What is a replacement for tramadol in back pain management other than surgery?
Question posted by jlbyrd on 11 Aug 2010
Last updated on 9 September 2012
My doctor is not going to allow me to continue taking tramadol as part of my pain management for my back . I have had 3 spinal epidurals which helped a bit and use a tens unit that helped at first but not much anymore. The tramadol does not take the pain away it does take the edge off.
I have been advised by two different specialist i will need a laminectomy, two disc removed and spacers inserted and spinal fusion. This does not guarantee relief from the pain or a second surgery in 10yr. I am trying all conservative measures and would appreciate any suggestions.
I just turned 53 and have a fairly physical job as a self employed contract painter, house keeper and odd jobs. If anyone could share their input on managing back pain other than surgery it would be greatly appreciated. Thanks
Added 25 Feb 2011:
first i want to thank all who have responded to my question and to let them know how much it helps to have the support and info provided. secondly i want to update my info for those still seeking help for relief of their pain and for those who where kind enough to ask for an update.
i have not had surgery nor have i received any new pain medications (07/2010) from my dr. who has moved from the area so i'm now without a family physician. so i now need to find a new dr. one who will be willing to prescribe medication and not just a surgical approach and work with my present wellness team but i'm hopeful because of the great people put in my path who have been helping with my current pt activities that there is also a dr out there for me.
i did find a dr. who is a licensed acupuncturist who has been very helpful both with her treatments and referring me to a great physical therapist who's treatment are based on a total wellness program, not just rotate exercise. Through my pt i found a chiropractor and have completed a spinal decompression, laser therapy, chiropractic adjustment treatment of 3x a week for the last 4 months. During this time i have reduced my work load and as long as i don't work my pain rating is a 5 and on the days i must work my normal job it is a 9. as i have had to pay for all my treatment my insurance does not cover any of my treatments the need for me to return to work is a necessity and i know that my level of pain will also return to a higher level.
but for those of you that are seeking conservative measures instead of surgery and who do not have a physically demanding line of work please try alternative treatments instead of surgery first. i have also found that the professional who have helped me the most where referred by friends and neighbors and not by advertisement. so one must actively seek, ask and be willing to go the distance to find good caring health/wellness professionals.
i do have a new question about a procedure called MILD, Minimally Invasive Lumbar Decompression and will post it soon.
again thanks to all and i will let you all know how things progress.
The information on this page reflects personal experiences shared by our community members. It is not reviewed for medical accuracy and should not replace professional medical advice.
29 Answers Page 2
IN
Inactive
30 Sep 2010
If your TENS unit helped some, perhaps check into having a Spinal Cord Stimulator implanted. I'm checking in to getting one myself - that way you may not need to be on any medications.
Votes: +0
VD
vdudley
1 Oct 2010
When checking into the spinal cord stimultor, make sure you inquire about the new tripolar model put out by Medtronics. Not all doctors are able to implant them now but make sure they are at least able to tell you about them and if they are not able to implant them, they should direct you to a clinic that does. The newer tripolar model is that much more effective in combating pain, especially in people that have both back and leg pain because it has more electrodes available to tackle both areas. Hope this helps you to be able to ask more questions. Valerie
IN
Inactive
2 Oct 2010
Thanks Valerie - appreciate you telling me that. I will be checking it out!
IN
Inactive
17 Sep 2010
I've read all of these responses. Good stuff. My doctor also refused to refill tramadol. I changed doctors and have a renewal, for a short time, as we need to go to specialists again now, another round. You might find some relief in medicinal marijuana brownies, cooking with it.
Votes: +0
PR
proffessional addict
8 Sep 2010
try suboxone or subutex, u will just get hooked on stronger meds like i did
Votes: +0
VD
vdudley
19 Aug 2010
Hey jlbyrd, My suggestion to you is this; Stay away from the PT practices that are owned by the doctors or the clinic that are part of a large chain (Novacare, Select Medical for example). They tend to offer "shake and bake" PT. This is where they set you up with someone (often not a PT but a student, rehab aide or PT assistant also known as a PTA) who will show you a few exercises, put you on a treadmill or bike or elliptical and walk away. You may not see a PT but at the eval and every two for the re-eval. Any hands on maybe done by a student or the PTA. They make do a few minutes of hands on if you have a surgucal scar or if you are an athlete. They will then end (or start) with some electrical stimulation, ice. ultrsound and traction. That being said, some of these modalties do some good, but only and I do mean ONLY when used with hands on therapy. Before going to anymore therapy, do your homework.
