Modern Vespa

I have severe arthritis in my lower back.

I have been putting this off for so long. He says I have a narrowing in the 4th and 5th.

This has been a problem since I was in my 20's. I used to be able to shake it off.

My sleeping patterns are fucked. I wake up all the time. I try to get in the right position to not cause me pain. I am not doing opiates yet. I'm doing strong NSAIDS.

I have been referred to a specialist. I really don't see what he can do.

My wife suffers arthritis in her neck causing chronic pain often keeping her from sleep or doing much at all. She went to see a doctor "neck and spine" pain doctor. She started a treatment of cortisone shots once a month alternating sides each month. She said the first two times the relief was minimal at best but did notice a change, going on a year now the pain is minimal and often forgets she had pain. The problem is she needs to visit the doctor every month so they suggested the cauterizing of nerves, not sure what that all is, she started the treatment two weeks ago. She said so far it hasn't helped much and the cortisone stopped as she is doing the cauterizing so she is starting to get a little pain back, the doctor said she needs the second treatment before the effects become apparent. The cauterizing thing is supposed to last over six months once it goes into effect. The third option was to fuse vertebrae which she will not do unless or until the current treatments don't work.
Because she is not allowed to drive after any of the procedures I need to drive her home and have seen many of the other patients all very pleased with whatever their procedure is for their particular back pain. Tiger Woods had a fusion on his lower back, he is now golfing again.

Sorry to hear that.

How's your back fitness generally? Muscle tone etc. While the spine supports the head the muscles support the spine so they need to be in tip top shape if there is any weakness anywhere else.

If you have access to a swimming pool to take the weight of you might find some small respite by floating supported by floats under your armpits.

Trotter, that sucks! But, don't despair (it's easy to feel down about this stuff), the specialists on this sort of thing are usually brilliant. My wife suffers from this ailment and takes all the usual stuff that is recommended here in 'urop' such as supplements glucosamine and omega three triple strength to lubricate the joints and chondroitin to hit the pain etc and that helps immensely and has actually started to reverse here condition. She was initially diagnosed 15 years ago at the age of 45 and was facing surgery. But she too saw a specialist surgeon who gave her some options, all good including surgery, injections other pain relieving drugs etc etc.. However, he also told her about the supplements mentioned above and these have completely staved off the surgery. But her main saving grace has been her chiropractor who can manipulate the affected areas on a regular basis (every 3 months now). Initially this was painful but she hardly gets any pain when attending the clinic now and afterwards she is almost completely pain free. Each case is different though and once you see your specialist I'm sure you will have some further options to go with. The main thing is to keep riding your bike if you can, that's a whole lot of medicine each time you go out on it. Good luck!

Do dips, pull ups and performance stretches.
Every case is different, figure out what works for you.

I have had my share of it, and ended up under the grinder/knife. With all the steps in between.

John

Exercise. As silly as it sounds when you can't sleep go for a walk until you sweat. May be five laces or half a mile. Exercise is free.

My Brother in law (former brother in law? we don't bother to formalize the relationship anymore) has had blackout pain episodes for a few years now, from an issue in his neck/spine. His doc said surgery. BIL says "How long can I wait", doc tells him "5 or ten minutes would be ideal".

His surgery went well, he's exercising now, lost 50 something pounds, will hopefully lose 75 more (he had gotten big over the years). At 53 he's looking to get out of the rat race, and try to change his mindset to enjoy life.

For pain management, have you tried cannabis? I know nothing about it, but have heard many stories of people managing chronic pain with it (professional athletes, etc).

Im not a fan of numbing back conditions with pharmaceuticals although sometimes you need it. The lack of sleep is more troublesome and know how much that sucks when youre in pain.

Personally when I was in a bad accident... had all kinds of back quacks wanting to do surgery, etc. I did a combination of exercise, stretching/yoga, and inversion. And daily calcium/ magnesium. You kind of have to be your own advocate. Most quacks suggest surgery because their avg patient wont follow a regimented exercise plan. Wish you the best in your course of therapy.

Sucks to be having bad problems at that age, although there's a bell curve for significant back problems, and you're smack in the middle of it (35-55).

