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MS & Herniated Discs - Common? Dr. advice would be appreciated.
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Tat2Kate posted:
I've been having lower back pain for month and a recent MRI (to check-up on my MS), revealed a herniated disc (or is it disk?). This is what the report says:

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At the L3-4 level there is a focal posterior disk protrusion which is primarilary central. This results in mild to moderate ventral encroachment on the thecal sac.

At the L4-5 level there is a slight loss of normal disk signal with very mild central posterior disk bulge but without high-grade canal stenosis.

At the L5-S1 level there is a small central and slightly right posterolateral disk protrusion. There is mild associated endplate spurring. There is no high-grade canal stenosis.

Impression: Degenerative disk disease noted from the L3 through to the S1 levels.

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My PCP put me on low dose prednisone (30mg) for 5 days because I'm also diabetic. I have one day left on the steroids and so far they've done squat.

She gave me the name and number of a pain doctor who could give me an epidural in the hope that it would alleviate the pain. As it is, I can't walk to stand for more than a few minutes without the excruiating pain kicking in.

I've been reading up on the epidurals but it seems that they don't work as well as most patients hope they would. And subsequent injections don't just last as long as the first.

So here are my questions to the community and any doctor who might read this:

1. Do herniated disks heal by themselves?
2. Would it make sense just to go to a chiropractor instead of going through rounds and rounds of epidural injections?
3. Are herniated disks common in people with MS? I ask because often our gait is off and we end up compensating for it on one side over the other. Perhaps that causes the herniation?
4. Is a nerve block the same thing as an epidural?
5. Is there anything else I should be doing such as stretching, physical therapy, etc.?
6. Should I sleep with pillows under my legs so my lower back is pushed flat against the bed so it isn't arched?

My Neuro is not a real big help in this arena because he doesn't consider it neurological. My PCP is trying to be helpful with giving me steroids and a number to call for an epirdural but I think this is a little bit out of her area of expertise too.

I'm not sure what kind of doctor I should go to or what other options I may have.

Sorry for the long post!!!

Thanks for reading and offering any advice or support you can.

All the best,
Kate
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hackwriter responded:
Dear Kate,

I have a disc herniation in the C-spine and one severe bulge and lots of mild and moderate disc bulges all the way down the C-, T-, and L-spines with arthritic facet joints in L5-S1. So I can understand your issues.

I manage the neck hernation pain by sleeping with a contour memory foam pillow for support. A heating pad works wonders when I'm sitting upright and the pain comes on.

Lower back pain needs a pillow under the legs or lying on your side in the fetal position; lying on your back with straightened legs will worsen the pain when you try to get up. (Trying to sit up after 40 minutes inside an MRI tube is excrutiating--even though they put a small pillow under my legs!)

Chiropractic is something I tried but I didn't get impressive results. My neurologist thought it was risky for a disc herniation since a correction could cause the disc to slip against the cord and cause paralysis. You might want to ask your neuro for advice on that.

Staying mildly active is the best way to manage the arthritis and disc problems. (Hard for an MS patient, but doable on some level.) My lower back starts hurting when I stand for more than a few minutes and is relieved by sitting. I feel best when I sustain some activity for five minutes then rest for fifteen or twenty, then up again, etc. Excessive standing or sitting brings on the pain.

Ibuprofen helps my back pain, too, and I have vicodin handy if I think I need something more. I rarely use it, though. If you can manage to do yoga, that can be very helpful, too. When my spasticity was milder, it worked wonders.

I'm not sure that our bodies overcompensating for weakness causes disc problems, but I suppose it could. Spine degeneration goes along with aging and strenuous labor. Most of us have mild disc bulges by middle-age.

Have you tried traction therapy? It wasn't successful for my herniation, but some people have success.

I hope you can find a solution at the pain clinic. I've never tried an epidural or any kind of injection, but I know a fair number of people who have and the results have been mixed.

Good luck, I hope you'll let us know what you find out.

Kim
 
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Tat2Kate replied to hackwriter's response:
Thanks, Kim, for your reply. Today was my last day on steroids and I took a sick day from work and basically slept all day because I wasn't feeling too good. So we'll see if the steroids have helped when I'm back to work tomorrow. Thankfully it's a desk job but we're a very social group of people who stand around chit-chatting a lot.

If the steroids haven't helped I'll try the epidural. I've heard mixed reviews on that too. Pain meds often don't work for me. For instance, Vicodin or Oxycontin, even in high strengths, is like taking a baby aspirin. The only pain med that really helps me is just plain old Tramadol.

My sister suggested getting the baclofen/morphine pump like she has but I want to avoid surgery if I can. Plus she walks around like a zombie half the time with that thing.

I've never been to a chiropractor - they kind of scare me - so I think I'll avoid that route unless my neuro or PCP really feel strongly that I should go to one (which I doubt).

So now it's off on the pain management doctor route, I guess. I'm 33 but feel like I'm 80 with this herniated disc!

Btw, the steroids, for whatever reason, didn't raise my blood sugar all that much. Granted I'm on insulin but I didn't even take the full prescribed amount last night before going to bed and woke up at 1AM this morning with a nasty cold/hot sweat and weakness. I made it to the bathroom somehow, tested my sugar and it was 38!! I was trying to wake my husband to help me but of course he slept right through it. I had to crawl to the fridge to get some OJ because my legs were like jell-o. Talk about scary! My glucose levels have never been that low.

I have a triangular wedge thing I can use in bed to keep my legs bent but I always seem to kick it off in the middle of the night. I may have to buy two king size pillows instead. I'm usually a side sleeper. I wonder if that memory foam mattress is as good as everyone claims? They're expensive though!!

I suppose I'll take this one day at a time, one treatment at a time like I do with my MS. If one thing doesn't work, I'll try another. There's never an easy fix, is there?

Take care,
Kate


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