Writing again because one of you lovely people suggested I saw my MRI results for myself. She was right, my doctor said it was wear and tear in the back. Keep taking the painkillers and walk. But I did see the results and it is Grade 1 degenerative spondylolisthesis. He did not suggest physio. But from my friends I got the number to self refer. In fact I have not had any advice or explanation of the MRI results. Some of which I do not understand. So trying to get an appt to question him. The painkillers cocodamol which I only take sparingly so walking is painful. On a waiting list for physio. No suggestion of a steroid injection and whether that would help. Really want some help with this as I do not want to need walking aids yet. Still can’t believe how quickly It came to this. One minute just normal and next day pain in leg. The surgery physio just gave me exercises which made it worse. Now worried if they caused it to escalate. Anyone out there with this and how they manage would be helpful. Thank you all.
Leg Pain pt 3: Writing again because one of you... - Pain Concern
Leg Pain pt 3
Hi, I have spondylolisthesis too, only my report didn't even grade it, and the rheumatologist didn't mention it. I wish they would realise how important this is, because if the patient doesn't know, they can't tell their physio and the physio can recommend the wrong exercises.
Like you I was giving exercises that made it worse, so I stopped doing those. I also have psoriatic arthritis and the private physio said she was reluctant to give me certain exercises until the inflammation was under control. But the rheumatologist has said I don't have enough joints to try any more medications (I had adverse reactions to sulphasalazine and methotrexate) so I have given up on physio, other than to keep moving, don't do anything that makes it hurt more, and do little muscle tightening exercises (like pelvic floor exercises only tightened all the muscles in the abdomen).
I hope you have better luck with the NHS physio than I did. Private can be really good, if you get the right ones.
And yes, I do wonder if the NHS physio that saw me for my neck made my spondylolisthesis worse. She wanted me to improve my posture, relax my shoulders, straighten my back.
When I saw her a few weeks later I said I have never had lower back ache but I have it now since I have tried to sit up straighter and stand straighter. She was a neck specialist and didn't want to know! And I quickly realised why I was tensing my shoulders, it was to stop them from subluxing! But then that physio had no idea that I had spondylolisthesis.
Thank you for your interesting reply. Is your problem more in the neck and shoulder? Mine affects my lower back. Since September when it was not so bad I only needed paracetamol and could walk quite well. After the exercises it became worse and has got steadily worse ever since. I cannot walk far because of pain in leg. The GP has left me to get on on my own. No mention of physio or other options such as injections. Would be good if he had explained what the MRI found.. Are you able to walk OK. Can’t believe this has happened so quickly.
No, my problem is in my lower back. I did have a neck problem before that, just a pulled muscle. Although having had no x-ray there could be problems there, but it is the lower back that is the problem.
I have had a couple of bad flares, the last one was during a lockdown so I couldn't be seen. I couldn't walk, and I couldn't lift my leg. By the time I managed to get an MRI the flare was long gone. The rheumatologist said nothing other than the spondylolisthesis which was when I got the x-ray report from the previous rheumatologist to realise that he knew about it but didn't tell me. It would have been useful for my GP and myself to have known this when I had a flare!
I saw a physio as well and he thought I had osteoarthritis in my hips but there was no sign of that on the x-ray or MRI.
I too have been left to get on with it. I have good weeks and bad weeks. I am on a bad week right now where I have constant pain in my hip. I know that soon it will stop for a while, then come back. The two really bad flares that I had where I wasn't able to walk passed luckily. Hot water bottles, three of them, were the only thing that helped.
I found Tom Jesson's information on sciatica really useful for understanding what is going on. Not sure if I have linked to him here yet?
shop.tomjesson.com/blogs/bl...
Hello Alloagirl , I appreciate what you are saying and the reply from Cyberbarn, but to make a patient fully informed takes time and many appointments, even though the information is important to good further treatment and as often happens opinions vary as do treatment ideas. Heres an example I had a knee replacement was sent to Physio who had been told it was my back. He did eventually apologise about not being aware of all the issues after taking a full history. and speaking to my GP . But what interests me is the mention of inflammation in cyberbarns reply. I was given injection treatment for suggested inflammation which still gets mentioned as the cause of the pain, my question would be is there no anti inflammatory solution to reduce the pain rather than strong painkillers that cause many unwanted side effects and mask the level of pain being suffered. Do you like me get the feeling that some of the opinions don't fit the results ? I like cyberbarn have been to private and NHS physio. I have worked for NHS but not as a medic just a meal supplier. I truly hope you soon get it sorted. Agreed do keep moving no matter how little as it reduces the pain. I have multi joint arthritis amongst other things and every time we try something different I get more symptoms so always try to do what you can manage without any further problems with your health. Best wishes for a solution that's good for you.
"my question would be is there no anti inflammatory solution to reduce the pain rather than strong painkillers that cause many unwanted side effects and mask the level of pain being suffered. "
Ibuprofen is an anti-inflammatory, but not everyone can take it. There are stronger anti-inflammatories, some that work on a different part of the immune system, but again, not all people can take them, and they are generally only prescribed by rheumatologists.
And some people can't take codeine, some because it doesn't work very well for them, and some because it works too well. there is a genetic test for this, but no appetite in the NHS for doing that type of testing, to find out which drugs would work best on people.
You are right cyberbarn Ibuprofen is not suitable for all nor is Naproxen. It is mainly Rhuematologists that suggest the type of drugs but many people with other illness cannot take them but there are quite a few herbal things that reduce pain and things we can add to foods i.e ginger & garlic. I get gout if I take codeine , so I am limited to a short injection course or opiods of another kind, we are all different . We have to manage our pain by trial and error and hope the DR doesn't think the cause as gone away forever. But manage we do . Thank you for your reply.
