[Ravenous]

I have been dealing with low back pain like the task master I am for nearly 3 years.

I am 35 now and have a strong family history of back mayhem. I thought I had back pain until new year's morning 2009... I woke up with waves of pain and had a limp for 2 1/2 months. I saw the world's greatest PT for back pain. No imaging. I started working out after three months and lost 25 lbs and am now in the best shape of my life. It got about 85-90% better. Working out actually still makes the pain subside...for a day or two. I had and still have calf pain in the leg that had the limp...exercise makes it stop.

9 months ago things started to slowly get worse. My low back seizes up if I lay on my back or stomach. It also gets irritated if I stand still. Sitting is fine. Walking or moving around is fine. No jumping or jarring activities and if I do anything where I am leaning forward...packing boxes, my catering, pretty much any of my hobbies... It starts seizing up. Most mornings I can barely get dressed but am ok once I am up for an hour or two. Coughing will bring me to my knees. Other than having to toss and turn all night I pretty much just adjust my activities, suck it up and do what I do. I am not a still person.

Three months ago it got another notch worse. I can now do recumbent bike or mat work (abs, leg lifts, etc.). Mornings also got a little worse and catering is a little more irritating. Still not bad enough that I would go for drugs, but I notice my back all day every day. It gets exhausting.

I finally bit the bullet and went in for imaging. Multiple PTs thought it must be atrophied stabilizing muscles from the blowout since I am so active and have poor body mechanics.

Turns out I have no disc left at L5 S1 and I never saw it coming. Ortho guy said "wow, that is bone on bone" and immediately started telling me about my surgical options. I have NO other bad discs and my si joint is perfect.

It looks like it might be starting to fuse on it's own. I have some pain but it is all in my low back. No radiating pain or numbness other than my twitchy calf. What are the chances it will just auto fuse and stabilize on it's own? There is no disc left at all and it is perfectly aligned.

I think the probable fusing on one edge means disc replacement is probably a bad idea. Should I get a fusion now before it escalates further? Should I wait a bit (my personal preference)? I am doing core work with my PT. I don't want to get surgery and just trade one kind of pain for another.

Since I have no other issues with any other discs at all I fear surgery will just start a chain reaction and lead to other issues. Quite frankly the pain I feel probably is the multifidus and ligaments already. Surgery is probably not going to help...or will it. I am apparently the ideal surgical candidate.

I have too many options and all seem full of potential bad outcomes. If it is a month of recovery pain and then I can jump around again...I would do surgery. If I suck it up for a year and it is going to resolve itself...I can totally do that too. I have a circus freak high pain tolerance.

Anyone have any advise??