Chronic back pain and incontinence at age 20... please help!

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bianca20
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March 20, 2013 at 12:50 am

Post count: 3

#8223

Doctor Corenman,
I ask for a few minutes of your time to read my story and see why I need your help desperately.
. Over two years ago I began to feel all over pain which centralized in my back and hips. I ignored the pain for about six months because I am an active gym junkie and I just figured it was normal. When the pain continued to worsen I went to an orthopedic doctor who diagnosed me with stress reactions and put me on crutches for 8 weeks. After that time, the pain never decreased or was relieved at all so the doctor in conjunction with a back doctor atn decided to give me an SI joint injection. The injection didn’t relieve any pain and the doctors were up in arms and told me to continue my imaging and to see other doctors. After that, I received a pelvic exam, CT scans, ultrasounds and a cystoctopy all in which came back without any concern. I then saw a rheumatologist who diagnosed me with fibromyalgia and put me on cymbalta. The medicine didn’t work I am suffering from pain daily and am not living a normal life that a twenty year old would. I have been unable to control my bladder. I wet my bed and pants and lose complete control of my body. I received a urodynamics test and the results came back that I have an extreme over active bladder. I was put on more Meds that didn’t work. My neurologist upped all of my vitamins, cymbalta and lyrica….still nothing. All my doctors assumed premature signs of a neurological disease and lesions in my nervous system. I got an MRI from my brain down to my lumbar spine and the results came back “unremarkable.” My pain is very mildly controlled with my medications and daily use of muscle relaxers, but these are all just ways of hiding my symptoms. My bladder is still uncontrolled and I live every day with fear of public embarrassment. My doctors has just put me a tiral of prednisone which I am currently taking. He wants to see in 2 months but I can’t wait any longer :(
Please can you have a look at my mri and maybe see something they missed.
Thank you,
Bianca

Donald Corenman, MD, DC
Moderator

March 22, 2013 at 11:50 pm

Post count: 8660

#8229

Unfortunately I cannot review your MRI over the internet. The site does not work but I cannot allow you to post a link as this is an anonymous site.

Your symptoms of bladder loss of control are unlikely to be spine mediated as the bladder control nerves are small and sit in the center of the spinal canal. It takes an extremely large herniation or bone spur to cause dysfunction of these nerves. I assume that your treating physicians could discern any pathology like this.

I am unclear what a “stress reaction” is in the lumbar spine. This could mean strain/sprain which is an unhelpful diagnosis or even a stress fracture of the bone (pars interarticularis).

Fibromyalgia is a diagnosis made by finding pain and tender points in all parts of the body. By your description, your pain is in the hips and pelvis only which would rule out fibromyalgia.

What was the radiologist’s interpretation of your lumbar spine MRI?

Dr. Corenman

PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.

Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.

bianca20
Member

March 27, 2013 at 7:24 pm

Post count: 3

#8282

Thank you Dr Corenman, for getting back to me.
Bianca was diagnosed with FM after being tested with generalized tenderness 11 of 18 tender points and slight hypererflexia in legs bilaterally.
November of 2012…MRI of brain, cervical, thoracic and lumber spine were largely unreavealing except for mild bulging in the lumbar region and slight disk bulge in the T5-6 and T7-8.she has had every bit of blood work done with nothing abnormal. she is currently on cymbalta, lyrica skelaxin, magnesium, B complex , D3 2000 and has tried vesicare and enablex but did not help with her incontinience (“extreme over active bladder”)
She was having full loss of control 3 days and week and once aweek at night while sleeping. Two weeks ago she was put on a tiral of prednisone 60mg and she was able to control herself. Since stopping after the nine days, she has started to lose control again. Doc has now put her on a month of prednisone which she will start today. He wants to see her in a month. What is going on??? why can’t anyone tell us why this is happening? Could the disk bulge be touching the spinal cord causing her symptoms? We went to another neurologist, just for a second opinion, who told us it has something to do with the cervical spine , maybe from an old injury. He ruled out MS. And when I asked about the bulging disk touching (very clearly on the mri) he said that it was normal.. He has ordered another mri of the cervical area but did not seem to care about our concern. So
we are back with our original neurologist who we really like and trust but sadly still have no answers.
Any input would so greatfully be appreciated.
thank you soooo much.
Louise (Bianca’s very worried Mum)

Donald Corenman, MD, DC
Moderator

March 28, 2013 at 12:18 am

Post count: 8660

#8286

You daughter’s diagnosis remains elusive. You can rule out compression of any spinal nerves or cord as the source of the symptoms with essentially negative MRI scans.

Predinsone reducing the incidence of bladder control makes me think of an autoimmune problem. Steroids (of which prednisone is a member) reduce the ability of the body to create inflammation.

Certainly, I am no expert in the field of urodynamics and this appears to be a neurological problem but you might inquire along this line.

Dr. Corenman

PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.

Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.

bianca20
Member

March 28, 2013 at 7:41 pm

Post count: 3

#8288

Thanks for getting back to me.
We will continue with neurology (as the urologist has told us there is nothing else they can do at this moment). Hopefully her next set of mri’s will give us, at least, some answers.
thanks again, Louise
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Donald Corenman, MD, DC

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81 reviews

Eric S

Sep 26, 2021

by Eric S on Donald Corenman, MD, DC

Successful pars repair at 46 years old

Back in November of 2018 (at 46 years old) I came from Vancouver BC to have a pars repair done with Dr. Donald Corenman at the Steadman Clinic in Vail Colorado. I'm finally posting this review nearly three years later in late 2021. The reason I waited so long was I wanted to know the final result before I posted my review. Unfortunately in that time Dr. Corenman has retired. Nevertheless, I want to post this review of Dr. Corenman and his staff at the Steadman Clinic in their excellent treatment of my L5 pars interarticularis.

