Slipped disc - does an injection / spinal fusion really solve the problem?

[FionaGFG]

Had back pain on and off for 5 yrs (had a few nasty falls in snow in 20s). 1 Sept 2012 had to call an ambulance as had sciatica, loss of bladder control and pelvic and back pain. Mri in hospital confirmed L4/L5 central prolapsed disc and degenerative disc disease. Also have Coeliac Disease (I like to blame that for my bad genes). Consultant said I would always have instability & should have a spinal fusion. But physio & a stimulating disc injection first. Had a carer for 6weeks to wash and dress me. Couldn't sit at all for 3mths. Improved with physio. Now doing 1:1 pilates & having Physio still. But had back pain flare up. Scary & fed up. Had a cry tonight but told myself to get a grip as overall things have been slowly improving. Am I mad for avoiding the pain of an injection and surgery? I've read spinal fusion is 80% effective & can cause stiffness and problems. There is new work in artificial discs. Not sure if NHS do these. In 30s, no kids. Want to be able to live life properly and wondering how long the ups and downs of this will continue? Any positive stories minus the gory bits? Self employed so none of this is helping my income much. Luckily have a supportive family. But worried it'll come back and be bad again. Relaxation tapes and breathing help a bit. Still on coedine and naproxen for pain & inflammation. Have others found it takes as long to recover?

[Hidden]

Ypu have done very well to get as far as you have, feel proud of yourself!!, xx 1 to 1pliates well done xx, the back pain might be a blip? contact Gp and physio asap, I have heard of people of having spinal fusion frenchay hospital near Bristol 30 miles from me is a centre or at least was of excellence xx

[FionaGFG]

Thanks. I just feel like it has dragged on so long. Altho I didn't see the physio until the end of Oct and she keeps telling me to stop being impatient and be pleased with progress. I guess I'm at the stage where I just want it solved and the flare up and sciatica is a warning that it's still there in the background ready to pounce. As I'm seeing my Physio on thurs I hope she can solve a lot of it through manipulation. My Gp was pretty pants as missed the real reason for my pain for 5 yrs and keep telling me I had CFS. Even I knew I didn't have that! Drs eh... x

[Hidden]

I have L3/4/5 disc compression. Totally repaired by alternative methods. 80% success was not good enough odds for me for surgery, 20% failure is 1:5 people worse off than before they started.

I rarely get any pain in my lumbar now, at worst I get a dull ache if my other physical problems are bad.

The physio gives you exercises to strengthen your core muscles which helps to support the spine from within. I do a bit of pilates now and then to keep it topped up.

It does seem like your not getting anywhere fast with physio and chiro etc, but you will start to notice that you can walk further, sit for longer, might even get to a point of being pain free for a while. But everything you do is doing good in the long run.

I think in all, it took a couple of months to sort my lumbar, (thats when I noticed it was not hurting and I had more movement - could touch toes - never ever done that before my back problems!). It was treated as part of other injuries and traumas which are still ongoing.

As a rule, I was told to expect the recovery period to equal the injury period when using alternative methods. This is because the muscles have been used to being in an abnormal position and this has become the new default. So when you are treated and the muscles are moved to the correct place, the brain thinks its wrong and tries to return them. This is why its so painful. But over time the brain accepts the new default. Just like in orthodentistry, the teeth are moved a fraction at a time until they are all aligned.

Its quite liberating being in control of your recovery. And you don't have to do it all at once. Understanding the pain and why its happening does make it less scary and you soon learn to read your pain and know which is good or bad.

Its not easy living with pain, but it has slowed me down, made me think whats important in my life, and allowed me to explore and discover talents I never knew I had. I've had my pain for 11 years and I'm at the point where I say, I've got pain, so what. It doesn't stop me doing things (might make it harder, slower or need more planning) I know what the pay off is if I over do it, but sometimes its a nice excuse to laze about doing nothing in particuilar, recharging the batteries.

I plan my day to include varied activities and functional exercises with rest periods. Once you get used to living like this and having lots of things half done, it can become more productive than normal. My pain loves routine (I hate routine) and now Spring is here, I can add gardening to my activities. I'm lucky that I work from home and slot this into my activity schedule too and it has become part of my therapy regime.