Hi there,
I’m sorry that you’re struggling.
You must keep moving, stretching, doing yoga, physio exercises etc as the pain from muscle spasms will only get worse.
I have extensive cervical & lumbar spinal injuries & have had numerous surgeries including both areas. I have cervical & lumbar radiculopathy & have severe chronic pain affecting the majority of my head & body.
I had emergency lumbar surgery a few years ago for impending cauda equina along with spondylolisthesis affecting 2 vertebrae. Now I am not suggesting that you will have the equina at some point as a result of your forward slipping vertebra/e. I had far more extensive degeneration than I’ve mentioned and needed 9 procedures in total).
You need to gain context from your MRI report/scans for peace of mind and that will only come from a pain specialist, spinal surgeon or neurosurgeon, you could pay privately to see one of them but MAY need a GP referral and you will only obtain one of those on the NHS is if there are red flags indicated too.
Does it end by saying something along the lines of “ abnormal refer to relevant specialist for advice?” . If it doesn’t then these degenerative changes may be in their infancy and we as lay people read a scan report, Google the medical terms & can often become worried at what we then read, context is the word here and we don’t have it as we’re not medics/specialists.
I’ve been injured 20 years and have had 2 rare conditions of the spine that needed surgery after years of causing me bladder symptoms & burning nerve pain (feet), pins & needles (legs,feet) & back ache, etc etc. In another report around 10 years before my cervical MRI reports mentioned I had retrolisthesis, my neurosurgeon never mentioned it & I believe that it has now resolved as it has not been mentioned after subsequent scans.
This can happen, disc prolapses can resolve and such a lot of the regular back pain (none nerve pain) comes from muscle spasms.
I was told once that our spine starts to degenerate from the age of 17 by another neurosurgeon and that some people have scans with lots of deterioration but no symptoms & others have little with lots.
See if your GP can help if you are so minded but not every one has sufficient knowledge to help with the scans.
Why do you not take cocodomol regularly? Are you on any other medication relating to your spine?
Use everything available to you to help with pain, hot baths, cold sprays, Tens machine (fabulous), massage gun (amazing) along with stretching at the very least, it may help release the sciatic nerve & reduce your leg pain.
Depending on how long you’ve been troubled with this, I would try your hardest with the physio when you get your sessions booked, even though it does hurt doing the exercises, you can be releasing pressure on the nerve/s by stretching your lower back & have less pain etc.
Good luck
Mitch.
Hi, I am not the OP but I have the same condition. you asked, "Why do you not take cocodomol regularly? Are you on any other medication relating to your spine?"
The only medication I can take is paracetamol. I can't take anything that contains codeine, and I have had adverse reactions to other anti-inflammatories such as the cox 2 inhibitors and ibuprofen like drugs.
I can't take naproxen either, it gives me headaches and raises my blood pressure.
So I have no medication support for my condition.
I think Mitch may have been answering my post cyberbarn. I too cannot take anti inflammatory drugs. I tried naproxen and was very ill with it. I do try to walk about and managed the supermarket today , the support of the trolly helps. I have the pain when walking or standing. Also pins and needles I do not know how you manage on paracetamol only. It does nothing for me. I am hoping the physio will get in touch soon.
Thank you for your reply. I just want to speak to my GP , he referred me for the MRI , he must understand what the report said. Telling me it was wear and tear in the back and just leaving me with painkillers was not good enough. I found out that I could self refer for physio from my friend, and that an injection of steroid could help from Google. Yes I did look it up but it was a positive experience as it gave what you would expect done to help with the condition. You have had a hard time of it , I know so many are coping with more than me. Also the reason I am careful with cocodamol is that I already suffer with constipation and I do not want to add to that problem. So I only take the 30/500 when it becomes unbearable. Yes once the physio gives me the exercises I will certainly make sure I do them . I do have a tens machine which I used for my OAB. So the setting is for that. Perhaps the physio will help me with that.
Hi there,
Thank you for your reply.
Your GP would be able to help no doubt with the scan & also with your meds. There are others that can help such as Naproxen or Baclofen for muscle spasms along with Amitriptyline if you cannot sleep/stay asleep with the pain. You may not get the full benefit of continued pain relief only taken if your pain relief when at your worst purely because of constipation, there are good laxatives that can help on prescription. I have had to take laxatives constantly throughout the 20 years that I have had spinal injuries, I’m on numerous different meds including the usual ones Naproxen, Baclofen, Gabapentin, Duloxetine etc plus Fentanyl patches (75 mcg) & Oramorph (both 13 years+), Fybogel & Cosmocol help me although I do have the added complications of Ulcerative Colitis and a second auto immune condition.
I’m hoping the meds will help you & that you do not have any referred nerve pain from the vertebra slippage.
Do everything that you can to make your condition as bearable as possible such as meds, stretching, walking when you can etc and if your pain doesn’t settle then you could ask to be considered for referral to a pain clinic, it’s quite tough nowadays getting referred as patient numbers are limited & each case is subject to scrutiny by the pain clinic due to clinical need and often referred back to the GP for them to treat.
Good luck, let us know how you get on.
Kind Regards,
Mitch
Yes I also take laxitives. Have done since taken Solifenacin an OAB med which has been very effective for me but caused constipation. So do not want to be totally ‘bunged up’. I do not have pain at night. Sitting and lying down at the present do not cause pain. Just cannot walk far. Some aching in my back. Just want the physio and see how that goes. Cannot take naproxen was very sick with that. It seems I have pinched nerves but on my left side and the problem is with my right leg and right side. Strange.
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