You can call the APTA ( the American Phyical Therapy Associan, located in Washington DC. There is an 800# but I don't know it. You can ask friends if they know of a good PT or Get out the yellow pages, make a bunch of phone calls. Look for the places that are individually owned and call them first. Call the places that appear to cater to athletes last. Look for places that might mention treating patients that have chronic back pain. See if they have ads in the yellow pages that mention certifications that their therapist have. See if their therapist have special degrees. Do they mention one on one treatment. Call the ones that have the ads that best seems to meet your needs. You may or may not want to already have orders from your doctor and authorization from your insurance company if your need it before you make your call. I would than ask to speak to the head therapist or the practice manager. Explain to him or her your concerns about your previous experiences (never saw the same therapist twice; therapist all gave conflicting info on how to do the same exercice no one seem to explain what the treatment modalities- ultrasound; traction etc. were for; what each exercise was meant to accomplish; and biggest of all NO ONE DID HANDS ON TREATMENT). If you like what the Practice manager has to say, book an appointment, however, let them know, that if you are not happy you will take you business elsewhere. Your therapy doesn't need to take 3 and1/2 months. If you don't start to see something in the first one to two weeks, move on. Like I said, the best PT practice can be the small ones with one or two therapist. When I got hurt, I was working for a large corporation, but I was the only therapist in my clinic and there were only two of us in my office ( the other person was at the front desk and she aswered the phones, booked the appointments, took care of the insurance etc.). Everyone of my patients got hands on treatment. I don't know how you can know what is going on with a patient if you don't touch them. jlbyrd I wish you the best of luck. Get a note book, a pen, the phonebook, PT orders and your insurance card and go to work. You have all the tools you need to do the job, now get the job done. Please keep me informed (you ask them if the do strain-counterstrain or any muscle energy technique, ask them what technique they use to mobilize the sacrum, how they calm and reduce trigger point activity). They may ask you how you know this stuff, just tell them you have your sources!!!
Votes: +1
CH
christineATU
19 Aug 2010
Although I didn't post this question,
your responses have given me
great information! Thanks for
taking the time to educate us all
on the ins and outs of PT and spine
issues. Very much appreciated.
VD
vdudley
19 Aug 2010
ChristineATU, You're Welcome. Although this is my profession I do think there are things we can do better. I do really believe that patients need hands on treatment. You need to do the hands on to have a feel for the muscles and bones and joints so you know what is going on with the orthopedic patient. As far as the patient, they must be proactive. The patient does not have to got where the doctor sends them, which is often a place the doctor has a financial stake in (which they are suppose to tell you according to the Stark laws but they often do not tell you). You need to go to a place that best meets your individual needs and that sometimes takes a bit a work to find, but it is ultimately worth it. I hope my info. has helped you and others and empowers you not only for finding the right PT but the right doctor as well. GOOD LUCK!!!
JL
jlbyrd
20 Aug 2010
Wow vdudley, the information and suggestions you are sharing are going to be so helpful i feel like I have a fighting chance of having some control over the decisions on what i can do about my back problems. This will really help me not feel so powerless in the face of people in the medical profession. I haven't had a dr., nurse, pt person yet put their hands on me except the guy that did my mri threw my boots against the magnet in the machine so i could see them stick to it. That's was as close as anyone has gotten to me during this diversion in life. My physical therapy was just like you described above except all the worker bees came in to look at my boots while i was on the rack. LOL
You get my vote for hero status. I've go my trusty notebook (picked one special) up and running. Having to learn what several of the terms you used above but it does feel good to have new knowledge. I will let you know how things are going and I hope you won't mind if I use you as reference material and ask you lots of questions. You just thought you got out of the physical therapy profession. Thank you so much. And if you think of anything along the way I'm all ears. Got a warped sense of humor too. I'm so grateful for you taking your time to help me and I'm sending up good and positive thoughts for you. jlbyrd
VD
vdudley
20 Aug 2010
jlbyrd... No, thank you, you have empowered me again. I do feel like a PT again of sorts. I feel that if I can't be a PT I can at least advocate like one. Too many people/patients feel that they have to do what their doctors or PT say just because they are told to not realizing that they do, indeed have options. No patient should ever be seen by a medical professional for their back without being touched (at least in a good and proper way, I know where you were going with that, get your minds out of the gutter this is a G rated site). How can that person ever know what is wrong with them if they don't touch them (again, keep it clean people) ? Are they pyschic? An x-ray, ct-scan or MRI can only tell a doctor so much, they are just two dimensional picture. People happen to be three dimensional. I think this is something doctors have forgotten to notice lately. Good luck with your search and by all means keep me in the loop. I too have a good sense of humor so bring it on.
