Back pain procedure , numbing injections , anybody have this done ?

CRJR45

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I'm 63 , and have already had Laminectomy/Discectomy on my L5 for sciatica . I have degenerative disc disease and a collapsed vertebrae in my mid chest .
I'm still highly mobile and can function without pain most of the time . Any repetitive bending down or lifting and I feel it the next day .
I can't run though , it just kills my lower back . I can walk all day and I'm still strong , for an old guy . But no backpacking or prolonged carrying anything .
I want to get into better shape though , so I talked to a Orthopedic surgeon about my options to correct my issues . He stated that they hardly ever do spine fusion anymore and suggested going to a pain management Dr for injections to numb the nerves .
I hate pain meds , and right now Alleve handles it ok , on my bad days .
So , anybody have any input on this ? I didn't really want the fusion , I was just hoping for another solution . But I don't want to make it worse than it already is , and it seems like if I couldn't feel what's going on in my back I could do more damage and not even know it ?
I go to the pain management Dr the 26th , just hoping to get some insight before hand .
Thanks
 

HeavyAssault

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Have you ever tried acupuncture?? While I never had surgery worked great for me just dealing with the pain or other issues.

I would suggest a chiropractor but I think they are best used before any sort of surgery. I found one that just focuses on the A1 (Atlas??) which has been amazing for me.
 
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CRJR45

CRJR45

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I have not tried acupuncture . I did have a good chiropractor in Michigan , but it's hard to find one down here in Florida , it seems . My wife can pop my mid chest back into place most of the time , unless it gets way tight , then I just have to wait it out .
 

HeavyAssault

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Well if you went to my chrio you would think you are just throwing your money away. The first visit I was like..."I just paid for that??". After the 3-4th visit I could hear and feel the difference. If you want to find an Atlas Chiro you got to ask around. Think of it as sort of a speciality as they only focus on your first vertebra at the base of your skull.

Same with acupuncture...just got to find the right one. It's WAY better than pain meds by a mile.

Just my experiences with back pain and sciatica issues along with what has worked for me besides meds and surgery.
 
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CRJR45

CRJR45

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Well if you went to my chrio you would think you are just throwing your money away. The first visit I was like..."I just paid for that??". After the 3-4th visit I could hear and feel the difference. If you want to find an Atlas Chiro you got to ask around. Think of it as sort of a speciality as they only focus on your first vertebra at the base of your skull.

Same with acupuncture...just got to find the right one. It's WAY better than pain meds by a mile.

Just my experiences with back pain and sciatica issues along with what has worked for me besides meds and surgery.
Thank you !
 

5MilesBack

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Shots are almost always a prerequisite before surgery. Sometimes they help and sometimes they don't. Not sure why an orthopedic surgeon would say that they rarely do fusions anymore. I know three different people that have had their lower spines fused in some capacity in the last three months, but all three were also by neurosurgeons. Maybe that's what he meant......."ortho's" aren't doing them.

I'll be doing some shots here shortly for my lower back. I've been fighting this 24/7 pain for three years now. Covid hosed me in getting anything done, and then a useless military NP didn't help things when he refused to order an MRI. Had an MRI on my own during elk season this year, and now things are progressing.

From just above my right knee all the way through my hip and groin, and even into my lower right abdomen......along with that constant pain above my right glute......24/7. That same pain seems to be creeping into my left side now too. Then every now and then, I'll twist or turn the wrong way and I drop like a sack of potatoes hardly able to move. That happened to me this year a mile from camp while elk hunting in September. That's when I came home and got the MRI.......and then went straight back up with some steroids and Motrin. The steroids helped a lot. (y)

I've never had lower back shots, but I have had some in my neck and they worked well.
 
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CRJR45

CRJR45

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Shots are almost always a prerequisite before surgery. Sometimes they help and sometimes they don't. Not sure why an orthopedic surgeon would say that they rarely do fusions anymore. I know three different people that have had their lower spines fused in some capacity in the last three months, but all three were also by neurosurgeons. Maybe that's what he meant......."ortho's" aren't doing them.

I'll be doing some shots here shortly for my lower back. I've been fighting this 24/7 pain for three years now. Covid hosed me in getting anything done, and then a useless military NP didn't help things when he refused to order an MRI. Had an MRI on my own during elk season this year, and now things are progressing.

