Why does my back pain go away when I am lying down?

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A little background: I've had 2 discectomes on L5-S1. The last herniation was the largest my surgeon had seen in his career. As a result of this large herniation, I am told my pain is permanent nerve damage. I have radiating pain from my lower back into my buttocks and right leg. I have had MRI's, CT Scans, you name it. All the images on my back are clean (besides some DDD and minor stenosis at L4). There is NOTHING that shows the cause of my pain. I had an EMG which showed LOTS of nerve activity at the L5-S1 level.. Doctors tell me this is the permanent nerve damage.

So, six back doctors have told me the same thing. I have permanent nerve damage and no surgery can correct this. All they offer is a spinal cord stimulator, which I am waiting for the MRI compatible one.

Anyway....back to my original question. Whey I lie down my pain is almost gone. It's when I sit or stand, the pain starts to flare up. I cannot sit or stand more than 20 minutes. So, I understand the nerve is damaged. But what causes it to flare up when the spine is bent or pressure on it (sitting and standing)?? If the nerves were damaged from the herniation, wouldn't my pain be constant...ALL THE TIME? They tell me my nerves are firing the PAIN signal to my brain. But it seems to me, there must be something there pressing on the nerves when I am in those positions? Right? If there is nothing touching my nerves, then why does the pain only come one when I sit/stand? Does my question make sense? (oh...I've also had a sitting MRI and that showed no compression.....I was in soooo much pain after that test)

Thanks!!
JRABun
 
It seems to be very hard to get any real explanation from surgeons and pain specialists, even just doctors. I don't know weather it's because they genuinely don't know or if they don't think they should have to share their knowledge with a patient. Are we just expected to smile and say thank you all knowing doctor. I really don't know. I have a similar problem that the pain in my back decreases when I lay down but that is when I can feel the leg pain when the overwhelming pain in the centre of my back calms down. The surgeon I saw last said he can only help me with leg pain, the pain I only feel when the localised pain is calm. I do hope that surgery will give me some relief from the excruciating pain I have when I move the wrong way and when I do any activity including laying down. So I know how you feel just don't have any explanation for you Sorry. Wish you well. Allan
 
It would sound like when you sit or stand you are putting pressure on the herniated region, since there is damage to the disc which is cushion then the absence of that cushion allows compression on the nerves
 
Hello,

YES, both sitting and standing put way more pressure on your spine than anything else. Sitting is the absolute worst, especially for long perioRAB of time. When you sit, all of your upper body weight now has to be supported by your spine and rear end. When you stand, at least you can shift your body weight around, or move around, so that your legs are also helping to support you. Your spine is made of a bunch of vertebrae and discs, all on top and below one another. The purpose of discs are to cushion the space between the vertebrae. Whenever you stand or sit, all the vertebrae move closer together, which puts a lot of pressure on them. If there is a problem in the spine such as a pinched nerve or stenosis or degeneration, it's very likely that pain can worsen in these positions. Not always, but in many cases. When you lay down, all your body weight is pretty much distributed from head to toe, plus the fact that it usually stretches out your spine a little. I believe most people are a wee bit taller when they first wake up in the morning. This is because everything in the spine gets nice and stretched out.

Of course I'm not a doctor, but, just so you know, just because a doctor might say an MRI shows nothing wrong, it does not necessarily mean nothing is wrong. MRI's do not always show everything for one. Also, is your doctor going by your MRI report or just by looking at the MRIs themselves? Radiologists, who interpret MRI reports can be wrong; not to mention that it could be any kind of radiologist. It could be one that normally looks at brains, or arms, or some other body part. You have no way of knowing. Also, even though my spine MRI's showed many things wrong, when I went to have surgery, there were even more things found that never showed up on MRI. And yet another point...just because it "appears", like "minor" stenosis", to be minor, that in no way can dictate how much pain and symptoms one person can feel. Pain is totally subjective, so....you could have one person with "minor" results on MRI be in excruciating pain and then have another person with a huge herniation have no pain at all, not even knowing they had a huge herniation (such as in incidental findings when maybe they had an MRI for something else done and this just happened to show up). The worst thing is, doctors know all this, they SHOULD know all this. I have read this sooo many times in medical articles and such.

It could very well be that your L5/S1 is causing your problems, however, just my opinion, it does sound to me like there is something hitting a nerve when you stand and sit. If you had surgery before, it could very well be scar tissue. I know I have that problem. When you had your MRI, was it done both with and without contrast?
 
It is good to see that someone else has looked into these problems and found what the drs should be doing instead of how they do it. It seems that they treat you to a certain extent and then dump you, they get paid and adios, or they get another nuraber added to their statistics and thats it. I really don't understand why they don't listen to the patient, how can they sit there and hear a patient camplain of pain and not investigate the reason, do they think that their work is absolute or that they are incapable of misjudgement or mistakes. The pain we feel is real not in our heaRAB.
 
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