I'm not sure what you've done already....some good suggestions already posted for conservative treatment, and it's well worth the patience and perseverance before taking on the big stuff. OTOH, sometimes things are just too far gone- too unstable, narrowing too progressed and surgery starts looking like a good option. There are risks, and outcomes aren't always what you'd hope, but if that's what's recommended, you've done your best otherwise and you really trust the doctor, I wouldn't run from it. I've had numerous people I haven't helped much over the years that have done much better when operated on.

Personally not a fan of drugs as a long-term solution, including steroids. Too many problems both short and long-term. Sometimes you've got to do something, but still....

Clearly your quality of life sucks, particularly with sleep. You need to do something to improve that.....it's a confusing and scary journey to get to that point, but you're far from alone.

Call Duke and set up an appointment.

I feel for you and know what you are going through. I was diagnosed with severe fibromyalgia a few (6?) years ago though in many cases that is a catch all for things they don't understand. Regardless I am in pain pretty much all the time and it can be very hard to deal with especially with loved ones. Hard to be in a good mood when you feel like hell.

Hopefully you can get yourself a good doctor that has compassion and an understanding of what you are going through. There is treatment and arthritis is and has been heavily studied. In my case they do not really understand the condition but it is getting more attention now. I get nerve block injections weekly, cortisone every 3 months or so and I am on some of "that" medication and others to deal with the pain. I also have a script for as much medical marijuana as I want. I can only use that for sleep, I have a company to run and can't do it stoned. Without the THC the pain relief is nominal at best. Not sure how many quality years I have left but I plan on making the most of it. Sorry, this thread is about you though, not me.

A good specalist can help you. Like I said hopefully one with compassion and understanding of what you are going through. If you can get medical marijuna it really does help with the sleep. I find gabapentin helps as well and has minimal side effects. I totally undertand the negative comments and media and risks of opiates. The other probelm with them is they god damn work. For someone that does not suffer from chronic pain I can in no way explain what it feels like to not be in pain. Good luck with everything and hopefully you get the treatment you deserve as a human being to have quality of life.

I am sorry to hear about your pains and how the back is misbehaving.
I would suggest inverting and hanging by your ankles. It has worked very well for a few people including my wife. She had been diagnosed with herniated discs and went down the road with getting cortisone injections in her spine and working on strengthening the core etc.. None of it really helped. Then I decided to get her a inversion table but I did not wish to buy one for $600 and find it was a waste. Went on Craigslist, searched for a teeter ups brand inversion table, found one for $100 which was brand new. Set it up, and she hasn't looked back to pain ever again. She doesn't even go fully vertical she is still at 60 degrees incline.
I would suggest if you can find someone who may have a table to try it and see do it for a few minutes a day and if it helps then find one on CL and hopefully it will be beneficial to you.
Almost all the suggestions/remedies made by the professionals have science behind it as as guesswork.
I hope you can reverse this and be pain free.

I had a 2-lvel spinal fusion at age 40 due to disc deterioration at 4 & 5. I'm 55 now, and I've never had to resort to opiates (thank goodness - I'd rather get hit by a runaway freight train than live that life). I live with chronic pain every single minute of my life, and it's always a struggle. Most days I win; there are occasional days I say "screw it" and don't do much but mope - but I work to avoid that state of mind.

Severe back pain is a lifestyle- and mind-altering situation. The biggest obstacle is learning to accept that your life has changed, then learn to mitigate your pain (without opiates).

My advice: Keep yourself fit as best you can. It keeps my weight off and my mind off my pain. My back sucks, but the rest of me is tip-top, so that boosts my confidence. Work with a good doctor to figure out meds that help. There are Rx meds such as NSAIDs, non-habit-forming pain meds, and others than can work together to mitigate chronic pain.

I have had my L5 operated on twice - the second time because I was too stupid to follow the Doc's recommendations about heavy lifting. I now have good days and bad days, more bad as I get older. I'm 62 and have had back problems since my 20s as well. I can suggest that you try Triangle Orthopedics in the Raleigh area - Dr. Masante. There are a lot more bad back doctors than good - you can read many horror stories on the net. I hope you have had a MRI, because x-rays won't cut it, believe me. X-rays are for Chiropractors for show and tell and to keep you coming back ever week for an "adjustment".