From just above my right knee all the way through my hip and groin, and even into my lower right abdomen......along with that constant pain above my right glute......24/7. That same pain seems to be creeping into my left side now too. Then every now and then, I'll twist or turn the wrong way and I drop like a sack of potatoes hardly able to move. That happened to me this year a mile from camp while elk hunting in September. That's when I came home and got the MRI.......and then went straight back up with some steroids and Motrin. The steroids helped a lot. (y)

I've never had lower back shots, but I have had some in my neck and they worked well.
Yeah , I'm not sure about this DR , but he said they don't do fusion because then it just progresses up to the next disc . The Dr that did my Laminectomy/Discectomy said that the only reason She didn't fuse it then was my age at the time , 44 . But she said I'd be looking at it in the future . You can see on the Xrays my bottom disc is less than half the rest of them and my back clicks when I move it just right .
I really just want to be able to do more , like carry a pack and be in better shape . Funny , I hated running when I was able to do it , but now I miss it , a little , LOL .
I don't want to to make it worse , but I want to do whatever I do now , so I'm ready for next hunting season .
 

260madman

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PMR doc will get things sorted out for you. I’ve progressed to TPI and next will be the nerve killer if the TPI doesn’t keep things at bay.
 

Theringworm

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Spine fusion is a daily surgery performed all around the US. Your ortho doesn’t know what he is talking about. Both Neurosurgeons and Orthopedic surgeons that have done a spine fellowship perform back surgery. Most insurance companies will make you jump through hoops before they will cover a spine surgery. Physical therapy first as it can help and often times prevent a surgery. In my case it did, but it took about 8 months of rehab/therapy before I was 80-90% normal and where Ill remain the rest of my life. Not all therapists, chiros, physiotherapists are all the same. Next you might need to visit a Pain Management physician. They typically provide anywhere from no relief to short term or even several months or a years worth of relief at a time. All depends on your injury and how well the injections help. If the injections provide zero relief there likely isn’t much else they can offer. If they do provide some short term or long term relief you can continue with the injections or progress to a longer term approach where they freeze/burn the nerves. Next would be a special consult with an Orthopod who has a spine fellowship or a neurosurgeon. If you can find a highly respected and very capable surgeon that can offer a minimally invasive approach your recovery and possibly outcome may be better than a larger open procedure. Then again, you might not be a candidate for a minimally invasive procedure. And then again, you may not need a fusion at all, rather a discectomy or a kyphoplasty. Only the consulting surgeon will know what you truly require. Surgery doesn’t always end up with excellent results. Failed back surgery syndrome is where you can end up and where the Pain Management Physican really becomes a vital part of your life long therapy. But it also can have amazing success and change your life for the better. I would do lots of research regarding whom you will see and what treatment options you have available to you. Do all you can do rehab wise before you have surgery. That’s my opinion.
 
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CRJR45

CRJR45

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Spine fusion is a daily surgery performed all around the US. Your ortho doesn’t know what he is talking about. Both Neurosurgeons and Orthopedic surgeons that have done a spine fellowship perform back surgery. Most insurance companies will make you jump through hoops before they will cover a spine surgery. Physical therapy first as it can help and often times prevent a surgery. In my case it did, but it took about 8 months of rehab/therapy before I was 80-90% normal and where Ill remain the rest of my life. Not all therapists, chiros, physiotherapists are all the same. Next you might need to visit a Pain Management physician. They typically provide anywhere from no relief to short term or even several months or a years worth of relief at a time. All depends on your injury and how well the injections help. If the injections provide zero relief there likely isn’t much else they can offer. If they do provide some short term or long term relief you can continue with the injections or progress to a longer term approach where they freeze/burn the nerves. Next would be a special consult with an Orthopod who has a spine fellowship or a neurosurgeon. If you can find a highly respected and very capable surgeon that can offer a minimally invasive approach your recovery and possibly outcome may be better than a larger open procedure. Then again, you might not be a candidate for a minimally invasive procedure. And then again, you may not need a fusion at all, rather a discectomy or a kyphoplasty. Only the consulting surgeon will know what you truly require. Surgery doesn’t always end up with excellent results. Failed back surgery syndrome is where you can end up and where the Pain Management Physican really becomes a vital part of your life long therapy. But it also can have amazing success and change your life for the better. I would do lots of research regarding whom you will see and what treatment options you have available to you. Do all you can do rehab wise before you have surgery. That’s my opinion.
Thank you .
But , how do you rehab a disc that is gone ? My L5 is only one third the size of the rest of them . I'm as strong as I ever was , still working and very active . I went through rehab several times and it did nothing for me , for my back . I've torn tendons in my shoulder and just let them heal , after rehab did nothing . Physical activity makes my pain worse , so how can rehab help ? Seems like if it was going to get better , it would by now , naturally ?
I know what you mean about the botched surgeries , my BIL is going through hell after his , he had a pain medicine pump or something implanted .
Not trying to argue and I appreciate your input , really I do , thank you .
 

