Never ending back pain

My back pain history all starts about 16 years ago, when I was 16 years old, due to a ski injury. I overshot a very large ski jump and compressed my back horribly. Due to fear of bankrupting my parents, I never got it checked out.
From there on out, it has flared up anywhere from 4 to 10 times a year. Sometimes I can go months feeling great, and out of nowhere, I'd throw my back out by putting my shoes on in the morning, or sneezing, etc..
about 12 weeks ago, I had an episode that was worse than I ever had in my 16 years of dealing with this pain.. I broke down and got an MRI done. The MRI showed that I have 5 bulging discs from L2 and down, with L5 and S1 ruptured with an annular tear.
The pain that I experience radiates severely in my hips and low back. I do not have numbness or tingling down my legs, nor do I have symptoms of foot drop. It is so severe however, that it is completely debilitating and makes it nearly impossible to walk or stand for any period of time. My job requires me to be very active, and I do not want to be on light duty all season..
The last doctor that looked at my images suggested getting a shot, which would require an epidural. I am pretty resistant to getting it because of the fact that it might work, but it might not.. and even then, it might only work for a short period of time.. is there anything that would "fix" it long term?
I have had very poor luck with them to even prescribe me anything to help manage my pain. They have prescribed me Meloxicam and zanaflex, neither of which help with the pain. They do however help me sleep through the night, which is extremely helpful. Most nights I only get a solid 2 hour chunk of sleep before I wake up and have to adjust because of my pain..
Thanks for listening..
Any suggestions?

Post Edited (Codester) : 10/8/2017 6:12:23 PM (GMT-6)

Hello & welcome to the forum. I am not sure what type of dr is treating you, whether its your PCP or a specialist. Regardless, the conservative approach is what any dr will offer including specialists. Skeye gave you a run down on different modalities used along those lines. I too, suggest seeing a board certified neurosurgeon for a consult. There are no quick fixes unfortunately.

Take care.

I just scheduled my appointment for next wednesday. I sure hope this works..
If a shot doesn't work, do people normally try to get another one right away? I've read that you can only get so many shots in a year? do they generally look at your MRI images and choose where to inject based off that information? How do they know where to inject?
I wouldn't say I have a phobia of needles, but I am a little bit apprehensive about this treatment. I've read that it may take 3-5 days for the injection to actually have results.. are there side effects I should be aware of? will it cause more pain initially? does the actual shot hurt?
Sorry for so many questions.. I have gone nearly 16 years dealing with the pain on my own, and I don't see doctors very often.. It's to the point where I can't take it anymore and need to do something..
Thanks for the kind advice

Yes, you can only have so many a year due to the steroids. I don't know the number, but your doctor can tell you. Yes, they usually say that it will take at least 3-5 days for the steroid to start to work, but it can actually take as long as two weeks before you see any effects from the shot. If the first one did not help, or only helped partially or briefly, my doctor recommended doing a second. If the second did not work, then he stopped. Although I have heard that some doctor automatically recommend a series of 3... My doctor liked to at least talk to the patient 2 wks after each injection, and ideally see them in the office. As for how far apart the injections are, I had 2 epidurals done at 2 different levels & I think mine ended up being done about 2 months apart (although I got no relief from the first ones at all), but that was mostly because legistically, that was what I could do. But I believe you can repeat it as soon as two or three weeks after the first one.

Side effects are generally transient, and are typical of those of any steroids: flushing of the face, chest, felling hot, increased hunger or thirst, and insomnia. I experienced some flushing & heat for a few days, but that was all.

Definitely bring your MRI images & report with you with you, if you have them on a disc (if not, you might want to call the hospital or facility where you had your MRI and request a disc), as that will be how the doctor determines what level(s) to inject, and what approach to use. Then they use fluoroscopy (real-time X-ray) when they do the injection to make sure that they are at the right level/location.