[Hidden in reply to Hidden]

I'm inspired by your words. I have disk bulge also. My pain is really horrible and take 2 different meds and a 24 hour pain patch. I did go to a physio but he actually pushed onto my spine and hurt me! (not even in the place that is in pain) My doctor has sent me to another hospital. Waiting to see what happens. Thanks for the +!

[Hidden in reply to Hidden]

Yes unfortunately the side effects of physio is more pain, but if you can work through it, it will turn around to much less pain for longer periods of time. They rarely work where the pain is to begin with as they break down all the compensation pain first. It's a long process, and alot depends on how your body reacts (wants to return to the muscle in spasm that is being broken down).

There were times of unimaginable pain, so much that I used to stick my hand in boling water to give my brain a different pain sensation. As each compensation pain was released a new set of reactions occurred. Nerves were released and were quite violent in their waking up - legs jumping when lying down - at least a foot off the bed. Headaches like the head was being crushed. It really was a dark time. But as the physio broke my body down, I built it up with exercise and being careful. Now its all fairly automatic - I prepare my body if I know I'm going to over do it and I have a cool down routine I do as well.

At the time, with 2 young children to look after, more pain was preferable to the fog and altered reality that the pain killers gave me.

Everyone has to do whats right for them, I can only tell my story and the more you hear about other people and their ways the better informed everyone is. Having come through this I do believe it was the best way for me at the time, despite all the extra pain, and how long it's taken to get to a reasonably stable and active life. It's an ongoing method and will have to be tweaked as I age.

I think now 13 years on I'm in a better place than I would be if I had taken painkillers. I have treated the actual problems causing the pain and reduced it. The original injury has been repaired - Ijust wish the pain mechanism would switch off! Painkillers just mask the pain, and the problem continues to worsen in the background.

Hope your new hospital can help.

[Hidden]

Hello

I can understand where you are coming from with regards to spinal injections through pain, if you are talking about spinal fusion, the operation I would be a little concerned.

Somehow I understand you are late in life if that is the case you will need and think if the risks support the possible benefit of this heroic operation.

I have disks 2/3/4 and further problems in the lumber regions also, I would worry that it went pear shaped and would restrict me more in the future, if I was younger, possibly I am 63 this year.and am getting problems with Osteo in knees and anckles now and would consider replacement for those joints but fusion it would worry me. Although it will be the hospital that would advise and possibly I would go with that

All the best

BOB

[chanisse in reply to Hidden]

I had the fusion 3 years ago and im still not right I wouldn't recommend it at all

[Boozybird]

Have the injection. Its not pleasant but it will give you stability and hence less pain which will give you more confidence and hence less pain. You are in a vicious circle where you will need to work hard to control your emotional responses (I know - the hardest part when in unrelenting pain worrying about the future!!!!). Nothing is clear cut about back pain. Ive met people for whom surgery was super successful and others for whom it was a disaster. I'm somewhere in the middle. Had surgery - L4 disc decompression not a fusion. Not really sucessful but not terrible either but wished I'd had the opportunity for bi-lateral steroid injections into the foraminal spaces with local anaesthetic first! You need to have a few and the effects build up over time. It made a big difference to me in terms of function. Try different anti-inflamatories - they are not all the same. I take meloxicam - naproxen didnt work for me. I don't know how these wil affect your CD - unfortunately GPs don't seem to be very good at working on the whole person so you may need to find someone who can help support your nutritional state? Be careful with pilates - too much core stability work can actually make sick discs worse so be sure to balance this with the breath work and back stretches. If your physio loses interest or does more talking than physical stuff consider finding a sarah key physio in your area. They are much more hands on and sometimes you need this to restore muscle function. bloated facets joints around the discs are potent sources of pain in themselves so massage is good too. People do recover from back pain but fear and worry are things that will hold you back. Accept your journey through this may have twists and turns but that you are young and you will find a succesful way to manage this problem. Hope this helps.

Best wishes,

x

[Hidden]

Hello fiona

Medications and injections seem to be the easy way around this. Steriods may be prescribed if you are having flare ups, these will only be for short periods.

Medications for your problem may take a while,many may need to be tried before the right one is found, as with many medication types. Again Tens may be a good bet. You will learn how to do nerve blocks that may help your condition, we should always try the simple before anything else more heroic be tried. Try and keep things simple the professionals will keep you right with regards to this. They will look at QWALIES in treatments that they offer you.