Tramadol is a joke as far as i'm concerned, It does absolutely nothing for pain and if it takes the edge off well your doing good. why wouldn't your Dr. allow you to continue it, or give you something stronger. My opinion you should set up an apponitment to see a pain management Dr. they specialize in pain and will get you on the right track with everything. Good luck to you
Votes: +1
JL
jlbyrd
18 Aug 2010
Hi wildbrat, my doctor has been very reluctant to prescribe any pain meds or oral anti inflammatory medication. She has been pushing me to have surgery since I had my initial MRI and she sent me to my first specialist a neurosurgeon and I had a hard time getting her to refer me for a second opinion where they did my first xrays and found two disc that need replaced in addition to mri findings.
Do you or anyone else know of a good pain mgmt dr or facility in Kansas? I live 100 miles away the Kansas City or Wichita area.
OX
oxm
1 Sep 2010
There is a pain management place in KC, KS called Mid American Physiatrists / Pain Management Institute. It is in Johson County. Best if you get a referral from your doc. It is a good legit place, and you will have to sign a contract and will have your urine tested, super tested for anything not prescribed. the name of the founder is Doctor Steven Simon. He does a lot of research, presenting and consulting. I believe he is quite a name in pain managment techniques. since you are a ways away, you may be able to get something sorted out by him and then, once stable, you could go back to your primary doc.
Good luck
OX
oxm
1 Sep 2010
There is a pain management place in KC, KS called Mid American Physiatrists / Pain Management Institute. It is in Johson County. Best if you get a referral from your doc. It is a good legit place, and you will have to sign a contract and will have your urine tested, super tested for anything not prescribed. the name of the founder is Doctor Steven Simon. He does a lot of research, presenting and consulting. I believe he is quite a name in pain managment techniques. since you are a ways away, you may be able to get something sorted out by him and then, once stable, you could go back to your primary doc.
Good luck
JL
jlbyrd
4 Sep 2010
Hey oxm Thanks for the info on the doctor in KC. jlbyrd
Hi jlbyrd, The generic for Flexeril is Cyclobenzaprine hope this is what they gave you please check. Good luck with the back they are tricky when it comes to the spine in any section. marjorie zych keep me updated please I am very interested in how you do
Votes: +0
JL
jlbyrd
16 Aug 2010
Hi Majorie, checked my script, the name of the medication was orphenadrine and it is a muscle relaxer. I will have to write down or have the dr. write down what medications she faxes to the pharmacy . Since posting my question I have been able to learn a few new things and will be preparaing my plan of action to present to the dr and hopefully we can work toward a mutual goal of pain free living without surgery or she will refer me to someone who can. Thanks for your help. jlbyrd
MA
marjorie zych
18 Aug 2010
That particular drug is Norflex not Flexeril so your doctor needs a refresher course in drug names I think, your right it is a muscle relaxer though. How is it working for you? Hopefully better than it did for me I think Flexeril is better but everyone's body is different though. Good luck my friend, marjorie zych
JL
jlbyrd
18 Aug 2010
Hey there marjorie It doesnt do much for me at all except make me tired. My sister has back problems much like mine and has used zanaflex and mobic with some good results in addtion to more pain medications and a team of dr's at good spine center for her care. I have asked my dr. about using them but she doesn't seem interested in prescribing them or much of anything else for me. Thanks for your help.
MA
marjorie zych
18 Aug 2010
Sounds like you need a new doctor, sounds like this doctor has no feelings. How would your doctor like to be in pain all the time? If you can fill me in on what insurance you have and where you are located I amy be able to help find someone with some feelings through my doctors who may know someone in your area. Take care my friend hope you get some relief soon. marjorie zych
In a situation like yours another options to ask your doctor about is a spinal cord stimualtor. This implantable device is an electronic device that blocks the nerve signals(works on the gate theory) that cause pain and in many patients with chronic pain allows them to return to full function. It is an out patient procedure done in two parts. The nice thing about the device is that it is started with a trial with temporary electrodes placed at first. If the patient has sucess with the temporary placement then the permanent electrodes are placed. The device is not for everyone but for those it works for it works great and they are able to return to their lives. I have heard that patients who have beem disabled greater than 10 years have been able to return to work. There bipolar options and a new tripolar option that is now out that works better for patients who have both back and leg pain. It may be worth asking your doctor about. Good luck.
Votes: +2
JL
jlbyrd
13 Aug 2010
Thank you for the info.I will look into this option as I have both back and leg pain. jlbyrd
RS
RSDHurtzme
12 Aug 2010
Look up Tramadol as you will find it is only supposed to be used short term only. With the pain you have now and the upcoming surgery, you will need better pain management for all you are going through.
A TENS unit doesn't help many people in pain for long and a Spinal Cord Stimulator is only an internal TENS unit so never go for that if the real one didn't work.
It sounds like you are going to need long term pain relief especially if you are able to return to work or even if this makes it impossible to. I would seek a pain specialist for this on top of your surgeon and family doctor.