Have the same condition along with an osteophyte (bone spur) impinging on the nerve. Had previous unrelated back surgery and wasn't keen on doing it again. Went to a "conservative" neurologist (NOT a neurosurgeon). After a myriad of test, he told me to try an inversion table. "It couldn't hurt." was his explanation, figuring if it didn't work we could go to the next step (injections or surgery).

Just to be clear, I could hardly sit, walk or stand for more than about 20 minutes. I bought a good inversion table and started using it every day. After a couple of weeks the pain was almost gone. Eventually I was using it about twice a week for 5 minute sessions and now (two years later) only use it before and after hard work and never lift anything real heavy (over about 70 lbs).

BTW, if they offer a nerve conduction study and tell you it won't hurt... they are lying... jus' sayin.'

As you go bounding into the medical system for complicated solutions and are sometimes overwhelmed by the information provided and the insistence of doctors to follow their recommendations, I would like to suggest a couple of books to read.

I'm a big fan of Dr. Atul Gawande. No, I don't know him. No, he has not treated me or my family. Yes, I have sold his books many times (I sell used books for a living, so he never profited off of my work, but I profited off of his).

He's an oncology surgeon here in Boston (raised in Ohio). And as his medical journey has moved along, his attitudes about medicine and the relationship between doctor and patient has evolved, and he has written extensively about it. It's not complex medical jargon kind of writing, or a complex kind of business speak either. It's a very straightforward look at his experience as a medical professional.

The Checklist Manifesto: How to Get Things Right - it's a fascinating look at how using checklists can help prevent mistakes in just about any endeavor.



Better: A Surgeon's Notes on Performance - a critical look at his own work

Complications: A Surgeon's Notes on an Imperfect Science

Being Mortal: Medicine and What Matters in the End - This is a fascinating book about elder care, taking the reigns of your path in later life, and making the best decisions as things go....

The last one is really not appropriate for your situation, but I tell everyone I know to read it. Because someday our parents will be old, our partner will be old, and we (hopefully) will be old. And making good decisions about the quality of your life is important, and that doctors often don't have a clue as to what is really important to patients, or how to help them achieve happiness.

One last thing... get your books from your local public library. It's FREE (wahoo!!!). The more we use our public libraries the more important and vital they will appear to the eggheads who want to cut their budgets or think that the internet is an appropriate substitution.

Good suggestions. I have one or two to read there yet. I'd also recommend "How Doctors Think" by Groopman.

Funny, back when I was young, it was assumed doctors were gods (and they would tell you so much). Turns out they're human *gasp* and the world of medicine is fraught with bias and error. Sooner or later as a patient you will have to deal with this maze of finding good physicians and getting proper treatment. It's not always easy. +1. But then again my wife works for our local library, so there's a touch of bias there. So that's my damned problem. I hardly ever take X-rays anymore.

Truthfully, while MRIs can be awesome, they're not always the final answer. My wife was convinced that it was necessary to have for explaining her chronic neck problem. Despite my suggestion that she didn't really have enough indications, she went ahead.....and found nothing wrong.

Family makes the worst patients... I get asked about inversion tables a lot. I think they can be great....not going to fix everything, but if it works, gives you a lot more control over your back pain, it's free (after the investment) and no side effects. I always recommend trying one first because if you don't like it it's just another expensive clothes hanger.

While I'm here, I'll throw in a self-promoting plug....along the lines of traction, one of the treatments I've used for my 35+ years in chiropractic practice is Cox decompression (or flexion-distraction as it was originally called). It's a segment-specific traction useful for a variety of spinal complaints (not the same as the decompression therapy that's been over-promoted and costs an arm and a leg). It may be my bias, but I think most of my colleagues using it have above-average clinical skills and more likely to refer when appropriate.

Back to you, Trotter, I think you'll need to get things sorted out and see what your options are (from in the flesh doctors rather than the MV specialists ).
Chronic pain is hard to endure, makes you desperate to do something while at the same time fearful that nothing will ever be better. It's hard hanging onto that thread of optimism.....

