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Is Tramadol Advisable For Severe Lower Back Pain?
Question: Hi my daughter just got off of our health insurance the end of March when she turned 26. She's had lower back pain for several years. When she was a sophomore in H.S. she had to get MRI's done which said she had a couple of bulging discs. She had PT and it seemed to help. She's been working in daycare for the past 3 yrs and she comes home with lower back pain and goes right to lay down. Last week however, it was so bad, she could barely walk without severe pain. She's been out all week from work. I took her to Urgent Care and they gave her a shot of muscle relaxer in the butt. It did nothing. They said they don't prescribe pain killers. So they put her on a Methylpred 4MG pak and told her to take Advil&Tylenol and use Ice. They said since she didn't fall or have a recent injury there was no reason to xray it. So she tried Naproxen 375mg from when she had her wisdom teeth out recently. Doesn't seem to help much. She has a painkiller from last summer when she had an abcessed tooth called Tramadol HCL50mg. I'm just wondering if you think it would be OK for her to take this. She never took it last summer because the antibiotic seemed tohelp her. Do you think this would be OK to take along with the Methylpredmg and/or with the Naproxen 375MG? My family dr. is out of town and I don't have the money after spending $115 at the Urgen Care to take her somewhere else. She's able to walk for about 15min but then the pain gets bad and has to lay down again. I plan to take her to a place on Monday for $77.they will xray her and give you a consultation to discuss the results. what I think she needs is an MRI but we can't afford that. I know this is alot of information but I'm at my wits end not knowing what to do for her. The pain is in her tailbone and hurts her the most when she bends forward. Do you have any recommendations or atleast could you tell me if the drugs are safe to take together? Thank you so much for any info you could provide.
Brief Answer:
Tramadol can be taken
Detailed Answer:
I read your question carefully and I understand your concern.
Regarding the question about taking Tramadol alongside her other medications the answer is yes, it can be taken, there is no interaction between them.
Looking at the other drugs I would only like to point that Advil and Ibuprofen are the same drug, Advil is only one of the brands of Ibuprofen. Perhaps you were already aware but since you mention them separately I thought I should point that out. Also Naproxen is of the same class as Ibuprofen so using it shouldn't have much added benefit.
For the moment that is all that you can do. Improvement may take time though. If still not effective after a month then local infiltration with corticosteroids and analgesics should be considered. For that though imaging would be necessary to pinpoint the origin. Since I can't examine her myself I wonder what the doctors at Urgent care thought about the cause of the pain, if the pain is limited to the tailbone area then the bulging discs shouldn't be the cause, there are no discs in that area. For coccyx (tailbone) issues x-rays are just as good as MRI, while if a case of bulging discs then a MRI is the exam of choice.
I remain at your disposal for other questions.
Tramadol can be taken
Detailed Answer:
I read your question carefully and I understand your concern.
Regarding the question about taking Tramadol alongside her other medications the answer is yes, it can be taken, there is no interaction between them.
Looking at the other drugs I would only like to point that Advil and Ibuprofen are the same drug, Advil is only one of the brands of Ibuprofen. Perhaps you were already aware but since you mention them separately I thought I should point that out. Also Naproxen is of the same class as Ibuprofen so using it shouldn't have much added benefit.
For the moment that is all that you can do. Improvement may take time though. If still not effective after a month then local infiltration with corticosteroids and analgesics should be considered. For that though imaging would be necessary to pinpoint the origin. Since I can't examine her myself I wonder what the doctors at Urgent care thought about the cause of the pain, if the pain is limited to the tailbone area then the bulging discs shouldn't be the cause, there are no discs in that area. For coccyx (tailbone) issues x-rays are just as good as MRI, while if a case of bulging discs then a MRI is the exam of choice.
I remain at your disposal for other questions.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you so much for your good advice. She was seen by a P.A. at urgen care who said if she didn't have a recent fall or injury then xrays would be a waste of money. At the time of her appt,my daughter never told me it in was in her tailbone so I think they thought it was just lower back pain. So are you saying that if the pain is originating in her tailbone then xrays may determine the problem? What could cause her tailbone to give her so much pain if she never had a fall? I know she had fallen years ago from slipping on ice. Could she have fractured it then and it still cause problems. She has gained quite a bit of weight in the past few years because she comes home with a back ache, eats dinner and lays in bed all night. I know that the weight probably isn't helping her back. Do you know of any physical therapy type of exercises that could help this type of pain? I just want to say thank you for any advice. I'm just so afraid of her needing surgery or something and having no insurance. She earns just a little too much to apply for state insurance. We suggested she quit so she can apply but she doesn't feel that is right. As her mom, I just want her to find help so she can go back to work and be happy again. Dr. Take you made my Easter with your advice. I hope this Tramadol will give her some relief. Take care!