Votes: +1
JL
jlbyrd
13 Aug 2010
Can you tell me what type of dr is a pain specialist? The doctor who performed my spinal epidurals is called a pain management specialist but will not prescribe medication and epidurasl are only allowed every 6 months. The neurologist I saw gave only 1 prescription and the orthopedic surgeon gave no presciptions. My family dr. will not refill the tramadol or prescribe any other pain medication saying she wants me to have surgury.
RS
RSDHurtzme
13 Aug 2010
A true pain specialist is a Board Certified Anesthesiologist. I hope this helps in your search for help with your pain.
VD
vdudley
16 Aug 2010
A TENS unit will not generally be effecctive if you are already taking narcotic pain medications because the pain receptors are blocked by the narcotics so the natural pains killers that we produce the endophins, are not able to "fill" those spots as they are already "filled" by the narcotics. The newer TENS units have many settings that prevents the accomodation and they work more like a high frequency e-stim unit which a lot of the physician I worked with preferred over the straight TENS units. The spinal cord stimulator is not exactly an internal TENS. It does work on the gate theory but it targets the exact nerve roots that are effected and the new tripolar units that are now on the market are better to target patients that have both leg and back pain and are made by Medtronic. Not all clinics are able to implant them yet because their physicians don't even know about them yet.
CL
clay81
27 Oct 2010
If I were u I'd tell the dr to kick mud u shouldnt be forced into surgery,and not givin u anything for pain is bs.I hope u can find a dr who will help u I to know what chronic back pain is like I have two ruptured discs and my dr agreed with me when I refused surgery.Im very grateful he helps me to get out of pain.I wish u best of luck.
There are so many ways to look at your problem but unfortunately we have only a little information to work with, so I will tell you a little about what I have gone through. First let me tell you that I am a Physical therapist and have been for 23 years. I have treated many patients with many degrees of back pain. Some I have seen go into surgery, many I have helped avoid surgery. I, myself have had four back surgeries to date. The first was elective because of a bulging disc that was compressing the nerve and affecting the nerve reflex. Conservative treatment (medication, traction, epidurals) did not work. I had a laminectomy done. I was out of work for 8 weeks, had PT at 4 weeks post op and was able to return to work at 100%. I felt great with no issues.
Three and a half weeks after returning to work, while working with a patient, with whom I had worked with many times before, using great body mechanics, I felt a "pop" and I ruptured the disc. My life has never been the same. It had nothing to do with 1st surgery (as proven in court in the worker's comp case). I had another lami but the surgeon left a fragment behind. I had ongoing pain, and my leg atrophied (muscles got smaller). The Surgeon didn't care, d/c'd me. I found another surgeon who did believe me, but by the time he operated the damage was done. He had to fuse my spine and put spacers in. My leg was left weakened by the nerve damage and I fell, knocked the spacer out of place, it compressed the nerve and again had to have surgery with additional fusion and the spacer had to be shaved down. I was very lucky that the second surgeon believed me and ran the necessary test. I still experience pain 24/7. I had an epidural last week and I am hoping it will help. I have tried TENS and a varity of medications. I also investigated a spinal cord stimulator but it does not appear to be an option for me at this time. I presently take oxycodone; cymbalta and topamax for the nerve pain; and zanaflex for the muscle spasms. I am getting a bracefor my lower leg next week that will hopefully prevent the falls (and further surgery)... and oh yes I have had to have the right knee cartilage repaired in June and the left knee is getting repaired on the 24th of this month due to falls because of the weakness in the right leg. Now, I AM THE EXCEPTION NOT THE RULE!!! Most people that have back surgery do great!!! You just don't hear about them because they go on living their lives. Go out and get a second and a third opinion. Most insurance companies will pay for them. Go to a big teaching hospital in a major metropolitan area. Seek out others who have had it done. Ask your surgeon for referrals so you can talk to other patients. Don't just go on the doctors says so. Ask the PT if you can talk to their patients too. It is not a HIPPA violations if the person agrees to talk to you. Talk to people face to face first and then make your decision. I am 1% of the population that ends up like this and as a PT let me tell you it is not fun being on the other side as a patient. GOOD LUCK AND LET US KNOW WHAT YOU DECIDE!!!
Votes: +2
ME
melissab(twilightfan85)
12 Aug 2010
vdudley, i went through physical therapy twice. the second time they did a full examination and found that i have a twisted pelvic bone. its causing one of my legs to be a couple centimeters longer than the others. im just wondering, since u are a physical therapist... do you know if its possible for a twisted pelvic bone to be the cause of all the lower back pain i have? my dr thinks its the arthritis but none of the arthritis meds or steriod shots have relieved my pain. i was just curious. cuz its obviously something besides the arthritis. the tens unit didnt work on my muscle pain. it kinda felt like it made it worse. im stuck and i dont know what to do about my pain. i feel like my dr just doesnt believe me. all these drs just look at me like a pill addict or something. i can barely get out of bed in the mornings. can u help?
