Help please....
 

Hi, i stumbled across this forum whilst trying to search online for information.

I have tears in my eyes because I am now getting desperate and don't know where to turn, I am looking at my 11 month old son playing in his crib by himself for the past hour while I lay in pain, desperately wanting to play with him and take him to new places.

I started having back pain three years ago, I had an ultrasound they said I have a prolapsed disc, I then had physio treatment which did not help at all, I was working out in the gym 4/5 days a week and could cope with the pain. Then I fell pregnant and could not get any treatment, then my baby was three months old I saw a new doctor, I went for MRI and was told I have a herniated l5 s1. She sent me for an epidural steroid injection (they did not use X-ray when performing this). This did nothing for the pain whatsoever.
I then had physio treatment for a couple of months twice a week as I started to get new hip pain as well. This did a little for the hip pain but the back pain seems to be worse now.
I saw a specialist neuro and he ordered another better MRI of lumbar and pelvis, result was annular tear l5 s1. Nothing else. He said this is the cause of low back pain, even though I questioned him that the pain is only in my pelvis, around SI joints. He wants me to go for two more epidural steroid injections.

My questions is, is the pain supposed to be leg or back pain from this? I only have very low back pain, feels like constant being stabbed in the back, when I am doing anything??! Please any suggestions, opinions or experience will be much appreciated
Thank you

re pain
 

Hi Km1
I'd go ahead w/the suggestion of the ESIs because they can be done w/fluroscopy or guided now that you're not pregnant and you can be given some sedation before and during and ask the doctor performing it if he can inject the site w/Marcaine afterwards if you're not allergic to the canies (like lidocaine).

It may be a certain approach that would help one better than another. I think I got L5S1 done in two approaches with the one being caudal which was less helpful to me tho still way more helpful than not getting the ESI at all.

I used to have alot of SI joint pain as well tho after a certain number of ESIs that seemed to have gone away.. (I had 10 years worth).

The other thing you can do is consult with a Pain Management doctor and/or see another neurosurgeon or osteopathic spine specialist and see what they recommend.

Really sorry to read that you're having so much pain. I had these problems since I was in my late 20's and just didn't have kids because my reproductive years were filled with too much pain and two spine surgeries which didn't help me and the latter one making me much worse. That's not to say spine surgery can't be helpful tho in my situation what was done the 2nd time made everything much much worse.

take care and welcome to the forum ~ Maria

Hi KM
As you can see from my signiture i have had many back surgeries, also have 4 children. The kids were all born first though.

Recently has been my lumbar journey with spine surgery. After 2 rounds of surgery in the lumbar area this summer/fall, i was still in pain., As you speak of also the lowest level which caused pain to sit down too. So last week i had steroid injections under flouroscopy and they did wonders. I have had many treatments with steroid injections and some are better than others, but so far so good. No more pain at all with sitting down, i can stand up straighter and walking is much improved.
I highly recommend getting the shots by someone who has lots of experience, uses fluoroscopy and anesthesia of some kind. My suregeon hates to see people in pain so he uses an anesthesiologist with general anesthesia.

Write with any more questions. Comments or just frustrations. Welcome.
judy

Sadly, it seems that you can't get evaluated for SI joint dysfunction, piriformis syndrome, or other related maladies by MOST spine surgeons. They like to diagnose and treat spine.

Also sadly, going to someone who specializes in these problems leads to overdiagnosis and treatment. Having said that, I'd try to get to someone who know the other issues well and can PROPERLY rule them in or out.

Where are you located? Search this forum for Dr. John Stark... with all I've done, he's the SI guy I trust.

Mark

Mark,

I am in the bahamas unfortunately, had to go to Miami for MRI even. We are supposed to be leaving here in the next 3-6 months though with any luck, three years long enough.

It's strange I asked that question to the last dr I saw who is pelvis hip specialist he said that nothing shows any problems with SI joints, illiosas muscle or piriformis muscle, my physio though I had SI problems, but when dr flat out says no, what am I to say. The drs here do not want to talk with you and discuss just to talk to you.
Is it possible to have so much pain with an annular tear but not in the legs or below upper butt area?
My physio also told me that normally patients with disc problems have relief bending backwards and not forwards but this is the opposite with me.
I have made an appointment with a chiropractor in two days hoping this might help? I was also reading up maignes syndrome and the symptoms sound exact to mine.
I can't take any meds I am breastfeeding, got a tens machine today, didn't even think of it until now so will be trying that to see if it helps in the meantime.
Thanks so much for taking the time to reply to me

Mark, you say i should see someone who could rule out all other options, who should I be looking for? Thanks so much

Maria and Judy,

Thank you very much for taking the time to reply. I think yes I did not have an effective or proper esi to judge by. It is hard for me taking care of one baby, I don't know how you did it with four! Its not having family and close friends nearby that is the most difficult part, no one to help out if you are having a bad day. I guess the pain could be managed if only I knew for sure what I was dealing with its the uncertainty I do not know how to get around

K1mh,
I had some significant spine and knee pain when the kids were little, but fortunately all in the teen years with my really bad back.I know those little ones just want to be picked up and held at some times.
My family was in Rhode Island and i was in California so the same situation there though. It makes it tough.
Mark is a very smart man and knows his stuff and good people so try as best to take his advice.
Judy

re annular tear
 

Kml1
I've had an annular tear at L3 for a very long time. Probably near 30 years. It has given me terrible pain bilaterally in the hip areas supposedly tho difficult to say as L4 and L5S1 were also bulged and had eventually been operated on and still had probs. The pain that I was told was due to my L3 annular tear however was different than the L4 and L5S1 pain.

None of my pain really has been below my low back except for neuropathies (burning) that I had for many years (episodically before my first spine surgery for 7 years and chronically post my 2nd spine surgery from 1992 to 2003/05).

Continued best wishes with your ongoing search for what will work best to alleviate pain for you and allow you to function well with your family. I know when I've been at my worst I'm literally bedridden due to pain and definately can't even think about lifting anything hardly let alone moving.

Well, if it's on the internet, it must be true!!! Thanks for the kind words Judy. But, instead of 'take my advice', I say, 'take everything I say with a grain of salt... I'm not a doctor, have limited experience and may be completely wrong!' I'm just another source. It is up to the individual patient to gather info, determine the veracity, weigh the value and hopefully make the most informed decision possible.

The SI issue is a huge frustration for me. There are surgeons that I work with frequently and have spent literally hundreds of hours with. Even those surgeons will scoff when I suggest that they seriously try to rule out the SI.

I don't know how you find an SI guy locally. I'm embarrassed when I tell my clients to go see a doctor in Minneapolis when they live in a major metropolitan area, across the country, that probably has a much larger surgeon population than does Minneapolis.

You might want to call around and find out who is experienced with SI procedures... not only surgeons but also pain management doctors. They may do SI ablations. REMEMBER!!!!! you are not looking for a procedure, you are just looking for someone who can rule the SI in or out effectively. If the results are not obvous, don't accept a diagnosis based on wishful thinking. I believe that someone skilled in identifying SI joint dysfunction will be able to manipulate you in a way that mobilizes the SI and will light up your pain.

Remember that the doctors that do the SI ablations may be too quick to diagnose it, but that is why I say you are looking for the diagnosis... not the procedure.

Did childbirth change things? I believe that the purpose of the SI joint is to provide flexibility of the pelvis during childbirth. Chemicals, enzymes, fairy dust or some other substance is released as childbirth nears that softens the ligaments allowing more motion.

Check for a private message from me.

All the best,

Mark

SI joint - excellent read on pelvic blocks
 

You might try your local university teaching hospital for a diagnosis.