Resolved question:
I am to the point that I need to start looking at back surgery. It is workers comp, so I don't know if the Doc has my best interest in mind or not.
Firstly I am a cop. I got injured when taking down a bad guy. I took a hard fall into concrete from about 4-5 feet up. Initially I thought the pain was going to go away, but after 2-3 months I noticed it getting worse. I went to a back doctor and he said there is a hairline fracture in my L5. I did a series of steroids with no reduction in pain. I then did 3 months of physical therapy and it didn't help, but the back back slowly got worse. This doctor said he didn't know what was wrong and have up. I then got a new doctor for my second opinion.
The new doctor ended up giving me 2 shots of cortisone in my lower back. 3 hours later I got T-Boned by a guy in a stolen SUV. I had pain shoot up my back and went to the ER. I followed up with the back doctor who decided to do an epidural injection. Last week I got my third one and no effect. I asked the Doc what the next step was and he said that he didn't want to go to surgery yet because I am 31 and he didn't see any pinched nerves in the MRI. He said to give the third shit a little more time.
My back doesn't hurt when sitting or lying down normally. After standing 30 min-2 hours (depending on having a gun belt on) it starts to hurt. Within 30 min - 1 hour I am in so much pain I am nearly in tears and have to go sit down until the pain goes away some.
I have read and spoken to people who have had such a surgery. They said they were much more stable, but the pain was about the same. Though each if them said that before the surgery they had constant pain.
If I got surgery would the stabilization prevent the pain that comes after standing for lengthy periods of time? Or would it make the pain become constant? I am worried because nothing has worked and the pain is slowly getting worse.
Please give any insight to pros and cons for me getting surgery and if there may be other alternatives before a surgery.
Thank you for your time!
Submitted:
4 Days
Category:
Spine Surgeon
Hello,
Thank you for your query at DoctorSpring.com. I understand what you are going through.
Back surgery is required only if there is a compression of the nerve in the MRI or if there is any spinal instability. Spinal instability can be evaluated from flexion extension X-Rays of the spine.
A hairline fracture of the spinal vertebrae does not need stabilisation. If the fall on the hard concrete or the car crash would have caused spinal instability, then the same should have been seen on the MRI in the form of a wedge compression fracture of more than 50% or spondylolisthesis(forward displacement of vertebra).
In your case, there seems to be no indication for surgery as your doctor appears to have ruled those out those abnormalities.
Your doctor does seem to have your best interests in mind as surgery does not seem to be a good option for you.
However, if the pain is progressively worsening then you might need a repeat MRI/CT to look for progression of the problem.
If this MRI too does not have any major abnormality, then your backache has to be termed as a mechanical backache and should be treated conservatively. Treatment options for this are:
-Bed rest
-Analgesic and muscle relaxants drugs
-Physical therapy and back strengthening exercises
-Spinal epidural steroid injections
-Complementary rehabilitation therapies like Acupuncture etc.
Although it looks like you have tried most of these, I would like to know the details of the analgesics you have been on as well as the specific physical therapy you have received so far. This will help me opine on further management for you as there are plenty of options for both analgesics and physical therapies and if some haven't worked for you, there are always better options.
I hope this was helpful.
Feel free to discuss further.
Thank you.