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Old 11-25-2011, 09:17 AM   #1
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Smile Pain Management for lumbar arthritis pain?

I have lumbar pain when I stand for more than 3 or 4 minutes and was recently told by an orthapedic doc that the cartiledge in my lower 3 vertrabre is gone, causing bone on bone action and arthritis. He gave me 6 quite painful injections in my spine a week ago, but the pain hasn't decreased.
I've heard of another person who had the nerves burned to relieve the pain and had good results. Where can I learn more about the possibilities. I'm only 61 and hate the idea of being hampered in my movements and literally hate to be looked at with sympathy while I'm in pain.

Any other ways to manage the pain would be appreciated.

 
Old 11-25-2011, 04:15 PM   #2
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Re: Pain Management for lumbar arthritis pain?

Having a bad lumbar spine myself, I know how you are suffering. But it sounds like you specifically talking about arthritis of the facet joints in the spine. Those are tiny joints on the back of the vertebra that connect from vertebra to vertebra by ligaments and they stabilize twisting motions of the spine. They tend to be the first to get arthritis and can be treated with epidural injections or a process known as Radio-frequency rhyzotomy. In this procedure, they put needles into both sides of the joint and heat them with radio waves just high enough to burn off the nerve endings in the joint. There are 2 facet joints in each vertebra.

The only issue with this procedure is that the nerves grow back anywhere from 6-12 months and you have to keep repeating the procedure.

Have you had the rest of your lumbar checked out for disk problems, nerve impingement and issues of bone placement(spondylolisthesis). Do you have an MRI report I could see so I can tell you if anything else might help? I do a lot of MRI interpreting for people on the Spinal Cord Disorders board. I'm on the fast track to an entire lumbar fusion myself and am already fused C3 to T1 with a possible 3rd neck surgery needed soon. I have a bit of history with spines!

I'm surprised your pain management doc hasn't suggested this procedure already unless he doesn't do it......some don't.

But I recently started doing PT in a warm pool.....92* water....and it has changed my life. All of a sudden I can exercise and do the core strengthening exercises I couldn't do "on land"...hurt too much. But in warm water, I didn't hurt and since it takes the weight off the low back, you can move with far less pain and just exercising 3 times a week has relieved a lot of pain for me. Might be something to look into.

The other thing that helps is a rigid back brace that holds the back stable and stops you from twisting while moving around.

There is a lot you can do but if you have an MRI report, it would help me to know what else to offer you....don't want to suggest anything that might make it worse.

Hang in there.................Jenny

 
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Old 11-25-2011, 06:33 PM   #3
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Smile Re: Pain Management for lumbar arthritis pain?

Actually, I've had only one visit with an Orthopedic doctor and the only test he did was xray. I've had scoliosis since I was a child and had been told a lot of years ago that I would have considerable pain when I was older. I'll be 62 in March so I guess
this means I'm old - ha. Anyway, the pain has been building for years and only seems to affect me when I stand for longer than 3-4 minutes. After I rest, I can walk around my block with absolutely no pain, but if I should stop to speak to a neighbor, I'll be in pain for the rest of the day. Twisting doesn't seem to be a problem, but lifting and standing has me bent over and moving at about 1/10 speed of normal. The doctor did mention there were other options but said he'd had a lot of success with the shots he gave me. It was combination of corteson, antibiotics and a numbing medication and said that it should last up to a year. It lasted less than 24 hours. I called his office and was told it would take 3 - 5 days to take effect and to give it a week before I checked back. It's been a week today and the pain is the same. I've talked with another person locally who said it always takes her two weeks to get relief. Unfortuately, patience is NOT one of my virtues.
The shots were very painful, and I would've gladly taken them again in a year, but if they don't work, it's just an extra exercise in pain. I need too work another 18 months or so before I retire, so I need to find a reasonable medium point. Thanks for your support. I'll get back with you after I talk to my doctor again.

 
Old 11-25-2011, 09:40 PM   #4
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Re: Pain Management for lumbar arthritis pain?

Hi,

I've been thru different kinds of injections, facet joint, epidurals and the radio frequencies. Yes they hurt but not compared to the pain I live w/ day to day, I guess I've gotten used to them too. (Not to say yours didn't hurt by no means)

To me the pain you are describing is discogenic pain, which I have. Anytime I stand in one spot for more than 5 min or so it starts to hurt but if I'm moving/walking its not so bad. Bending hurts as well.

I think you should give more time for the injections to work and if they don't give the radio frequency (RF) a chance. I like them the best they work the longest to ME. Its like killing a weed, it also take about 2-3 weeks to work waiting for that nerve to die off and shrivel up. But works great when it works.

Have you tried ice on the affected area (w/ a towel)? It works wonders for me when I'm hurting. 15-20 min or so at a time.

I'd be sure these injections are being done under a flourescope as well (like an moving xray). I'd be asking about that MRI too.

