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Lower Back Pain Treatments/Fusions

Spine Health | Last Active: May 11, 2022 | Replies (22)

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@lioness2001

Good morning, yes if I follow the DOC program, I'll let you know what I think. Right now I'm a third of the way through Hanscom's book. My takeaway so far is there are docs that cut and docs that are conservative. What's on the MRI doesn't always dictate surgery. Unfortunately, some docs that cut are correct in doing so and give their patients a good life. It's just so hard to tell what kind of outcome a person's going to have. Is acupuncture working for you? What is MBSR? I'm in water PT three times a week. So far so good. As I said, I'm doing the conservative approach first and then see where that leads me. I have opinions from two orthopedic surgeons and one neurosurgeon. I'm not big into drug therapy, but when I hurt I've been using Meloxicam (which is stronger than Ibuprofin), Flexeril, Alieve, and Tylneol. (not all at once of course). I'm not sure a fusion is the answer. I keep reading about the failure rates of it and the impact on other joints. At some point I'll have to "pick a doctor" as my husband says. Oh and Gabapentin hasn't really been good for me due to side effects. On another note, tell me. What specifically is wrong with your spine? Do you have stenosis, spondylosis, etc? Best, Jeanne

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Replies to "Good morning, yes if I follow the DOC program, I'll let you know what I think...."

Hello Jeanne, good to hear back from you. So far I've not noticed any reinvigoration of nerves from the acupuncture, but then I've only had 3 sessions. I'm thinking I'll reevaluate after the 6th session. I think I mentioned MBSR in an earlier post, but maybe that was in another group.....anyway, it stands for Mindfulness-Based Stress Reduction. Developed by Jon Kabat-Zinn at the Univ. of Massachusetts Medical Center some years back and now used by many other institutions. I took the 8-week zoom class through our university medical center (last class was this afternoon). Yes, it's what is sounds like: meditation. I'm drawn to it because I like the mental discipline that it requires and the physical and mental calmness it fosters. But it's been a slog, because my anxiety level was sky-high at the start of the class, and it's not much decreased now.

I know the reason I'm still anxious is because I don't have all the information I would like about how all this slowly increasing numbness ends. But I'm calm enough now to do what I know has to be done: get my head out of the sand and schedule another consultation with my doctor, insist on his answering all my questions; referral to specialists if needed (neurologist? pain-management? orthopedic surgeon?) Then, as your husband says, "pick a doctor" if it comes to that.

Drugs for me are a very occasional use of 400mg ibuprofen and 500g acetaminophen. That's all. From trial and error I found that Tylenol by itself doesn't do me much good, that I really need the anti-inflammatory component of Advil.....reducing the inflammation of my L5 nerve gives the nerve just a bit more space, so the compression is reduced. When I combine the two drugs, I almost feel like my old self again (although at age 75 it's kinda hard to remember who she was....). What bothers me, though, is I KNOW that the pain-relief ingredients of both these drugs aren't doing anything to solve the physical problem. Sure, they alter the neural pathways, and I feel calmer....and that's a good thing.....but the spine is still arthritic, still has some herniated discs, and still has the bony growths that are causing stenosis in the lumbar area (specifically, L5 nerve on the right side). Tylenol, medical marijuana, CBD, opioids, and whatever other pain relievers are out there, just DON'T CURE the problem. And so far neither has acupuncture. Nor does meditation.....but it does help one cope with the condition and its attendant pain. I figure with meditation I don't have to ingest anything, don't have to schedule appointments with various practitioners, don't have to pay $$$ for treatments...it's just me, on my own time, practicing calming myself.

Since spinal stenosis apparently can't be cured, only managed, it's not unrealistic to expect that the arthritic spine will continue to "age" and, thus, different symptoms will appear over the years. For that I do rely on PT. Usually 8-12 wks does it for me. (I wish I had access to aquatic therapy.)

The few people I've known who tried Gabapentin all reported having to stop it owing to feeling drugged all the time. I dunno, maybe varying the dosage would have helped them. But as for me, when I read that among the side effects are depression and suicidal thoughts, I knew that it was not a drug for a melancholy pessimist like me, given to catastrophic thinking!

Somewhere I've got some research articles bookmarked about decompression being sufficient, without fusion. If I can find them again, I'll post the links.

Best,
Pat