Sounds like you are doing a lot just be careful to listen to your body and pull back or eliminate things that aggravate your pain.

lol.. I figured you had DDD for sometime as the changes don't occur overnight ;) What I meant by acute inflammation causing the modic type 2 changes -was that whatever happened that caused this huge increase in pain also created an inflammatory response a normal reaction when our body is injured or sick. You already know this but the left paracentral disc protrusion means that the disc is herniated (and leaking the painful nucleous fluid) protruding to the left side and impeding the normal position of the nerve.

My best guess is that they will try a round of medicated steroid injections along with PT before any other types of treatment.

Is there a pool that you could walk in anywhere near you? That would be so much better than trying to walk on land for now.

Wishing you well
Tessa

Thanks Tessa. I don't have a pool I can walk in nearby with any comfort - its a cold pool and created all sorts of CRPS issues last time I tried it, no chance with the bad back as well... So yet again it's my immune response at work with the modic changes.....do you know if they can heal and repair, or if it's a permanent change? It's hard to tell from the sites I've seen.

Bram.

Bummer about the pool! Perhaps the physio will have an aquatic therapy pool that you could use - crossing fingers.

As far as I understand about the modic changes with DDD is that those changes can occur and actually go back and forth between type 1 and 2 depending on the stage of the inflammatory response. From my understanding and based on what you shared it seems that it is a 'focal' change meaning it is only seen at the level where the disc is protruding. If it was a 'diffuse' finding then those changes would signify something else as the cause and further evaluation. I would guess that the modic change isn't what your doctor will be concerned about as the nerve displacement and clear aggravation is the reason for your pain.

Just in case you are thinking your immune system is behaving poorly in this - it isn't. It is doing exactly what it should be doing by sending the inflammation and triggering pain to warn you that something is wrong. Just like an alarm system.

What day do you see your spine doctor?

I sent you a message quite some time back - I have similar issues. I think my MRI showed worse damage than yours.

Pain meds do not help me, so I do not take them.

I got pneumonia after getting the flu in January and they put me on a burst of steroids, which helped.

I have been doing the very beginning of Tai Chi and Qi Gong and so far, it's going ok…. but, with the RSD, I am going really slowly. After a month, I am still working on the "warm up" exercises.

I still have my legs going numb, tingly, burning painful when I stand for more than a few minutes. I can't sit very well.

I try to walk some for exercise, but it is difficult.

They want me to go to a chiropractor, physical therapy, acupuncture etc…. but I just cannot afford it on SSDI. The two DVDs for Tai Chi and Qi Gong were $20 so I could afford that.

I need to much $$$ spent on eye surgery and dental work right now - can't go to the other things, so am doing the best I can.

I was not able to use a TENS for my RSD, but found it works for the lower back/scoliosis etc. So I got some more of the pads for it and have been using it. Seems to help break up the pain signals.

Hi daylily :) I can't find a message from you sorry - the system must have eaten it...but thank you anyway, I appreciate it all the same!

There are quite a few YouTube vids of the Qi Gong and that kind of thing, mindfulness meditation exercises, etc. I haven't paid for anything so far, lol, bit of a cheapskate, me :rolleyes:

I'm not doing that much yet, I'm only doing a few reps of anything if I feel up to it, which isn't often. No way I'm risking anything at the moment. Just want to get a definitive view of a specialist so I know what to do for the best and what my chances are of getting ay without surgery.... Hate the waiting around.

I'm sorry you've got such horrible spinal issues, back crap really sucks, you don't realise how much it affects things until it goes wrong.... Hope you're having an ok day today. What happened to your back? Hope it's something that can resolve with time or be treated.

Take care, and thanks for posting :grouphug:

Bram.

Bram,

If it gives you any comfort - a dear friend of mine who is 84 years old just went through the surgery that they usually do for this issue, this past Friday. She is doing very well post-op even at her age! She suffers from RSD/CRPS in her arms after going through radiation/chemo for breast cancer over 20 years ago, so there is hope that this could help you even with CRPS/RSD.

I also had similar issues in my cervical spine C3/4 & C6/7 and had a successful operation in 8/2012. I had immediate relief after they opened the nerve holes on both levels and haven't had any further problems since then. My only regret actually was enduring daily pain and headaches for so long before finally agreeing to surgery. I did have good relief from the injections, but they only gave temporary relief as the nerve openings were being closed off by bone spurs from the effects of DDD. The injections did however help the doctor determine if surgery would help so I'm glad I went forward with them even though they caused me great anxiety before hand. The one thing I would caution is to consider getting several opinions before agreeing to any surgical intervention.

:hug:

NOTE: Hey guys, so I didn’t read all the prior responses before posting mine (sorry, running tight on time), so if I’m overlapping I apologize.

Oh wow Bram… Sounds like you’ve got degenerative disc disease :( (me too) and have herniated the disc real good, yikes. That can hurt so bad and take a good bit of time to heal up, only to later have it herniate again. DDD sucks! Our MRI’s sound somewhat similar.

BEFORE I had surgery and we’re talking 24 years before, I would often go see a chiropractor and sometimes that would bring me relief. I will not see one since surgery. I feel like I am too fragile now.

