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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Lower Back Pain, Have Slipped Vertebra Above Sacrum. What Should I Do?

I had a lumbar/sacral MRI scan(pars view) done 15/06/12 after I eventually got to see a specialist on 11/05/12. He told me I have a slipped vertebra above sacrum and demonstrated on a plastic spine . He also mentioned that nerves were misfiring causing abnormal muscle tension in glute and hamstring and other leg muscles going unused.( I have been doing physio to strengthen thighs. I had arthroscopy , debridement and removal of bone cysts 2008. Cartilage damage in left knee then only stage2, right a little better). I have not got my scan results. The extreme discomfort in lower back stabbing and wrenching pains in hip and odd numbness side of left leg worsening steadily.I cannot find a comfortable position to sleep. Any activities are severely unpleasant. I have an active job in retail and I find I cannot do things at pace anymore as I cannot tolerate sudden movements .I find bending down to access low objects a torture which I have to force myself to do. This makes me urinate too frequently, strangely lifting heavy objects is not any more painful than the bending.( When I first started having back symptoms I thought it was severe cystitis and even had a course of antibiotics.) Walking to and from work is also a torture. I cannot even handle sitting in one position for very long esp on hard chairs. Luckily I do not have the opportunity to sit at work except for on a kickstep (I work 50hrspw ave). I still go to gym about once a week where I was told the leg press is helpful. I choose my activities carefully but still like to push!! My current pain relief daily is up to 400mg tramadol, 240mg cocodamol,2 naproxen(crap) omeprazole and now amytriptiline25mg evening and I still get breakthrough pain( and I am now a cabbage). I need treating as I am getting worse, I dont think resting works particularly either. How do I proceed?? I have only been offered a phone appt with specialist for fri 6/7/12 for 10 mins. I asked diagnostics to send scan to gp but they failed at that too. I cannot concentrate as I can t get comfortable. What should I do???????? How is it acceptable for a working person, who pays ni, to be fobbed off and not given any specific info or advice just some meds. I do feel the slip is not stable and wondering what may happen next...should I obtain my own copy of mri??
Mon, 30 Jul 2012
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Spine Surgeon 's  Response
I think you have significant back pain. From your history it looks like you have unstable spine and you are a surgical candidate. This problems can be cured completely with surgical management. Daily dependence on pain medications is not advisable and it has adverse effects. Do you have Lateral flexion and extension xray? MRI? need to see that. You will be back to your work in 2-3 weeks after surgery. Also this is not only about pain, I think you started developing neurogenic symptoms and signs and in that case timely interventions gives the better prognosis. If you can send you xray and mri images I will be able to tell you more about type of surgery you need. hope this helps you.
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Lower Back Pain, Have Slipped Vertebra Above Sacrum. What Should I Do?

I think you have significant back pain. From your history it looks like you have unstable spine and you are a surgical candidate. This problems can be cured completely with surgical management. Daily dependence on pain medications is not advisable and it has adverse effects. Do you have Lateral flexion and extension xray? MRI? need to see that. You will be back to your work in 2-3 weeks after surgery. Also this is not only about pain, I think you started developing neurogenic symptoms and signs and in that case timely interventions gives the better prognosis. If you can send you xray and mri images I will be able to tell you more about type of surgery you need. hope this helps you.