[Leonard Skinner]

Lower back pain

My story....

For years I’ve been burdened with mild lower back pain. It would occasionally flair up, maybe once a year for a week or so. In the last two years it has gotten much worse. Last summer it hit a 10 on the pain scale. Doctor always ask how the pain rates on a scale from 1 to 10. I guess for many years it was around 1 or 2, just a slight dull pain but hey very bothersome. It’s been getting worse and I just took more over the counter pain medication.

About 5 month ago like I said it zapped to a 10. I could barely move without excruciating pain. I went to emerge after a couple of weeks. Why did I wait? Like I said I had the odd flair-up that lasted maybe a week so I thought this was just another one of those. Finally I went to the hospital. They pumped me up with some toradal (a muscle relaxant) and three hits of percocet (a pain killer that probably reproduces heaven on earth). I thought there is a god and I was him. I had x-rays done but they said this was not good enough and I needed to have an MRI. I was then sent home with some heaven in a bottle.

So next I see my family doctor who sets me up for an MRI. Soooo eventually I go thru this whole rigamarole. Man is that machine noisy even with ear plugs (like a jackhammer).

Then next to my doctor again who says it don’t look to good and sets me up with a orthopedic surgeon (turns out this guy is one of North America’s top guns). By this time most of the pain is gone but he (my doctor) sends me on my way with a prescription for some percocet just in case I get zapped again.

I go to another hospital to see THEE specialist after about a month for tests and a diagnosis from the MRI. His minions do all these tests on me which consist of poking and jabbing me and hitting me with little hammers and making me do funny stunts and stuff. Then they leave the room. I wait and I wait and my back is just killing me from the torture I just went thru. I can’t sit anymore so I plop down on the bed. I nearly fall asleep.

After an hour the doc walks in, looks at my file on the computer and the gist of what he says is this : “I’ve got good news and bad. The good news is you don’t need surgery...YET. The bad news is your back is borked”.

Turns out four of my disks in my lower back have a degenerative disk disorder caused by nothing more than daily wear and tear. The MRI (which was really cool by the way) showed all these nice healthy looking disks and then when it got to my lower back it shows four disks in a row which were about half the thickness of the healthy ones AND this I can’t forget, each disk protruded from between my vertebrae maybe a third of an inch or more. Man it was really weird looking like maybe the end of your little finger. it's called a bulging disk.

These disks protrude out and put pressure on all these jumble of nerves going down the spinal column hence all the jabbing and hammering to see if it’s causing any nerve damage in the legs. That’s all OK but the constant PAIN...You cannot know.

Last week another 10er hits my back and back to emerge I go. The resident doctor pulls up my file on the computer. He says my MRI is very impressive. He orders up a shot of toradal and a shot of morphine...MORPHINE!!! Yeah, I guess he was impressed and my screeching and howling may have added to his decision too. I thought the morphine would be like in movies where the medic runs over to a guy who just got his intestines blown out and jabs him with a syringe and he stops screaming right away. It was actually very slow, maybe 15 minutes for full affect and I didn’t get very high. But the PAINNNN!!! was gone...whew.

I see my family doctor again first week of february. The emerge doc set me up with some baclofen (muscle relaxant) and percocet (oxycodone - acetaminophen) to last me till then. If I stop taking this my back is around 5 on the pain scale so guess what I don’t stop anymore. I also spend my time mostly flat on my back on the couch with the headphones on listening to audio books.

The specialist recommended physio to strengthen muscles in my back and also ‘deep tissue’ massage therapy. He’s leaving the medication up to my doctor because he knows my history and can decide better what would be best for me for chronic back pain.

A friend of mine has similar problems and he takes codeine-contin. I looked it up and it’s 100% codeine...25% fast acting and 75% slow acting. It’s pretty high dosage and he takes one every 8 hours. He gave me a few but they aren’t as good as the percocet. I told him to try some acetaminophen with it.

Anyone else have back problems? What medication? I realize most of you are young whippersnappers but I know some old farts hang out here.

I’d really like some input to see how doctors vary their stuffs for chronic lower back pain.

Thanks

[Spheric Harlot]

Oh man, I feel for you.

I've had lower back problems for years, but they really started acting up when I crashed my van and switched to a friend's Toyota Yaris Verso in the months it took to get it fixed back up. Shit seats completely ****ed up my lower back, but over a few months with physiotherapy, it returned to the usual low-level annoyance.

