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Wife looking for help for husband--what is left for him to try?

wifewwife Posts: 3
edited 06/11/2012 - 8:43 AM in New Member Introductions
I am trying to help my husband find some options. We are not sure who to see next or what treatment options may stil be out there. Hopeing someone can help--here is some info:

-intermittent back pain prior to 2003, however, became frequent enough in 2003 to seek out a Doctor's help
--2004 MRI results:
Lumbar Spine MRI
Spondylolisthesis at L5
advanced spondylosis at L5/S1 with 80 % loss of disc height

Cervical Spine MRI
Multilevel dehydration of discs C3-C6, degenerative bulging of disc at C 3/4 adn C 4/5

He has been to:
2 different Chiropractor's
2 different-Back Surgeon's (1st Dr. wanted to do surgery, 2nd Dr. said no way to surgery)
--Physiatrist (Physical Medicine/Rehab Dr.)
-Physical therapy
-Pain management Dr.

Currently on:
-vicodin for pain (which are only working for about 30 minutes)
-Trazodone for FINALLY sleeping
-lidoderm patches (only very marginally help)
-Lyrica-worked a little, but his eyes were looking yellow so we discontinued
-Ultram ER
--injections in the inflamed area of the back--tried 3 different time. 1st time was horrible and didn't help, 2nd time only mildly helped, 3rd time was worse than the first and he was in pain for several days and it never helped.
-several other med's I don't remember the names to

*3 MRI's
*Several X-rays
**Nerve and muscle tests 4 years ago

My questions are:

1.)Who do we see next? A Neurologist? Someone else?
He currently is seeing a pain specialist that tries to help with the pain, but no one is really monitoring his back/neck progression and we were not pleased with either back surgeon and his pain is getting worse.

2.)Also, since he's tried different meds and 3 different injection and chiropracty--is there anything else to do other than surgery?

3.)Has anyone had any experience with Mayo clinic--if so, would this be beneficial at this point?

Any and all help is appreciated-sorry for the length


  • j.howiejj.howie Brentwood, Ca., USAPosts: 1,730
    Nice that your trying to help him. If he's in other wise good health. Have they said why nothing is helping him? Would the pain management Dr. consider a different approach to the pain meds. 30 min. relief is not considered good pain management.
    I don't know what specialty spine institutes are near you. But certainly you would want someone board certified with a fellowship.
    I would definatly want another opinion. I really don't know if a neurosurgeon is better than a orthopedic. I do wonder why the second Dr. said no way to surgery?
    Good luck, Jim
    Click my name to see my Medical history
    You get what you get, not what you deserve......I stole that from Susan (rip)
    Today is yours to embrace........ for tomorrow, who knows what might be starring you in the face!
  • I'm sorry to hear about your husband's difficulties. It's frustrating, isn't it?

    As silly as it may sound, when things got really rough painwise for me I bought myself a rocking chair. Rocking really helped me tolerate some of the tough times. I know this is probably not what you're looking for, but I'm just saying when I was really messed up a while ago in pain, frustrated and feeling hopeless I turned to a rocking chair!

    I hope someone else will come by and help point you in a direction that will be helpful for him, but I'm not from the US so don't about the particulars of hospitals and the likes there
  • I'm afraid I can't really help, but I can appreciate your frustration in getting an accurate diagnosis leading to treatment or at least management.
    It is often very time consuming and difficult to find the doctor that is able to help, but keep looking and hope you find one.
    It's the same with a lot of illnesses and ailments. Most say they can help, but in the end can't.
    From my recent experience in finally finding a really proficient physiotherapist, at last, I'd suggest that you try to find one that is personally recommended, and get him to do a thorough back examination.
    Back problems are very common, almost everyone has one at some time or other, so bear in mind that it might also be a common complaint, and not something more serious.
    But don't give up, just keep trying new people who have a good name. They are out there!
  • Hello,
    The option of surgery should only be included where no alternative is possible and you already have diverse opinions where surgery is recommended by one and not from another, similarly the more opinions you get does not always determine a categoric solution. We are right to be cautious and listen to what the doctors tell us, it may well not be what we want to hear but that does not distract from the truth. Surgery for the most part is irreversible and this site is testament to the difficulty and courage needed to progress along the surgical route where no other reasonable option is available, you have to decide what you want to do.

    In reality only a finite range of procedures would be suitable so you have to pick from the best that in your opinion will give some improvement and you are continuing to seek that varied strategy of ideas. On the basis that he has had some injections and they too have been ineffectual the next progressive stage beckons and three should have been sufficient if it was going to improve. They would only be expected to mask the symptoms rather than address the origin.

    How is his function, that in itself is sometime the determinant of the next stage, we can all equate with your frustration and many here have similar experience and time lapse, pain is never easy and the solution not as simple as we may have first imagined.

    I know you are looking for a visible improvement and this is not always possible and many have to live with this pain and impact on those around them. Time itself develops the traits of chronicality, what are the pain clinic doing, some use shots or alternative medication strategies, some use CBT to help patients manage pain more effectively.

    How are you ? what is your name, I know from experience the impact pain has on families and everyone trying to cope, support and encouraged our loved ones, where no easy solution is possible. Encourage a positive outlook and get him to pace well, the techniques used at the Mayo Clinic are integrated into all PM programmes, most have a support network for the carers and you could ask those relevant questions and some support and guidance for yourself.

