Recent Spinal Injury

Good wishes and luck with all non-invasive proceedures that may be tried. My situation stems from osteoporosis and degeneration (age 67) I started with physio and found this vital to maintaining as healthy a lifestyle as possible. We must keep moving within the best of our abilities! I also tried 3 steroid injections but they had no benefit for myself. Three years later I finally had surgery and it has given me a new lease on life- though I don't recommend this unless nothing else has worked. I had a fusion of L-3-4-5 and S1. I feel about 80% back to normal functioning, although the upper fusion has not healed completely after a year. I did end up using prescribed meds in increasing doses before surgery and will admit, tapering them off has not been totally easy. (Really, it's insomnia that has been the issue, but that's finally improving.) I am maintaining an exercise regime with an exercise therapist, and I feel that's vital to my well-being.

@heatherm Kudos to you! It's great to see you here again and helping a new member. I know we connected before you had your spine surgery and I am so glad that it went well for you and you are continuing to progress. Do you have a protocol for treating your osteoporosis? You are still young enough that what you do now can affect the aging of your spine. My 92 year old mom recently had a spontaneous compression fracture of her spine because of severe osteoporosis. She had been on Alendronate for years, which I believe suppresses the cells that reabsorb bone. Some of that problem came about from disease in the parathyroid glands which affects the deposition or removal of calcium in the bones. Now she is under the care of an endocrinologist who is treating this with injections of Evenity instead. She had high calcium readings in her blood because the parathyroids were pulling it out of her bones. The damage had been done, however and at her age it is hard to build bone because she is sedentary and she is at high risk for another spinal fracture. Exercise does help bone building, so good for you!

@sleeplessinmissouri Welcome to Connect. I'm sorry you are dealing with an injury and spine pain, but I do like your name! I am a spine surgery patient, and my injury was a whiplash years ago. With aging, spinal discs dry out a bit, and if there are small cracks in the outer fibrous layer from an injury, those can open up as a disc dries a bit. That is what happened to me. I had a bulging disc for years that eventually herniated, and the jelly like contents spilled out. By the time I had spine surgery, my disc height had collapsed by 50%. The extruded disc material causes inflammation, and bone spurs grew next to the disc as the body tries to stabilize the spine. Sometimes a spine issue takes years to develop.

One question you may want to ask is what is causing the foraminal narrowing? Is that something that was there before your injury or was it caused by your injury? Where are you feeling pain? Is it always in the same place or does it change locations? I can understand how this must be troubling. Some of what can happen when a disc is compromised is that the vertebrae can start slipping past each other. If that happens at the lower end of the spine, it can cause difficulty in walking by compressing nerves that service the legs. Someone should explain to you in detail what is affected with the spine and what may happen in the future because of it.

You may want to keep a journal of how your symptoms are changing. I realize you are looking for noninvasive treatment. Sometimes physical therapy helps by helping to maintain proper alignment. Have you considered getting another opinion from a spine specialist? If you are on a track toward surgery, who you trust to operate can have a huge impact. You want the very best surgeon you can find with expertise in what you need. You may find yourself in a situation with an urgent need for surgical intervention, and it would be difficult to shop around at that point.

Spine problems are unique in that there is no standard. Your experience can be completely different. When you have a pinched nerve in the foramen ( the space between the vertebrae), it is very specific to that nerve. If you have compression of the spinal cord, it may have symptoms that change. Pay attention to what posture increases your symptoms, and that can be different for sitting, standing, or laying down, Sometimes doctors get full spine X-rays in different positions to confirm if there is any instability that causes a vertebra to slip past another.

You may be interested in this story about a teen that had a lot of instability at L5S1. This surgeon is one of Mayo's best, and he was my surgeon that decompressed my spinal cord in my neck. https://sharing.mayoclinic.org/2017/07/26/spinal-surgery-saves-teen-swimmers-mobility/

By learning as much as you can and advocating for yourself, you will have some control over your future. Don't let this defeat you. I know this is a shock to suddenly be facing a spine problem. There are some very real risks with spine injections too. I had a problem with an epidural injection that caused burning electrical pains that lasted several weeks. I won't do those injections anymore. I hope I'm not causing you stress. You need to know what you are up against so you can make educated choices.

Do you have more details about your spine condition that you can share? Have you considered a second opinion somewhere else?

Good morning! I have a bulging disc that is causing the foraminal narrowing. I’m having left and right sided pain. It’s not constant, or at the same time, but from my low back to the bottoms of my feet, I have intermittent pain, burning, and numbness/tingling.

