Multiple hernitaed discs and stenosis. Trying to avoid surgery.

Hello,

About two months ago I experienced severe leg and low back pain. I wasn't doing any strenuous activities or involved in an accident. I noticed the pain when I stood up from playing with my youngest son on the floor. I've dealt with bouts of back pain in the past - normally lower back pain that would last 3-4 days and then clear up after rest, exercise, etc. This pain started the same week I received a promotion at work that has caused a decent amount of stress the last two months, even though I won't actually start in the job until early 2019.

I've read Dr. Sarno's books in the past and believe very strongly in TMS principles. I typically have back pain symptoms around stressful times and have learned to manage the symptoms based on Dr. Sarno's recommendations. Prior back or leg pain has always felt like strong muscle pain, not nerve pain that would refer down my leg.

My issue this time is the pain has not gone away. I've had continued leg pain, numbness and tingling in my lower left leg/hip/pelvic area. The numbness down my left leg and into my foot continues to be a problem and I'm experiencing muscle weakness in my leg as well. I tried to address it as normal TMS pain the first few weeks, but the numbness and tingling became a concern so I went to a Physical Therapist to see if that made a difference. After three sessions the Physical Therapist referred me back to my PCP because the exercises and treatment she tried to put me through kept producing pain and/or numbness. They decided to do a MRI and the results showed the following:

L3/4: In conjunction with a moderate-sized central/right
paracentral/subarticular recess disc extrusion with mild superior and
inferior extension, moderate to severe spinal canal and left subarticular
recess, severe right subarticular recess, and minimal neural foramina.
Cinching of the cauda equina with greater deviation of the descending
right L4 nerve root.

L4/5: In conjunction with a small central/right paracentral disc
extrusion with minimal inferior extension, mild spinal canal and left
subarticular recess, moderate right subarticular recess, and mild to
moderate neural foramina. Posterior deviation descending right L5 nerve
root.

L5/S1: In conjunction with a moderate right paracentral/subarticular
recess disc extrusion with minimal inferior extension, moderate right
subarticular recess; mild left neural foramen and moderate right neural
foramen. Posterior deviation descending right S1 nerve root.
​

After the MRI results were received, my PCP called and recommended seeing a spinal surgeon right away. They consulted with several spinal specialists and they all recommended surgery, simply based on the MRI results.

I want to avoid surgery at all costs. I still want to believe my issues are TMS related, but I don't want to do something that will jeopardize my health in the future as well. The medical opinions on spinal stenosis vary greatly and it's difficult to determine how I should proceed. The herniated discs on the MRI don't concern me, but the severe stenosis at L3/L4 does. If anyone has any advise or guidance I would certainly welcome it.

Thanks,

Paul

 

Hello Paul,
All I can say after reading your post is I know how terrible it is to live with back, leg, hip pain and numbness and tingling etc. because I have done it for over 2 years now. I also can appreciate how exhausted one can get trying to decide whether to turn yourself over to the spinal surgeons or go down the TMS path. The MRI terminology can be really frightening. If you do see a spinal surgeon, just remember, you don't have to do anything if it doesn't sound right to you. Have you thought about seeing a TMS physician for an exam and taking your MRI results along? Sometimes your brain can't let go and give over to the TMS approach until you chase down the structural stuff and rule in or out those problems. At least that is what happens to me. I have been told (well, let's say 2 years ago per lumbar MRI) that mine was not a surgical case. Unfortunately for me, my brain still cannot get off the structural issues. Anyway, I too do not know what my next move will be. I have been to a TMS physician this summer who assured me I had TMS 100%. Have you looked at the spinal stenosis section of this site - you might find others who have had similar problems and possibly some inspiration from them. Thinking about you and wishing you well. Hope you find your way out of this soon.

 

I definitely recommend consulting with a surgeon who will correlate your symptoms to your MRI results. It matters what specific leg weakness/numbness symptoms are occurring and if they are a good, consistent match with what is on imaging. A good spinal surgeon should see you in person, evaluate you and discuss this with you.

 

I agree with Mindbody, if you DO go forward, make sure that your pain pattern matches the MRI findings of a clear pathology. Are your symptoms all explained by the severe stenosis? And, are all of the surgeons recommending the same surgery?

That said, you've identified major stressors contributing to your symptoms, as well as significant exceptions to the pain. You've also had major success with TMS work. And - for what it's worth - people have had your same symptoms and recovered through TMS work alone.

Surgery is a very personal choice. In my case, I met with three surgeons: all three said no (thank god). Two of them said if the pain continued though that I should consider a double lumbar fusion. Scary stuff.

So, I feel for you!

One option is to hit the TMS work hard. Give it all you got, and search for whatever pieces were missing from your recovery before. If you see progress, then there's your ticket. (Remember the stories of people with absolutely gnarly MRI findings who are pain-free.)
Another option is the surgery, since you'd need a few months to recover before your new job (I'm assuming they're recommending a laminectomy/foraminotomy). I know several people who have had full recoveries from surgery (their pain patterns were consistent and matched the findings).

What is your intuition telling you at the moment?

Wishing you the best

 

So you were not doing any activities and you recognize that the pain got activated when a decent amount of stress was caused. In Sarno's books he talks about studies of people who have pretty messed up backs physically but had no pain and viceversa. I went thru the pain spiral until I got unnecessary surgery and the doctor got thousands of dollars happier, but as for me I got no relief and a big debt left over. I would get opinions from other doctors, possibly from other states and that do not belong to the same local health system. Surgery should be the last option, when it have been proven completely out of any doubt that is the reason for your pain. There are so many things to try before the knife. My lower back pain of 3 continuous years went out by itself. Deal with the stress first, and see if by getting stress free you have any kind of relief. Touch your whole leg for trigger points, they feel like small round balls of pain in your muscles. Should you find them you can approach this differently, by first treating those trigger points. Those MRI results could have been there for the last 10 years without you knowing and without any symptoms. That is how TMS works.

 

Please read my story here, I was in exactly the same situation as you. https://kevinmviner.wixsite.com/tmscoach/my-tms-story (TMS Coach | MY TMS STORY)