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L5-S1 disc bulge question

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Posted 11/20/2013 5:03 AM (GMT 0)
I am a 33 year old female suffering from back pain and had a couple of questions. A bit of history, back in July my lower back started hurting on the left side and after ignoring as sleeping incorrectly for a couple of days I went in to see my dr. After ruling out things (and giving me a two back to back prescriptions for a Medrol dose pac) he then ordering an MRI. The MRI showed "There is a mild loss of disc space height at L5-S1. There is an asymmetric disc bulge to the left with mild facet joint hypertrophy resulting in left neural foramen and left lateral recess stenosis."

The dr. recommended physical therapy. At this point my pain was mild..not as bad as it was when I first went to the doc. I went twice a week for about 6 weeks or so and then I was doing ok. I had pain when I bent etc but it was very mild and annoying. I just stopped going to therapy. Then last week my pain returned with a vengeance. The pain started radiating all the way down to my leg - almost numbing my leg, with tingling sensation etc. My back also aches but the leg pain seems worse than the back pain. I cannot walk properly because of all the pain. As long as I am sitting I am ok. It is when I stand the pain is returning. I went to dr. again last Thursday and he gave me another Medrol dosepak and I am on day 4 of taking it without any relief. When I went on Thursday dr. said if the pain does not go away then he recommends a cortisone injection. Yesterday, Monday I went to the dr. again because my pain did not go away and he had the anesthesologist schedule me for a cortisone injection on Thursday. They are going to use 40 mg of Kenalog. In my mind I was prepared for this injection until I Googled about this and came up on a Dr. Oz video where they are talking about how Epidural Steriod Injections are not that good. I am freaking out about that. In another interesting turn of events I noticed that my pain this evening is NOT as bad as it was this morning when I am up except that the numbness in my feet is still there. It is mainly in my big toe and the top of my feet. This makes me wonder if I am getting better on my own and if my numbness will also go away?? Just at a cross roads with this and wondered if I can get any input from anyone..sorry for the novel I just wrote!!

Post Edited (desimom99) : 11/20/2013 8:26:14 AM (GMT-7)

Posted 11/20/2013 7:50 AM (GMT 0)
It varies from person to person on having your disc heal on its own. The radiating pain down your legs means a nerve is now pinched. (Personal experience)
The spinal injections are an off label usage but again for some people they do work. I would get it done and see if it helps. You could have just over done it and your disc swelled up impinging your nerve causing the radiating pain. If that's the case then the injection should help the swelling go down and bring pain relief.


Best of luck and if you have any more questions feel free to ask.

Morgan
Posted 11/20/2013 8:51 AM (GMT 0)
I really feel for you. I am 62 year old female with quite a back history as well. My back surgery occurred when I was 33 also. I was an RN at the time working in ICU and I had a hard time working. I had tried many modalities at that time, finally resulting in back surgery. Well, I would say that the surgery helped. I had L4-5/ S1 stenosis and the foramen was narrowed also. I had a bulging disc. A TENS unit helped me tremendously to "dial out the pain".

After several months of physical therapy, I was able to return to nursing but in only home health. I still have sciatica from time to time, but it comes on, sticks around for a couple of weeks and then it resolves.

My advice to you is to have the injections. They are not a bad thing and could help you quite a bit. Consider surgery as a last resort only and get two or three opinions if you do consider it. Make one of those doctors for an opinion, a neuro-surgeon and not an orthopedic doctor only. Try hard not to get addicted to pain pills if you can. Take your NSAIDs, whatever works best for you and hopefully you can manage this weak spot in your body. Also, a good physical therapist is your friend!

God bless you.

Lindaloo
Posted 11/20/2013 12:13 PM (GMT 0)
Hello and welcome! 1st try to avoid buying everything you read on Google and Dr Oz!!

As for the kind of pain your describing that's most common with disc collapse and stenosis as the nerves get pinched or put in a bind and swelling can aggravate it and cause it to flare! Hence the steroid use. It may bring about relief by reducing the inflammation but can and usually does return shortly after finishing the meds.

As for the injections they're like anyother type of treatment, work for some not for others, how much and how long again is debatable and individualized.

Nothing to lose by having them but possibly a longer period of remission with them.

The majority of us that have sciatica have had several rounds and types of injection series.

Good luck and wishing you success!
Posted 11/20/2013 2:41 PM (GMT 0)
Thank you for all your responses. I think I will keep the injection appt (for tomorrow) and hope and pray for the best. What sucks is that I have a 2 year old and I cannot keep up with her with all this pain. I have no idea if my life will ever be "normal" again or if I always have to deal with this for the rest of my life. This has put a halt to our plans for trying for another baby. I cannot imagine how I would have dealt with this had I been pregnant..but we do want to have another baby at some point..sooner than later...so I am just frustrated ......thanks for listening to me....
Posted 11/20/2013 3:13 PM (GMT 0)
hello desimom and welcome to the forum. been traveling down that road myself for about for alittle over 8 years now. i can relate to the lower back and leg pain. i'm not gonna share my story with ya because i don't want to scare you away. i will say that everyones story/expireances are different. i will say a prayer for ya and that it may find to some good pain relief. though this is a great forum to be on. lots of friendly advise.again welcome and best of luck to ya. keep us posted as we would like to know how your doing...
Posted 11/21/2013 2:01 PM (GMT 0)
So my injection is this afternoon. For all of you this may seem very silly but I am pretty nervous about it all! I hope I start feeling my feet again after the injection. How soon do you generally see results? i.e. how soon do you all think my inflamed nerve will get back into its regular form?
Posted 11/21/2013 2:48 PM (GMT 0)
There is a bit of a roller coaster ride with an injection. Any non- nerve based pain is usually much better right after the injection. This is due to the lidocaine or other local anesthetic which usually lowers pain that is caused by the disc and the surrounding inflammation. That will dissipate in 24 hours, give or take.