VD
vdudley
16 Aug 2010
A pelvic obliquity (the rotation in the pelvis) can absolutely be the cause of your back pain. It can also cause a rotation of the sacrum and the combintation will affect the muscles and the bones. The pain may or may not respond to meds and TENS on a temporary basis. Some people will get relief from chiropractic treatment but again I have found the relief temporary because the adjust they do only affect the bones. In my practice, I have found that the treatment needs to be be mutli-fold. After thorough examination, during which I explained what I found to the patient using the skeleton, and drawing on a piece of paper the spine, pelvis and the muscles including the piriformis, quadratus luborum, psoas and the iliacus (and others if needed).
I address the trigger points in the muscles first because if I did not calm the muscles using a gentle osteopathic technique they would pull the bones out of place of corrected alienment because of the spasm they are in (think of the pain you feel in you buttocks, deep in your side, deep in the front of your pelvis, deep in the front of your abdomin). You may not know that these trigger points are there unless the therapist were to point them out to you by poking into these muscle and you jumpimg up off of the exam table, sound familiar? After relaxing the trigger points, I would then address the pelvis obliquity and finally the sacral issue if there was one. Throughout the treatment I would continue to educate the patient. I would instruct the patient on core strenthening and would finish the session with ice and electrical stimulation if time and insurance, doctors ordrers etc. permitted. Now this is just an example, each pt is different. Some patients may never need to come back, but I would encourage them to because I would want to make sure that we address their core strength more than I could in that initial visit. Sometimes it takes more than a few visits to get the alignment to hold. Education has to be a part of all treatment. I have had a patient that came to me that had not worked in 8 years with pain that was consistantly an 8/10. In the first his pain decreased to 3/10 and he reported that he has his frist full nights sleep since his injury 8 years before; next visit the was decreased to 2/10 with treatment and he was able to walk on the treadmill for 20 minutes. He completed therapy in two weeks and was able to come off all pain meds. He was able to return to work. No therpaist before had ever looked at his pelvis and sacrum they just threw exercises at him. We had to addresss his core strength and his flexibility and his overall strength. He was also able to return to the gym. His wife had her husband back and his children had their father back. He was able to reutn to his hobbies, essentually, he had his life back!!! His doctors just threw meds at him. You can't help people if you don't touch them and look at them. I had a nurse practioner at a Pain clinic that believed in the work I did and she sent him to me. She a lot more patients to me after that. I miss the work I did but unfortunately I can no longer work. I hope you find the right therapist. Good Luck and ask your doctor to help you find the right PT. Friend me and let me know how you make out.
JL
jlbyrd
18 Aug 2010
Greetings vdudley with your pt background and first hand experience i would like to ask what to look for in a physical therapist and the related program and how does one assemble a heath & spine care team?
I tried a physical therapy for 31/2 months which included elec stimiulation, ultra sound, cervical and lumbar traction and strengthing excercise. Which I firmly believe would have been me a great help if I had been made to understand what each treatment and exercies where meant to do and how to properly do them. I went for 2 x a wk for 3 wks before I worked with a helper/student who showed me what and how to do things and then stayed focused on how I was performing them. I had a different person for every session, some told me the wrong way to do the excerises, forgot some of them, left me while visitng with other workers and didn't help me set up equipment I was to use. And after I still had pain they kicked /failed me and sent me back to my dr.
Once I had a small understanding of the purpose of my progtam I felt like it would help me a great deal but I really needed a hands on approach and someome who would push me to try harder. Is this unrealistic ? Do good programs like this exist and how do 'i find one.?And how does one assembly a team to treat someone such as myself? Thanks bunches for all time and information you have shared with me. Have a great day jlbyrd
Hello there my name is marjorie zych. I too agree with christine avoid back surgery as long as it is safe to do so. I have had 5 major back surgeries and have yet to have alot of relief, atleast my spine is now stable instead of moving back and forth but I still have pain in varing degrees at times. Vicodin ES has been the best pain relief for me when absolutely needed, I would advize staying away from the narcotics if you can but don't make yourself suffer too bad though just watch for addiction signs. Not everyone gets addicted but be careful anyway. Good luck and hope you feel better soon. Also Flexeril has helped me a great deal when my muscles lock up, get a good mattress as well, walking and swimming are the best exercises possible if you can handle them, especially the water because it takes all the weight off you as you move around. Always consult a doctor before any exercise though for safety. Take care .