Hang in there my friend. I've had back problems since i was 42. I just learned to live with it. Real accident at work where i fractured T10-12. I'm on opioids and they do work. Pisses me off thsat their hard to get because of all the people who abuse them. Most of them use them to get high. I use them so i'm not bedridden. I did All kinds of things before taking opioids. They are what worked. They can't do surgery because of my RA. I used to be able to get long acting steroids in my back but my spine has collapsed and they can't get in there anymore. A good nights sleep is what you need. Here's the solution. In Feb i bought a Sleep Number bed. Not cheap but if you have good credit they have a 3yr no interest loan for them. I paid almost $4000 but it's worth every penny because i sleep thru the night now. They also allow you to try it for 3 months and if it doesn't work you can turn it back in. I had it over 30 days before i started paying for it and i knew it worked with in the first week. Amazing how one can handle pain better after a good nights sleep.

I encourage you to read "Healing Back Pain" by Dr. John Sarno. I had crippling sciatica (discs in my nerve column) and the results were miraculous for me.

Yoga. Stretches.

Crippled by back pain for two decades. Yoga and ZERO pain for two years.

Only YOU can determine which mattress configuration is compatible.

If interested in performing mattress surgery, and experimenting with different top surface zone densities, Foam By Mail is one resource. It can be an extremely aggravating "trial & error" process, and may result in a lot of foam being donated to a local animal shelter.

Great for you! I'd read it, and I think there's some truth to it, but like a lot of other things, I don't think its a panacea. Sarno, IIRC suggests a pretty high rate of response. But hey, it's free (other than the price of the book) and can't hurt!

Give me time to read into all of the comments. Thank you all so much. I feel pretty alone in this.

I am in good shape, although I need to do better.

I have an appt. on the 23rd with a spine "guy".

Thank you all again.

I have a yoga place next to my favorite Thai place. I'll do it.

Stay strong, Trotter.

Because you can't get them or because you prefer to be in pain? How does the quality of your life improve by not treating severe back pain with medication that actually alleviates the pain?

That train probably already left the station. And what you have is only going to get worse. It's a degenerative condition. Look up the word degenerative in the dictionary. If you can get a doctor to write a script for the stuff that works in this political climate, do so, and get it filled as often as you can, even if you don't need them now. You will. And that's when you will find out most doctors can't differentiate between drug seeking and pain relief seeking behaviors.
The best doctor you can ever find for a chronic pain condition is one who has a similar condition. Until you have severe chronic pain, it's easy to tell someone to take glucosamine and tylenol and go see a chiropractor or hang upside down and do yoga or cover yourself with ashes and live in a yurt, because you don't really have any idea what you are talking about.

I have/had severe lower back issues form 25 years of bicycling racing. The position on the bike trew most posture to shit, the crashes didn't help either.

It came to a head last Spring when the narrowing of L4-L5 finallay caused a disk to herniate. That was followed by six months of no sleep, pain when standing, sitting, sleeping - pretty much all the time. I started with massage, followed by chiroprator, inversion table (which I still use) and finally Ortho Spine Doc.

I was lucky, two rounds of shots in the back toned the inflammation enough to get on a stretching routine I must do 2x a day. The main focus of the routine if from a book - Treat Your Own Back, by Robin McKenzie. I thought it was bullshit until the PT gave me the same exercises. It has turned my life around.

I have a friend, another ex bicycle race, go the surgical route. He is fine and following the book also. Make sure you get a good neurosurgeon do to the operation if you go that way.

Good luck.

Or Jordan-Young in Va Beach +1-757-490-4802

As the boomers age, this is going to be more and more of an issue, and I think treatments will get better. If you can use meds or other techniques to avoid surgery, I would suggest doing so for as long as possible.

Trotter so sorry to hear this. I have a friend with lower back pain and has been using the cannabis patches with a bit of candy for a couple months now as she tries other remedies, losing weight, slow stretches, etc. She says the patches and candy are helping her sleep. She also switched to a foam top for her bed.

There is a balm out there as well but it smells like weed. I don't want to go to work smelling like I just walked out of the dispensary!

Good luck to you!!

Wow! - Nothing like a pessimist to cheer you up. Don't lose heart and do keep looking for the right solution for you. Could be massage, therapy, shots, surgery or ??? but don't throw the towel in.

Truer words have never been spoken. And you can't possible make a healthy person understand the magnitude of pain you are experiencing. Nothing, and I mean, nothing touches nerve pain. I was lucky to get three hours a sleep a night. I hated waking up. Hang in there, and keep reporting back with your progress. Send me a PM if you care to.

