What is my situation???

To borrow a phrase from another blog I read recently...back pain sucks! You don't realize how important your back is to your daily activities until it hurts... and when it hurts it mentally takes you out of the game. Your limitations and frustrations affect not only you but those around you as well.

Background

I consider myself an athlete and have always been in decent, but not great shape. In high school I played football, baseball, and track and field. For some reason I caught the running bug in HS and began running and did so for 30+ years.

The first I noticed any issues was about 10 years ago when I had some tingling on the top of my right thigh right above the knee. It resolved itself in about 3 months and I really did not think much about it after that. Like most people I would “tweak” my back every so often and honestly just assumed it was soft tissue damage...it would tend to go away in a day or two and all was well.

In June of 2010 it came on with a vengeance. By this time I had quit running 2 years ago...ironically it was not my back that caused me to stop running but instead chronic achilles tendonitis. But 30 years of damage had been inflicted. I was in Jackson WY...after a couple days of relatively strenuous hikes I noticed that it was too painful to stand upright. I could relieve the pain by bending over. And now I had something new...the tingling in the thigh came back. My pain was just slightly to the right in my lower back...at the top of butt. I could make the pain subside with riding my stationary or road bike but when I stood up it would come back as if I had done nothing. Walking was the worst. I would have to shower hunched over to make the pain subside...albeit temporarily.

Diagnosis

After about a week of this...I decided it was time to see my primary care physician. He referred me to a Osteopath in their practice. His first step was to order an MRI which is able to detect soft tissue problems. The initial report came back with problems at several different levels of my back. His assumption was that the years of running were to blame...and to quote him...”you can run for 30 years and see me...or not run (or exercise) and see the cardiologist down the hall..pick one”.

The initial diagnosis was “spinal stenosis”. My doctor tried several “adjustments”...like a chiropractor...but those provided little or no relief. He then referred me to a orthopedic specialist who tried a series of epidural steroid injections (ESIs). They have been used for low back problems since the 1950s and are still an integral part of the non-surgical management of sciatica and low back pain.

The goal of the ESIs is pain relief...at times the ESI alone is sufficient to provide relief. Most practitioners will agree that, while the effects of the injection tend to be temporary - providing relief from pain for one week up to one year - an ESI can be very beneficial for a patient during an acute episode of back and/or leg pain. Importantly, an ESI can provide sufficient pain relief to allow a patient to progress with a rehabilitative stretching and exercise program. If the initial ESI is effective for a patient, he or she may have up to three in a one-year period. Unfortunately for me...no such luck. My pain level had increased and I was experiencing a combination of increasing lower back pain (my most prevalent symptom) and leg pain and numbness (also intense at times but sporadic).

By now I was starting to get worried and felt it was prudent to see a medical practice that specialized in spinal maladies. I did some research and settled on Denver Spine. My initial visits were with a generalist who evaluated my case and tried two more ESIs...more from a diagnostic perspective than a pain management standpoint. After a couple of months I was referred to discuss my case with a surgeon in the practice...Dr. Gary Ghiselli.

Dr. Ghiselli ordered a new MRI and a CT scan. To cut to the chase he very quickly determined that my symptoms were the result of two conditions:

• Spondylolisthesis...the facet joint between my L5 & S1 vertebra was broken and my disc was completely shot resulting in my spine slipping forward. After much speculation Dr. Ghiselli agreed that it was most likely the result of increased degeneration from a childhood injury. I'm sure with all the sports I played...over time it really took its toll. I don't recall what stage it was identified as but I'll tell you it was the "hurts like hell" stage whatever that is. Spondylolisthesis was the source of my back pain...which in my case was the main symptom.
  
• Degenerative disc disease...the sciatic nerve travels out between L4 & L5 vertebrae and that level had a ruptured disc as a result of DDD. This is likely brought on by the structural problems caused by the spondylolisthesis. The disc ruptures and the soft spongy material from the inside of the disc presses against the nerve causing all kinds of fun symptoms as leg pain, numbness, etc. In lay terms...it made my leg hurt in addition to my back hurting.
  
  

Tomorrow....How do you treat this??? Can you treat this???