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In need of some advice!! please help!

Started by jfred101 on 09/03/2011 3:37am

I have been reading some of the posts others have written and decided to see if anyone could help guide me. so here it goes. i am 26 years old and have been dealing with chronic lower back pain for 2 1/2 years. I now that may not sound like very long, but up to that point i was very active. I had seen my primary at which an MRI was ordered which revealed multilevel degenerative disc changes as well as facet degenerative hypertrophy at L4-5 and L5-S1. (disc bulge at T12-L1, L1-L2, L3-L4, L4-L5 and L5-S1) and a Schmorl node with adjacent fatty endplate changes at the superior endplate of L3. Two small Schmorl nodes at both the superior and inferior endplate of T12. disc desiccation and disc space height loss at L5-S1, T12-L1, L1-L2, and L2-L3. and "minimal spinal stenosis" (sorry that got at little winded). also having right leg pain/weakness. I started seeing pain management in December of 2010. i have tried physical therapy with no improvement. i also purchased an inversion table which it did help for a little while until about 3 months ago when i began having daily neck and head pain and was advised to stop using it until Pain management could take care of the current issues. i have been given numerous pain medications to help control but they left me feeling groggy and so on. i could not continue using them due to being a medical assistant for a small podiatry clinic. about 3 months ago they placed me on Nucynta 50mg along with a muscle relaxant. that helped for 2 months at which now my body has gotten used to them and they are not working as well as before. i had recently seen pain management which prescribed gabapentin. i had a bad reaction to that med and stopped taking it. i get about 2-4 hours of sleep a night due to the pain and tingling. some weeks ago i began having tingling and weakness in bilateral hands, 4th and 5th fingers, sharp pain left side of neck that radiated up the back of my head, and numbness feeling on the left side of my face. i saw a neurologist who said "you need surgery to fix this mess, but I dont feel like doing it" then walked out of the room. i also seen an orthopedic who said," clearly you are in a lot of pain and need surgery, but i dont feel comfortable operating operating on you. I need some suggestions or names of good doctors in Wisconsin. i am so frustrated that all pain management wants to do is give more and more pills and adjust the dosage. My insurance only approved 1 S1joint injection which failed and getting them to approve any more is like trying to pull teeth with them. i see a chiropractor weekly, have been placed on 10lb max lifting restriction, and also wear an adjustable brace almost daily. HELP!!!! i need to do something else but what?? also what is a Schmorl node, seems when i ask, the doctors tend to change the subject. i would like my quality of life back, is that so much to ask. If any one has some ideals or words of encouragement i would greatly appreciate it. thank you


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8 Responses


"what is a Schmorl node"?
I found these answers on Wikipedia.

"These are protrusions of disc material into the surface of the vertebral body, which may contact the marrow of the vertebra and lead to inflammation."

"Schmorl's nodes are fairly common, especially with minor degeneration of the aging spine, but they are also seen in younger spines. Schmorl's nodes often cause no symptoms, but may simply reflect that "wear and tear" of the spine has occurred over time; they may also reflect that bone strength was at one time somewhat compromised, perhaps due to a vitamin D deficiency, although this has yet to be confirmed with studies."

On an X-Ray it looks like a dip or pothole in the vertebrae.

Pain Management. Their job is basically to relieve your pain and help you cope with your symptoms. Hence, manage your pain. They are not designed to "fix" what's causing the problems. That is the job of your neurosurgeon or orthopedic, etc.

Chiropractic is great for adjusting subluxations and working out the spasms, etc associated with it. However, there are times when you need to move on to a doctor who can physically fix what is wrong.

If your doctor is recommending surgery, he should be referring you to someone who can/will do the procedure. If he can do it himself... but won't... ask why!

I'm not an advocate of surgery unless you've exhausted all the non-invasive options available. But, if you need surgery to resume a normal way of life, please get a second or third opinion.

BTW, I also have DDD, and Spondylosis in the lumbar region with myelopathy. L1 through S1 are effected and a lateral herniation at the L4-L5 level was very prominent . I understand what it's like to bounce from doc to doc for pain management and physical therapy. I was given the option of surgery to correct several issues, but he also gave me reasons to delay the surgery. However, those options were up to me.

Again, I would suggest you get another professional opinion.
I hope you are able to find a solution that gives you relief.


Wow...and I thought I had a messed up back. I would definitely get a second opinion regardless. The neuro surgeon is more than likely going to just want to treat your symptoms where as the orthopedic surgeon wants to correct the mechanism that is causing your symptoms. I have DDD with herniation beginning at the L3 all the way down to the S1. In 2008, I had a discectomy on my L4/L5 level due to a 11mm herniation, which was compromising the nerve. All went well for about a year until I got hurt again. This time I had problems at the L5/S1 level. After trying all kinds of stuff (meds, physical therapy, steroid shots, acupuncture), my pain continued to worsening and became very debilitating. I am a career firefighter and I literally could not get to work anymore, walk, sit, lie down. Everything was so painful. I got very depressed, especially since I was not able to go to work. I finally gave into getting a fusion surgery at the L5/S1 in December 2010. My orthopedic surgeon told me that he was about 95% sure that this will relief my pain and he was right. I still have struggles with having a fused level on my spine, but I take that anytime over the pain I had to endure prior to surgery. The issues I am still dealing with are having to due with lack of flexibility (for instance, I cannot even come close to touching my toes anymore when I sit down and reach for them - prior to back problems, I was able to reach past my toes), not being able to bend or twist and just the feeling of having this extra hardware in my back. I can totally feel it, but not so much in a painful way but awkward kinda way. I don't regret the surgery. If I was you, I would try acupuncture (I really, really enjoyed that but your insurance will probably not pay for it) in combination with either a steroid block or ask your doc about a facet joint arthrogram to figure out where you pain originates from. They would normally follow that up with a radiofrequency thermocoagulation. The arthrogram is a testing tool to see if your pain improves temporarily after the procedure. If it does, then they are sure that the facet joints are the problem and will then permanently kill the nerve so it can no longer send signals to your brain. It helped for me for a little while until I was involved in a motor vehicle accident. Then all hell broke lose on my back. I hope this helps you a little bit and gives you other options to explore. I would not do any type of invasive surgery (fusion, disectomy) until the pain becomes debilitating enough to keep me from walking or getting out of bed).


