Question: My father aged 74 is dignosed with degenerative lumbar spondylosis (took MRI) He has unbearable pain since the last one week around the buttocks to the left bottom foot. Pain killers are proving to be useless (Ultracet tabs / Tramadol injection (1ml)/ Tapal tabs 50 mg - Since yesterday after giving Alprax 0.25 mg, it came down, but subsequent doses (.25 mg twice a day) are proving to be ineffective. We are also giving him hot towel bath massage, heat pad etc. Additional info : He is a cardiac patient (85% block, but did not perform surgery as kidney came down after angio. He has daily doses of clopilet and amlong (amlong discontinued now due to normal pressure) - No sugar complaints.
Earlier test results of significance : Serum Creatinine - 1.6, S.Potassium 5.4
Our ortho has said due to his cardiac and nephro conditions and age, surgery may not work.
He was for years on pain killers like Proxyvon and Brufen almost daily due to frequent body pain and hence ordinary and high grade pain killers do not work much for him. (had undergone thyroidectomy 40 years ago and now takes Eltroxin supplement for thyroid).
Kindly advise us what to do to manage this unbearable pain.
The current set of medicines are 1. Ultracet / Zyflex Nano gel / Pantodac / Alprax 0.25 mg twice a day for trauma management which is proving to be insufficient

Thank you doctor, very much.

I have some questions on this transforaminal root block injection sir.

How frequent will this be required ?

Our current orthopaedician has not recommended anything like this - would there be any concerns on taking this injection sir ?

I stay in bangalore and gave a call to our ortho (Dr.Shivarajiah) and he reluctantly agreed to give .25 for the evening as well as for night, but cautioned me that it is nothing more than a calm down tablet. I google a lot and understand the various side effects of all the pain killers, but my father is a proxyvon addict (tons of them over the last several years regularly for back pain, which has now become clear that the L5 L6 degeneration has caused it.

Today, the dosage went like this : -
Morning - 0.25 mg Alprax and Ultracet (he calmed down, but complained of pain)

Afternoon - 0.25 mg Alprax and just now one proxyvon.

Night - will give 0.25 mg Alprax as agreed by my Ortho plus may be one more proxyvon.

Hot towel massage, Gels are keeping things a little bit under control, but the pain is flaring up easily. Hope Proxyvon (it gives him a mental boost) keeps pain down today - Doctor, my question is, is this injection painful ? Will it be required too often ? Side effects ? Can I ask my ortho for this ?

Thanks for your advice and timely help.

Regards,

XXXXXX
0000 0000
Bangalore.