etc. Tell him what makes it better and what worsens it.

I hope you will continue to post and keep us updated on what is going on.

Blessings.

Carol
 
That's interesting. I never knew they could do a MRI while sitting or standing. I have always wondered if the standard lying on your back position was masking a problem that couldn't be seen. A neurosurgeon seems like a good place to look into. Hopefully I can finally get some results like you have gotten.
 
The MRIs are called positional MRIs as they can be done standing, sitting or in flexion/extension as well. They are relatively new, not available in many locations and many spinal specialists consider them a gimmick and do not put much credence in them. One neurosurgeon I went to for a "second" opinion would not look at mine -- he wouldn't even pull it out of the envelope.

Sometimes it is necessary to be very persistent when looking for answers. Do not get discouraged. It may take awhile to get an accurate diagnosis and to find a specialist who will listen carefully to your description of your symptoms. I encourage you to use the Internet and do some reading and research. Through trial and error you may run across something that will have particular meaning to you.. Keep searching until you get some answers. It can be a long and frustrating road, but there are doctors out there who can help you. You just have to find one.

I wish you the best on your journey.
 
Have you ever seen a rheumatologist? They are arthritis specialists. There is a group of arthritic disorders that have low spine and SI joint arthritis as the prime feature of them. They are called the "sero-negative spondyloarthropathies". They can not be diagnosed by blood work but you sure sound as if you have some of the cardinal symptoms, especially the stiffness on sitting. It's called "gelling phenomenon" and is a symptom of inflammatory disorders. the joints "gel" when you keep them in any one position for any length of time.

The most common of these disorders is Anklosing Spondylitis and it affects the lower spine and SI joints in the pelvis on either side of the spine and can go on to cause the entire spine to fuse into one long rod if not stopped. Can also go on to affect the large joints of the body and the eyes. Great new drugs to stop it in it's tracks. 80% of the people who get this are men. Most carry a gene called HLA-B27 that predisposes them to get this disorder.

Please consider seeing a rheumatologist if for nothing more than to make sure you don't have one of these disorders. Most docs haven't a clue about them and these are the doc's who do. Not that rare but so often missed until it is almost too late.

good luck..............Jenny
 
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