Brief Answer:
Read below
Detailed Answer:
Hello again. Sorry for answering a little late.
Coccyx (tailbone) pain is a common issue especially in women. It may have several causes, trauma is one of the most common ones. Even an old injury may leave arthritic changes which over the years may cause increasing pain, so yes it is a possibility. Other causes apart from trauma may include tumors, but given the long history I wouldn’t think that is the case. In addition to that there are also idiopathic cases in which no cause is identified even after extensive exams.
If the pain is related to coccyx yes X-rays may be enough to identify fractures or dislocations. Why I asked whether at the urgent care precised that, is because it is important to know what one is looking for in imaging, whether changes to the lumbar spine or the coccyx are being searched. That is because the imaging protocol may not include the coccyx at all unless requested. Also when the suspected cause is in the coccyx there are special projections (x-ray angles) which are used, so the radiologist must know what he’s looking for.
As for exercises of course it is usually advised to do them first under the guide of a physical therapist and after pinpointing the cause. However I am including a link for some coccyx related exercises http://www.healthline.com/health/fitness-exercise/tailbone-stretches
If the cause is in the coccyx usually surgery is not needed, most patients improve with physical therapy so try not to think of surgery for the moment. Even if related to the back, there doesn’t seem to be nerve root compression (no pain irradiating downwards in the leg), so probably surgery not needed either.
I hope to have been of help.
Read below
Detailed Answer:
Hello again. Sorry for answering a little late.
Coccyx (tailbone) pain is a common issue especially in women. It may have several causes, trauma is one of the most common ones. Even an old injury may leave arthritic changes which over the years may cause increasing pain, so yes it is a possibility. Other causes apart from trauma may include tumors, but given the long history I wouldn’t think that is the case. In addition to that there are also idiopathic cases in which no cause is identified even after extensive exams.
If the pain is related to coccyx yes X-rays may be enough to identify fractures or dislocations. Why I asked whether at the urgent care precised that, is because it is important to know what one is looking for in imaging, whether changes to the lumbar spine or the coccyx are being searched. That is because the imaging protocol may not include the coccyx at all unless requested. Also when the suspected cause is in the coccyx there are special projections (x-ray angles) which are used, so the radiologist must know what he’s looking for.
As for exercises of course it is usually advised to do them first under the guide of a physical therapist and after pinpointing the cause. However I am including a link for some coccyx related exercises http://www.healthline.com/health/fitness-exercise/tailbone-stretches
If the cause is in the coccyx usually surgery is not needed, most patients improve with physical therapy so try not to think of surgery for the moment. Even if related to the back, there doesn’t seem to be nerve root compression (no pain irradiating downwards in the leg), so probably surgery not needed either.
I hope to have been of help.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dr.Taka,
thank you for the website with the tailbone exercises and for your very Sound Advice. I found a chiropractor and took her to one today. For $77 he examined her, took x-rays, and gave her a laser light treatment for 10 minutes. he gives her a report on Wednesday of his findings and tells you if he can do anything to help your problem. I'm hoping he can be of some help To and with any luck maybe we can afford it. he told her to keep putting ice on it. 20 minutes on 40 minutes off. I told her this the last few days and she kept putting a heat pad on. And in the car ride home, she said the pain was gone but after 10 minutes it started coming back. I guess that's a good sign. I thought I'd let you know since you were so kind and helpful and put my mind at ease a little bit regarding needing surgery. I wish I had a doctor like you available all the time.Thank you so much!
thank you for the website with the tailbone exercises and for your very Sound Advice. I found a chiropractor and took her to one today. For $77 he examined her, took x-rays, and gave her a laser light treatment for 10 minutes. he gives her a report on Wednesday of his findings and tells you if he can do anything to help your problem. I'm hoping he can be of some help To and with any luck maybe we can afford it. he told her to keep putting ice on it. 20 minutes on 40 minutes off. I told her this the last few days and she kept putting a heat pad on. And in the car ride home, she said the pain was gone but after 10 minutes it started coming back. I guess that's a good sign. I thought I'd let you know since you were so kind and helpful and put my mind at ease a little bit regarding needing surgery. I wish I had a doctor like you available all the time.Thank you so much!
Brief Answer:
Thank you.
Detailed Answer:
Thank you for the update, it is very kind of you. Hope things will get better soon.
Thank you.
Detailed Answer:
Thank you for the update, it is very kind of you. Hope things will get better soon.
Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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