I think I have spelling right here, This sets,cost, benefit and time in a given operations if this does not match will prefer not to give that treatment, only if this is urgent. will they continue with this pathway

All the best

BOB

[skanty]

Hi Zanna

Hats off to you. u are dealing bravely with your problems. Back problem is with me too. i have problem in all the discs of my spine. Lumber too and cervical too. Read your comments and it gives encouragement to people suffering from health problems.

[FionaGFG]

Thanks Guys all good advice. I guess I didn't ever expect to be in this position in my 30s. If only I'd had a crystal ball eh. I'm sure the Coeliac has caused the degenerative disc disease in my faulty disc. And when I get glutened (which is rare and annoying) that buggers up the front stomach muscles that should support my back so I get doubly annoyed. Which of course is no good for the nervous system or muscles.

Luckily my physio is v good and I trust her a lot. I guess I wanted a an honest response from anyone who'd had fusion and how long it all takes. You've all offered good positive sound advice. I know there's people worse off that me but sometimes things just piss you off don't they?! Today at least there's been another small improvement. And until this week I was progressing well be being able to sit for up to 2 hrs and walking 10,000 steps a day with my pedometer. I'm lucky that I work from home and I can get up every 20 mins and stretch without any co-workers giving me mad looks. I had read about the 80% success rate of fusion and how it causes problems inc extra strain on the other discs and stiffness. Not sure I fancy the op let alone those side effects. I'll have a good chat with the Physio tmrw. She's pretty straight talking and practical. Burst into tears many a time updating her on progress. She must think I'm nuts. Thanks all - give me hope. And I've already been through so many twists and turns I know I can't give up now ; )

[talgarth]

Spinal Fusion & Facet injections! I can only describe my own experience, my apoligies if it's not what you are hoping too hear. Following much back pain it was decided I would benefit from a L5/S1 fusion, this was performed 15 years ago, by the way, please DON'T listen to the suggested success rates and do your own thorough research, you may well be startled by the reality. Having been admitted on no less than 15 occassions for facet joint injections, all I can confirm is, sometimes you will gain pain relief for a time, the same goes for denervation (RF). In my particular case the fusion was only partially successful, that is , fusion took place on 1 side but not the other, this has resulted in far greater pain than pre-fusion. I've adhered to all the recommended treatments, 5 years of physio, 4 week inpatient intensive pain management course (which was of some help in coping strategies), I won't bore you with the 'alternative treatments' I've tried. You will, I hope, consider 'fusion' as a last resort.

[kebsa]

i am 51, i have been wheelchair dependent for about 15 yrs as i am an amputee, i have chronic pain syndrome and i also have MS. about 5 yrs ago i fel and landed hard on my butt resulting in 2 crushed lumbar vertabrae, i have a moderate spinal stenosis and bulging discs and nerve impingement. this has resulted in severe pain.

thankfully i was alreay under the care of a very good pain unit, I had a vertabraplasty in which they inject bone cement to fix the fractures to help reduce the pain and i have had facet joint injections a a few occassions now with varying results- the inital one was very effective but none since have been as good, none have made it worse but the last one di no good. They are going to have a noter try soon as a diagnostic test to help pin down the exact source of the worst of my pain.

they would not be quick to offer spinal fusion to me for medical reasons but i would be hesitant anyway- my inital problems were with a foot injury and i had one joint below the ankel fused but while that helped for a while it puts additional stress on the joints above and below- for me with my foot i had eventually had all the joints of my foot and ankle fused and it was agony! hence the amputation! now with the spina there is a thing called failed back syndrome where people who have had spinal fusion end up with either no l asting relief or worsening symptoms this is because when they fuse one level- the levels above and below take the strain- the spine is not designed to work like that. there are new procedures being developed where they replace the damaged disc with a replacement without fusion and i believe thes would be more likely to give lasting results.

if they offer surgery, make sure you ask lots of questions and do you homework before making a decision

[sharonb45]