Last August, I twisted it getting on my bicycle, and a muscle just seized up. Couldn't move. Spent two days in hospital, where they pumped me full of a muscle relaxant and bent me back into shape.

LUCKILY (luckily luckily), this is all from slouching and just generally terrible posture (classic keyboard players' disease) and complete lack of muscle tonus. My disks are fine, and so are all the vertebrae.

A couple of months of physiotherapy with an excellent therapist, and regular training with the exercises she showed me, made a WORLD of difference - up until four weeks ago, when the swine flu hit and I blew my entire reserves on trying to stay alive through eight days of 104+ fever.

I'm slowly rebuilding my strength now, so I haven't done anything for my back, HOWEVER: This is the first time in as long as I can remember that I've spent extended time in bed and not had ANY back problems WHATSOEVER.

I've now ordered an Aeron chair and am completely rebuilding the studio for ergonomics this week.

Am starting my exercises again this week.

[Big Mac]

Sorry about your back problems, LS. Doesn't sound fun.

You actually got H1N1, Spheric? Whoa, I thought you were just giving people a hard time. What happened to getting vaccinated?

[Spheric Harlot]

I didn't get vaccinated.

They also no longer test for H1N1, specifically - unless you die. The way influenza works, the new strain tends to replace the previously dominant strain. So if you get a real influenza now, it's pretty much safe to assume that you've got H1N1.

And no, I've never had anything come quite as close to killing me as that particular bout of sickness.

Next year, I'll be first in line for vaccination.

[Big Mac]

Originally Posted by Spheric Harlot 

The way influenza works, the new strain tends to replace the previously dominant strain. So if you get a real influenza now, it's pretty much safe to assume that you've got H1N1.

Are you sure? According to what they've been telling us around here, normal seasonal flu and H1N1 can be propagating in a population at the same time, so they've been saying to get vaccinated against both.

[Spheric Harlot]

That's what my doctor told me. Either way, it doesn't affect treatment (except that there seem to be a good many variants of H1N1 around that are Tamiflu-resistant already).

Anyway, this is the Lower Back Pain thread - I don't want to hijack it.

[ghporter]

Did they tell you which discs? Did they show you the pictures? It's kind of mysterious if all they say is "you have some problems," but if the doc bothers to show you the pictures and tell you "the nerves that go to X come through spaces around this disc..." then it's a lot less scary.

I have been diagnosed with "degenerative disc disease" for many years, but my symptoms are more like muscle strain-at least most of the time. As long as I follow all the rules (lift with the legs, etc.), I'm fine, and pain is a powerful teacher, so I've been fine for quite a long time.

While degenerative disc disease isn't fun, it isn't some sort of omen of doom. Did you get a referral to a physical therapist? Most people get a lot of relief from PT that focuses on strengthening the muscles around the discs in question and the relief lasts if the person follows the rules carefully. Plus this sort of approach doesn't involve cutting or extended recuperation.

[Atheist]

Sorry to hear about your troubles. Back pain is the worst. I suffered mild lower back pain for years with occasional flair-ups but have been able to control it with exercise. Seems in my case it was just weak muscles.

How long can you keep taking these pain killers without becoming dependent?

[ghporter]

You don't develop a dependency from taking meds for pain you're experiencing. It's when your pain becomes manageable without drugs and you keep taking them that you have problems. Someone with really serious pain could be completely lucid with a bunch of morphine on board, while someone without that level of pain would be sedated pretty seriously. That's the point at which the doctor needs to reassess the prescription and change to something less robust. Other meds have less potential for dependence. Which is why the doc usually moves a patient to NSAIDs instead of narcotics as soon as possible.

[Love Calm Quiet]

It's been 30+ years since I was first diagnosed with "early disc degenerative disease" after my back "went out" in high school.
The experience with minor and with *huge* pain episodes has taught me a lot ( the bright spot ).
1) Physical pain is *not* necessarily linked to how permanent the issue is.
2) Orthopedic surgeons (who know the data) will be first to tell you (if honest), that placebo may be more helpful (and less debilitating, less costly).
3) The state of my mind (attitude) has *way* more to do with my "putting my back out" than does lifting, etc. (unless done stupidly (i.e., with stupid posture: back curved foward; lifting with back instead of thighs) ). YMMV: *if* I listen, my back can be my teacher as to to what is an unhealthy attitude for me.
4) In the long run, posture is crucial: your spine is designed to be S-shaped, not bow-shaped (like most auto seats encourage). Having further damaged my posture by years of following *bad* advice that just about eliminated my lumbar curve, I now make sure to take a lumbar pillow with me in riding/driving a car. For long hours of sitting (e.g., at my Mac, for meditation) I sit *without* any back support, with my spine erect in the gentle S-shape it is designed to hold.
5) Back *and* abdominal strengthening (e.g., sit-ups) is critical preventative measure (sit-ups strengthen not only the abs but muscles on front of spine that you can't even touch).
6) Gentle stretching and strengthening with yoga is also excellent.