I fractured my pars at age 42 back in 2014 when rolling on the gym floor, and was denied treatment by the Canadian healthcare system, probably due to my age. First my GP told me there was no surgical option for a pars defect, which was quite incorrect! I tried to live with it, but the symptoms worsened (periodic random spine slippage and weeks of resultant pain after just bending over to tie my shoe, so I eventually learned to mostly squat and hardly bend). When I finally consulted with Canadian spine surgeons, I was told they believed my pars defect had been congenital (since birth). This was absurd, considering I had done extreme martial arts (including jiu jitsu) for years prior, as well as 5 years of reinforcing steel full time in my 20s, probably the hardest job on the back you can find. No pars defect like mine would possibly have allowed this--ergo it was impossible that I had had the defect since birth. I did however have an asymptomatic congenital spina bifida occulta that made me more susceptible to a pars fracture. In 2014 in one instant, I went from having the strongest back people I knew said they'd ever seen, to being unable to safely bend over and tie my shoe without a non-negligible risk of my spine slipping randomly (which would lead to weeks of pain after each occurrence). This was due to the unilateral L5 pars defect, otherwise known as spondylolysis. It was when lying in pain on the floor 4 years later after maybe the 6th spine slippage event post injury, that I had had enough, and resolved to have surgery. If Canada's "universal health care" said no, I would make lemonade from lemons, and find the very best surgeon in the world at pars repairs. That was Dr. Donald Corenman. Dr. Corenman back in 2018 ran a website https://neckandback.com/ that dedicated many pages to the science of every aspect of pars repairs, from eligibility (good discs on MRI), to best surgical techniques (minimal open compared to minimally invasive), best imaging to use (i.e., O-Arm with Stealth imaging vs. older fluoroscopy), the ideal amount of BMP to use and why not use too much or too little, and much more, all to do with pars repairs, pages upon pages of his site just on the pars, with scientific references and his own extensive expert opinion. As a health research statistician, I was very impressed with this. It was in stark contrast to the websites of other spine surgeons which barely gave the pars a word or two, focusing almost exclusively on fusions. I had found the best surgeon in the world for pars repairs, and so after Dr. Corenman personally screened my MRI to ensure my discs were healthy, I booked the surgery.

Being 46 years old at the time of surgery in 2018, with a 4-year-old pars fracture from 2014 combined with a congenital SBO meant my pars fragment was somewhat atrophied, but it was "very solid", said Dr. Corenman in the operative report. Nevertheless, it was challenging with two things to fix, the pars and SBO, and OR time was around 4 hours. Recovery over the following months was guided by a very clear "Spine binder" from the Steadman Clinic with strict rules of "no BLT" (no bending, lifting or twisting), and illustrated physiotherapy guidelines. They even warned patients to avoid fish oil supplements, which could excessively dampen inflammation and hence slow bone healing. They answered many questions I had during months of recovery, with responses coming from the very supportive Lori Fugate (then director of Dr. Corenman's practice), and Ehrich Bean (then physician's assistant at the practice), as well as a couple calls with Dr. Corenman himself after two of the CT scans. Ehrich Bean offered great advice for taking the spine binder conservatively due to the nature of pars repairs vs. fusions. The final post-op CT scan I had was a couple weeks ago at 34 months post-op, and Dr. Corenman had retired, but I got a very positive and informative call from Eric Strauch (current PA at the Steadman Clinic under Dr. Corenman's replacement there, and who had also worked with Dr. Corenman previously). The staff at the Steadman Clinic were extremely supportive all the way through the process. I should mention, the local Canadian spine surgeon did offer me very good post-operative support including antibiotics as needed to deal with a mild surface incision-site infection early on, booking numerous x-rays when I felt something was amiss, as well as booking all four of my post-op CT scans. I am very grateful for that support also.

My final result shows plenty of solid bone across the pars and a healed SBO, with my vertebral body now a solid bone ring instead of being broken at two places as it was pre-op. Does my spine hold up in the real world? You bet! I have recently dug and moved several yards of dirt and sand and gravel by myself (shovel and wheelbarrow!) to fix our water main, pulled roots from the yard, moved several "portable" (these are HUGE) air conditioners up several flights of stairs my myself, and lifted weights. I now run 2 miles (3.2 KM) several times weekly with a hard 100 meter dash in the middle. I bend deeply before each run I go on, with no spine slippage. My spine feels amazing. I can bend over to do exercise, or real word tasks, with no risk of spine slippage.

My sincere thanks to God, Dr. Donald Corenman, Lori Fugate, Ehrich Bean, Eric Strauch, and the Steadman Clinic, as well as the Canadian spine surgeon who offered me excellent post-operative care back in Canada. You have all given me a new lease on life.

Sincerely,
Eric S

Robert S

May 11, 2021

by Robert S on Donald Corenman, MD, DC

Back Fusion Surgery

I had my entire lumbar spine fused in November of 2018. I had scoliosis , with pinched nerves that were so painful I could hardly walk - and standing for more than a few minutes was impossible. Even sitting was painful.
The fusion surgery produced immediate relief! And the recovery was much easier than I expected.
To this day I can do all the activities I love from hiking, to standing in a stream fly fishing to riding my bike long distances - or just walking down the street with my wife.
Kudos to Dr. Corenman and his staff, (including the two Erics) for taking such good care of me!

Leslie R

Jul 9, 2020

by Leslie R on Donald Corenman, MD, DC

TLIF

I had my TLIF surgery on 6/24/2020 by Dr. Corenman, I can not say enough good things about the Dr or his staff. I was always treated with respect and explained everything throughly, that made it easy for everyone to understand. I highly recommend Dr. Corenman and the Steadman Clinic.

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Chronic back pain and incontinence at age 20… please help!