Not sure what's next

[Cindylou]

Hi everyone, and Happy Turkey Day to all you Americans out there!

I have been betwixt and between on my whole pain management issue. Just not sure where to go from here. I'm not sure I want to get any other opinions, as it seems these docs just assume I want surgery, and that's not my point at all. I'm just trying to understand why I am still in so much pain. I made an appointment to see my hip doctor who did the right hip scope 7 months ago as it seems that the same pain as before surgery is starting to come back again. Very discouraging. But I can't get in to him until right around Christmas, so another month out. I was going to have him check my hip again and my bad left knee, which has a large Baker's cyst behind it now. Perhaps just an injection will give my knee relief. This was originally going to be my only physical ailment to follow me into middle age, this bad left knee I blew out in college, skiing my last run, my last day, through the powder on a black diamond run in Park City Utah, when I was 19. I never dreamed a bicycle accident in my late 40's, breaking my back, would be the snag that would trip me up so relentlessly. But it did, and so here I am. What I am considering right now is more physical therapy to improve my core strength, if my hip doc agrees, and writes the script for it. I'm also wondering if it is time to consider a trial for the spinal cord stimulator. I just don't know. Try the pt first maybe? My back just stays perpetually locked up. Whatever is causing this pain, has my back just locking up to protect itself. It's just awful...the pain. I have been getting so discouraged as of late. It certainly hasn't helped with the 4 tires being slashed now 2 times in a row, and being $4,000 poorer because of some jerk kids that don't give a rat's ass about anyone except themselves! Anyone have any thoughts or suggestions? Not about the criminals....but about my back. CL

[Katie]

Oh sweetie, I am so, so sorry that you are still suffering like this

I have little to offer except for this 'way out in left field' thought. Stay with me on it. Years ago, I was suffering from abdominal pain post hysterectomy. There were a lot of other semi-debilitating symptoms too that I won't bore you with right now, but a good friend suggested a homeopathic doctor. After several treatments, I felt much better, including the pain. It had something to do with inflammation, etc.

Years before that, I had developed a bad lung and sinus infection that hung around for over a year. It started after I ripped up several layers of old flooring in a 100 yr old house I was renovating. Lots of useless treatments later, including from ENT specialists, I almost gave up, but then stumbled upon a naturopath.

She took one look at me and said I was full of Candida, and put me on a strict no-carb diet and some strong supplements including very strong acidophilus. Within a week I was feeling much better, and a month later, I was completely healthy.

All of this is just to say that sometimes the alternative doctors/therapies are what we need. We have a homeopathic doctor in our neighbourhood, a lady in her 70s who moved here from South Africa. In that country, they work hand in hand with the conventional medical system instead of being frowned upon as most often here in North America. At least up here, most doctors won't recognize their value. (Coincidentally, I told her about my fight to get ADRs, and she had a daughter back home in SA with similar issues. I gave her the information I had, and her daughter found a surgeon that was able to do surgery for her, with an ADR. It was a great success...that was three years ago now.)

So maybe one out there may have some ideas on how to help. It may be a long shot, but when the 'regular' guys don't work, I always go round the corner for the other kind of help. Just an idea?

Hang in there. We are all pulling for you.

[ajj1001]

If it were me I'd be going for the spinal cord stimulator, I'm a big believer in doing whatever necessary to keep on my feet and moving and know any PT would be easier if I was in as little pain as possible. What length of time is the trial over as that would be another deciding factor?

[dalhousie]

I'm not sure what to say really. As far as your back is concerned from what I can gather there doesn't seem to be any unanimous, obvious answer to your problems. Out of the opinions you've had is there a doc in there that is a leading light who is extremely well respected & trustworthy who you feel talks sense.

It is important to keep as active as possible so maybe a SCS can help you achieve that - is that line of thought backed up by the medics & what are the pros & cons of that? When SCS is mentioned I can't help thinking back to Daveinaustin who had one but he needed to take time out from the forum so I'm not sure how that turned out for him long term.

I'm very "for" alternative therapies & they work well for some people. Despite trying many complimentary therapies for my back issues they have ended up being solved by conventional medical intervention (i.e. surgery) but I have backed that up with alternative treatments to help me along my way.