Sadly I'm old enough to have had inversion boots before someone invented a whole table for them. One learns quite quickly to hand a piece of rope on the support

Add to the yoga, floating in a swimming pool supported by floats under one's arms. Takes the weight off and the torso can be moved around with much less or no pain.

Daughter has 3 degenerating discs in her back. Pain so severe they were doing spinal taps etc to try and find the nerves for the area so they could cut them just to release the pain.

She is on opiates for the pain but would rather not be due to the side effects that she encounters.

We are hoping medical marijuana might be able to replace the opiates to a degree.

Unfortunately, Motovista is probably correct.

You left out prayer and emotional support peacocks, just as effective as ??? when you hurt like a motherf....
If you talk to a surgeon, don't be surprised if they suggest surgery. If all you have is a hammer, everything looks like a nail. They say about half the people who get the surgery are back in pain within a year, so the number is probably a bit higher, and if you have two or three bad disks in a row, you are a bad candidate. A surgeon's job is surgery, and they want to get paid.
Pain does a lot of bad things to the body, mind and spirit. It ages you and saps your desire to engage with the world around you. If you have chronic pain and can get a doctor to put you on meds, try to avoid getting put on the time release ones that are very popular right now. You are medicated all the time, and you will find that once you start to control the pain with meds, there are times it's completely gone, and you don't need to do anything but enjoy life, and when it comes back, you want to hit it, and make it go away.
If you have chronic pain and take meds when it hurts, you feel a little loopy at first, but after a week or so, that feeling goes away and you can lead a fairly normal life, but they still control the pain. The right doctor is one who will empower you to regulate your own level of medication depending on the severity of your pain. They are getting very hard to find.
One thing I think people who first get diagnosed with chronic pain from disk damage in the neck, especially the type that causes the muscles of your mid back to knot up, even though they are far apart, needs to know is that the pain will go away, and it might be gone for a long time. But it's coming back. And then it might go away, but it's going to come back again, sooner. And guess what. Every time it goes away, it's going to come back until it finally just doesn't go away any more. A lot can happen in that time. Your doctor can retire, your insurance can stop covering certain medications, etc. Keep that in mind when it doesn't hurt.

My spinal story begins with football (HS & college) and having been told I had "smashed" discs while still in my 20's. I'm one of many millions of lower back pain folks. # 4 & #5 are a often told story trotter. My spine report is 3 full pages and fusion is my end game-like many others. There are the latest procedures available when it comes to that and I suppose the older ones too.

YOGA!!! and the McKenzie ( New Zeland physiotherapist guy-read about him!) Therapy.

My back salvation: Yoga- Little Cobra AKA McKenzie #3

Do yourself a favor and do Yoga/McKenzie regularly. NSAIDS are a fierce battle between your arthritis and your kidneys. Make certain to have a regular renal panel to ensure the kidneys aren't losing that war.

If you are not finding relief with more conventional approaches, and are at the point of having to consider opiods, it might be worth considering therapeutic fasting.

If you are interested google the work of Dr. Valter Longo USC. They are finding some pretty amazing benefits of extended fasting in multiple areas. If I understand correctly how it works, at a certain point in fast mode the body begins killing off old and damaged cells to minimize caloric requirements. After you begin the re-feeding cycle, the body is stimulated to produce extra stem cells to replace those old damaged cells with new healthy cells. It might take repeated cycles to begin noticing the effects.

If you haven't ever tried a pure water fast, it can be challenging. I go about 3 days before I decide I'm done. However, Dr. Longo's research has found that you can eat a minimum controlled diet that can trick the body in to activating the same metabolic pathways as a pure water fast. You might Google "Fast Mimicking Diet." I can go about a week on the FMD before I have to stop.

I had been doing a few cycles over the last year just for the health and anti-aging, anti-cancer benefits, but I was surprised that some problems I had been having with leg cramps and plantar fasciitis (and inflammation of muscle connecting tissue in the feet) just disappeared and hadn't come back so far. That could be purely a coincidence. $0.02.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3946160/
https://www.youtube.com/watch?v=6KGqo9z6fOE
Etc.

Good luck.

I wonder if there is an upper age limit for cell regeneration? My mother is 87.