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Old 01-07-2012, 05:00 AM   #1
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Could Really Use Some Advice.....

Hello:

I have been suffering from low back pain since 2004. Long story short, doctors think its facet issues but still can't tell me when my pain is coming from even though I have had numerous work up. I have since switched doctors hoping that this one would get to the bottom of it once and for all. I'm in physical therapy but so far, its not doing much good. He wants me to finish out the three weeks I have left of therapy and then he might try an injection (cortisone) to see if he can tell where the pain is coming from. I've had two done already by a prior doctor. I guess my question is, would a third one possibly work to get me some relief? I'm also curious to know what possible tennis shoes might be a good support for my back.

Any thank you for your time and any and all advice would be appreciated yet understandable if you can not offer me. This has been a continued problem since 04 and no one has come up with a solution yet!

 
Old 01-07-2012, 10:21 AM   #2
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Re: Could Really Use Some Advice.....

Have you been seeing a fellowship-trained ortho spine surgeon or a neurosurgeon during this time period from 2004? Or, what type of doctor has diagnosed you?

Cortisone injections are usually done for purposes of pain relief and/or to help shrink any inflammation. If the doctor is looking for information, trying to determine which facet joint is causing the pain, a diagnostic nerve block is performed...usually in advance of doing a nerve rhizotomy or radiofrequency neurotomy, where the small medial branch nerves are burned. Usually x-ray and CT scan are able to see any arthritic changes on the facet joint. The nerve block is done to confirm what is already suspected from the imaging.

Sometimes when there is a complaint of lower back pain, it can be difficult to track down the cause of the pain. But in many cases, a combination of physical therapy, a change in life style, medication and appropriate exercise, watching structural alignment and using good body mechanics and posture will reduce the problem to a manageable level. So sometimes even when you don't know for sure what is causing the pain, you are able to bring it down to a level you can learn to live with.

Not every back problem has a solution that will result in the patient being pain-free.

It may be would be worth your while having your posture and structural alignment evaluated by a physical therapist or someone knowledgeable in this area...maybe a chiropractor or someone who does bodywork. Often people with unspecified back pain suffer from improper body alignment, which can cause all kinds of back problems, hip problems, knee problems, plantar fasciitis, etc. Often a pair of professionally made orthotics one wears in the shoes will help the patient achieve proper alignment.

Because of these issues of proper posture and structural alignment, I was advised to stay away from these "new" shoe models that advertise being better for the back, or burning more calories, etc. and anything with a zero-gravity heel. Again a PT that is very knowledgeable dealing with orthopedic cases should be able to make some recommendations.

People are usually partial to their own particular brand...so it is hard to give you specific suggestions. Any of the well-known athletic shoe makers have models that will work for you. Look for something that has good support and good cushioning. I have seen New Balance recommended by many back patients, for example.

 
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