To be honest, this is my first injury. I’m 44 and have not had any issues. I was injured at work and I’m going through work comp. I am guessing they want me to see the Physiatrist first and go from there before sending me to a spine specialist. I’m guessing really, as this is all new to me.

As far as second opinions, I think I’ll give this Physiatrist a chance. I hope he’ll have something up his sleeve that helps get the disc back where it belongs and not something that hides the symptoms.

@sleeplessinmissouri You might want to keep notes on your condition. A work comp situation can be a dance of the assigned medical specialists trying to avoid having the company pay the bills. Spine surgery is very expensive and some companies are self funded, so that comes out of company profits. Work comp is also more than just paying the bills for medical treatment. It pays lost wages, and if you file a case with your state's board, there would be an award for the "loss of use" or damage. There are tricks to that as well, so getting an injury attorney can help facilitate this. The company will be consulting their own attorneys in all the responses they make to you. You can also get caught between your health insurance that won't pay because it's work related, and the work comp process that doesn't want to pay either. You do have to cooperate, but you have the right to choose your own doctor or surgeon instead of a doctor assigned by the company. You certainly don't want a surgeon who does all kinds of orthopedic surgeries instead of just focusing on spine surgery.

I agree with you not to rush into surgery, and that should always be the last resort. If your disc is causing foraminal narrowing, it is likely ruptured and spilled the jelly like nucleus inside into that space. That causes inflammation and prompts arthritic changes and bone growth there that will further impinge and put pressure on the nerves. It isn't a disc slipping out where you can push it back in, it has a tear in the fibrous outer covering. Get copies of all the medical records and imaging in case you want to take that to another doctor that you choose. You need to get a sense of how fast that can progress and when surgery may be indicated. Sometimes, they do a procedure to just clean up the extruded portion and leave the damaged disc in place. It can cause the same problem later when more disc jelly gets squished out.

44 is pretty young to start with spine issues. There may also be other bulging discs that will have issues years into the future. I had a whiplash and bulging disc that took about 20 years before it herniated, but once that happened, there were bone spurs that grew and pressed into my spinal cord. The only way to improve that was surgery. This location of L5S1 is also bearing almost all of your body weight, and that does make surgery at this end of the spine a more difficult recovery. When you do get a consult with a spine specialist, make sure you have a list of questions.

Will you share your progress as you move along on this journey? Good luck with your therapy.

@sleeplessinmissouri You might want to keep notes on your condition. A work comp situation can be a dance of the assigned medical specialists trying to avoid having the company pay the bills. Spine surgery is very expensive and some companies are self funded, so that comes out of company profits. Work comp is also more than just paying the bills for medical treatment. It pays lost wages, and if you file a case with your state's board, there would be an award for the "loss of use" or damage. There are tricks to that as well, so getting an injury attorney can help facilitate this. The company will be consulting their own attorneys in all the responses they make to you. You can also get caught between your health insurance that won't pay because it's work related, and the work comp process that doesn't want to pay either. You do have to cooperate, but you have the right to choose your own doctor or surgeon instead of a doctor assigned by the company. You certainly don't want a surgeon who does all kinds of orthopedic surgeries instead of just focusing on spine surgery.

I agree with you not to rush into surgery, and that should always be the last resort. If your disc is causing foraminal narrowing, it is likely ruptured and spilled the jelly like nucleus inside into that space. That causes inflammation and prompts arthritic changes and bone growth there that will further impinge and put pressure on the nerves. It isn't a disc slipping out where you can push it back in, it has a tear in the fibrous outer covering. Get copies of all the medical records and imaging in case you want to take that to another doctor that you choose. You need to get a sense of how fast that can progress and when surgery may be indicated. Sometimes, they do a procedure to just clean up the extruded portion and leave the damaged disc in place. It can cause the same problem later when more disc jelly gets squished out.

44 is pretty young to start with spine issues. There may also be other bulging discs that will have issues years into the future. I had a whiplash and bulging disc that took about 20 years before it herniated, but once that happened, there were bone spurs that grew and pressed into my spinal cord. The only way to improve that was surgery. This location of L5S1 is also bearing almost all of your body weight, and that does make surgery at this end of the spine a more difficult recovery. When you do get a consult with a spine specialist, make sure you have a list of questions.

Will you share your progress as you move along on this journey? Good luck with your therapy.