At this point, you may have a slight increase in pain levels or they'll be about the same. The steroids will need at least another day or two to start to take effect. Sometimes even as long as five days or more so be patient, it's not a instant sort of thing.

I've had seven to date. The most recent one has been extremely helpful with nerve pain starting in the buttocks and radiating all the way to my foot, causing me to walk with a nasty limp. Took about two weeks but I'm almost pain free in the right leg. The previous shot in the right side gave me about a year and a half of relief.

Good luck and btw, the procedure is not painful. A small sting with the first local injection and from there're just some pressure.
Posted 11/21/2013 3:19 PM (GMT 0)
For me the main symptoms now are 1) pain in my leg when I stand/walk for longer than a few minutes 2) The numbness in my feet...in my big toe and on top of foot towards the big toe.

Both of these symptoms to me sound like they are nerve related so I may not feel any relief immediately...I guess I will have to wait and watch...thanks :)!
Posted 11/21/2013 3:44 PM (GMT 0)
You might find it does get better for a short time, due to the local. Then the pain returns and then much more slowly, have the pain fade over several days.

Everyone is different and it is impossible to say how it will go for you. Be positive and don't overdo things if you are feeling better. No heavy lifting, etc. Let us know how it is working out for you.
Posted 11/21/2013 3:50 PM (GMT 0)
Can you sit and do things or do you have to lay down to rest for 24 hours after the injection? I ask because I like to craft and would like to get some things accomplished for my daughters birthday party :)!.....
Posted 11/21/2013 8:58 PM (GMT 0)
Came back home after the injection. Felt a little numb for about 30 min in my legs but I feel fine now. The pain levels are same as before....will see what the next couple of days brings...
Posted 11/21/2013 11:16 PM (GMT 0)
Welcome to the Forum.Hope the injection helps.

I started with a bulge at L1-S1.Now 12 years later I have 5 bulges.

Try not to do anymore damage.I know that's easier said than done.Stretching and flexibility and core strength are very important.

I learned this after the fact.

Welcome aboard,
Rick
Posted 11/22/2013 12:42 AM (GMT 0)
Tidalmouse,
I went to therapy for 6 weeks and that is pretty much what the therapist told me - how to bend, how to lift, how to stretch and improve my core strength. Doing it there is one thing..coming home and actually practicing it is another. But if there is anything this ordeal has taught me, it is that I NEED to take time out for myself and do it....I was advised not to do anything for the next 2-3 weeks to see how the injection is going to work. I am supposed to go back for a second injection in two weeks time.

I have the exercises that the Physical Therapist gave me but is there other ones that someone can point me to?

Thanks,
Posted 11/22/2013 6:59 AM (GMT 0)
….it can take a good two weeks for the full effect of an epidural to be realized if at all. Many patients get the second one done, and some a third.

I have had several of them, and some worked for a while, and others didn't. Surgery is a last resort of course, and may or may not take care of the pain issue.

Take care,

SE
Posted 11/23/2013 9:27 PM (GMT 0)
Hi desimom99 and Welcome to the Chronic Pain Forum, I read your post yesterday, and wrote a reply and then lost it all! So I thought I would come back today and try again! Often these injections are given in sets of three, usually a couple of weeks apart. They are not always successful in relieving the pain, as it is all dependent on exactly what is causing the pain in the first place!

It sounds like you are having sciatica pain! Often that happens with problems with nerve root impingement at and around the L5 area. Anyway the steroid injections are used to lessen the inflammation process, often when a nerve is pressed upon ( impinged) it becomes inflamed, and that can cause pain, thus the steroid injection. However, if the pressure is bad enough, the pain can continue, and you could also experience numbness and tingling and possibly impaired or loss of reflexes. If you start falling or having difficulties walking or using your leg, then please seek medical care ASAP. Often with problems with ones back you can also experience muscle spasms and charley horses in your affected leg, talk with your doctor if you are having any problems with this. If your problems continue, you might want to see a neurologist or neurosurgeon to get it checked out more thoroughly.

With the symptoms you have described you definitely sound like you have some problems going on, so do be careful on how you lift things and bend over, and do certain movements, be good to yourself, and treat yourself gently for a while. I hope things get better for you!

White Beard
Posted 11/25/2013 4:16 PM (GMT 0)
Thanks White Beard.

Now my symptoms are that I have a headache. Yesterday around the same time, I started getting a headache (and nausea) and I had to literally lie down and take a nap. I woke up after 3 hrs and the headache was gone for the rest of the day. Today its a repeat. Headache, but I am at work now so I cannot lie down. The Dr. who did the shot said headache could be a side effect but he said it generally lasts a while until you lie down. I am now wondering if the headache is related to the shot or not especially because it went away for the rest of the day yesterday.....
Posted 11/25/2013 10:43 PM (GMT 0)
….some sort of exercise and or strengthening of the back muscles are very important to the health of the spine. You must be diligent about it, and often a physical therapist will have you doing these several times a day. Also don't discount the Epidural's as they may provide you some relief. It may even take a second dose to realize optimum results. If your insurance covers it, then by all means consider your Dr's suggestion. Back surgery should always be a very last resort, and there is no guarantee of complete pain relief.

The only thing I would add, is that if possible, ask for sedation. It can make the procedure quite a bit more pleasant.

Good luck!

SE wink
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