I could go on and on about what is wrong with my spine, but I won't. I have had three major car accidents and live with chronic pain from the C3 to L5/S1. I do yoga to stay flexible and biofeedback to control my pain. As for getting your life back, that may not be an option, so start with accepting that, however, you can live your best life within your physical limitations and on your terms. Some psychological therapy will help with the anger of not having the life you thought you'd have. All the best to you Jennifer, and I am sorry you have to go through this. Second and third opinions are always best.


Hi Jennifer,
Not knowing where in WI you live, I wonder if you can go to U.W. Hospital & Clinics. I am fused L3-4-5-S1. This was through 2 surgeries, but the end result for me is doing things I never thought I would ever be able to do again, and I am 55 yrs. old now. My surgeon was Dr. Paul Anderson. He is seen at the Spine Clinic at 621 Science Drive, Madison, WI 53711. Call 608-265-3207. If you see him tell him I refered him to you because he is so wonderful , he gave me my life back (Delores Meyers). He did my surgeries in July 2004 & Dec. 2005. I hope he is still there. If you need to see an Orthopedic Dr. 1st, ask for James W. Leonard, DO at the same address and #. He got me to Dr. Anderson. Maybe you can just get a referal to Dr. Anderson from one of your doctors.
I wish you all the best. If you do have surgery, I recommend you do EXACTLY what you are told. You won't regret the effort if the end result is like mine, totally AMAZING!!!!
Good luck.


Jennifer, Get thee to an orthopaedic surgeon who specializes in the spine or limits his/her practice to the spine. Forget general orthopod surgeons, they will NOT risk treating neck injuries/diseases due to the liability attached if they goof. I am in advanced years (76) but was forced to have my cervical spine fused (C2-C5 plus C5-C6 is autofused) with hardware due to invasion by ligaments that impinged on my cord. This did remove the pain associated with that impingement but added new pain, probably as a result of that surgery, called occipital neuralgia, a kind of permanent, 24/7 head/neck ache. No more tennis matches for me as i cannot swivel my head. This followed by 3 years surgery to fuse my L1-L2, L3-L4 and L5-S1, again with hardware, all due to advanced arthritis of the spine. That was the 3rd lumbar surgery as the first 2 surgeries were failures mostly caused by the surgeon only doing a discectomy at one disc level when he saw the beginning of the same condition at the next disc but did nothing about it. 4 months later he had to do the next one, which, incidentally, failed as well.
If you get to see the RIGHT surgeon, he will justify to the insurance company the necessity of going that next step and surgically correcting your problems. Only after the operation and physical therapy will you need to see pain managers to take care of any residual discomfort you experience.


Hi jfred,
Welcome to the group.I have same issues as as u , my T5-S1.L 5 n L 6 i had laminectomies done on them in march, I have degenerative disc disease in all those discs.After surgery they labeled it failed back surgery, but dont get to nervous its a term they use meaning ,they fixed problem they went in for, but patient still experiencing unexplained pain. And if u read everyones bloggs, we all pretty much had surgeries n r experiencing continuous pain,,,Hence we all pretty much have that diagnosis.
If you have to have surgery at some point if surgeon saiys so. ( 2nd opinion, even better).try not to get fused and rods,I am an experienced nurse in orthopedics..its my recommendation. (im not dr,) but recommending ,if u HAVE to have surgery have the discs addresed by laminectomy, Try not to get fused and rods. But again im not surgeon,,,just my input...Hope ur on an anti-inflammatory, pain meds,psychotherapy...(good for the soul :) :)To find good surgeon, go to ur best surrounding hospital.look up who the neuro-surgeon is,Better hospitals give priveledges to the better surgeons ,Good luck to you,,feel better RENE :)


dear jennifer

you are correct about Pain management doctor's , it's what they do . very suprised the neurologist's
comment , and then leaving the room . i believe if you were to call the *county or State medical society in your city , they may be able to direct you to someone willing to help . clearly , you need some real direction for the way things are . i hope you find someone good and with compassion to listen . chronic pain 24 / 7 is awful . good luck to you .


jfred, i hope you've seen the above comments, all of which can be of some use. Now is the time to be proactive. Go get help before your problems get worse, which they will if un- or mal-treated. You seeked help, you've been offered some excellent suggestions, now's the time to go find a competent and sympathetic orthopaedic and/or neurosurgeon and end your suffering. Then get a 2nd or even 3rd opinion and demand a clear explanation in writing of what is going on in your spine, what they would do about it, and what outcomes you can expect. If you opt for surgery, plan on a period of intensive rehabilitation (those plans should be included in your surgeon's explanation) and get yourself back to a quality of life with minimal or no pain. I sincerely wish you only the best.