[James1970]

#35772

Hello, I found your forum and appreciate being able to write to you about my pain. I am in a position of not knowing what to do next. Here is where I am.

Lower back pain started around 18 years ago, I continued doing very physical work as I was self employed, no insurance. For most of that time the pain was manageable, however around 4 years ago it became so bad I finally went to a doctor. Fortunately I now have health insurance through an employer.

In those four years I have been out on short term insurance twice, now this will be the third time. I have had two MRIs in four years. First time I was out I had an MRI, physical therapy was prescribed and it did get the pain under control. I went back to work. Over a year later, I had a recurrence, the pain slowly became intolerable. Another MRI was done and Was prescribed physical therapy and an nerve block injection. Pain became manageable again but not completely gone.Went to work and over time it has come back and now it seems even worse.

Just recently I went to a spine surgeon (no referral was needed) and he looked at the last MRI and could not find anything that he would recommend operating on. He is sending me to get more shots in my lumbar area, which is in the process of being scheduled.

Here are the findings of my last MRI:

Lumbar spine remains in anatomic alignment. Disc spaces generally well preserved for age, no worrisome marrow signal, compression deformity or subluxation. The conus terminates at L1 with normal appearance of the distal cord, conus, and cauda equina.

Disc space well preserved for age.
L1: Normal appearance
L1-2: Normal disc profile
L2-3: Very shallow central disc bulge, no central canal or foraminal compromise
L3-4: Very shallow annular disc bulge. No lateralized herniation or root impingement. Central canal AP dia. 12mm
L4-5: Annular disc bulge with shallow right foraminal disc protrusion and mild facet arthrosis. There is mild to moderate right and mild left foraminal encroachment. AP diameter central canal 12.5mm
L5-S1: Normal disc profile. Mild facet arthopathy. No central canal or foraminal compromise.

Conclusion: Lower lumbar facet degenerative changes with minor disc profile abnormalities L2-3 through L4-5 . There is resulting right greater than left foraminal encroachment at L4-5 but no central canal stenosis.

I do find some relief through daily use of an inversion table. Although it is beginning to not be effective.
I would say pain is 8 out of 10 at least 50% of the time, although my tolerance has grown, it is also starting to break down, physically and mentally.

At this point I am not sure which way to go. I am not sure if most of the pain is coming from the Stenosis or some sort of other neurological problem. I can almost always feel my heart beating in that area, and also what seems like a mild electrical current. Having someone push lightly on L-4 and L5 the pain is excruciating. The pain travels down the front of my groin, into the testicles, and down the front of my legs. Some intestine pressure also occurs. Sleep is difficult, best configuration is flat on my back.

Would you have any recommendation on where to go from here? I am planning on getting those lumbar injections but the last time they didnt seem to help much and it didnt take long for the pain to reoccur. Thank you for reading this lengthy post.

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