Votes: +4
CH
christineATU
11 Aug 2010
Hi there Marjorie! Hope you're feeling ok. You are so right about the swimming. I finally talked Jim in to putting our small pool up and it has helped a lot with pain relief. It's the getting out of the pool that hurts. Must be all the gravity hitting me at once. Excellent advice as usual.
ME
melissab(twilightfan85)
12 Aug 2010
flexeril was good at treating my muscle spasms, but it made me a total bitch. my mood swings were hell on my kids and my fiance'... even my parents caught the wrath of my moods. the best muscle relaxer they ever put me on was robaxin. now im on skelaxin, im about to ask my dr to switch me back. im so tired all the time. i cant take the drowsiness afftect it has on me. i fall asleep everywhere like a narcoleptic!
SA
Sacosam
13 Aug 2010
Hey Sis, How you doin'... Hi marjorie! seeing your name,makes my day! ! ! I aggree with both of You. I am totally against back surgery. I've seen it destroy too many people. The only way I would aggree to back surgery is if pre-op, I was totally paralyzed ["bottom of the barrell syndrome] or if pain meds just didn't work anymore as Pain and I don't get along very well.
Wow! got to talk to , 2of my favorite Ladies and got some good ,' if worse comes to worse info"! besides. Sacosam I am
VD
vdudley
13 Aug 2010
I have tried several of the muscle relaxers also and I am presently taking Zanaflex. It is a muscle relaxer usually used with patients who multiple sclerosis. I have found that I don't get as tired on this as I did with the Flexeril and the others. I also find that I don't feel like jello with the Zanaflex, my muscles are comfortable, more normal. Hope this helps, just one more options for those of us who are suffering but wish we weren't.
JL
jlbyrd
13 Aug 2010
Hi Majorie, Do you know the generic name for Flexrill? My doctor gave me a perscription for a muscle relaxer once and said it was Flexerill but that isn't what the pharmacy gave me. They said it was a generic brand. Swimming has been a help and I live on a lake which makes it easy in the summer months. Part of my diagnosis is for spondylolisthesis at L3, L4. Thanks for your support jlbyrd
Since you marked the question conversational, I was just wondering what "replacement" procedure/medication your doc is recommending since he took you off tramadol? Which by the way, is a GOOD thing. It is not very good at controlling pain in my opinion. Unfortunately, I had no choice about having spinal surgery. I had an accident and shattered my mid spine. 80% spinal cord compression from the bones fragments that entered the canal. But prior to that, I had been seeing the same surgeon for a lower back problem, similar to yours. The PM doc he referred me to had broken his back in an accident so I knew he would know about pain! Not very nice of me being happy he knew exactly what back pain felt like. After years and years of meds, injections, I finally found something that worked pretty good for me. The Radio Frequency Thermocoagulation (RFT) You may have had this already? They numb the area of the back with 3-4 injections.
Then they insert a long needle, feed a thin tube through the needle, inject the various medications while watching live on a video monitor. With me, they did this in 2 separate areas. Not exactly a comfortable procedure, but the last medication he used (prior to my accident) lasted about 4 months. That is quite a long time for someone with a very bad disc. Usually when you have a regular Epi done, you sit on the edge of the table, bend forward, then they inject. But doing it this way is really guessing at where the meds are going. The RFT can also be used to zap nerve roots, inject long lasting numbing agents in to the facet, disc, wherever they feel the pain is radiating from. PUT OFF SURGERY AS LONG AS POSSIBLE. Although my surgery was a must, I'm now looking forward to more surgery due to problems with the hardware, and I also re-injured the original bad disc. It's a waiting game as I needed to apply for SSI and Medicaid. Sorry to ramble on. I sure know the type of pain you are in. Whatever you decide to do, I wish you the very best and much success. The only reason I said to put off surgery is only because of my personal problems. I have heard good and bad stories. It's up to you to decide what is the best route for you to take. Oh, by the way, my husband was rear ended injuring an already fragile neck, 4 years prior, T-boned at an intersection which fractured his neck right where he had his first surgery, broke up a fight among students, he is now almost 4 months post op from his 3rd cervical surgery. But the good news is, he has more range of motion, and his neck has never felt better! Even his headaches are gone. So I guess the moral of this long ramble is everyone is different and my best wishes in whatever you decide. Chris
Votes: +4
JL
jlbyrd
13 Aug 2010
Hi Chris, in answer to your question when I asked the doctor's nurse what else I could since they where going to stop the tramadol (prescribed 50mg 4x daily) but I only took 1 during working hours if I hurt so bad I couldn't move. I usually tried to hold out until I finished work and was at home. She said the doctor says you need to have surgery. I had alreday explained to my doctor why I did not think surgery was an option for me at this time. Reasons I gave where no guarantee it would stop the pain, I'm self employed and insurance is a joke so finacial it's out of the question and each time I've seen a new specialist they find something else the MRI didn't show that needs fixed. I was told I wouldn't be able to work for 6-8 months, if I would ever be able to do the type of work I do.