[ sorry for sermon, but I've meant to write it up for my web page for a long time ]

Good luck with it! [and don't start working hard on the stretching/strengthening until your current spell ends].

PS: In last 15 years, I almost *never* have severe episodes. I mostly get gradually-building discomfort if my posture is bad (a reminder).
PPS: My mother is totally different case: she had spinal (vertebrae) defect that gave her unrelenting pain until she had the bone surgically reinforced.

[Jawbone54]

I have a considerable amount of sympathy for anyone with back problems. People that haven't experienced it can't fully realize how debilitating it is.

I've lived with chronic muscle spasms in my mid/lower back for around five years now. I've had several tests run on me (including an MRI mid-2009), and all the doctors can figure out is that it has to do mostly with posture and stress levels. The only thing I can do about it is to consider my posture at all times and do some serious stretching every day. There's nothing worse than being awakened at 3 AM by the sensation that your back muscles are being clamped and wrung out by Andre the Giant.

My personal opinion: whatever you do, stay away from chiropractors. I went to one (for whatever ridiculous reason), and ended up twice as bad as I had been. I never felt the slightest bit of relief while going, unlike some people.

[SeSawaya]

My wife is suffering from a ruptured disc in her lower back. Morphine did nothing, Vicadon - nothing. Percocet is the only thing 10/325 - 2 every 4 hours would start to help. No sitting was possible, just laying on her belly or standing was tolerable. Cortisone shot did nothing for the pain, now just waiting on the probability of surgery. Sucks.

It did get her into the hospital though through the 3 MRIs she's had since Nov, to discover she has extremely low blood levels. Air lifted to Indy for what they thought was something else all the time not treating what she was suffering so much from, the pain.

$100k later......

[olePigeon]

There're several procedures that you can get in Europe and the UK that involve an artificial disc, but the FDA hasn't approved them here in the states. I don't know if there's a waiting list or not. My dad has 2 ruptured discs. He's on heavy pain medication, but only while he awaits for surgery after the procedure gets approved (which is supposed to be soon.)

His other options were to get his vertebrae fused in either a standing or sitting position, which is not what he wants to do. So he's just going to wait it out for the new surgery option.

[olePigeon]

Originally Posted by Jawbone54 

My personal opinion: whatever you do, stay away from chiropractors.

I can't stress this enough. The fers are playing doctor with your health, and that is not something you should leave to some quack. It is completely reprehensible what those people do. If you're having problems with your back, see a doctor that specializes in backs. If you need stress relief, see a licensed physical therapist that is not a chiropractor (they're salesmen, they're going to try to sell you a bunch of a bullshit while you're there for legitimate reasons.) If you want to relax, see a licensed masseuse.

Chiropractic is 100% bullshit, that's why the 4 or 5 different Chiropractic boards always tell Chiropractors to also become licensed physical therapists, nurses, or other medical professional avenues in addition to Chiropractic. It makes them sound more official.

I don't know what annoys me more; the fact that they're con men peddling bullshit to people looking for help, or that they run around calling each other "doctor."

OK, time to calm down. Sigh.

[Thorzdad]

I ruptured a disc in my lower back around 20 years ago. The pain, as others indicate, is something that can't be described adequately. You suffer through it, taking various pain-killers and trying one form of physical therapy after another, until, one day, you simply cannot go on. For me, that day was the one where I couldn't navigate through my home without crawling.

Through happenstance, I found myself paired with an ortho surgeon who practiced a technique called chemonucleosis (or something like that.) The gist of the procedure was that, instead of cutting you open and fusing your discs, they snaked needles through your back and into the ruptured area of the disc. They then injected a special enzyme that both sealed the rupture and dissolved the disc material that had spilled out from the disc and was pressing against the nerves. I was walking upright and totally pain-free the same day of the operation. It was a revelation. I had completely forgotten what life without debilitating pain was like.
(In the spirit of full-disclosure, I do have to say that I was one of the few individuals who experience an allergic reaction to the enzyme, resulting in a temporary inability to urinate unaided. That lasted about a day.)