Sorry I can't be more help. I hope something comes to light soon that will improve your situation.

[Justin]

Hi CL,

I'm sorry you are stuck between a rock and a hard place. If I were in your shoes, I would definitely go the physical therapy (PT) route first. The PT should be at least 2-3x / week for 6 to 8 weeks to start. As a result of your accidents, it sounds like you are going to have ongoing pain. Unfortunately, there is no easy "fix" (as I know you are fully aware). A dedicated PT plan daily, light stretching, counseling and pharmacological therapy will give you the best result.

A spinal cord stimulator (SCS) is an option. However, most people that get SCSs end up having them taken out. Personally, I've only spoken to a handful of Spine Patients in the clinic that have had relief from their SCSs. Before placing a SCS, they will do a one week trial. As you know, a SCS is kind of an "end of the road" type of therapy.

Good luck in your steps ahead and I do hope your hip doctor can shed some light on your hip problems.

Happy Thanksgiving!

[JK2234]

I have one of those Baker's cyst behind my right thing from when i hurt it at 25. It "clunks" everytime i straighten my leg.
Doc said if he drained it would just come right back.

[KBear]

CL- I'm with Justin on the SCS, definitely a end of the line treatment; but I guess if you feel you are there, then it's up to you. I wouldn't want one, but I'm also not in your shoes, so I can't say that I wouldn't try it. I definitely would give the PT a shot. Alternative treatment is worth a shot too, worst case scenario it doesn't work, nothing to lose. I'm sorry you have so much going on and wish you could find pain relief, you so deserve it.

[Hooch]

Hi CL, I'm sorry to hear you've gotta go this road.

If it's your lumbar spine that is still causing significant problems, first step would be PT and I am also not afraid of options like SCS and morphine pump, that is what they are there for if the pain is bad enough.

But you have multiple injuries, so it's tough. Hip damage can refer to directly to the back, the pathology isn't a guide to pain etc.

PT is a must for you, but listen to me now since I gibber this crap all the time, it's not 2 or 3 times a week, it's every day and you start from the ground up reactivating your transverse abdominus, multifidus and pelvic floor. These are the endurance muscles which stabilise your spine and in your case still undergoing constant muscle spasm they will be grossly non-functional. The exercises begin lying on your back gently activating your TA, and a good physio who knows your history will do it under an ultrasound with you cause you will have absolutely no awareness of these muscles by now.

Any PT which has you recruiting outer muscles or anything which gets your pulse up you may as well sack them you aren't there yet. This program will only reduce your pain and disability that is due to lower back pain by stabilising the lumbar spine, and will not eliminate pain as there is too much tissue damage. It's also probably an ongoing commitment.

Bounce Back :: Home Page

That's the link for the Australian program. The research was done in Australia less than 10 years ago and is still spreading throughout the medical community, so you're going to have to hunt out someone who will help with 'spinal stabilistion' exercises.

Good luck.

More surgery is always an option if you're willing to go through it too. You need to find a surgeon who will examine your case seriously as not palm you off as FBSS. Is a significant portion of your pain facetogenic? Has that been diagnosed? If so why isn't a posterolateral fusion considered?

[Cindylou]

Thanks everyone. Random thoughts? Yes, I do feel I am at the end of the road, but definitely willing to try some consistent physical therapy. Hooch, I wish you lived in Minneapolis to guide me. You sound like you really get the whole "core stuff." Alternative roads? I've been to naturopath's and homeopathic docs, and frankly, I always walk away feeling poorer but saying to myself: that didn't help me at all. But I would consider giving it the ole' college try, one more time. I may consider the SCS or the morphine pump...as a last resort, that's how desperate I am feeling. More thoughts, but time to sleep first. I'll re-visit this tomorrow. k? Thanks for caring. It means alot. Cindylou

[Hooch]

When I moved state I emailed the people through that website (apologetically because it is a business contact) and asked for a reference for someone good in my area. Not that I'd encourage people to pester them, but I don't see why it wouldn't be worth a shot to ask them who in the US is up to date, then follow the chain down. These days a lot of surgeons are demanding you do this stuff before surgery is even considered.