Stretching my knees to my chest, ultimately stretching my back to open the vertebrae sometimes helped. Alternating heat and cold (I know & you know about crps & cold) so now I just soak in heat now.

Often it required doses of pain medications, muscle relaxers, and nsaids. If you can, get a lidoderm 5% (lidocaine generic) patch or Voltaren gel 1% and put on your back, this would be of great help! Now that I know something about these injections, I would definitely recommend you try them for this! PT will help you too.

Rest your back. Be patient, it can take a while (weeks) for this to work itself out. Listen to your back. It will tell you when you’re done doing whatever you’re doing. Then get off it. Like completely off of it. Don’t sit. This only puts a whole lot of pressure on your lower spine. Can you lay on your right or left side? I know lying on my back is not an option for me. I’m likely to never be able to get up. Once your back feels better (could be weeks from now), build your core. Get as much strength in that area of your body as possible. Something I myself wish I had more of.

Ultimately my disc gave way (23 years later) and ruptured. In hindsight what I learned was that there were some options (artificial disc, etc) that after my surgery were not options. Years and scar tissue and now more discs involved, and those are not available to me. Once the disc ruptured, compressing my spine some crazy 75%, it became an emergency and surgery was required/mandatory. Does that mean I would have had surgery before it ruptured, I’m not sure about that, but the reality is that my options changed after it ruptured and I had the discectomy.

Bram, I am really thinking that it may take weeks, but that your back will probably start to feel better soon if you baby it. Take a bit of time and look at treatment options. I think any kind of spinal surgery is risky and the results frankly usually are just not that great, but you have to decide what might be best for you. I really believe this will settle down, rear its head, and rinse, repeat, cycle. <big deep sigh> I’m so sorry hon. It’s just one more thing! :hug:


Something I found I thought you might find interesting.
Modic Changes:
The prevalence of Modic changes among patients with degenerative disk disease (DDD) of the lumbar spine varies between 19% and 59%, with type 1 and 2 changes being the most common and type 3 and mixed-type changes being relatively rare. There is disagreement as to whether Modic type 1 or 2 changes are most prevalent in this patient population. Although several series, including the original study of Modic et al, have shown that type 2 changes are the most frequent and may account for up to 90% of Modic changes, other studies have suggested that type 1 changes may be more common and may constitute up to 68% of Modic changes in these patients. Such differences in the quoted prevalence of Modic changes and the relative frequency of each Modic type are most likely the result of sampling errors and variations among the studied populations. Modic changes are most common at L4-L5 and L5-S1 and are associated with increasing age. These changes usually occur adjacent to degenerated or herniated intervertebral disks.


In their original study, Modic et al analyzed histopathologic sections from 3 patients with type 1 changes and 3 patients with type 2 changes. The authors found that type 1 changes were associated with disruption and fissuring of endplates and formation of a fibrovascular granulation tissue. In contrast, type 2 changes were associated with fatty degeneration of the red marrow and its replacement by yellow marrow. They concluded that type 1 changes correspond to the inflammatory stage of DDD and indicate an ongoing active degenerative process, whereas type 2 changes represent the fatty stage of DDD and are related to a more stable and chronic process. These authors later postulated that type 3 changes represent the sclerotic stage of DDD.

Thank you Vrae! :)

Loads of information there, thanks such a lot... I'm actually sitting up at the moment simply because I get sooooooooo bored lying on my side. I only lie down once my back starts complaining loudly, and then rest and repeat. It's getting old very fast.

I do think it's improving. Slowly. So slowly. Some days are worse than others, but overall there's an improvement. It's been hard to get my head around the realization that now this has happened, I have to be very careful for ever now or it'll a) not heal, b) happen again or c) rupture completely and really give me grief. All excellent reasons to be wary....

I'm doing some core exercises, but hoping to see the physios before I really put the work in, as I want to be sure I'm doing them right. Don't want to risk making it worse...

Thanks again Vrae.

Bram :grouphug:

Hi Bram! I am so sorry to hear you are having these spine issues. I was diagnosed with degenerative disc disease in my thirties and have survived four spine surgeries. The third one is when CRPS came to live with me.
I agree with most everything that has been said by the others so I will try not to repeat. My best piece of advice is to go very cautiously with treatments especially if any doctor proposes surgery. Spine surgery should be the last resort when nerve damage is imminent.
I highly recommend conservative physical therapy, pacing your activity and resting BEFORE the back screams, warm water pool is ideal, NSAIDS if you can tolerate them, keep up with your meditation exercises, short walks. My guess is that you are in a acute phase and it can get better. Then, the challenge will be not to get into another acute phase - physio can help you with core and spinal muscle strenthening to stabilize the spine.
Feel free to private message me and I can share with you more of my personal spine story.
Wishing you wellness ~ Lottie

Hey Bram, I'm not so sure that you should really be doing too many exercises on your core right now. I'm thinking you should let it heal. And you're right about letting the PT guide you to know how to do them correctly.

Don't be too down. It may heal, and you may build up more strength in your core, and get real strong there and not have much trouble again. Try not to borrow trouble hon, it may turn out okay. :hug: