Senior Member (female)
Join Date: Feb 2007
Location: Portland, OR 97035
| | Educate me on the usual next steps - I'm sick of back pain
Hi Back Boardies,
Here is my story, as briefly as I can tell it and with apologies because it's so long!
I am a woman in my 40s, always a daily walker, active type. I have never been overweight, 5'2", 110 lbs.
I suddenly developed back pain about 4 or 5 years ago. The main symptom I have is horrible (!) lower back and hip pain in the morning which is only alleviated by 30 minutes on a heating pad, which has become my morning routine. Once I do that, I am pain-free for the rest of the day. The morning pain used to come on at 3 am, but in the past year and a half, through my many alternative, palliative measures (which I list below), I have shifted that time to 6 am, allowing me about 6 hours of sleep. (Hallelujah!) Since my problems did not start due to any known injury, I was put in the all too-typical "woman comes into doctor's office with subjective pain" treatment track. I was told I had fibromyalgia and that depression was causing my pain. I was sent to physical therapy twice, which did little. I kept begging for an MRI, and was met with resistance because I "don't have pain down the legs or numbness". I begged for a year for an MRI and finally my doctor figured out I was going to self-refer through my insurance and find a doctor who would do it, so she said okay. Well, lo and behold, I have a "mild disk protrusion L5-S1 with arthritis". This was a happy day for me. I was referred to an orthopedic surgeon at OHSU (which was out of my mediocre health care system and now ostensibly in the care of one of the best health facilities in Oregon) and when I saw him, I think one of the first things out of my mouth was, when can we schedule surgery.
Well, no not from him. He said because of my age (young) that he would not like to do surgery on me yet because the standard is still fusion and what happens in many people who have fusion is that in about 10 years or so, adjacent disks start to wear out abnormally and people find they need the surgery on these disks. The thinking is, if you start out young this obviously puts you into this situation too early and you don't have enough disks in your back to keep that up. When I asked him about injections, he said that the success rate is still about 50-50 and that I will need to weigh those odds myself as it is not without risks. Basically, he tried to instill in me the idea that while lousy sleep is nothing to trivialize, I am "lucky" because I don't have pain during the day. So, I went home completely deflated that day.
So it put me back into a mode of dealing with something that is chronic, and toward that end, I have spent the last year since leaving his office doing anything my insurance will cover and many other things as well. I've been having weekly massages (I had no real expectations here), weekly acupuncture (gave me about 3 weeks of pain free mornings), weekly chiropractor (concurrently with acupuncture, gave me about 3 weeks of pain free mornings), take glucosamine/chondroitin (interestingly, gave me about 5 weeks of pain free mornings), physical therapy (did NOTHING), traction (did nothing). In every case, the morning pain was either untouched or it eventually returned. I bought an inversion table, but I am unthrilled about trying it because it's just going to be more of the same, or that is my expectation because nothing works for very long.
I've gotten used to the pain now, but my god, it's not quality living. I am perfectly fine with getting a second opinion on this OHSU doctor, but part of me thinks some other doctor might be all too anxious to do surgery, and that idea bothers me too. So I know it really is my choice. I think if I insisted with this doctor, he would do it, and he's probably a great surgeon. I am looking at surgery someday, when I am "older".
But what pray tell, can I try now? What is the next thing people typically try before they get to surgery? Injections? What kind? What should I be looking for in a doctor? A sports medicine ortho? I'm willing to try the next more radical thing, short of being prescribed drugs for chronic pain (though I will listen of course but they aren't for me).
I am humbly "all ears". THANK YOU FOR READING THIS LONG POST!