I live 20 miles from town and do not have anyine who can help me during the first part of the recovery from surgery getting out of bed, putting on the brace, driving me for the first month. My fustration level with my doctor is somewhat high at this time although we have had a great dr. patient relationship in the past. The spinal epidural I had where done where called lumbar, cadl,,epdrl ster,with ipm fluoro guidance and isovur contrast. I don't think it is as complicted as your procedure. They give you a set of three and then I have to wait 6 months. The thing with the epidurals was the low hip,leg pain and the pins and needles and numbness in my toes was better but my lower back hurt worse. So I don't know what I'll do when my medication runs out. I am not ready to consider surgery but I can't cope with my pain with just aleve, ibuprofen and my heating pad. Sorry if I'm rambling. jlbyrd
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Sacosam
16 Aug 2010
hi jlbird; a point to ponder that personally makes Me want to go out and kick a few of those "effen"! Medical People? POINT: Which puts the most money in the Med. Establish. Pockets... pain drugs or operations/surgeries!! TA - DAAAA! ! ! Christine ATU knows what she's talking about as the Lady has been there and so has her man JIM! Sacosam
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The Mad Man
14 Jan 2011
I had the Radio Frequency done about two months ago and it is working for me. I have DJD and after 8-going on 9 bouts of physical therapy, morphine, different forms of Hydrocodone, and Tramadol, TENS unit and more, the radio frequency thing was the only thing left and IT WORKED BUT the nerves will grow back and may cause pain. Check with your doctor about this procedure. I am also getting a Quitenza patch procedure coming up here shortly for my hip and will advise on that.
CH
christineATU
14 Jan 2011
Thanks so much for the info Mad man, the more input from members, the better. I never knew the nerves grew back? My surgeon told me the nerve damage and neurological defects were permanent. I guess it depends on what nerves and the type of damage done. Have a great weekend. chris
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taintedserenity
11 Aug 2012
I am 28 and have been on tramadol for about a year now. It was first given to me for my knee after my knee surgery. But when the pain management doc got my records about my back he upped the does of tramadol and also put me on zanaflex. Both these make me very tired. Plus add on the xanax I get from my family doctor to help my body relax I am always tired. They have tried different things in 2 weeks I get started on the spinal epiderals but they want to sedate me for that. I love tramadol it helps me a lot I am so srry u are going through the pain. I totally understand 6 herniated disk. Bulging disk in my lower back plus arthritis and my bones in my hips and lower back r deterating (srry) bout the spelling. The doctors keep wondering why I'm having such bad problems with my joints and bones at such a young age it started when I was 22. I can't be on narcotics because I have chronic migraines. And cluster headaches. And narcotics just make those worse.
Plus I had a total thyroidectomy because of carsanoma cancer just 2 years ago. But no one can find out why my bidy is falling apart. I eat healthy. Played sports as a kids. Was a cheerleader. All that good stuff. Hell now I can't even run. Its hard having to tell my 8 and 6 yr old srry mommys in a lot of pain right now I will play with you later.
i was taking lorcet 10s for my back pain. my pain management dr just knocked me down to the 7.5s. i have been on the 10s for a year and the 7.5s just dont do anything for me. i hate for you to resort to narcotic pain meds because they are addictive... but they have worked for my dad. he is 56... works in a mill as a fixer... and he has had back surgeries. he has a bulging disc and a pinched nerve. they wanted to put rods and screws in his back and he refused because it would def limit his mobility. he is on lorcet 10s as well. he gets 120 a month. he is a strong man! he usually doesnt even take the pain killers. he just deals with the hurt! he always has them tho, just in case the pain becomes too much. he is better than me, i have to take my pain meds everyday... just to get out of bed. i have alot of localized pain in my lower back, but i also have body aches all over. i hurt all the time. we are thinking that i have fibromyalgia.
i went 2 rounds of physical therapy, i used the tens unit and i swear it made the pain worse. I hated it. the first round worked on my upper back pain. the second round that concentrated on my lower back pain, didnt work or help in any way shape or form! they wanted to do the fusion on my dad, he didnt wanna go that route. he said he will just use the pain meds and they can do the surgery when he can no longer move!!! he is hard headed to say the least. he didnt even go to the hospital when he had his 2nd stroke... HARD HEADED MAN!!! i love him. it would kill me to lose my daddy... my hero!
