Severe lumber pain and numbness

Bones, joints and muscles
1

Hi

first a bit of history about me, I am male 54 yrs old worked as a Signalman until last year when I was medically retired due to Osteoarthritis of the left knee, left hip and Lumber spine.

I previously had a serious RTA in 1986 on a motorbike, causing compound fractures of the Femur ( ended up underneath me) Tibia  and Fibia.

Tibia fixed by plate, Femur was set in traction for some 7 wks in hospital , discharged only to find the Tibia was a non Union , and returned to hospital shortly after for a bone graft and external fixation.it was 9 months later before I was able to walk again in aided and return to work.( left leg approx17mm shorter than right)

Fast forward to two years ago, I noticed I was having difficulty getting up from the floor, and lumber region was painful after walking/ Standing 5-10 mins . I also noticed my left leg becoming weaker.

August 2013 my knew gives way climbing stairs, unable to weight bare for about 5 mins, but the. Recovered so I finished shift.

Knee was painful getting in and out of car and operating clutch, A few days later left knee gave way again, this time descending stairs ( felt like the bones hit each other) I couldn't bare weight at all after this event. 

I was taken to the local A&E where a possible Meniscus tear was diagnosed, sent home to see GP, this was just the start, I was put on crutches, had an X-ray at health centre on GP's request , but nothing really showed up.

GP requested an appointment at local hospital with Orthopaedic dept, and some 6 wks later I went for the appointment, had a X-ray of left leg and lumber spine . The Consultant informed me I had slight to moderate Osteoarthritis of the left knee, left hip and Lumber spine, and gave me a cortisone shot in the knee, and made arrangements for the same for the left hip in theatre.

The period between the first visit and going for the cortisone shot in my hip I had noticed my left foot getting this strange numb, warm water sort of feeling , and more serious imo was my right thigh also going completely numb, I was also finding I would have to lean on shopping trollers etc in supermarkets.

A few weeks later I had a step inserted in my shoe sole which was 17mm , made no difference , and Ibadan the hip injection Nov 2013 ( still off work)

 Consultant sent me for full left leg XRay to check alignment which turned out to be very good. I was then sent for MRI scans of the Lumber spine and left knee in Feb 2014 , it took 6 wks to get any form of result which basically came back with " wear and Tear" of the joints mentioned, I explained my concern of now nearly a year later I was unable to stand or walk for more than around 10 mins due to the pain and numbness , Consultant had the MRI's reviewed , and I was then informed I was to get facet joint injections for diagnostic purposes.

I had the injections (4 in total) in the middle of June2014, and noticed an immediate improvement, crikey I could walk normally what a difference, only for all my hope to be diminished some 5 hrs later, with the weakness reappearing and all the symptoms returning within a month!

 I was then referred to Neruology and the Pain clinic, started receiving Amiytriplynr (75mg) at night, and Gabapentin building up to 2700mg daily( which did nothing but give me serious memory issues, and absolutely zilch for my pain etc, )

Further appointment with Consultant who offered a left Arthoscopy which I had done in March of this year, ( Forgot to mention I was ruled medically unfit by BUPA for my employer, so lost the job I loved doing, and had the joy of our lovely Gov's support, ie ESA and PIP assessment. )

 Now May 2015  I still cannot walk or stand for more than 10mins, numbness still persists , the left knee does seem stronger since the Arthoscopy ( which by the way was she filed for 45-60 mins , but took 2 hrs 10 mins , when I woke in recovery , I don't know how long it takes to come round after an Op, but would not think its that long.

 The strange thing  the only person that connects the accident to my issues now is me and my GP , despite my surgeon back in the eighties saying I would have real issues with Arthritis and spinal problems . 

Certainly, I don't think the left being shorter would have helped for some 27 yrs, when I was carrying out heavy engineering work .

  

 Sorry for the length of this thread, just wondered what others thoughts are on this. 

Still taking Naproxen 500 mg Solpadol 30/500  Amiytripalyne 75 mg nightly. 

Cheers

 

 

2

Hi Clive, I can relate to some of your issues, more around the back pain and leg pain / weakness and as an ex medical rep with a degree in pharmacology am pretty genned up on any drugs I take, and areas of medicing I was trained up in, as I sold as high up as Prof's in hospitals. My experience though is first hand. I have not worked for 7 years now, am only 41. I had had episodic lower back pain and v bad sciatica in left leg with numbness on outer side of foot and down calf, hard to get a layman to underrtsnad how sthg can hurt so much and feel dead at same time. I very often have my hip ''give way'' from under me and likewise my knees can go from under me, causing me to stumble. I have taken many drugs over last 7 years and had corstione injections at Pain Clinic in theatre, diff sites of my spine ( and yes they do work, not for everyone, best I had was 6 months, last two times I got a month max ). It is said that the more steroid injections you have that over time they get less effective, but where I live I was lucky to get in once a year ! I have asked my consultant Pain Management Dr at hospital before now if she could administer the spinal injection a month before I was going on a plane for family holiday, as I have two children 13 and 16, they were younger then, and I wanted to take them to Florida ! It certainly helped. Can take 1/2 weeks post injection to settle down and the steroid to kick in, then lap of Gods how long it lasts - varies a lot from one person to another and what used for. I know people who are fantastic for up to 9 months after spinal injection ( done under X-ray into epidral space at specific levels of spine ). My discs are herniated at L5/S1, L4/L5, and L3/L4. I have nerve irritation, some ''wear and tear'' as you call it, osteoartritis but mild-moderate, also my lumbar facet joints have croaked it, so i cannot flex much, my muscles in the base of my spine shoot into spasm a LOT !! I have taken Gabapentin before, I took 1800mg, as there is no clinical evidence that using a dose aboce 1800mg a day has any clinical benefir for pain, only increases side effects. Funny you metion that your memory affected - me too. I was switched to Pregabalin ( Lyrica - trade name), as I would fotgert names, what I was doing, ''lose words'', like I could see them like in a crossword but couldn't grab the word - bizarre. Anyway, after feeling like I was getting Alheimers disease in my 30's I have finally at age 40 made the decision to stop it, al be it gradually, or you can be v poorly. I am half way there. I think that poss the receptors numbers have adapted or something like that, as doesn't work like it did after I got over the initial side effects of starting treatment. Therefore, I got in contact with my GP and Pain Clinic at hospital and have since seen the consultant.....I may be having more invasive procedure for my back and hip/leg pain if I am deemed suitable candidate as got pretty horrendous after 8 years now. 

I used to take tramadol 50mg, or tramacet 75mg for the pain. but I began to tolerate this, so had to switch to slow release morphine, I take 20mg twice a day of zomorph.( tablets). I also take 2mg diazepam for muscle spasm 3 times a day, was more effective a few years ago too. I am also allowed a bottle of liquid morphine, oromorph, at home for bad flare ups. I am deemed educated enough with my degree in Pharmacology to not OD on it all !! I have got a pack of 500mg naproxen too, which I take as an add on if need something in the middle, is. not as heavy duty as oromorph - as eventually I will tolerate this and not really any where else to go !! I don;t want to become dependent on it !! but I need it !! I have already haad to escalate the dose in the last year. 

Low dose amitryp. is an old antidepressant but has a dirty side effect profile, the worse of all AD's ( I sold SSRIs and know that market inside out ). I tried it as can be helpful for some people, but for me I felt like I had flu, sweating profusely, dizzy, reaaly tired, and dose was lowest could prescribe (abbrev Rx). 

I too could go on all night, but supper nearly ready ! I would question the dose of gabapentin you are on !!! Look it up online, I do, then talk to dr, they don't like informed patients but please never put your dr on a pedestal as I have been wrongly diagnosed etc in the  past - info. is power, so long as you undertsnad it and the source is reliable. Lot on US websites too. 

Hope this helps a little. Feel free to ask me anything, I have even had my nerve ending burned away in my spine ( that hurt a lot !) - aka radiofreuency ablation - i think I got some benefit from it, had it done at Leeds, but was wearing off within the year. 

Sorry I have no knowledge on kness, not my thing, !

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Just as an adjunct, no one knows what happened to my back, and why it is so bad and so painful. An MRI scan can tell a lot, but not the whole story. Nerves have diff. routes in some people. I had my first episode of sciatica at 19, revsing for my first year exams hunched over table at Uni, lasted 6 months, and drs did and x-ray, which of course shoed nothing. For years, when it had an episode they have me diclofenac, but they did nothing and have dreaful side effects on the stomach lining, so I rarely took ( they were cheap to Rx for the dr ). I had two large babies, my son who is 13 was nearly 12Ib when born !!...so maybe I am multifactorial. I can only shop for a few items at supermarket but hardly ever go now, as problems getting to anything in the trolley and if I lift weighty bags mt back muscles shoot into spasms, poss. put me in bed for a week ! When my husband is at work as a teacher and the kids are at school it's pretty har work especially since we live in a house with a staircase, I now have an automatic car, as predominantly my leg that goes numb and I use a hiking pole for walking outdoors. If we were to go shopping I now need a wheelchair which we purchased some years ago now for our family trip to Disney in Florida. 