Hi,I am new to this so im sorry for late reply,reading your story was like looking at myself six years ago,i went to work one day and i have never been the same since.I was taken into hospital with such bad burning down my left leg,foot pain in back and loss of bladder control.After an MRI scan they fond a huge disc prolapes and operated after a few days,this was left too long and has caused me so much damage that if treated staight way would not be there now.i had 3 microdisectomies (soz for spelling) i was sent to LGI for a fusion op,it has helped a little but its like i said i was left too long before been treated.You seem to be doing well tho but if your anything like me you put on a brave face.Its taken a long time to come to terms with how i am now nd the only advice i can give is dont let your doctor put you on morphine patches cos im now adicted and iv got no support to try to get me off them and sometimes to side effects of them are worse than the pain!!! good lck with whatever you decide to do.x

[Saltydog]

I too have had sciatica for several years. It got much worse after radiation therapy for prostate cancer. I couldn't walk more than a block. We hiked every weekend 10-15 k.

Anyway it appeared I develop leaky gut, which increases inflammation. My GI system was a mess-IB symptoms. I tried various diets for the GI and an assortment of meds and physio for the sciatica, inversion table, nubax, back brace, stretches, all useless.

My brother, the paleo runner, said to try Gluten Free to fix GI. I cut out bread and wheat and beer and GI improved. Amazingly my sciatica symptoms were greatly reduced.

My MRI does show issues in L4-5, bulging disc, stenosis, enlarged ligament in back pinching the main nerve, and arthritis at nerve routes, but back specialist says they go by the pain not the imaging.

Sounds like you have a similar inflammation problem cause by leaky gut. That causes general inflammation also inflames your spinal nerve(s) causing the sciatica. So try a month with no gluten (no food containing wheat, barley or rye). Your gut should start healing. Read up about leaky gut. Forget BRAT diet. You just have bad inflammation that's causing you a lot of problems.

Eat whole foods you prepare yourself, not processed. Fat is good carbs are bad.

Lots of omega 3, fish or oil, eggs and meat, rice pasta.

I can now hike like before, (snow shoed 15 k yesterday). I need no meds. Not bad for a senior citizen.

[solx]

Cbd oil helps my Neuro pain.

[bentleyfoxer]

I have an artificial disc in my nexk which was done in Germany. I can say that spinal fusion is not a good move as while it may relieve things in the short term eventually it puts a lot of strain on the joints above and below leading to further problems. So disc replacement is done in the UK and on the NHS too I think. But your age isn against you as they have a thirty year life span and therefore the older you are ( I was 58) the better. consequently I doubt they would carry out a disc replacement on you. However I would enquire about it as techniques improve all the time. Good luck you seem to be doing all the right things anyway

[Emieanne]

Hi Fiona,

Sounds like a hellish journey. I hope that things have improved for you since this post? I came across this post as I have similar disc probs + spondylosis. Had a great physio when I was living abroad, now back in UK and I notice you are possibly in the Bristol area (?) If so, could you recommend your physio? I also find Pilates so helpful and it would be so great to get a physio recommendation from someone with similar issues. Thanks for your help and sharing your story.

[mutterley1]

Hi GPG. Sorry your in the ever growing club of knackered backs. I speak from 30 years of one back thing after another and some outcomes I had not planned on. I believe, and my mother was 'in the business' also that a slipped/herniated or otherwise out of place disc is surgically dealt with by a 'decompression'. This is the most basic surgery for discs BUT as with all surgery has risks- minimal- but nevertheless I have to state the obvious. Suffice to say I have 4 L discs fused after becoming unconscious just b4 going to my mums funeral. Woke up in ICI and had no idea what had been going on. A Consultant turned up after 72 hours, told me about the fusion and let me out 10 days later after showing I could get up 3 stairs !!

