1. < Spine Health

Suggestions for care o disk pushing on spinal cord at L4

Posted by rjjacobsen @rjjacobsen, Sep 12 10:53am

71 years old - diagnosed with spine alignment problems where the disk at L4 is pushing approximately 2/3rds of the way into the spinal cord per the MRI. This is thankfully not a pinched nerve root, but is the disk impinging on the spinal cord.

Received a cortisone injection to reduce swelling and pain 6 weeks ago, but that seems to be wearing off already. Pain is moderate.

Been referred to PT, but that's pending his return from a hunting trip. Ortho doc thinks strengthening the muscles can correct the crooked spine. Could also nip the part of the disk that's pushing on the spinal cord, but trying the PT first.

Heat helps with the flexibility of the spine, cold packs help somewhat with the pain.

Trying to keep mobile while not over-doing things, doing stretching, bending at the knees instead of the waist and avoiding lifting anything over 20 pounds. No lifting 40 lb. bags of water softener salt! Also trying to keep my posture straight and upright and avoiding things which cause leaning forward.

I am somewhat limited with exercise I can do because I have one hip that is bone-on-bone which needs replacing.

So... asking for suggestions on how to best handle this and prevent further problems.

Thanks!

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Mentor
Jennifer, Volunteer Mentor | @jenniferhunter | Sep 12 1:59pm

@rjjacobsen I think you are doing the right things and time will tell if surgery is needed. When I asked my spine surgeon how to not need his services again in the future, his answer was to maintain core strength to support the spine. I hope your PT can help you. Good posture makes a difference in preventing problems.

REPLY
1 reply
rjjacobsen | @rjjacobsen | Sep 12 2:27pm
In reply to @jenniferhunter "@rjjacobsen I think you are doing the right things and time will tell if surgery is..." + (show)
@jenniferhunter

@rjjacobsen I think you are doing the right things and time will tell if surgery is needed. When I asked my spine surgeon how to not need his services again in the future, his answer was to maintain core strength to support the spine. I hope your PT can help you. Good posture makes a difference in preventing problems.

Jump to this post

Thanks for your comments. Appreciated!

REPLY
dlydailyhope | @dlydailyhope | Sep 13 7:01am

@rjjacobsen
You do sound like you are doing a lot of good things. I just had surgery 8/2/2024 on L3-L5 due to severe spinal stenosis, degenerative disc disease and neurogenic claudication. I am 55. Having congenitally narrow spinal canal made this all happen for me earlier than many. My desk job sitting for 10-12 hours a day made it worse.

I decided to do surgery after it got really bad and spinal injections stopped working (had them for 3 years). PT would not help get my discs/osteoarthritis off my spinal cord/nerve roots. It was hard to walk, stand or sit for long without numbness, weakness and pain. I have noticed an improvement in my symptoms where I no longer have the numbness and weakness from the compression on my spinal cord. The pain from surgery has gotten much better. It is a 3 month recovery so I will know if my pain is fully resolved by then.

It is good you are not lifting heavy things and you want to be careful not to fall/twist or do anything with spinal force impact (like jogging or running/jumping). Keeping weight at a healthy level is also helpful (I need to work on losing weight to relieve more pressure on my spine). A diet that supports bone and nerve health is also good.

Another suggestion is to use pillows between knees and under legs when sleeping on your side/back so you don’t twist your back or out extra strain. Sit with a lumbar support pillow (chair/car seat). Salonpas lidocaine nerve pain patches helped me, too. When standing for periods of time, it is good to prop one leg/foot in a low stool to support your back. Stretching for you back, hips and legs helps relieve tightness in your back.

REPLY
1 reply
besmith57 | @besmith57 | Sep 13 8:11am

I saw the pain specialist yesterday for terrible pain in my lower back. I had a double spinal fusion in 2022. Steroid injections don't work at all. She tells me I have very bad degenerative arthritis at L3-5. She ordered an MRI with contrast to see if any procedure would work for me. I can't stand or walk for more than 5 minutes. Does anyone have knowledge of this and can it be treated with surgery or medication? I can't imagine living like this for the rest of my life. TIA

REPLY
1 reply
rjjacobsen | @rjjacobsen | Sep 13 10:58am
In reply to @besmith57 "I saw the pain specialist yesterday for terrible pain in my lower back. I had a..." + (show)
@besmith57

