Saturday, January 7, 2012

Failed Back?


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Gender: Male
How old are you?: 35
How long has this been going on?: More than a month
Check all symptoms you are currently experiencing:

Musculoskeletal Pain
Describe associated symptoms not listed above: 
Doc, severe lumbar, thoracic muscle spasms.

What have you done so far to remedy this condition? Please include tests and relevant studies here: 
I have bulging disks l3,4,5. Had 2 epidural injections to l5 which is the worst. Muscle spasms will not stop.

Please list any chronic medical problems and also list any prior surgery (lacerations don't count!): 
Htn
Check all conditions present in your immediate family... :

Cardiac Disease
Diabetes
History of Back Pain
Hypertension
Please list any medication allergies that you have : : Nods
Please list any medications you are currently taking (and dosage if known) :: Lisinopril
soma
simvastin
ultram
ultram
zanaflex

When was your last menstrual cycle?: Now
Are you currently using or do you have a history of tobacco use?: Yes
Are you currently using or do you have a history of illegal drug use?: No
Please describe your alcohol consumption :: Daily


Docs, I've done everything from pt, massage, ice and heat. These spasms won't stop. There worse if I'm laying down and try to move in bed. Relaxers don't help! What could be any other causes other than muscleskelton issues?

___________________________________________

Dear Back Pain Sufferer,
Please be sure to check the comment section for some very good answers. With your underlying KNOWN pathology it is unlikely that a second cause for your symptoms would be likely. But, that being said, after seeing a spine specialist and inquiring about surgery, you might consider seeing a Rheumatologist. There are conditions like ANKYLOSING SPONDYLITIS which are rare and hard to diagnose and often confused with more common back ailments, and this may be worth considering. I hope the below comments will be helpful to you. Please feel free to add questions or comments there.

Thanks

MD STAT Docs

4 comments:

MDSTAT_ER_DOC_1 said...

Questions for you...
I assume you mean you are allergic to NSAIDs?
Have you been evaluated by an orthopedic spine or neurosurgical spine specialist?
Also, have you been on Baclofen or Valium?
Was there an inciting event or injury?

MDSTAT_DOC_7 said...

Quick reply-
1. Stop Soma.... Worst drug in the world
2. Spasms by definition are musculoskeletal. They might be triggered by nerve irritation and inflammation, so if you have know bulging discs and conservative therapy is not providing relief, it's time to talk to your orthopedic surgeon about surgery to clean up the bulging discs
3. Medication wise I recommend an anti-inflammatory (since the root cause is inflammation) combined with a muscle relaxer (but not Soma). Personally, I had great success with epidural steroid injections for my back- avoided surgery (that was over 10 years ago, knock on wood).
4. I STRONGLY suggest that you avoid using narcotics for your back pain.... Given that your pain is chronic, you will place yourself on the edge of that slippery slope of physiologic dependence on the stuff.
5. See your ortho doc (or neurosurgeon- whoever covers backs in your community). In the interim, continue with massage therapy and lumbar stretching exercises. (www.dynamicchiropractor.wordpress.com has an image/ illustration of a series of stretches)

space doc said...

A very tough problem.
I totally agree with Doc 7 to stay away from narcotic meds (vicodin, demerol, morphine, percocet, etc.)

It does sound like you need to seriously look into surgery for the bulging dscs as they are so often the cause of pain and spasms.

If you don't want surgery you could consult a physical medicine M.D. (physiatrist) who are specialists in musculo-skeletal problems but don't do surgery.

One of the muscle relaxants---Flexeril-- tends to make many people drowsy and might help at night time.
Be very careful of alcoho;!! It so often is used to dull the pain and can easily become a problem on its own.

Also be careful of the zanaflex whiile you are on lisinopril--could drop the blood pressure and create the possibility of dizziness and falls.

Remember, too, that cigarettes and diabetes are a nasty combination in terms of your heart (oronary arteries) and your circulation in general.

A lot of things to tackle---good luck!!

Space Doc.

space doc said...

A very tough problem.
I totally agree with Doc 7 to stay away from narcotic meds (vicodin, demerol, morphine, percocet, etc.)

It does sound like you need to seriously look into surgery for the bulging dscs as they are so often the cause of pain and spasms.

If you don't want surgery you could consult a physical medicine M.D. (physiatrist) who are specialists in musculo-skeletal problems but don't do surgery.

One of the muscle relaxants---Flexeril-- tends to make many people drowsy and might help at night time.
Be very careful of alcoho;!! It so often is used to dull the pain and can easily become a problem on its own.

Also be careful of the zanaflex whiile you are on lisinopril--could drop the blood pressure and create the possibility of dizziness and falls.

Remember, too, that cigarettes and diabetes are a nasty combination in terms of your heart (oronary arteries) and your circulation in general.

A lot of things to tackle---good luck!!

Space Doc.