    As Jim said, we all need support from another to survive this and it is a learning process for us all and not how we surmised our future would transpire.

    Take care and good luck.

  • I sent you a PM with a couple comments regarding your question about the Mayo Clinic. The Spine-Health rules frown on discussing particular doctors or clinics on this forum.

    It is not uncommon for people on this board to collect a variety of opinions from spinal specialists. If you have only seen ortho spine surgeons, you might want to try a neurosurgeon for another opinion.

    It has been my experience that for most spinal problems there are several approaches to treatment. One exception to this is spondylolisthesis. If it is determined that the spondylolisthesis at L5-S1 is the source of your husband's pain, there is only one way to treat this: surgery. Many people have spondylolisthesis and never know it until a X-ray is taken for some other purpose, and the spondylolisthesis is noticed. These are people who are asymptomatic and have a condition where there is no movement involved.

    However, if there is instability caused by the spondylolisthesis, it usually is a pain generator. The reason for this is that one vertebra slides over the top of the adjacent vertebra which lessens the space in the foramen, which can result in nerve compression. It causes spinal stenosis...stenosis is a narrowing of a space...in the central spinal canal, or as in this case, in the foramina.

    If there is instability, surgery is usually recommended because if the vertebra continues to slide, it can cut off the spinal nerve, causing nerve compression and even permanent damage.

    Nerve pain does not always respond to treatment. There are specific drugs for nerve pain, such as Lyrica, which you have tried already. In the same family is neurontin (gabapentin) or some of the SSRIs like Cymbalta. The opioid family of drugs does not work for nerve pain...so there are very limited options. The best way to deal with nerve pain is to find what is causing it and eliminate it or change it somehow so the nerve is no longer effected.

    You don't indicate where your husband's pain is located. Are the cervical discs more of a problem than the lumbar area? Unfortunately some back problems are hard to pinpoint. The patient just has to keep looking for answers. Sometimes this involves seeking out a variety of opinions.

  • I was typing late last night so I probably forgot some pertinant information:
    Pain is in the lower back, just above the right buttock--numbness radiates down the leg and to the foot--
    This was the primary problem for 5 years with the neck being secondary. Within the last 2 months the neck has become worse than the back. I see him rubbing his neck himself alot and streching it out. It seems to really bother him quite a bit now.
    He does seem most comfortable in a recliner as some people have mentioned.
    The doctor questions are coming up because no one has really been able to help him much and the two doc's had such a varied opinion.
    Doc #1--1st Dr. we saw, said physical therapy, then surgery. Diagnosed after MRI
    Doc #2--2nd Dr. we saw a few years later. Basically asked if he could get out of bed, walk o.k., (which he can) then said he wouldn't even consider surgery yet because he was not "bad enough." Also, doesn' t believe in MRI's to see this progressioin of problem, prefers X-rays.

    Thanks in advance for any insight
  • I would get a 3rd Neurosurgeon or Orthopedic Surgeon's opinion. He should also get an EMG again as it's been many years since his other one he had done if his symptoms are worsening if your Primary or PM Dr. agrees to it. When I got my EMG the Neurologist saw me right away and referred me to an Orthosurgeon but I was sent to a Pain Management Dr. I've been to 3 different Pain Management Drs for their opinion and have found a great PM Dr. now who is so gentle with the facet joint injections and the epidurals I wish I could refer her to everyone.

    I also had to return frequently to the Dr. to let them know I was having too much pain and the meds were wearing off after a few hours. One PM Dr. recommended an infrared platinum heating pad which I could never sit without it on my back and penetrates the muscles 2-1/2 inches in the muscles compared to only 1/2' of a regular heating pad. I also take Cymbalta to help with the nerve pain. Acupuncture was also a gentle procedure that helped for a short time done by a Physiotherapist. Keep looking for a Spine Specialist to help. Take care. Charry
    DDD of lumbar spine with sciatica to left hip,leg and foot. L4-L5 posterior disc bulge with prominent facets, L5-S1 prominent facets with a posterior osteocartilaginous bar. Mild bilateral foraminal narrowing c-spine c4-c7 RN
  • Hate to sound uninformed, but what is an EMG? Is that the nerve test?
  • Yes that's right. Charry
    DDD of lumbar spine with sciatica to left hip,leg and foot. L4-L5 posterior disc bulge with prominent facets, L5-S1 prominent facets with a posterior osteocartilaginous bar. Mild bilateral foraminal narrowing c-spine c4-c7 RN
  • hi and welcome to the forum! :H we are here to offer you support and answer what questions we can. so glad you stopped by. your husband is so very lucky to have you by his side. :X i am sure he really needs you now more than ever. giving him your support and sharing these difficult times with him is so very important to him.. i cannot help you with your issues but you have come to a great network for information and much needed supprort for both you and your husband.. :D we are here for you as well. remember to take care of you, get rest when you can and take a time out every once in awhile and do something just for yourself. :D all the best and stop by anytime! Jenny :)
  • Just wondering if your husband has tried getting into a good physiatrist? (Physical Medicine Doctor) They may be able to evaluate all his symptoms, cervical and lumbar, evaluate what images he has so far and what further testing may need to be repeated or done. He then may refer him to someone from there.

    A good physiatrist will also help him with better pain management as well.

    Keep us informed. You are awesome for helping him and fighting the good fight with him.

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