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Mark asked...

I have a chronic lower back condition.

I was diagnosed with herniated discs at L3/4 and L4/5 in 1991 and following a 9 month wait underwent chemonucleolysis at both levels. This addressed the most severe symptoms such as the debilitating sciatica, levels of pain in my lower back, and immobility. Although I did not receive any rehabilitative therapy as such, through patience and some hard work I returned to university about 11 months afterwards.

The subsequent 20 years have involved a regime of self management with various courses in physiotherapy, pilates and pain management helping me along the way. I've also sought the help of osteopaths on occasion.

Whilst I accept that I do and will experience numerous episodes of moderate pain each year, I manage these with a combination of medication and exercise. I remain in very condition for a man of 41 years old, and when well, participate in plenty of sports and activities. I did suffer and acute episode in 2007 for which I spent a few days in hospital but made a good recovery. Most recently, however, about 6 weeks ago now, I suffered another severe/acute episode which left me in agony and highly immobile for a few weeks.

I subsequently returned to work eager to keep moving and maintain a normal life. Unfortunately I suffered a 'relapse' the following week and am now trying to manoeuvre myself back into a position where I can once again return to work, albeit in a phased manner if my employer accepts it. I have moderate to sever pain on a daily basis. My sleep patters are quite poor. Each day begins with a few hours of shuffling around until I am able to undertake a set of exercises designed to mobilise my lower back.

I recently saw a neurosurgeon at our local Spire hospital. He ordered bloods, X Ray and an MRI. Unfortunately, none of the above diagnostic tools showed what he was expecting to see. His comment was that if he had thirty patients like me he would hang himself. This didn't really inspire much confidence on my part. He offered me a discogram to which I agreed if it was the next logical diagnostic tool but 2 weeks later I have not heard anything despite chasing.

I feel I have and am exhausting my options at present and am not sure what I should do. I have also concurrently sought help under the NHS. I have another MRI, incorporating the pelvis and sacrum, due later this month. I have had a full set of bloods and all results are normal and/or negative for any abnormalities. Whilst this is great and aids in the process of elimination, I am again unsure as to where to turn for help.

I feel there must be someone out there who can help, or at least take sufficient interest in my predicament to want to investigate through to an accurate diagnosis and treatment plan - but who and where? I feel that the older I get the more susceptible I may become to such 'flare-ups'. Can you offer any help?

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The Answer

Clearly you have been having a very difficult time and this in in itself can be frustrating.

It would seem in your situation that a discogram would be helpful. As you aware, good diagnostics are very helpful and necessary when drawing up an effective and appropriate treatment and management plan. It would certainly also be sensible to continue with the NHS tests suggested whilst you are seeking an opinion and discogram elsewhere.

In the meantime if you feel, as your question suggests, that you are unable to move forward with your current consultant you can always call your PA team here at PPP to explain your concerns and they may be able to help you find and transfer to someone where you might also receive the discogram more promptly.

I do hope this will be of help, and I wish you the best of luck.

Answered by Health at Hand nurses.

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