It may sound bizarre after me having stated meds and procedures as I have, but I went on a Leeds Breathworks Mindfulness Course 18 months ago, teach meditation and can be found online. The NHS do a watered down version of it, but this is a lot better and no medicine !, very calming and taught to be able to do at home. It was set up my a lady called Vidymala Burch ( Manchester is the main centre ). 

In the early years I did find mild exercise such as aqua-aerobics really helped, helped firm up the core stability muscles. sauna after fab for muscle relaxation, but don't exercise for couple of hours after a sauna or will hurt oneself. I know you area guy, but if balance not an issue some people find Pilates helpful to gain strength too, get do at home with a DVD, lots on Amazon to choose from.

4

Hi Holly

cheers for the replies, I was put on Gabapentin by my GP on instruction from the pain clinic, I had told them I doubted it was neuropathic pain that was causing my issues, as it only becomes a lot worse when standing or walking, occasionally seated.

I built up over many weeks to 3x300mg doses 3 Times  daily of Gabapentin, giving 2700mg in total, but once they saw it was having no effect , and some pretty bad side effects I was slowly taken off them.

Inhave another appointment with the Orthopaedic Consultant, which is basically a review since the knee Arthoscopy.

The pain clinic did advise me before putting me on Gabapentin, that they would not be carrying out another set of Facet joint injections, as basically it was a failure, and they were expecting a good 6.- 9 months of relief , and not 3-4 wks as what occurred .

MRI review came up with the following, pitting of the facet joints and evidence of possible impingement, evidence of possible bony growth/Spurs possibly doing the same, evidence of slippage , and Degenerative L5 , The Doc that carried out the Spinal injections also reported issues he noticed when carrying out the procedure using fluoroscopy, but I cannot recall the terms he used, but basically issues around the facet joints. 

Consultant did say he was sending  a report to a spinal surgeon , but did not think he would operate as it would likely lead to more issues than present. 

Cheers

 

5

Hi Clive,

Regarding your Facet Joints I know exactly where you are coming from. As well as discs rpolapsed at 3 level to varying degrees I too have facet joint degenration and muslces in lower back always in some degree of spasm and impinging on nerves in hips and down legs. Varies fom sciatica through to feeling like someone is pouring a kettle of boiling water down the front of my thigh constantly, or like 4 nights ago 12 hours of my lower leg being really numb yet really painful too, was in agony and even good dose of diazepam and oromorph acieved no relief from it....anyhow, please be aware that these ''newer epileptic drugs'' that are used for peripheral nerve pain as a side license have a fair whack of side effects that come with them. I found it to be a magic bullett for about 6 months, before the long term side effects started kicking in at around 12 months into treatment at 1800mg. ( split into 3 doses). I swapped to pregabalin, and got down to 200mg of that, but no improvement in cognitive function which I have found very concerning. I too have had steroid injections into facet joints, and epidural spaces under xray in surgery at pain clinic, these too wre great at first, but now have limited if any effects, and I too have had those stopped. I was then told nothing else other than the Expert Patient Programme was of any use to me - which was of more use to some patients than others - I think I am a little too experienced with my science background! - anyway, I did pay for myself a course of Mindfullness and Meditation aimed at people with chronic pain ran by Western Buddhists - lovely people , I went to Leeds for 8 weeks, not a cure but very good, can find on the net under Breathworks ( base in Manchester ). Sometimes anything is worth going to with an open mind !! I am now waiting to see if I am a suitable candidate for electrodes being placed in my epidural space in my spine, a relatively new (ish) procedure done In Leeds Teaching Hospital - when all else fails - it is quite a serious procedure but then so is the pain I endure !  I only hope things get better for you. I had my case notes sent to a Dr Timothy at Leeds over a year ago now, I was later told only 1 in 20 patients actually get to see him in his clinic ( I wasn't one of them), once again I too was deemed the risk:benefit ration not in my favour and not a good candidate for surgery. It is true that scar tissue can cause pain too, and sometimes the expectation to come out pain free is too great, even after major spinal surgery which has a long recovery time. That said I met a lady about 50 in my vets ( my dog gets fab treatment, as insured my moi !), who has suffered for last 20 years and had spinal surgery last year, taking only 'yes' as an answer, and had just returned from a skiing holiday. was like a new woman in her own words !! and she had gone through all the back treatments we have mentioned to no joy previously