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Suggest Treatment For Back Problem, Arthritis In Spine And Joints
Question:
XXXX 2015-06-04
I have severe back problems (stenosis, 10 screws/lumbar area) as well as arthritis in my spine and pretty much all joints (knees, shoulders, hips and a few I haven't found yet). Regular pain med is Oxymorphone HCL 10mg, 7 pills/daily XXXXXXX Cannot take any anti-inflammatories what-so-ever - OTC or prescriptions. I am allowed to use Voltaren Gel 1% and Acitaminophen (don't really work). I don't know what to do anymore and would appreciate any advice if there is anything I may use for the arthritis. Thank you.
XXXX
XXXX 2015-06-04
I have severe back problems (stenosis, 10 screws/lumbar area) as well as arthritis in my spine and pretty much all joints (knees, shoulders, hips and a few I haven't found yet). Regular pain med is Oxymorphone HCL 10mg, 7 pills/daily XXXXXXX Cannot take any anti-inflammatories what-so-ever - OTC or prescriptions. I am allowed to use Voltaren Gel 1% and Acitaminophen (don't really work). I don't know what to do anymore and would appreciate any advice if there is anything I may use for the arthritis. Thank you.
XXXX
Brief Answer:
I think your medicines are appropriate.
Detailed Answer:
Dear Madam,
Thank you for posting your query on HCM.
Well going through your entire history I think you are on appropriate medications . Since antiinflammatories are ruled out we are not left with many options , the ones you have been prescribed appear safest .
Others can be paracetamol , tramadol and may be pregabalin but this decision needs to come from your treating doctor as he knows the exact situation and has examined you . Also age is a big consideration as side effects can be unpredictable . So you can discuss these options with him . Physiotherapy can help you a lot if done regularly .
Any other queries please let me know .
Take care.
Dr. Shruti
I think your medicines are appropriate.
Detailed Answer:
Dear Madam,
Thank you for posting your query on HCM.
Well going through your entire history I think you are on appropriate medications . Since antiinflammatories are ruled out we are not left with many options , the ones you have been prescribed appear safest .
Others can be paracetamol , tramadol and may be pregabalin but this decision needs to come from your treating doctor as he knows the exact situation and has examined you . Also age is a big consideration as side effects can be unpredictable . So you can discuss these options with him . Physiotherapy can help you a lot if done regularly .
Any other queries please let me know .
Take care.
Dr. Shruti
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thanks for your reply. There is one more question that would help. I have not been to a particular arthritis specialist yet. I am seeing my back doctor, who basically prescribes my pain medication; a knee doctor (for shots) and my regular physician. Would it be beneficial to see a rheumatologist? Thanks for your help again.
Brief Answer:
Follows.
Detailed Answer:
Dear Madam,
If your changes are mostly degenerative that means they are age related changes which I believe is the case with you then there will be little to offer if you see a rheumatologist as they cannot be reversed but in case you have inflammatory arthritis it can be of help .
You can send your records to me , I will guide you accordingly.
Dr. Shruti
Follows.
Detailed Answer:
Dear Madam,
If your changes are mostly degenerative that means they are age related changes which I believe is the case with you then there will be little to offer if you see a rheumatologist as they cannot be reversed but in case you have inflammatory arthritis it can be of help .
You can send your records to me , I will guide you accordingly.
Dr. Shruti
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thanks, Dr. XXXXXXX
Except for the records at my back doctors offices, covering my surgery and following treatment, I really do not have any other records (except my regular doctor, of course.) Officially I was never diagnosed with arthritis. However, I had juvenile arthritis as a 2nd grader in my legs. My doctor in Germany wt anted to send me to a mud bath at the time, but the war interfered and I outgrew it. However, the numerous MRIS I had in the last few years showed quite a bit of arthritis up and down my spine. Both my knees are quite swollen, particularly the right one. It was suggested that I consider surgery, but I am afraid that my back is not up to having surgery on my knees and the doctor agrees. Since I am very familiar with arthritis pain, I know that my shoulders and my elbows, particularly the left side are also affected. I also can tell the difference between stenosis and arthritis pain so I know when what hurts.
I am left-side dominant, even though I am not left-handed. My left SI joint has stenosis and quite a bit of arthritis, right side is some better.
