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Help Needed 40 yr old Male L4/L5c

Hi Everyone,  I have been reading so much on here and it has been really helpful to read everyone's stories so thank you for that.

I am a 40 yr old male.  Last year I injured my back getting out of the car,  LOL yep that easy I got my foot caught in the gutter and I started to fall as I was falling I reached back to grab the car door to stop myself falling and twisted my lower half and upper half in opposite direction this caused me to do an injury to my L4/L5.  The injury was slow to heal and was getting better around August September until one day I coughed and did it all over again.  

The real concern that I actually have is that all scans have shown no nerve root compression.  Yet I am getting pain in my buttock and into my groin area and having a lot of trouble walking.  I have spoken with my doctor a number of times about the possibility of a problem with my SI joint as I am started to truly believe this is causing most of my pain but he doesn't agree. I am wondering if anyone else has done something similar and has caused and injury to their SI Joint as the pain is not improving at all and yet when I have acupuncture around the SI joint area I almost fly off the table at first.  I am getting desperate now as am living day to day on pain killers which barely take the edge of the deep throbbing that I have  down my leg and around my hip and groin area.  I still have pain in my lower back but I am wondering now if this is all referred pain from something deeper. 

Thank you so much.



  • tmacttmac OklahomaPosts: 6

    All I can say is do your research! Don’t settle for anything or anyone but the BEST. Once you cross the into the surgery world things can change not always for the better. I was at what I thought was the point of no return and elected to have 360 S1-L4 its been a nightmare I wish I would of truly exhausted every non evasive procedure known to man. I just assumed I would do well because I’ve had lots of injuries lots of surgeries and done well every time but I guess the back is a different kind of animal.  You are your own advocate especially when things don’t go as planned. Your condition may be  very treatable that’s my hope for you. Not trying to be Debbie  Downer just do your research!!

  • After living with failed back surgery syndrome for 34 years, my only regret is I did not do everything I could to research the possible ways to treat the injury I suffered to L-3 - L-5.  A softball injury was my start.  A friend tackled me between 1st and 2nd base and bent me sideways.  Two days later I couldn't move.  The leg sciatica was intolerable and the back pain excruciating.

    I had successfully incurred a compression of the discs at L3 through L5.

    At the time I was 33 years old and accepted anything a physician in a metropolitan city Hospital told me as being the right answer. Unfortunately for me, the right answer was a recently approved treatment by the FDA was the injection of a material called chemo papain, an MSG derivative which was intended to dissolve the discs between the vertebrae via injection, alleviating the need for surgery. The illustrative movie was great.  A woman had the procedure and the next day was dancing.  In my case the next day I was on a morphine drip.

    Unfortunately, this is the part I regret not asking is what happens if that doesn't work because after the surgery I still couldn't move and was in more pain that I started with. Because the discs had been dissolved it was necessary to fuse L-3 through L-5. I wish I had understood what that meant for the long-term at the time.

    I do not fault the many physicians that I have worked with over the last 34 years some of whom were marvelous and some were not. You have to remember that physicians are only people with medical degrees. In my case I'm sure my physician wanted to try this newly approved  procedure. He was in a teaching hospital in New York City and I fit all of the preferred parameters for the procedure at the time.

    The point of this comment is that I agree with the other recommendations from other participants. Do as much research as you can into your symptoms, the injury, possible procedures you might try,  and then work with a physician who is willing to consider all options beginning with the least invasive, leaving surgery for last.  There is no undoing a surgical intervention.

    In my case with what I have learned over the past 30 years, I would have opted for a simple laminectomy of L3-4 and L 4-5. Unfortunately for me, the L-3 through L-5 fusion failed a few years later as a result of my travels and it was necessary to refuse from L-3 to the sacrum. The multiple back surgeries and the resulting scar tissue etc. put me in a position of enjoying severe back pain and sciatica for the next 34 years.In my case, after research post-operatively I went through physical therapy, acupuncture, massage therapy, meditation therapy, Boot Camp physical therapy for one month spent at a hospital in Florida, the use of every medication known to man, epidural injections, facet injections.etc.  Like many others in this forum, you name it I have tried it.

    So I agree with the other comments. As much pain as you are in now, take a deep breath, research everything you can, do not be shy to interview doctors with candor. Write down all of your questions and concerns before you meet with your doctor(s) so that you don't come back from that meeting saying "I wish I had asked..." and; when you get home, write down all of the responses so you remember what you were told.  Keep a daily journal for yourself and your treating physician.

    Best of luck

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  • MarWinMarWin OhioPosts: 702

    It is possible your back was already injured and the catalyst was the twisting. If you think about the mechanics of the spine and hips, they are designed to twist when needed. Same as with the cough, just another catalyst to something you already had going on. 

    Pain doesn't just exist without cause. You know your body better than anyone. Scans aren't perfect. In fact, done too much, they can be hazardous to your health. A bulging disc may be the site of your pain, but it surely isn't the source. For that you'd have to go to the bones that are compressing the disc. And for that you'd have to go back to the muscles that are moving the bones into misalignment. 

    The sciatica nerve basically controls the lower extremity functions (Sciatic Nerve Anatomy - SpineHealth), so you're on to something thinking there's nerve compression. Your doctor disagreeing and not substantiating why is a sign that he/she has no answer. I mean, the patient could never know more than the doctor, right! 

    You may want to start by looking at your pelvic and shoulder alignment. When I had my sciatica I found that I had the laundry list of dysfunctions: Rotated Pelvis, High Hip, Anterior Pelvic Tilt, Everted Feet, Scoliosis, Low Shoulder, Forward Head to name a few :D . All of which led my lumbar vertebrae to compress the disc causing it to bulge and impinge the sciatic nerve. My symptoms started slow - slight back pain, tingling, buttock pain, and from there escalated to pins and needles, hot/cold, electricity, sensitivity, all the good ones. 

    Keep searching. Never give up. Educate. 

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