[Random Trivia]
Sherlock Holmes never said "Elementary, my dear Watson" in any of the stories by Conan Doyle.
[/Random Trivia]
I think I may have discovered the source of my back pain. It's not quite a revelation but the findings excite me. What exactly happened to start my back pain? I am not positive, but the most likely cause was the time I fell off of my friend's trampoline.
What's important here is how I landed. I tried to jump from the center of the trampoline to the outer supporting ring, with my back to the center of the trampoline. So I was jumping from the center to the outer ring, jumping forward. It had been raining so the trampoline (and thus the metal outer ring) was wet. My feet landed on the ring.. but my left foot slipped forward and my right foot slipped backwards. Momentum carried my head and chest forward. Within an instant, my chest was on the ground with my right leg caught up on the outer ring. This caused my back/spine, and I believe my neck, to become severely hyperextended.
This is this best picture I can find to demonstrate what it might look like (bloody internet), except in my case I was landing on my face/chest with one of my legs caught up like that. So just rotate the picture CCW 90 degrees and there you go.
| A point. Wrote: |
http://www.thatcham.org/ncwr/images/whiplash/hyperextension.jpg This is an extremely exaggerated picture but it's to illustrate a concept. Whether it's your spine or a beam of solid steel, whenever something bends it undergoes two different kinds of stress. One side of the material is being compressed while the other side is being stretched. This is why something like un-reinforced concrete can break so easily. It can take tons of stress when being compressed, but it is easily stretched and pulled apart. |
I believe that when I landed from that fall, I severely hyperextended my lumbar spine. This is probably when I herniated my L4-L5 disc. I remember it being incredibly painful, but the pain must have subsided relatively quickly because I never asked to go to a hospital. And unfortunately I do not remember exactly when this happened. This might have happened when I was in middle school which would have been before I joined the football team. If so, it's possible that my activities on the team, weight lifting and the tackling, may have gradually worn away that ruptured disc until it disappeared all together.
But because my back pain did not improve after my fusion surgery, I have to assume that that disc being damaged was just a side effect. I believe that I also damaged a specific part of my spinal cord during that fall. I had thought that the spinal cord ran from the brain all the way down to the bottom of the spine. I assumed that the spinal cord was just the name for the nerves that meet along the spine, but I was wrong. The spinal cord ends at a specific point known as the Conus Medullaris and this is located around the T12-L1 vertebrae. If this is where the spinal cord ends, what's below it? Below the Conus Medullaris, the nerves in the lumbar spine branch out into what's called the Cauda Equina, which means "Horse's Tail" because of what it looks like. This is means that when someone damages a nerve in his lumbar spine area, it's within the Cauda Equina, because it covers that whole region.
However, any time a nerve in the Cauda Equina region is damaged, that damage will also affect the person's hips, buttocks, legs and feet because those nerves all travel down the Sciatic Nerve. This is why most (99.99999%) people with low back pain (caused by nerve damage or impingement) also have pain or numbness in their legs and/or feet. That's where the nerves go, so it's only natural. But my pain doesn't! (I did have some pain go down my leg but it was fixed during my fusion surgery, but in a seperate "operation"? Not sure what word to use there. But 99% of that pain is gone now.) So, since I still have severe back pain there must be nothing wrong with the nerves in my lumbar spine, right? It makes sense. All of the nerves in the lumbar spine go down to the legs, right?. WRONG! All of them except the Conus Medullaris. The Conus Medullaris, which is at T12-L1, is the only section that has nerves that go down the lumbar but NOT all the way down to the hips/further.
The Conus Medullaris is the only section of the spine that, as far as my research has told me, will cause pain in the lumbar region of the back but not cause sciatica pain (nerve pain/numbness in the legs) if it is damaged or otherwise affected. The nerves coming out from the Conus instead go to the bladder and intestines, so patients that badly injure that region can lose control of their bladder or be unable to use the toilet. Thankfully I don't have these problems, but I have had minor issues with regularity and such for at least as long as I've had this pain. Also, sometimes when I need to use the toilet my back pain will shoot through the roof, and it will feel very specifically like neuralgia, which is nerve pain. (I am very familiar with neuralgia because of the dozens of times I've had needles stuck into my lower back. I have long suspected that the source of my back pain must somehow either tie in to or be adjacent to my colon/rectum, and I have suggested this to my doctors, but none of them have said anything about it. But because of this and everything else, I really do believe the source of my pain to be the Conus Medullaris.
My lumbar pain couldn't be coming from damage to a higher disc or nerve because damage to a nerve in the T9-T12 region would probably affect my inner organs such as my liver or kidneys and such and not result in very much low back pain. It's possible that I also caused some damage to maybe the nerves around T12 or T11 but I know that the majority of my back pain is coming from the Conus Medurallis.
Unfortunately, if it is true, there's probably not much that can be done about it. I have had at least 5 MRIs and more than a dozen X-rays taken over these years and none of the people looking at these films have seen any obvious damage to the spinal cord. This must mean that if there is some scar tissue or edema or inflammation putting pressure on the Conus that it's so minor as to be easily ignored. If it's that minor, I am not optimistic that anything can be done about it. If the damage was more severe though, probably even less could be done about it.
For all modern medicine's majesty, both the treatment of pain and the treatment of nerve damage is still infantile.I have an appointment with Dr. E, the orthopedic surgeon, on June 1st, and I will be making an appointment soon to see Dr. F, the neurosurgeon who performed my spine fusion. I will be asking each of them to take a good long hard look at my previous films, do new scans if necessary, and dig as deep as they have to to find SOME abnormality with that region of my spinal cord. SOMETHING is putting pressure on it and I need it to be fixed NOW.
If they "try" and say there's nothing wrong I will go find another neurosurgeon/orthopedic surgeon. This is the first and only medical problem I've uncovered in almost a decade that fits my situation. 
If nothing else, it will give me the evidence I need to reapply for disability insurance....