Right now in XXXXXXX we have been having some severe weather and the storms and rain have been horribly painful.
Thank you ever so much for your help. XXXX
Except for the records at my back doctors offices, covering my surgery and following treatment, I really do not have any other records (except my regular doctor, of course.) Officially I was never diagnosed with arthritis. However, I had juvenile arthritis as a 2nd grader in my legs. My doctor in Germany wt anted to send me to a mud bath at the time, but the war interfered and I outgrew it. However, the numerous MRIS I had in the last few years showed quite a bit of arthritis up and down my spine. Both my knees are quite swollen, particularly the right one. It was suggested that I consider surgery, but I am afraid that my back is not up to having surgery on my knees and the doctor agrees. Since I am very familiar with arthritis pain, I know that my shoulders and my elbows, particularly the left side are also affected. I also can tell the difference between stenosis and arthritis pain so I know when what hurts.
I am left-side dominant, even though I am not left-handed. My left SI joint has stenosis and quite a bit of arthritis, right side is some better.
Right now in XXXXXXX we have been having some severe weather and the storms and rain have been horribly painful.
Thank you ever so much for your help. XXXX
Brief Answer:
Follows.
Detailed Answer:
Dear Madam,
Thank you for reverting back.
Well with all the information that you have provided it seems that in knees you are having bilateral knee osteoarthritis , but the spine stenosis , fusion and sacroilliac joint are involved in seronegative sponyloarthropathy , so it needs evaluation . That doesnt seem age related to me .
I think you should see a rheumatologist if feasible .
Dr. Shruti
Follows.
Detailed Answer:
Dear Madam,
Thank you for reverting back.
Well with all the information that you have provided it seems that in knees you are having bilateral knee osteoarthritis , but the spine stenosis , fusion and sacroilliac joint are involved in seronegative sponyloarthropathy , so it needs evaluation . That doesnt seem age related to me .
I think you should see a rheumatologist if feasible .
Dr. Shruti
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
I was afraid you would say that, but not really surprised. Back problems run in the family and mine are worse than the others. Actually, my mother had written in her diary that on my 6-week baby check-up the doctor told her I most probably would have problems with my back. He was right!
My main problem is not being able to tolerate all these wonderful new medications. One of them, Lyrica for nerve pain, works wonderfully, however, it gives me hallucinations, and not even nice ones.
I will make an appointment with my regular physician and ask her for a recommendation. I would like to thank you for your help. You clarified my thoughts about my condition. After all these years I can't help but know my body pretty well, but was not sure which direction to go. So, thank you again.
XXXX
My main problem is not being able to tolerate all these wonderful new medications. One of them, Lyrica for nerve pain, works wonderfully, however, it gives me hallucinations, and not even nice ones.
I will make an appointment with my regular physician and ask her for a recommendation. I would like to thank you for your help. You clarified my thoughts about my condition. After all these years I can't help but know my body pretty well, but was not sure which direction to go. So, thank you again.
XXXX
Brief Answer:
Follows.
Detailed Answer:
Dear Madam,
Thank you for reverting back.
Well the treatment line would become different if its seronegative spondyloarthropathy so that becomes an important issue although its not that common in females but since you have history of back issues in family dont ignore it and get it checked.
Anytime you need any help and guidance further let me know , also if possible tell what your rheumatologist says so we can help you out further .
Dr. Shruti
Follows.
Detailed Answer:
Dear Madam,
Thank you for reverting back.
Well the treatment line would become different if its seronegative spondyloarthropathy so that becomes an important issue although its not that common in females but since you have history of back issues in family dont ignore it and get it checked.
Anytime you need any help and guidance further let me know , also if possible tell what your rheumatologist says so we can help you out further .
Dr. Shruti
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
I will do that. I'll make an appointment with Dr. Sato today and will keep all this correspondence so I can share it with her and the neurologist she recommends. I most certainly will let you know what the outcome is.
Again, thanks a million for your help,
XXXX
Again, thanks a million for your help,
XXXX
Brief Answer:
Follows.
Detailed Answer:
Dear Madam,
It gives me immense pleasure if I would have been of any help to you.
Take care.
Dr. Shruti
Follows.
Detailed Answer:
Dear Madam,
It gives me immense pleasure if I would have been of any help to you.
Take care.
Dr. Shruti
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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