Resolved question:
I am a 31 year-old female in otherwise good health. I have 2 children. I also have extreme back pain. I’ve had some mild-moderate pain for the past 10 or so years, and have been seeing a chiropractor with some success. However, in the past nine months, the lower back pain has morphed into something else. I went to the doctor, who did an xray. Nothing came up except moderate disk space narrowing in the lumbar region. So she assumed it was muscle spasms. I was very frustrated as I know myself, and knew those weren’t muscle spasms. Although reluctant she agreed to do an MRI. Anyway, it came back, and shows some issues.
Before I recopy the results, I want to describe the type of pain I’ve been having. It mostly happens at night. I wake up with severe, stabbing pains in my low back which radiates outwards towards the hips whenever I move at night (which is dozens of times). And in the mornings, I have trouble getting out of bed and getting dressed as I am in so much pain and also so stiff. Things get a bit better during the day, except that those stabbing pains return when I stand from sitting, walk on uneven ground, or, for example, try to put the baby in his crib. Needless to say, it’s making child-rearing difficult and much less enjoyable than it should be! Also, during the day, and in the evenings when I first get into bed, I have moderate-severe pain in my mid-back. That type of pain is more dull and somewhat feels like muscular pain. That one is constant throughout the day.
Anyway, after getting the results, the doctor agreed to let me see an orthopedic specialist. However, I live in Canada. That means to get any kind of specialist appointment takes months. My appointment is a 5 month-wait. In the meantime, she’s given me T3s, but they give me horrible insomnia and don’t last through the night. I don’t know if my problem can get better on its own over time, and/or what to expect at the specialists. All I know is that the pain is getting worse and more frequent, and that it’s making life difficult. I’d love to be able to play on the floor with my kids! (among other things!)
Of note, I have seen a chiropractor for years. I’ve also been doing physio for months. They referred me to an osteopath. He’s helped me, but the relief is always short-lived. Does anyone know what the specialist might be able to do for me? Please give me hope! I’m terrified he’ll look at my MRI results and tell me it’s just something I’ll have to live with. In Canada, the medical field tends to focus only on the most serious cases as resources are limited. Others can be brushed aside. I’ve also noticed some reverse ageism going on… The doctor was reluctant to even give me pain meds because ‘I was so young’ and was worried I’d get addicted. She’s also told me I shouldn’t consider surgery as the risks were too high for someone as young as me.
Ok, so firstly, there is a small central disc herniation at T6. Also, almost all of my discs C, T, and L are bulging. The big one is as follows:
“At the level of L4-5, there is at least mid desiccation of the disk. There is moderate to significant loss of disk height. There are degenerative changes of the endplates. There is a small circumferential disk osteophyte carp lex. A superimposed small central disk bulge is seen. There is mild narrowing of the caliber of the spinal canal. There are mild facet joint degenerative changes bilaterally. There is mild to moderate bilateral neural foraminal narrowing. L4 nerve roots exit cleanly bilaterally”.
What worries me is that this says the nerve roots are fine. In my limited knowledge on such things, wouldn’t that mean that despite the foraminal narrowing, that the nerves are fine and are NOT causing my pain? I am worried the specialist will not clue in to the fact that the pain occurs during movement, not while lying still on an MRI table. Which to me means that the nerves do get pinched, but it just doesn’t show up on an MRI…
Please help! I just want to feel like a 31-year-old again.
Thanks in advance ?
Submitted:
4 Days
Category:
Orthopedic Surgeon
Hello,
Thank you for choosing DoctorSpring. Apologies for the delay in the reply. I was waiting for my colleague Rheumatologist's opinion in your case and hence the delay. Before we take this up further would you mind answering few questions for me ?
1. Do you have pain elsewhere ? Like knees, small joints of fingers etc ?
2. You have mentioned that there is some amount stiffness in the morning. Is it only in the back ? Or is it a general stiffness. How long does this stiffens last ? 30 mins / 1 hour?
3. When you cough or sneeze do you get the shooting pain ?
4. Does any one in your immediate family has these symptoms ?
I will give my comprehensive consult reply once I update the answer.
Thanks. Apologies again for the delay
Regards
Thank you for your response... to answer your questions:
1) For the most part, no pain elsewhere. It's all in my back. Sometimes in my neck area. Frequently in the thoracic area (the dull, unending pain), and the lower back (the stabbing pains at night and randomly during the day and stiffness in the mornings).
2) The stiffness is confined to the back. It usually lasts for an hour or so after getting out of bed. And there is stiffness again when I get up from sitting, which leads to stabbing pain if I so much as move my back while getting up (I have to get up without moving and with my butt sticking out and bending forward).
3) I do get the pain when I cough or sneeze, but not always. Only when I'm having the stiffness.
4) My father is in horrible pain most of the time, but he used to be a paratrooper and wrecked his body doing that. There is probably no connection to my problem as his was acquired.
Of note, I did get tested for rheumatoid arthritis, and the results came back negative. (rheumatoid factor 11, C reactive protein 1).
I could also add that standing for long periods of time is also excruciating. I end up having to lean on something and putting a foot up on a stool to get any relief.
Thanks again!
3)
Hello,
Thanks for your answers
From your symptoms and MRI report, it appears to me that you are having some degenerative changes in your disc at the level of L4-L5. You may also have mild narrowing of spinal canal which is not a cause of major concern though. Desiccation of disc is due to loss of water content which reduces it's shock absorbing capacity. This happens due to repetitive stress and trauma to the spine.
I want to assure you that your problems can be managed by conservative measures like mile pain killer medications like tramadol and paracetamol, avoiding stressful postures, physical therapy with the help of physiotherapist, he may help you finding ways to position your spine in greatest comfort during sleep and resting and correct posturing and exercises, adequate rest and application of heat may help.
In short, Please consult a physiotherapist who can give you a plan to work on.
I hope it was useful
Fell free to discuss further
Regards
I have bee seeing a physiotherapist and osteopath since early January an neither have been able to help me. I should probably note that it is severe pain and leads me to sometimes only sleep about 2 hours at night. I don't complain easily either... I've had kidney stones and natural child birth. I know what real pain is and this back pain is among those... No conservative measures have helped and I am desperate to stop feeling like an 80 year old. And there's the herniated disc as well... Sounds like you also feel it's just something I'll have to learn to live with? (Even though I've tried all conservative measures and they've failed). Could it be the foraminal stenosis that is compressin the nerves when I move?
I have bee seeing a physiotherapist and osteopath since early January an neither have been able to help me. I should probably note that it is severe pain and leads me to sometimes only sleep about 2 hours at night. I don't complain easily either... I've had kidney stones and natural child birth. I know what real pain is and this back pain is among those... No conservative measures have helped and I am desperate to stop feeling like an 80 year old. And there's the herniated disc as well... Sounds like you also feel it's just something I'll have to learn to live with? (Even though I've tried all conservative measures and they've failed). Could it be the foraminal stenosis that is compressing the nerves when I move?
Hello,
Thanks for getting back
I feel sorry for the pain you are going through. Your pain might be due to osteophyte complex. In such unresponsive cases, a spinal surgeon may try ESI (epidural steroid injections) which may help relieve the symptoms. An other option is surgery; a surgeon can decide about it after a thorough physical examination and your physical fitness.
Hope it helps
Regards