fusion surgery ?

I am sorry that you are having such a difficult time. However, back pain are one of the most difficult disorders that a surgeon faces because most people DON'T need surgery. That does not mean that they do not have pain, it just means that there is no surgery that will be able to successfully address the problem.only 2% back pain patients need surgery,so,don't rush! go to see another doctor for second opinion.good luck!

Thanks for your advice, Zak_han.

I am finding it difficult in general as I am young and have a life ahead of me and don't want to be disabled for most of it as I would like to be able to work and do normal things that people do like physical things i.e. tennis, swimming, sports of all kinds as I used to like being sporty and active and now I can't as the pain is too much and it isn't worth getting in pain. I now lead quite a sedatry lifestyle where I don't do much unless absolutely necessary physically.

My GP has referred me but the hospital system is confusing. They keep making it difficult to even see a consultant. It's as if they don't want me to? I don't know.

It would probably be better to get an initial consultation with a consultant somewhere else privately but I've heard it can be expensive just for a consultation but it'd probably be worth it in the end.

I am in the UK by the way, just in case you were wondering.

Hello Gehner,

Permit me to expand upon Zak han's thoughts. Surgery is not a guarantee that you will be pain free. Yes, it may help, however in my opinion it should be the last option.

About a year ago my spinal surgeon recommended that I have two fusions on my spine as well as other procedures performed. AND that I should have the surgery by the end of '07. He like other spinal surgeons I have seen for their advice all mentioned I had one of the worst backs they had seen from the MRIs, with a multitude of issues.

I know the doctors at the institute discussed my back in a meeting and tried to determine what should be done or not done surgically. A pain manageament doctor spoke up and recommended that they first try nonsurgical options.

The pain management doctor gave me an epiduraal injection containing the corticosteroid Kenalog to reduce the inflammation where the nerve was being pinched by a bulging disc. To my surprise the injection worked!!! No, I am not pain free, but the pain is much much less. I now can do activities I could not do before the epidurals.

Do get a second opinion as Zak han recommends. In fact, search out the very best spinal surgeons/neurosurgeons that you can find in your area. Get the opinions of the top two on your list.

I wish you the best.

RichT

P.S. Pain meds - I was on a pain med about 1-1/2 years ago for several weeks. Yes, it covered up some of the pain I had, but I literally slept the day away, AND I knew the pain med was addictive as many are. I knew I did not want to be a zombie for the rest of my life so I slowly withdrew from taking the pain med. SOOOoooo glad I did. Perhaps Zak han could give you his thoughts on pain meds.

Thanks for your advice, RichT.

I agree with you and Zak han that surgery is not always effective but I have heard as many that have found it effective and it has cured some people of their back problem pain altogether. It seems like it's 50-50 as to whether it may or may not be effective so I am finding it a difficult decision to make.

The thing I am worried about is that because my spine is unstable it will eventually get worse if it isn't stabilised now. I don't want to just cover it up and have to live on painkillers for the rest of my life, although this sounds like it nearly always is the case for back problems, unfortunately.

I am thinking of getting a TENS machine as these I've heard are good for the pain but again I'd be just masking the pain rather than treating the actual problem.

I am nervous and worried about having any epidurals or nerve blocks as they may hit a nerve or make my pain worse. It can be as risky as surgery. I don't know at the moment what I would like to do.

The other worrying thing which I have heard is some people have found physio made their back condition and pain much worse and this is supposed to be conservative. I wouldn't want my back manipulated. How would I know that they are not doing permanent damage?

Hello Gehner,

You have raised some very good questions and concerns, many of which I dealt with for several months last year. You can receive thoughts, experiences and advice from doctors and people like us spineys, but ultimately you will be the one to make the final decision. Take your time, don't rush into something you may regret later.

I have told you a bit about myself and my back pain. If you have any questions do let me know.

Okay, time to start to respond to your questions and concerns from this spiney's perspective, and I'll start with the last one first.

By "physio" I will assume you mean who we call a physical therapist in the U S. However, you mention that you would not want your "back manipulated", which to me sounds more like a chiropracter. I have had a physical therapist help me for a torn rotator cuff and also for my back pain. She is a fantastic lady and gently takes me through various exercises. She ALWAYS tells me to let her know when I feel pain for then she will stop, or I will stop. Without a doubt, physical theraphy has helped me.

Now to that "back manipulated" thing. To be honest that scares me to death. No way am I going to take a chance with some chiropracter "popping" my back. That is just me, others feel differently about it.

