As I'm sure you all know, I've been going to lots of different doctors about the chronic leg pain I've been having since September 2007 (coming up on 4 years for those counting). At this point, I've tried just about everything under the sun (physical therapy 3 different times, yoga, pilates, acupuncture, chiropracter, TENS (electric nerve stimulation), medications, injections, rest, exercise, etc). I've just had an appointment today, and really felt like recording this whole journey (specifically the last year) as I gear up for the next step, so the first part of this is background, the second part is what happens next.
This past year, I decided to go after it a bit more aggressively. Over the years, I've usually seen a doctor until they gave up, and then stopped until I got a new doctor. This time, though, instead of giving up, I had my doctor refer me to another (and another), with the hope that someone, somewhere, would be able to give me some answers.
The first specialist I saw was a physiatrist (a doctor who specializes in rehabilitation and pain medicine). He had me try a few different medications (an anti-inflammatory, nerve medication, and vicodin, all to no effect). After some very normal looking MRIs the physiatrist made a somewhat more invasive suggestion. So, I took a day off work and got an epidural between my L4 and L5 vertebrae. Unsurprisingly (given this injury's stubbornness), the epidural did nothing. With that, this doctor was done, and referred me to a neurologist (an doctor who is an expert on the nervous system - given the tingling in my foot/ankle, a nerve issue is likely).
My new doctor thought we might as well do another set of MRIs, which showed nothing. We tried yet more pills, and I went back to physical therapy for a few months. The pills did nothing, so, why not - another MRI. This time, he focused on my lower spine and used contrast solution.
Surprisingly enough, when the results came in, it appeared that there was actually something there - a fuzzy 6mm "enhancement" near/on my L4 nerve. He believed it to be a shwannoma (a benign tumor) and sent me to get a second opinion, which is what brought me to my appointment today.
Today, I met with a neurosurgeon, whose job was to give me a second opinion about my MRI and possibly talk about having back surgery. The doctor was very friendly, but basically said that the MRI was inconclusive and, even if it was a schwanomma, that they are notoriously difficult to operate on
(because the tumor basically is growing on the outside of the nerve, trying to remove it can badly damage the nerve itself). Besides the pain, they aren't dangerous, so in that sense, it's not a horrible thing to have, but resigning myself to this pain forever was a pretty upsetting thought.
This doctor, like the last, told me I had to really think about whether I felt the pain was bad enough to warrant the risk of a serious surgery that might not even help.
At this point, I got a bit teary (which I think communicated that, yes, this pain is bad and, no, I can't just forget about it if there's an option) so he gave me a couple of other options that I could try.
The first of these is to get another epidural. He said that there are a couple of different positions for these that can be helpful, and it's the least invasive option to try, so I have that scheduled for Monday. It's funny how last time I got it (in November) I was pretty nervous. Now that I've been thinking a lot about back surgery, this doesn't seem like that big of a deal (also, it hurt less than I thought it would).
If that doesn't work, there is also something called a spinal nerve block, which I don't totally understand, but basically it's injected (inserted?) into my spine and is a way to deal with general/undiagnosable nerve pain. This is a lot more invasive than simply an epidural, so he didn't want to start with that option.
The final option is exploratory spinal surgery (which also might happen if I get the nerve block, I'm not sure), where basically they would open up my back and look around, to try to see if they can figure out what's wrong. Obviously, this is a last option since there can always be complications with any kind of major surgery.
So, that's where things stand. It was sort of a wake up call, to realize I might need to simply accept that I will always have this pain and there might not be any solution. I'm a bit disheartened, but hopefully something from my new "list" will work.
Send some good thoughts my way that someday my leg will feel better.