Steve from GA

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I was on the back pain merry go round for a good while and had a hemilaminectomy on L4/L5, which helped considerably. I will say this - I think there is a very good chance that you can manage your back pack pain without any injections or additional surgeries. I still have flare ups on ocassion, and I now know how to move past them and get back to normal. You just need to find the routine that works for you.

Do not underestimate the need to stretch, particularly your hamstrings. I have figured out that tight hamstrings are the #1 culprit for my back pain.

I recommend you do the McGill Big 3 back strength exercises religiously:


If you don't know who Stuart McGill is, you owe it to yourself to read "Back Mechanic". The guy has been a leader in scientific research on back pain.

So I would say, try stretching your hamstrings, IT bands, and hips every day. Do the McGill Big 3 every day. Stick to it for at least a couple of weeks, and I would be surprised if you don't notice a difference.

I have been there. Good luck!
 

ETtikka

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After battling sciatica and herniated disk:

This stretch really helped me; after doing this for a while, my disk looked completely different on MRI

1666526733820.png
 

Yoder

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I've had the shots twice. I have a pretty high pain tolerance but the second set of shots were pretty awesome. By the time they were done I was in a full sweat. I honestly didn't see much relief. I know it may take a few times to see results but I just didn't want to go back. The needle wasn't bad until they hit the spot that was all inflamed. My wife had it done 3 or 4x and she was mostly pain free for several years. It's definitely worth a try before getting surgery. If the pain is too bad they do offer anesthesia.
 

journeyman713

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I’ve done the pain management route before and can tell you, it’s truly an amazing science.

Basically it comes down to stopping the communication from the exact nerve that is telling your body you are in pain. A pinched nerve for example, causes Inflammation, Inflammation causes pain, and more of a pinched nerve. It’s a never ending cycle.

Your pain management doctor will probably tell you about a procedure called radio frequency ablation. They find the exact nerve, then through high frequency radio waves, sever that nerve. This effects can last a year or longer, before the new nerve grows back.

The procedure itself is not a big deal, it’s quick and done with needles. There will first be a couple trial runs with a Cortizone injection, to ensure they are in the right place to get your results.
 

Wapiti1

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My dad has the shots occasionally. He has also had 18 surgeries stemming from a botched fusion 30 years ago. Don't do a fusion if you can help it. It will work for a while, but the joints above and below take the strain, so they eventually wear out. It ends up being a chain reaction.

And don't go to an orthopedic surgeon for spinal issues. Orthopedic surgeons rarely have much spinal experience and are more joint doctors. Find a good neurosurgeon.

There are a lot of options.

Jeremy
 
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CRJR45

CRJR45

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Thanks everyone ! I'm going to try the exercises above , make the effort and see if it actually helps . Mostly , because I don't want to be an Askhole , LOL .
I forgot , my main time of constant pain is when I'm sleeping . 5 or 6 hours is all I get , before my back hurts so bad I have to get out of bed . Getting up and moving makes the pain subside . Not crazy pain that requires meds , just aches and pains , I guess .
 

260madman

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Stretching hamstrings are extremely import for pain relief. Mine tighten up quickly and it’s a never ending battle. My body is still in fight or flight mode for 3 years since my accident so it’s frustrating. If you do press ups to stretch don’t clench your glutes. They must be relaxed.
 

K1United

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I’ve been getting shots for 8 years and has helped me avoid the knife so far. Strengthening your core is the key. Planks, supermans, butterflies, Russian twist, hip flexors, etc (google core exercises and you’ll be inundated). No sit ups or crunches, and for me personally no heavy/routine running.
 

EdP

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CRJR45, I am in a similar situation as you but at 68. I have a neuro appt next month and expect the steriod shot will be my next step. I'm not going to go into the details but rather address your desire to backpack. A properly fitted pack that puts the weight of the pack on your hips could possibly resolve that aspect of your issue. I had no difficulty backpacking this summer despite my back issues. Carrying the pack weight on the hips puts it below your spine. You only need enough weight on the shoulder straps to provide stability. For me, an external frame pack works much better for this than the internal frame models. I also bought a Kuiu 2300 that allows me to do the same thing for day hikes whereas many other smaller pack models ride on the shoulders.
 

5MilesBack

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When I went to physical therapy the therapist showed me some stretching exercises to take away any tightness. I got on the floor for the first one and pulled my leg up and over the other one with my knee all the way down to the floor on the other side. He said "Wow, I guess tightness isn't an issue for you". I've always been very limber.
 

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