From what I can tell, no-one in the US performs this procedure anymore, though. That's a shame. It really should have been developed further. I know so many people who opted for a disc fusion and still have not been able to live completely pain-free.

[andi*pandi]

that sounds like a good procedure. I have a ruptured disk in my neck that causes my arms to go numb. Yay. Cortizone didn't help. Massage helped some, but it came back. Fusing does not sound fun.

[olePigeon]

My dad says if you have international coverage for your health insurance, you can get the artificial disk surgery in Canada. It's still not approved for the U.S.

[Jawbone54]

Originally Posted by olePigeon 

I can't stress this enough. The fers are playing doctor with your health, and that is not something you should leave to some quack...

I only went three times, and only that much because I was trying to do SOMETHING to get the family off my back. My mom and wife prodded me a bit (my dad, as usual, was the sensible one saying to not go), so I relented and said I'd go.

The first session he barely did anything. The next session, he gave me an "adjustment." The third session hurt so bad that I yelled a bit and got visibly irritated. He said, "That one hurt a bit, didn't it?" I responded, "Yep, and I'm done." His receptionist asked me when she could schedule a return visit and I just shook my head no on the way out.

It took my spine another week to get over what he'd done, and a visit to a specialist and an MRI confirmed that my spine wasn't even the problem.

Chiros are witchdoctors, plain and simple.

[Jawbone54]

Originally Posted by olePigeon 

My dad says if you have international coverage for your health insurance, you can get the artificial disk surgery in Canada. It's still not approved for the U.S.

Those who have the discs fused almost always have several surgeries afterward, from what I understand.

[Spheric Harlot]

Originally Posted by Jawbone54 

I've had several tests run on me (including an MRI mid-2009), and all the doctors can figure out is that it has to do mostly with posture and stress levels. The only thing I can do about it is to consider my posture at all times and do some serious stretching every day.

Find a GOOD physical therapist. Mine has shown me some exercises that are truly amazing. Stuff where you hardly move or tense anything at all, but after thirty seconds, you feel like you've just run up four flights of stairs.

The ONLY thing that's really helped me - apart from watching my posture and seeing to it that my workspace gets reorganized to keep me from screwing up my back.

The most important thing is to build up the internal muscles that keep your back supported and moving smoothly. Daily exercise - three or five minutes is enough.

[dedalus]

We’re one sick bunch of ****ers, aren’t we? I’ve had back problems, as well as various arthritic complaints, for most of my life (I’m 34, haven’t felt right since I was 12 or so). I guess I should exercise more, at the moment I am really having to force myself to keep my back muscles tensed up so the frigging discs don’t press down on the nerves too much (I know, I know, I’m not a surgeon, all this is purely intuitive). Unfortunately, I don’t know any good doctors, all the ones I’ve met, well, sucked. Back to the bottle.

[ghporter]

The artificial disc itself isn't the issue holding up approval in the States. The procedure to install it is still not approved, so the device itself isn't approved. It's not a simple thing to do, though it's not that different from a standard laminectomy. In this procedure, the surgeon removes the deteriorated disc material and basically cements the adjacent discs together using surgical cement and sometimes bone chips. It's a permanent fix, but it also makes that vertebral joint stop moving entirely, so the patient loses some flexibility.

The biggest difference between the laminectomy and installing the artificial disc is that getting the new disc in is sort of tricky, and there haven't been enough experimental procedures performed to establish which technique is sufficiently repeatable and safe, plus there isn't enough of a track record for the device or procedure. It's much simpler to replace a knee or hip joint than an intervertebral disc...

[Jawbone54]

Originally Posted by Spheric Harlot 

Find a GOOD physical therapist. Mine has shown me some exercises that are truly amazing. Stuff where you hardly move or tense anything at all, but after thirty seconds, you feel like you've just run up four flights of stairs.

The ONLY thing that's really helped me - apart from watching my posture and seeing to it that my workspace gets reorganized to keep me from screwing up my back.

The most important thing is to build up the internal muscles that keep your back supported and moving smoothly. Daily exercise - three or five minutes is enough.

Yeah, the specialist advised me to sign up with a physical therapist if things didn't improve with stretching and posture control.

Just out of curiosity, do you know the names of the exercises? I'd love to look some up.

[lexapro]

This is hilariously well written! Bravo!

Hope your back gets better. Sorry.

[lexapro]

Just one question- if you had the severe pain for a few weeks, why did you go to the ER and not to your family doctor?