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Suggest Treatment For Chronic Lower Back Pain
Question: I have had bad pain in my lower- middle back for at least 1 1/2 - 2 yrs now. It feels like a strong metal-like "belt" is there. I cannot stand more than 10 minutes at a time or walk very far without having to rest. I have tried chiropractic care, (almost one year) - physical therapy, (six months) - and deep muscle, tissue massages. Nothing seems to help. I also had three injections to the lower back which was the first thing I attempted. An MRI just shows three herniated discs and some arthritis. After spending a lot of money and not too mention a lot of time, I am almost ready to give up and accept that I will need to live with this pain. I say almost, because I just cannot believe that there isn't "something" out there that can help me. Someone just mentioned acupuncture the other day. After reading up on this, I feel that this would just be another dead end. I forgot to mention that I am 66 yrs of age - will be 67 at the end of September. Lower back pain is something that I had most of my life, however, it would come and go. This pain that I am describing is there 24/7. It does not bother me when I am sitting or lying down. Do you have any suggestions as to what I could try next?
Brief Answer:
Read below.
Detailed Answer:
I read your question carefully and I am sorry about that long history of chronic pain you are experiencing.
From the non medication point of view you seem to have tried the usual options. One remaining option might be transcutaneous electrical nerve stimulation (TENS). Another option when pain is thought to be due to arthritic changes to facet joints might be radiofrequency ablation, a method of stunning the nerve by inserting a needle nearby and sending current to an electrode in order to stop the nerve from sending signals. Acupuncture is an option, it is not well studied as not exercised from medical professionals, but some patients report success and at least it is safe. Spinal decompression therapy or spinal traction as it is otherwise called has also been beneficial for some of my patients, it uses devices which aim to stretch the spinal column.
None of the above options work for all patients, only in a percentage of them, so no guarantees, but since you've run out of options they may be considered.
On the medication front, chronic pain medication consists on two main classes, anticonvulsants such as Gabapentin or Pregabalin, or antidepressants like Cymbalta. Again though effect is partial and only in a percentage of patients. There are also NSAIDs like Ibuprofen, but I suppose you already have experiences with those, trouble with them is long term regular use may have side effects.
I remian at your disposal for other questions.
Read below.
Detailed Answer:
I read your question carefully and I am sorry about that long history of chronic pain you are experiencing.
From the non medication point of view you seem to have tried the usual options. One remaining option might be transcutaneous electrical nerve stimulation (TENS). Another option when pain is thought to be due to arthritic changes to facet joints might be radiofrequency ablation, a method of stunning the nerve by inserting a needle nearby and sending current to an electrode in order to stop the nerve from sending signals. Acupuncture is an option, it is not well studied as not exercised from medical professionals, but some patients report success and at least it is safe. Spinal decompression therapy or spinal traction as it is otherwise called has also been beneficial for some of my patients, it uses devices which aim to stretch the spinal column.
None of the above options work for all patients, only in a percentage of them, so no guarantees, but since you've run out of options they may be considered.
On the medication front, chronic pain medication consists on two main classes, anticonvulsants such as Gabapentin or Pregabalin, or antidepressants like Cymbalta. Again though effect is partial and only in a percentage of patients. There are also NSAIDs like Ibuprofen, but I suppose you already have experiences with those, trouble with them is long term regular use may have side effects.
I remian at your disposal for other questions.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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