On to epidurals - Your concerns are proper. There is always a risk with such injections into the spine. HOWEVER, Gehner, that risk can be greatly reduced when one has an expert doctor to give you the injection WITH the aid of a fluoroscope. The fluoroscope enables the doctor to "see" where the needle is and where he needs to place the medication. I'm totally convinced that the reason the epidurals help me is because I have a doctor who very precisely moves the needle to EXACTLY the location the medication needs to go. If a doctor recommends that you have an epidural injection which contains a corticosteroid to reduce inflammation make SURE he/she is well trained and DEFINITELY uses a fluoroscope. No flouroscope, no injection. Over the past year I have had four epidural injections. Very little pain, and no adverse side effects.

Epidurals risky as surgery? Perhaps it depends on how one defines that. To my way of thinking an epidural injection is far less risky.

I personnally have decided to stay away from nerve blocks. I WANT my nerves to be able to tell me when something isn't right, or that I need to stop doing something that I should not be doing.

Yes, a TENS machine in providding a slow release of a pain medication such as morphine would just mask the pain and not treat the actual cause of the pain. For me it would be one of my last options.

Continuing on the subject of pain killers - For some, that ends up being the last option when surgery is not an option or has not worked. For myself, only then would I go the route of pain killers. I will avoid pain killers like the plague. Yes, I do take Tylenol. Yes, I do take Voltaren as an antiinflammatory medication for my arthritis, but NO addicting pain meds for me as long as I can stay away from them.

Unstable spine - Yes, that is what I have. AND that means I have had to learn what I can do and what I cannot do. Sure, sometimes I forget and do what I should not be doing. For me the most important thing is to keep moving!!! To keep gently exercising my back and strengthening my back muscles to help support my spine. Okay, what can this ole 72 year old man do? I can garden, and I mean dig holes for planting 6 ft trees. I lift mulch and spread it around our gardens. I mix soil in my wheelbarrow. I clean the gutters on my home and shovel snow in the winter time. The list goes on. What I can't do - I can't stand in one spot for more than 2-3 minutes before the pain really sets in. I can't sit in hard uncomfortable chairs. It is NOT moving that takes care of my my back.

Well Gehner, I have written far too much. My apology. I hope I have given you some food for thought. Do your research, check out prospective doctors, AND ask questions of everyone.

Oh yes, and DO get that 2nd and 3rd opinion from the best spinal surgeons you can find. I've been to a total of 6 spinal surgeons, one pain management doctor and one neurologist. Each one has helped me to decide the path I want to follow.

Take care.

RichT

Hi,Gehner
I am happy to address the issues that you pose, although it is important that you recognize that my impression is based entirely on the information you have provided in your posting and is by no means a replacement for an office visit with your doctor.
It is totally up to you whether or not you have surgery. it's important that you consider the pros and cons, risks and benefits, and potential for success,The information your doctor provides should help you make an informed decision about whether or not to have surgery. NOT HERE !!! If you feel you have not been given enough information to make a decision, ask more questions. Getting a second opinion is also a great way to get additional information to help you make a decision.
Good luck!

Thanks for your advice and help, RichT and zak_han. It has given me some food for thought.

Yeah, by physio I do mean physical therapist. What I mean by manipulated is moved around in any way that may make my spine degenerate further as mine is bone on bone because it's my discs.

I would consider an epidural, etc if it was very effective and took my pain away so I could go to work and do general daily things.

If I leave my spine unstable and don't have a fusion will it get worse as I have heard some people say it can but sometimes it stabilises or gets better with time?

I haven't been referred to a surgeon yet and don't know if the hospital is even letting me yet. My GP has referred me after he ignored me for three years and told me my back pain was normal and did nothing to help me at all. Not even giving me advice but the hospital is dodgey as they said I was on the surgeon's waiting list but now I have been told I am seeing a physio therapist practitioner specialist on behalf of him which I don't understand as it doesn't make sense that the hospital can say I am seeing a surgeon and then on his behalf see a physiotherapist in his rapid referral clinic whcih is no way rapid - I waited 11 weeks or so to get this appointment?

I feel that I should've been referred to more different healthcare professionals like pain management doctors for epidurals, etc when I first presented to my GP with these symptoms.

I'll see what other conservative treatments may be available and see if they'll refer me for some.

I'll wait and see what the physiotherapist practitioner specialist says when I go for my appointment and let you all know of the outcome of this.

I'll try and get a second or even a third opinion if I can so that I can make a decision from at least two or three different doctors' advice on treatments available.

Thanks once again, RichT and zak_han for all of your help and advice.