There are other meds out there to help w/ the nerve pain, neurontin, topomax and such you can ask about. I take topomax. Neurontin tends to put weight on topomax weight off. Start each at a low dose a tritrate up.

Of course all of this would be discussed with your Dr. I like the idea of the brace when you're hurting bad but wouldn't wear it all the time don't want to lose your core strength, Water workout is a great idea as well.

good luck and let us know how it goes.

 
Old 11-26-2011, 04:11 AM   #5
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Re: Pain Management for lumbar arthritis pain?

Good suggestions from both of you! I'll try the things you mentioned and let you know how it goes.


Melna

 
Old 12-05-2011, 04:37 AM   #6
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Re: Pain Management for lumbar arthritis pain?

It's been a little over two weeks since my injections and while I can say they are SOME better, it's still not what I would call improved. I can still only stand for 3-5 minutes before the severe pain is back.

What should I be reasonably able to expect from this treatment of injections? I don't want to be a whiney baby, but I had expected at least more relief than I have gotten so far.

I'll be calling the doctor again this week, but wanted to hear the voices of experience before I do. I know that I can just continue to stand only briefly and use heat/cold and a pillow under my knees, but hope there's a bit more mobility that can be achieved. Anyone had any results from taking Glusosamine?

Melna

 
Old 12-05-2011, 02:12 PM   #7
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Re: Pain Management for lumbar arthritis pain?

I take it all you had was a cortisone injection and not the facet joint nerve burning procedure? I know with my doc, the initial injection was to see if it made any difference and then they knew where the biggest problem was and would go head with the nerve burning procedure. Is that is what they are planning to do?

In terms of just cortisone shots, the latest way to do it is to do 3 shots all fairly close together and then let you rest and see how long it takes to get better.

Let me add, that most spine surgeons won't operate until you've tried these procedures and most insurance companies won't okay surgery until you try them as well. The failure of these procedures to help is one of the ways they know it's time to operate. Sp let's hope they help.

Jenny

 
Old 12-05-2011, 02:51 PM   #8
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Re: Pain Management for lumbar arthritis pain?

You are correct - I only had the injections - 3 on each side - 6 total. The doctor didn't indicate I needed to rest, or even restrict my activity and did not mention that it would take several days to 2 weeks to work, so maybe it WILL take longer since I didn't change my activity that much. Of course, it hurt to move much, but I didn't make any major change. He mentioned the facet nerve burning procedure, but if it only lasts 6 months to a year, I don't want to have it done. He had said that this procedure should last up to a year. I was surprised to see that they listed these shots as surgery on the insurance claim and didn't mention even a follow up visit.

The nurse was off today, so I'm going to call her tomorrow and see if it's like the song says "if that's all there is.....". Have you ever tried glucosimine and
condroitan? I've read things that say it is helpful, and also other things that said it was no better than a placebo. I'm going to give it a try for a month or so and see if it makes any difference. Thanks so much for your reply - I'll report back.

Melna

 
Old 12-05-2011, 03:19 PM   #9
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Re: Pain Management for lumbar arthritis pain?

Amazing isn't it how a shot is surgery? But anything that is "invasive" is surgery and injecting a joint....even if it's in the spine...is still surgery.

Studies on glucosamine...hmmm... I get a lot of flak on this as some people swear by it...but they did a huge study on the studies done on glucosamine. It turned out that if the study was backed financially by a company that made glucosamine that it usually showed it helped. Studies done by financially independent companies showed no help. Never helped me at all and the only thing I've ever heard was that it helped with knees and not backs.

What helped me was a good rigid back brace, core abdominal exercises and lots of heat. I can't take narcotic pain meds due to allergies so it's 800 ibuprofen just like you. And patiently waiting for my surgeon to go in and fuse the whole darn thing although there is no promise that any pain will lessen...the problem with spine surgery. For about 70%, the pain remains. Not good odds but it's all they can offer. I will be in neck pain for the rest of my life but it's not that bad....currently. We'll see!

Jen

 
Old 12-10-2011, 03:30 AM   #10
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Re: Pain Management for lumbar arthritis pain?

Quote:
Originally Posted by Melna View Post
I have lumbar pain when I stand for more than 3 or 4 minutes and was recently told by an orthapedic doc that the cartiledge in my lower 3 vertrabre is gone, causing bone on bone action and arthritis. He gave me 6 quite painful injections in my spine a week ago, but the pain hasn't decreased.
I've heard of another person who had the nerves burned to relieve the pain and had good results. Where can I learn more about the possibilities. I'm only 61 and hate the idea of being hampered in my movements and literally hate to be looked at with sympathy while I'm in pain.

Any other ways to manage the pain would be appreciated.
My PT let me do serveral exercises to make the muscles around the pelvis stronger & stimulate bloodflow. This has created revolutionary feelings in my lower back because I always felt somehow weak & tired in my lower back with pain that came & went. However, the making stronger of this area takes time and I got lots of massage to improve bloodflow on my back. Don´t give up!

 
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