I saw the pain specialist yesterday for terrible pain in my lower back. I had a double spinal fusion in 2022. Steroid injections don't work at all. She tells me I have very bad degenerative arthritis at L3-5. She ordered an MRI with contrast to see if any procedure would work for me. I can't stand or walk for more than 5 minutes. Does anyone have knowledge of this and can it be treated with surgery or medication? I can't imagine living like this for the rest of my life. TIA

Jump to this post

I have no personal experience with this except my wife had a triple fusion at the L3 through L5 which included rebuilding at least one of the vertebrae with a mix of her bone and cadaver bone. She also had a nerve root pinched for which they augered out the arthritis to stop the pinch. She had that done in June 2023.

She still sleeps in a recliner because the back can't handle the bed - still does PT and is now doing a senior exercise class to rebuild strength. She actually moves pretty well though.

I suspect (and I think your pain management specialist does also) that there's still something possibly orthopedic that's causing the ongoing pain. It might be worthwhile to have an orthopedic specialist look further if you haven't done so already

Sorry for your situation. Wish I had better ideas.

REPLY
1 reply
rjjacobsen | @rjjacobsen | Sep 13 11:14am
In reply to @dlydailyhope "@rjjacobsen You do sound like you are doing a lot of good things. I just had..." + (show)
@dlydailyhope

@rjjacobsen
You do sound like you are doing a lot of good things. I just had surgery 8/2/2024 on L3-L5 due to severe spinal stenosis, degenerative disc disease and neurogenic claudication. I am 55. Having congenitally narrow spinal canal made this all happen for me earlier than many. My desk job sitting for 10-12 hours a day made it worse.

I decided to do surgery after it got really bad and spinal injections stopped working (had them for 3 years). PT would not help get my discs/osteoarthritis off my spinal cord/nerve roots. It was hard to walk, stand or sit for long without numbness, weakness and pain. I have noticed an improvement in my symptoms where I no longer have the numbness and weakness from the compression on my spinal cord. The pain from surgery has gotten much better. It is a 3 month recovery so I will know if my pain is fully resolved by then.

It is good you are not lifting heavy things and you want to be careful not to fall/twist or do anything with spinal force impact (like jogging or running/jumping). Keeping weight at a healthy level is also helpful (I need to work on losing weight to relieve more pressure on my spine). A diet that supports bone and nerve health is also good.

Another suggestion is to use pillows between knees and under legs when sleeping on your side/back so you don’t twist your back or out extra strain. Sit with a lumbar support pillow (chair/car seat). Salonpas lidocaine nerve pain patches helped me, too. When standing for periods of time, it is good to prop one leg/foot in a low stool to support your back. Stretching for you back, hips and legs helps relieve tightness in your back.

Jump to this post

Some solid suggestions along with some real and helpful experience. I like that 3 month recovery time. Thanks!

I've been able to keep the weight down - before the hip problem got nasty I walked 2 to 2.5 miles three times a week - I couldn't jog or run due to intense pain - so while I've kept my weight under control, I haven't been able to significantly reduce it.

REPLY
besmith57 | @besmith57 | Sep 13 12:38pm
In reply to @rjjacobsen "I have no personal experience with this except my wife had a triple fusion at the..." + (show)
@rjjacobsen

I have no personal experience with this except my wife had a triple fusion at the L3 through L5 which included rebuilding at least one of the vertebrae with a mix of her bone and cadaver bone. She also had a nerve root pinched for which they augered out the arthritis to stop the pinch. She had that done in June 2023.

She still sleeps in a recliner because the back can't handle the bed - still does PT and is now doing a senior exercise class to rebuild strength. She actually moves pretty well though.

I suspect (and I think your pain management specialist does also) that there's still something possibly orthopedic that's causing the ongoing pain. It might be worthwhile to have an orthopedic specialist look further if you haven't done so already

Sorry for your situation. Wish I had better ideas.

Jump to this post

Thanks so much for your response. I'm sorry your wife is dealing with this too. A neurosurgeon did my fusion so if you're right about more surgery I guess he would be the one to do it. I will check out other options if they can't help me. Hopefully, the MRI will show something that can be fixed. Thanks, again.

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