The epidural is painful in that it is an injection, but it isn't too bad. Actually, you will really only feel the injection of local anesthetic (which burns fairly intensely, but briefly). After that, you should only feel pressure, and maybe some mild pain/tingling down your leg as the doctor injects the steroid. They usually talk you through the whole process. And yes, sometimes your pain can be a bit worse for the first 24 hrs or so (that happened to me with my first epidurals), but sometimes it also gets temporarily better for a few hours due to the local anesthetic, and then goes back to the way it was, or feels a little worse once that wears off, but before the steroid kicks in.

As for whether or not you can drive after, I would call the doctor's office ahead of time and ask. If they use any sedation, you will likely not be allowed to drive home. However, it seems that most docs don't use sedation for lumbar injections these days. However, you still may not be allowed to drive, as the injections can temporarily make your leg(s) feel weak. I was still always required to have a driver, even though my doc did not use sedation. You might also want to ask about whether or not you can eat or drink before the procedure. If your doc does not use sedation, it likely won't matter, but if he does use or offer it, then you will likely have to stop eating and drinking several hours before the procedure.

I think that answered all your questions...

Skeye

Well after all these years, I finally got my first epidural steroid injection yesterday. The actual procedure wasn't nearly as bad as I thought it would be. They gave me the injection between L5 and S1 and it took maybe 20 minutes total. The anesthetic shots were the worst, and even then they were just a mild sting.
The side effects I felt was a sort of crampy, achy pain that was localized to the injection site and my lower buttox. I felt mildly nauseous at night, but it may have been a weird combination of food I ate. And I had very bad insomnia, where I layed in bed all night, but I was practically awake the whole time. The pain got pretty intense at bedtime and I took 600mg of advil. It was hard to get comfortable, but my 3am, the pain diminished and I fell into a light sleep.

Today, I feel like it may have helped moderately. The pain is still there, but it is a different kind of pain. Hopefully as the week progresses it will feel better and better, but at this point in time, I have to say I feel better than I did before the shot.

Thanks for the encouragement! And for those out there considering this option, it is nothing to be afraid of trying.

Follow up of the treatment 12 days later:
I felt like the pain for the first 3 days after my shot was getting better. The pain wasn't completely gone, but it felt "different". Now, 12 days later, it feels as though I am back to square one.. The pain is almost always constant, and I especially feel it when I bend over or sit.. No pain down my legs, but excruciating pain that radiates all in my hips and lower buttox.. I'm looking for a physical therapist that's local, and now I need to schedule a follow up with my doctor to see what the next plan is..

No problem new member.. I am new too. Keep posting..

Don't give up hope. Not all docs agree. May need to change to different Neurosurgeon. Call Michael Chang in Sac. I did not have any hop till he did my 4 level neck surgery. I am having great results at 2 months post op. Would recommend him to anyone. I am 67 had no hope before him !

Codestar, even though you have multiple levels of bulging discs, that does not mean you are a candidate for surgery. I applaud your dr for his honesty. A good surgeon would have done as your dr did. Without cord involvement & nerves being compressed, appreciate his honesty. By all means do what he has suggested to strengthen your core muscles, that is very important for people with back issues.

Look at the age of your mattress on your bed. If it is several years old, replace it. If you don't have the funds to do so right now, put a thin sheet of plywood between the mattress & box springs to firm it up. Look at your shoes that you wear. Invest in good shoes & try to have 2 pair to switch out every other day. I need a lot of support & spend a fair amount for my Brooks tennis shoes. Never thought in my wildest I would ever spend this kind of money for shoes, it makes a difference.

Now about the Gabapentin, go to Drugs.com & check out the interaction with medications. It gives a detailed list. I use Tylenol PM, without Tylenol in it, its called Sleep Time. I went from sleeping 2 hours a night to 8. A friend of mine was on sleeping pills for 13 yrs & her dr cut her off cold turkey. She uses this all the time. If you are a side sleeper, put a pillow between your knees, it takes pressure off of the back. In the mornings when you get up, do gentle stretches, I have to do this several times a day. You have to keep moving your body, its tough don't get me wrong.

Keep asking questions, we will try to help all we can. Take care.