I've been to gp, chiropractor, physiatrist, spinal surgeon, and now a PM doctor. Consensus seems to be that I am in the 85% of chronic LBP for whom there is no clear diagnosis (mild degeneration on my MRI, mild L5-S1 protrusion, no radiculopathy). My problem is constant STIFFNESS in the lower left back and sacrum. Sometimes, it drives me nuts. Bending forward aggravates it. Not agonizing like it was one year ago, but continually nagging me and preventing me from living my life.
What are the best meds for mild-moderate DDD, if that is indeed what I have? That is one guess of my spinal doc but who knows? Assuming it is DDD, and I DON'T have nerve pain, should I take Tramadol (it provided more relief than Neurontin and Topamax, which did nothing for me)? What is one step up from Tramadol? Lortab? Is it hard to get an Rx for it? I'd just like to exercise, play with my kids (and wife!), etc. for a few hours each day without thinking about the stiff back. the NSAIDs do nothing.
BTW, my PM doc has done diagnostic procedures: medial branch block (facets) and SI injection which did nothing. Next stop: Epidural?
I have DDD, stenosis, and have had about every treatment there is including surgery for a herniated disk. I don't know too much about meds. and the only thing that helped me for inflammation and pain before I had surgery was Vioxx. I would suggest you ask your neuro. to be referred to a physical therapist. This was and still is the best form of treatment I have ever received for pain and stiffness. It seems to be the number one treatment for many back and neck problems. This is not exercises, I am talking about soft tissue work, where the therapist kneads the knots and tension out of your problem areas. This is usually what is causing the horrible ache and stiffness. I have been to therapy for whiplash after a car accident and for the horrible pain and stiffness in my muscles from my herniation. I have heard that some therapists do not do soft tissue work so i would talk to your doctor and find one that does this type of therapy. It has done wonders for many people including me and I have many back and neck problems my entire life. I went to chiros. for years and once i went to therapy, i was shocked at how much quicker I started getting better and the treatments lasted much longer, i didn't have set backs but continued to just get better. Even if somebody else can help you with the meds., you could still go to therapy. You would see an improvement after just the first visit if this is what you need. A therapist who does soft tissue work will be able to tell your first visit there if he can help you and this is the problem. In the meantime, before i got to the doctor, long hot baths helped with the pain and stiffness. I really hope you try this and it helps you. Good luck in your recovery. I know how it feels to be in constant pain.
I was prescribed anti-inflamatories when I was first diagnosed with DDD. Was on Cataflam for two years then switehed to Relafen for a couple of years, then to Vioxx before my surgeries and since. Prior to surgery, the anti-inflamatories pretty much took care of the pain except for an occasional flare up that nesessitated pain meds.
(just FYI, my initial surgery had nothing to do with pain; rather my curve needed to be fused because it was pregressing)
love and prayers,
aj in Oregon
~ 48 year old female; currently self-employed as an artist/designer/woodcrafter.
~ Previously worked in the restaurant biz for 27 years (not so good for someone with a bad back!)
~ Hereditary and congenital scoliosis, but it never caused any problems until I was 40+ years old.
~ 76 degree curvature had increased 2 degrees in two years 1999-2001; indicating surgery was necessary.
~ Surgery in March of 2001.
~ Fusion and insturmentation of C7 - T9.
~ Fourth rib removed; 5th and 6th rib cut back halfway; removed ribs were morselized and used for the grafting, plus additional bone harvested from hip.
~ After tthe hardware was attached, spine was straigntened 20+ degrees.
~ 2 weeks in the hospital.
~ Brace worn for five months. Bone growth stimulator device also worn several hours per day.
~ PT 5 mos. after surgery caused increased pain.
~ Follow-up surgery to remove hardware scheduled for Feb. 2002.
~ Round 2 of PT 2 mos. after hardware removal.
~ Medically released to return to full activity in July 2002.
~ Increased pain upon returning to regular work schedule.
~ Round 3 of PT in April/May 2003; continually increasing pain.