Votes: +2
AS
astrokittycat
11 Aug 2010
Tramadol never did anything from me, I've had back problems for 5 or 6 years now - after a while you lose track and it seems to practically take over your life :( I've had epidurals as well but they didn't help me, none of the dozen or so dr's I've seen can find anything they feel is significant enough to cause the pain I have. I've tried physical therapy 3 different times with little to no luck, had a tens unit that I used until it died - not sure if it really helped or not but I used the heck out of it at the time. I've done lots of research online and a lot recommend exercise - low impact stuff like yoga, swimming, walking. My pain is in my mid-upper back, which is different than most people who have lower back pain. The only dr I see anymore is pain management and they've got me on narcotic pain meds and muscle relaxers.
They've tried giving me things like lidoderm and flector patches, which are not narcotic, so you could ask your dr if he things something like one of those might help. Also, I've found a couple things that provide some relief. It's not permanent, at least not for me, but things like heat, using an inversion table to stretch out your spine, or even a good massage or massaging chair help me for a little while. And I certainly don't want to push stronger meds like narcotics, but on the same token I understand what it is to be in pain all the time and I take them b/c it's often the only way I can get through the day or even pick up a gallon of milk. I actually wish they'd find something wrong with my back and want to do surgery, at least that would give me some hope that maybe whatever is wrong and causing my pain could be fixed. But I understand where you're coming from on wanting to try conservative measures, so if you're interested you could try some of the things I've mentioned - PT, yoga, swimming, heating pads - I think those stick on heat pads (like the therma care heat wraps or whatever) are a godsend, though they do get expensive. And you could also try to talk to your dr - see if he has any advice, ask about other possible treatments or meds or if maybe a back brace might help with your pain since you said you've got a physical job . . . And if you haven't already, the internet is full of info - so research research research. No guarantee all the info is good or right, but if you read enough your bound to find some stuff that helps, whether it just helps you understand, gives you ideas, or helps you find people to talk to.
I hope something I said might help and wish you the best of luck from one chronic back pain sufferer to another.
Votes: +2
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dianaclark
24 Feb 2011
You can get GOOD heat patches at Dollar Stores for $1.00
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KaiteDash
13 March 2012
I also have pain in my mid to upper back,and I've been taking Tramadol and a narcotic break through pain Med as well. Tramadol is my Godsend as I've been on it for about 6 years. It doesn't totally take the pain away but takes the edge off. I started out taking 1 every 6 or so hours. Now I'm taking up to 4 every 3-4 hours with 1-2 Vicoprofen 7.5/200mg with the Tramadol. My body is getting so used to those meds that it needs more to take the pain down to a manageable level. I've done physical therapy numerous times and it has helped however my insurance only pays for 4 weeks a year,and I don't have the money to pay out of pocket. Massage definitely helps as my mother has been rubbing the huge knots in my back every other night. My Dr says there is No cure, just keep doing what I'm doing.
I am 27 years old, how is it gonna be when I'm 47? I was diagnosed with Fibromyalgia about 2.5 years ago because my X-rays were negative and they can't find nothing else wrong. HELP ME!!! I don't want to be a pill junkie, but it's all that helps when I get out of bed in the morning. I'm so stiff even after morning stretches. I am a nurse and I know how these things turn out... I use a heating pad too. I'm out of options. I also have No time for extra things. I am a full time nurse and head coach of pop Warner cheer. Btw, that helps doing the arm movements with the girls as they're doing the cheers. Anyway, please help!! Thanks!
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Rajive Goel
11 Aug 2010
Really feel for the pain that you might be undergoing, rather unfortunate, could I recommend a web site for your reading, please?
Thank you for the web site. Sometimes there are just too many sites so having a direction helps. jlbyrd
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Rajive Goel
13 Aug 2010
Most welcome, please be well & safe!
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puppypal
6 Jan 2011
I have been a lower back pain patient for 11 years now... I was on some pretty hard drugs at first then I made a choice to wing myself off and stay on darvon (darvocet) and Soma. I was doing super! now that they took my BABY pain medication off the market I am stuck taking Ultram (name Brand)... It doesnt tend to the pain nearly as well as darvon did. But I was given the choice of going back on the Oxy (Which Fried my brain) or try this... I opted out of the second surgery and i too run my own business full-time. I would suggest getting your primary doctor to send ya to pain management if you are not already involued with that type of doctor... 2ndly Most pain management doctors prefer you be on a low dose pain med than give ya something stronger... Might want to check into a new one Hope you have double good days ahead!
AR
ArlenRThomas
20 Feb 2011
You have a lame intimidated Doctor. Option 1) Get the surgery ASAP and ensure you get a prescription for Morpine(MS CONTIN 60 mg 3 times daily min.) or a large bottle - 100 - of Tylox. The pain is bad for 3 weeks while muscle heals - then you are in heaven. I have had it done. Stay on Morphine in hospital at least 3 days and you'll be fine. Good Luck
