Brief Answer:
Have you seen a rheumatologist for the RA?

Detailed Answer:
Good evening sir. My name is Dr. Saghafi and I am a neurologist in the XXXXXXX OH region of the world. You've got a tough problem but by way of the information you've provided there indeed may be a couple of things to do in order to try and maximize relief. I wish I could be more definitive and use the word CURE but you really wouldn't believe me if I tried misleading you like that would you?

Having said that there are some amazing things available now for this type of scenario that was either in its infancy or just not available 20 years ago. So at first glance I notice you are stating that there are essentially TWO bulging discs in the neck. The first is between C5/6 and the 2nd is between C6/7. Next you state something about L1 and S5, however, I'm wondering that's a typo of some sort. We really don't have any discs in the sacral spine so S5 wouldn't really designate anything anatomically localizable that had to do with a disc. Did you possibly want to say a bulging disc between L5/S1? That is the most commonly bulging or herniated disc in the lumbosacral spine. There are no discs of clinical significance beyond S1.

I'd like to know if you've ever been talked to about aggressive therapies and treatment protocols with agents other than narcotics medications for you rheumatoid arthritis? For example, there are steroids such as prednisone. There are chemotherapeutic agents such as methotrexate, and there are biologic agents such as Remicaid for the Rheumatoid Arthritis. What has your rheumatologist mentioned about any or all of these alternatives to treat your condition?

Typically, speaking "bulging" discs" are not believed to cause symptoms of severe pain as herniations do. Bulging discs are known to exist in nearly 40% of patients who undergo MRI imaging of the spine and only a small portion of them are symptomatic therefore, the presence of bulging discs should not prompt either surgery or aggressive treatment with anything until it is known for sure that those disks are definitely responsible for the unbearable symptoms of pain.

Then, there are surgical procedures that can be utilized and for my patients the one that has had the most degree of success with the minimal amount of down time or debility afterward is the minimally invasive laminectomies, laminotomies, and fusions. What this means is that you get your neck or back operated in the morning and you're on your way home by the afternoon. Radical neck and back dissections now are not the only way surgeons can take care of their pain patients any more.

Then, there are the whole plethora of modalities that pain management doctors utilize such as TENS units, VAGAL STIMULATORS, outer wear devices such as SOOTHEAWAY with its different pads that can used to stimulate both hot and cold water to circulate through a pad that wraps about the head, and the famous and infamous SHOTS to the back and the hips.

And so, let's come full circle and once again answer the question of what you can do for pain and muscle spasms in the back and neck for the past 15-20 years.

If you've been diagnosed with serum positive RHEUMATOID ARTHRITIS then, I suspect that if we were to focus and generate a lot of our efforts against just the arthritis alone that we would be able to knock out a few birds with one stone. An excellent resource organization you should contact that can provide you with help and assistance both in understanding your disease process as well as locating health professionals would be THE ARTHRITIS FOUNDATION OF XXXXXXX There are likely chapters within your own state if you are in the U.S. They have a general website on the internet and then, depending on where you're located they can point you to offices that are around your residence.

The Arthritis Foundation also sponsors classes of AQUATHERAPY which are done in many affiliated centers of exercise such as YMCA's and others for either absolutely free or nominal charges. For the most part their activities are free. The one activity which has been shown to be especially relaxing and soothing for patients is WATER JOGGING. Classes of water jogging can be found throughout affiliate centers which support pools. I've provided you with a number of options that can be successful alone or in combination with other choices and actions.

I think your first step should be to contact the Arthritis Foundation and let them know that you suffer from Rheumatoid Arthritis and require some guidance for how to intervene.

Second, you should get connected in with an active physical therapy type of program that can help you start using joints and parts of your skeletal anatomy that haven't been used in a very long time.

Thirdly you should work together with your primary care physician to determine what if any combinations of medications you can use to specifically target the arthritis and then, work with him to make sure you can wean off by the end of this skit.

Finally, there are devices and even procedures which would likely help with the pain but a lot of these things require cooperation of insurance companies in order to acquire. Nevertheless at least one device should be considered and this is called THE SOOTHEAWAY machine.

If you feel that I've provided you with some level of information valuable to answers and information that you were originally asking for would you be as so kind as to provide some written feedback of my response as well as a STAR RATING? If you have no further questions or comments your CLOSING THE QUERY would also be greatly appreciated as this signals the network to begin processing, archiving, and crediting the conversation for future reference.

You may directly ask ME questions in the future if you have found my information and advice useful by looking me up by name on this website (DARIUSH SAGHAFI, MD- XXXXXXX OH).

This query required 60 minutes of physician specific time to review, research, and finalize draft for envoy.

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