Discogenic back pain

Discussions relating to Lower Back Pain.

Discogenic back pain

Postby Jackie » Sat Mar 21, 2009 9:18 pm

Hi. I read a lot on this site about sciatica/herniated discs, bulging discs but am I the only one out there with discogenic back pain? I ruptured my disc last year and prior to that I believe it was bulging. The pain changed from generalized back pain to shooting pain, I believe this is when my disc ruptured. The neurosurgeon told me I was not a candidate for surgery as there was no significant nerve root impingement but the bottom two discs were diseased and I would likely be in pain for 2-3 years. There is no disc material showing on the MRI, just that the discs are grey and not white like my other discs. The rupture is right in the middle and when I am flared up the pain shoots down to my tail bone. I have frequent flareups and do have to use meds daily to control it. so far I am resisting taking lyrica or gabapentin as per the neurosurgeon's recommendations but am getting tired of the constant pain when I am standing. I am controlling it with herbal remedies and sometimes ibuprofen. I would like to hear from others with this problem. I walk as much as I can and I do the stretches that don't aggravate my condition. I also work out on the stationary bike as I have less pain sitting (as long as not for too long) than with standing. Does anyone else have this problem? Am I being a fool for not taking the meds which actually are for nerve pain? I am way better than I was when the disc ruptured but still feel like I have a long way to go. I would love to hear from others with this problem.
Jackie
 
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Postby randolph 2 » Sun Mar 22, 2009 2:09 am

Hi Jackie

Gabapentin is commonly prescribed in cases like yours. Dosages commonly start at 100 to 300 mg, but can go as high as 3600 mg/day.
Contraindications for taking it are if you are elderly, at risk for falls (I assume this means taking blood thinning meds, which it appears you aren't), or have arrhythmias. I don't know how expensive it is, or it's side-effects, but I'd be willing to use it to control my pain if the OTC meds I was trying weren't cutting the pain AND I was working closely with my doc to monitor the effects of the drug. NOBODY wants to use prescription meds, but if you work closely with the prescribing doc, you are most likely in no danger of misusing it. I'm not trying to convince you to use the gabapentin, but why don't you want to try it?

A relatively new, non-invasive outpatient therapy called IDET (intradiscal electrothermal therapy - takes about an hour - a thin wire is inserted into the disc) is showing some promise in clinical trials for your disc pathology. Have you spoken to an orthopaedist about trying IDET?

Please keep us informed on how you deal with your discogenic discs.

Randolph
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Postby Jackie » Sun Mar 22, 2009 6:44 pm

Hi Randolph. thanks for the info. I guess I am holding off on taking gabapentin as I keep hoping I will get substantially better soon. I am able to manage most days on OTC but the pain is always there, going up and down all day as nerve pain will. I'm interested in IDET but it only seems to be available through private pain management clinics and is really expensive. I'm on the waitlist for a pain management clinic through a hospital, it will take 18 months to be seen. I only have a GP at this point so I believe the next step would be the pain management clinic if I still need it by then as there are specialists from different disciplines working there, including orthopedists. any specialist referral can take months and months. The gabapentin is costly but extended health will cover so I may as well try it. it is just my stubbornness and reluctance to take something everyday, even though I have days when I don't need to take much to get through the day. your reply was helpful though, I have a great GP that would support prescribing pain meds I am willing to try for this condition.
Jackie
 
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Joined: Mon Mar 24, 2008 7:31 pm

Re: Discogenic back pain

Postby bobbyd » Sun Apr 05, 2009 3:27 pm

Jackie,

I have had a similiar diagnosis for 20 years and find it very frustrating. My MRI's never show any root damage but lately I do have some disc height loss but again no nerve compression. I do have flare ups 2 to 3 times per year depending on how hard I push myself to do things. Sometimes I careless things and end up suffering.

There is quite a bit on discogenic pain and IDET info on the "net" but I am I have not found any convincing evidence that agrees that discogeneic pain is real or theroy or that the IDET process works. This is like most back remedies. I have tried most non-surigical treatments from inversion/DRS/chrio/physio/injections/back to life/etc..... with little relief.

I have stubbornly been at it for 20 years suffering at different levels of pain with some years better than others. The time to reovery has been the worst part (Loss work time, time with young family and all the mental and emoitionl anxities that come along with it) but with the exercises here the recovery time has subsatintialy decreased.

I would say that since I found this site last Sept. I have been very much closer to managing my back and the associated pain.

I do take celebex for the last 4 years and some herbal treatments as well. I am trying to get away from celebrex but I think it will take quite sometime.

On exercise I have tried many things but found that swiming is the best for me. Any water threapy takes the weight and load off the joints where bikes walking etc seem to increase inflamation and joint irrataion (L4 to S1 for me). My swiming is combined with Dean's exercises.


It sounds like your are doing quite well and I would encourage you to keep up exercising (while not increasing the pain or problems).

I used to have a hang up about being "drug free" but my experience is that more pain and less meds leads to more inflamation and more chance of a flare up. A flare up of a week long proportion isn't good for the joint, work, family or long term recovery.

I hope this helps.
bobbyd
 
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Postby Jackie » Sun Apr 05, 2009 8:09 pm

hi Bobbyd. I really appreciated reading your post, I am sorry to hear you have been dealing with back pain for 20 years. your response was so helpful. I have started taking gabapentin as I need to regain control of this pain and have a better quality of life. here I am feeling sorry for myself that I have had this miserable pain for a year and a half while you have been coping with it for so much longer. I do believe the pain is coming from the disc, I don't have any sciatica, and the MRI does show a disc herniation right in the middle of L5/S1. On a good day the pain stays at the disc level, on a bad day it shoots downward right in the middle. I am managing ok, much better than last summer when I couldn't even stand or sit for five minutes and had to take a medical leave from work. you are so right about getting rid of that hangup about meds, part of my reluctance was that I was prescribed meds that are habit forming and that make me sick. The gabapentin is helping but it is such a low dose so I will need to work out with my doc taking a dose that is a bit higher. and yes, the swimming is amazing. I have added some walking and the biking but do have to be careful not to flare myself up. I do have a question for you, if you don't mind, how old are you? it seems you developed this pain at quite a young age. thanks again for sharing your story.
Jackie
Jackie
 
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Postby bobbyd » Mon Apr 06, 2009 8:49 am

Jackie,

I am now 48 and developed pain in my late 20's. This was my first flare up but flare ups were few and several times at most per year. I continued to try to work out but always got into a back stifness etc. in the early days I didn't really understand the pain or process and it usually went away.

As like most people, life stress kids sucsess all added to this journey.

I am self employed so I need to "keep on keeping" on as they say.

In 2000 I went to a surgeon who is well known and very competent. He gave me a 50% chance of making things better and 20% of it getting worse. I am very much a numbers person and didn't go for the conventional decompression opertaion.

I have got other opinions form others DR. and am always looking for other back suffers to see how they have manged with or without surgury. I find most people who have had surgury at about 50% chance of being somewhat better and the rest the same or worse.

The unfortunate part is that most people that have had back surgury might know what disc or the level or maybe the root nerve that was being compressed. Some I ask have no idea of the problem or even who the surgeon was...wow

My problem (and yours as well) is that nothing shows any specific compression that Dr.s can say this has to be the definate problem.

Studies online I have read say that the disc can have a nerve system and it might even grow with an injury ( i find hard to believe).... Others calim that disc don't have any conection to the nerve sytem at all. So much science... so few answer... lots of ideas....but lots of pain for us...

All the best with your back managment. I will contiue to keep reading and exercising. Let me know if you discover anything interesting.


Bob
bobbyd
 
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