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Suggest Treatment For Severe Pain In The Back After Fusion

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Posted on Fri, 19 Jun 2015
Question: I am 56 years old Female. Scoliosis and fusion from T 4 to L 1 and disc at L2 is gone, bone on bone. Curve in lower back is now twisting. I'm having, besides normal back pain, excruciating pain in my front right hip. Most of the time I can't get up without pain, it feels like nerve pain. I've been to hip docs and gp docs and everyone thinks its from my back. By the way I have 4 bulging discs in my lower spine. I'm desperate for help because it's affecting my life so badly. I hurt bad. It feels like a long knitting needle is being shoved up my front of hip near the groin.
doctor
Answered by Dr. Indu Kumar (4 hours later)
Brief Answer:
Pain may be related to disc prolapse.

Detailed Answer:
Hello

Back pain may be due to disc prolapse in lumbar vertebra.It is important to know about nerve root compression,central canal narrowing etc.Your symptoms indicate neurological involvement.
Other causes of pain like arthritis,severe osteopenia etc should also be ruled out.

Your condition also need proper clinical examination by a neurologist.
As you are not responding well to physiotherapy,you may need surgical intervention.
If pain due to disc prolapse is confirmed then endoscopic disectomy can be considered.
It is also important to exclude arthritis.You may need further tests and X-rays to confirm arthritis.
Proper treatment depend upon findings.

Get well soon.
Hope I have answered your question.
Further queries are most welcome

Take Care
Dr.Indu XXXXXXX
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Indu Kumar (2 hours later)
Thank you.
I have another question, is this common in adults with scoliosis?
The doc I see is the son of the doc who actually did my fusion with Harrington rod back in 1986.

He says I need surgery up on L2 because of bone on bone. He hasn't really addressed my lower back pain, because he wanted to make sure it wasn't my hip.

I wish I could send you a picture of my xray of my spine. It's a mess. I do have some arthritis up in the area of L2. Down lower I have some issues I guess due to the twisting of my lower spine. The 4 bulging discs are in lower lumbar area.
Right where you can see how its twisting.

I'm scared because I can no longer turn to my right. An orthopedic doc I saw about a year ago told me there was nothing he could do for me and that my window of activity would shrink and shrink until I ended up in a wheel chair.

Also I refuse to take pain meds because the constipate me horribly. I use Bayer back and body, and I guess it helps that I am tough and have a high tolerance for pain. I had 5 babies, all natural births.
doctor
Answered by Dr. Indu Kumar (9 hours later)
Brief Answer:
Yes,back pain is common in scoliosis.

Detailed Answer:
Hello

Yes,back pain is common in scoliosis.
As we discussed,it is important to know more details of MRI.It is important to see whether bone on bone at L2 level is compressing nerve roots or not.Your doctor has suggested for operation probably due to compression effects of excess bone.

I presume that your doctor has given proper attention to lower disc prolapse.

As we discussed earlier,you need proper evaluation for arthritis as well because patient will arthritis doesn't respond well to these measures.I suggest to consult rheumatologist for proper evaluation.

There is no need to be so worried.I am sure you will be benefited after complete evaluation and treatment.

Get well soon.
Hope I have answered your question.
Further queries are most welcome

Take Care
Dr.Indu XXXXXXX
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Indu Kumar (2 hours later)
Thank you so much for giving me some answers.
I'm having a bad day with pain today. It's that pain in my hip/groin. Getting up from sitting is the worst. It takes me a while to put my right foot down. It is excruciating pain. I try to walk. OMG. I can't believe this pain.

Sometimes too I feel like somebody clobbered me in the middle of my back. When I have a busy day my lower back hurts so bad I try to lay down for a while.

I had 3 kids before the rod, and 2 after the rod. For years I tried to keep busy and stay ahead of pain. Now I'm done with kids and on to grandbabies. It seems like I sit more because I guess pain has caught up with me. My older age too, has made my spine start to twist. You can see this on an x-ray. Sometimes I feel like I will end up a cartoon guy, my body facing one way but walking the other way.

None of my kids has scoliosis and so far neither do the grandbabies. Thank God.

The bone on bone in L2
Its because its just below the fusion, for years taking the brunt of all the upper fusion, I rotate there. No disc, its gone. Yes arthritis there. No I do not have rheumatoid. I have some osteo. In my lower back, well, I'm hoping to have that addressed when I see the doc in XXXXXXX

You have provided me with some good information to kinda put me at ease. I just want to enjoy my grandbabies and just have one single day without pain. Just one. And actually I would take a half of a day at this point. Thanks.
doctor
Answered by Dr. Indu Kumar (52 minutes later)
Brief Answer:
You can opt for deep ultrasound therapy,hot therapy,TENS etc.

Detailed Answer:
Hello

I can understand your condition and suffering.
Since you avoid medicines,you can opt other measures for pain relief like deep ultrasound therapy,TENS(trans cutaneous electric nerve stimulation),hot fomentation etc.
Steroid injection under C-arm for neural foramen block can be one of the option.
Enjoy your time with grand babies.

Get well soon.
Hope I have answered your question.
Further queries are most welcome

Take Care
Dr.Indu XXXXXXX
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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Answered by
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Dr. Indu Kumar

Radiologist

Practicing since :2004

Answered : 6729 Questions

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Suggest Treatment For Severe Pain In The Back After Fusion

Brief Answer: Pain may be related to disc prolapse. Detailed Answer: Hello Back pain may be due to disc prolapse in lumbar vertebra.It is important to know about nerve root compression,central canal narrowing etc.Your symptoms indicate neurological involvement. Other causes of pain like arthritis,severe osteopenia etc should also be ruled out. Your condition also need proper clinical examination by a neurologist. As you are not responding well to physiotherapy,you may need surgical intervention. If pain due to disc prolapse is confirmed then endoscopic disectomy can be considered. It is also important to exclude arthritis.You may need further tests and X-rays to confirm arthritis. Proper treatment depend upon findings. Get well soon. Hope I have answered your question. Further queries are most welcome Take Care Dr.Indu XXXXXXX