I 'understand' that fusion is a serious and final procedure to fix a number of things. What things and are there negatives. In my case I do not know what would have been optional other than fusion. If there was I would probably have taken it. My personal fusion result involved an end result whereby I cannot stand up straight- totally impossible so I lean forward from the waist, sort of looking more at the floor than straight ahead. Notwithstanding my ego refused to let me walk anywhere that highlighted my 'quasimmodo' impression so hanging on a Sainsbury trolley- no one looks or notices. Taking my best pal dog Mutterley (friend of Dick Dastardly) and leaning over and with a flopping left foot put massive strain on my left knee turning it to dust in 12 months so new knee fitted- perfect problem free. Walking now placed strain on my right knee despite using a quality pair of 'ski poles' so now thats turned to dust and hoping to get a new one b4 Xmas . I agree that once the back gets a problem it can sometimes the start without an end in sight BUT I would try & seek a 2nd opinion because rushing into FUSION is a BIG decision and I have regular contact with family, friends, ex employees etc and there is not a single person having had fusion has wished they had not. I have had just about everything going and discs require a basic surgical procedure 'compression' 9/10 patients having no side effects unlike the tablets we all seem to be addicted to - personally speaking. Our daughter has lived & worked in Naples, Florida and my wife and our 'mutual mummy- mine is in the great operating theatre in the sky- and there was a chance for me to talk to her Company Medical Scheme people (they have 90,000 employees !). They talked about ongoing work for replacement discs with the final hurdle being longevity of such a disc. They also have a COFLEX and I DID get one of those in Hampshire- its like a spring that fits between the bones and it has been GREAT. Any back procedure or MRI should highlight whatever and however many issues me/you have but it seems quite common for there to be genetic/inherited/bad luck creating ongoing degenerative disease- I also had that advised 20 years ago yet even tho I have had lots of surgery none of it has been because of that -touch wood. I think all of us with a variety of issues- I have had surgery for STENOSIS FIVE TIMES but in different places- hospital for me became like a caravan not near the coast & with a leaky roof YET I know that aside from the one yet serious blunder I have only got praise for the delicate work we get from our surgeons AND things have come a long way until now with options and I think you need to get a hold of those options so you are able to make a decision that you feel happiest with. I am sorry this quick reply is now a small book but it would be irresponsible to reply without some genuine real life 'history'. I look back on my career as an NHS patient and, food and cost of watching TV aside- it has all been good and my floppy rotated left foot was manageable by wearing Dr Marten boots- I have become a collector with 20 pairs but the support and the sole is cushioned. If I personally could change any single thing that has involved my spine and surgery it would be to NOT HAVE HAD FUSION. You have it right when you mention stiffness as for me it is an overbearing mental weight. I had no option as I was unconscious and spent 3 days induced coma so I never got to choose. Certainly it can contain disc problems because you dont have any with fusion. My MRI shows screws, nuts and metal rods so it is NEVER going to bend and the greater the fusion the greater the risk of being left with an unnatural posture which brings, as I mentioned, its own problems. I have come to believe, after many years, that we all want to get fixed, off dodgy tablets and never have to luck back - and I dont know you but I wish that scenario for you as you are young with so many things to do. If it helps, even men have to do pelvic floor exercise with/without a physio BUT I do believe, and wish I had believed it sooner, that anything that stretches the body and is directed gently at the spine & hips is an absolute must. nothing like that will prevent degenerative problems but it will keep them at bay, help the nerves from being constricted and that, to me, is the number 1 priority. Stenosis is where the holes the nerves go through get squished- same pain, same everything but quite easily surgically fixed & I had 3 ops about 12 years ago & never had a stenosis problem again BUT we can never be sure of what, if anything, will come next. I will stop boring you with a final positive comment. 2 weeks ago I was in theatre to have 6 big needles stuffed into the FACET JOINTS of my spine. Never felt a thing as asleep for only an hour. Didnt hurt then and doesen't hurt now. These are the latest and most successful on a long road to get them to do whatever it is they do. I was trialled with them 10 times 2004-5 and whilst they didn't bother me they didn't help me but thats was trials are fr and why I support them. PLEASE PLEASE dont cry, at least not by yourself. I get p....d off nearly every day but I have found that mind over matter ncluding yoga, reflexology (my wife is a Reflexologist) and her beliefs are in the proof- I have had the proof many times but what is broken stays broken until its fixed. Your tablets are very basic and codeine is not the latest in medicines AND in the USA is still the subject of trillion $ class actions due to addiction yet any medicine synthetic of made by bumble bees & earwigs for serious pain which back sufferers DO have is going to have a downside. I have the years of positive & negatives & my final 2 comments :- (1) if nerve pain is a main problem your GP is not doing his/her job. GABAPENTIN is used for epilepsy and similar but its super benefit iis milder addiction over time AND it works for 9/10 people- might take 14 days to get going but its a definite MUST & (2) you are too young to get fusion unless it is the very very last option which I cannot imagine it is. Look into your medication & especially GABAPENTIN. Keep going with the physio and the yoga (especially the yoga) & keep the mind positive. David x