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Facet joints and discs!

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Posted 11/20/2013 1:58 PM (GMT 0)
I am afraid when it comes to facet joints and discs I get a bit lost.

As those of you who know me, I had three SI fusion ops in 2012. Since then I have been doing OK, but only just. I was doing well until coming back from holidays in July. On the plane home my back started to spasm and that has been the beginning of yet another problem.

Turns out my disc at L5/SI has slipped inwards and is causing me severe pain. I'm back to spending days in bed again, it just seems to lock and I am struggling to move. I saw my surgeon a few weeks ago, he was struggling to know what to do. He did think I may require surgery but thinks its much too early after all the surgery I had last year. I agree with that, I'm still working with my physiotherapist.

Today I saw my pain consultant. He's willing to try injections, but is not sure if they will work. I did have a injection at L5/SI two months ago but that didn't work. Now he's going to inject L4/5, hoping that he will catch the nerves as the run down, if that makes sense.

I guess my question is, and I apologise if I sound stupid, is how will injecting the facet joints help, if the pain is coming from the disc that has slipped forwards? I'm willing to try anything as I'm losing it a bit. He's also going to refer me to a pain psychologist, i've always resisted that but things have changed so much, I will try anything. I guess it's just like was discussed on another thread, my life will never get back to where I had hoped, and I need to come to terms with that.

Hope you are all doing well. We've just had our first snow of winter, and that sure makes my pain worse, as I'm sure it does for lots of you. Take care.

Jane
Posted 11/20/2013 3:33 PM (GMT 0)
A possibility may be that he's considering even though L5/S1 has slipped forward, the result is that it's tugging on the spaces just above it, so he's hoping to lessen that inflammation.

Just a thought?

M.

Posted 11/20/2013 4:02 PM (GMT 0)
Sounds feasible Merrida, I just can't seem to think straight myself these days! Blaming time of life lol.

How are you holding up honey, I've been thinking of you. Hope you get a phone call soon then you can get plans in place.

Jane
Posted 11/20/2013 4:28 PM (GMT 0)
I had a slipped disk as well, so I can relate.  And it started out with an anterior herniation, blah-beddy-blah...you  know the drill.  So I definitely understand how you're feeling.

I didn't really grasp the concept of what a "slipped disk" really looked like, or was, until I actually saw the XRay my surgeon had taken where I had to extend my back.  Once I actually saw the mechanics of that diagnosis, I understood it a whole lot better.

Me?  Still waiting for that phone call.  The more time that passes, the more anxious I get.  Once that confirmation comes in, I feel I'll be in a stronger place.  It's all this "not understanding" and "not knowing" that's stressful.

Thank you.

M.

Posted 11/20/2013 11:27 PM (GMT 0)
Jane the way it was explained to me by my PM and neurosurgeon, is when they do the epidural injection, they try and get as close to the problem as possible, but the steroid that they inject will spread around, and travel to other areas in the vicinity. If the nerve is being pressed upon or other wise impinged by the disk, the nerve can become inflamed, (thus the steroid injection) it is to counter act the inflammation. The doc says the theory is the inflammation is what is causing the pain, and if the inflammation goes down, so will the pain??? But the problem is, if the nerve is still being impinged upon or there is still severe enough pressure on the nerve, then even if the inflammation goes down or away, you can still have pain.  If the nerve root is pressed so severely that it is compromised, and you lose feeling in the limb it innervates or loss of reflexes then there is a more immediate and serious problem to be addressed. For me these injections rarely gave more than just a few weeks of relief, usually three weeks at best, hardly worth the trouble in getting them! But from what I have been told by my surgeons, they like you to get them, because if you do get some relief, ( no matter how little or brief) it is a very good indicator that, that is where the actual problem is, and by surgically relieving the pressure on that nerve, then then you ought to get relief from your pain.  It makes sense to me, and I have had really good luck with most of my back surgeries, but the problem is the other areas of my back that haven't had surgery keeps getting worse and going bad! Getting old is a real "son of a gun" isn't it! LOL

White Beard

Posted 11/21/2013 1:32 AM (GMT 0)
White Beard

Thank you so much for taking time to answer me. You have helped me a lot.

Unfortunately I'm getting an old hand at back surgeries too! My spinal fusion was a complete success and one of my sacroiliac fusions was too. The other SI joint was fused twice, and I'm still having some pain from that but it has been less than a year and I have been told it can take a long time for the pain to fully subside. It seems like when they fuse something the pressure just gets transferred elsewhere. That's my worry about having more surgery. That, and the fact that my daughter is getting married next year. I need to be able to help with the wedding. I didn't have any back issues until five years ago, and it came on after I broke my lef. Not sure if I injured it in the fall or whether it was all the sitting around and walking oddly in the eight months it took to heal.

I don't have a great history with injections. I've never really had any more than a few days with any. I did have RFA and that was a waste of time. Here they will only do RFA after three positive injections, but they seem to consider anything from a few minutes pain relief a positive result. I think the idea is that this will be diagnostic, and well take it from there.

Thanks again for your help. How are you enjoying your new home? Do you miss your old are? Hope you are settling in well. I've just realized you're now a mod, well done on that. You'll be very good at that, you are very knowledgeable and empathetic. Maybe you've been a mod for a while and I've just realized, I'm not sure, but I'm pleased for you.

Jane

Post Edited (Fusiongirl) : 11/20/2013 6:39:51 PM (GMT-7)

Posted 11/23/2013 1:56 AM (GMT 0)
Thanks for your kind words Jane, I have been a Mod for a little while now.  As for getting settled, I am getting there. It seems it is slow going, just trying to find the things that I have packed up. Some of the things have been packed up and stored for several years now. During my divorce in early 2010 as part of the settlement we sold our house at the lake.  After the house sold I moved into a near by rural town, and rented a house for a few years and left allot of my stuff packed up. Now that I purchased a house down here in Kentucky, I have the room to unpack every thing and put it in its proper place, where ever that is????? Ha. I still have a couple of rooms to go yet but it is slowly all coming together! I have even put up some Christmas decorations outside on my porch. Can't believe it is going to be Thanksgiving this week and the beginning of the Christmas holiday season. This afternoon I went to a live Mannheim Steamroller Christmas concert at the Lexington Opera House, it was fantastic! Really gets you in the holiday mood!

White Beard 

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