Question: How to ease chronic back pain when exercise has failed?

I have suffered from chronic back pain always in the lower lumbar area since 1996. I have had 3 MRI's that have all come out negative (i.e; back is 'normal'). I had 3 injections in the L4 and 5 region in 1997 that alleviated the pain somewhat, but now the pain has returned. I always feel relief after lying recumbent for several hours so I think that the pain is axial.

The pain feels like a pushing, pressure sometimes stabbing pain usually directly over the L4-L5 spine area. I liken it to someone wrapping a towel around my back and pulling it really tight. When I bend over and return upright if feels like there is a rusty hinge in my low back.

I have tried exercise, chiropractors, acupuncture, a million NSAIDs, and muscle relaxants. Nothing helps except for massage and very hot baths, sometimes with Tiger Balm applied to the lumbar region and afterwards bed rest.

I still do not know what is wrong with my back, but I wish I knew. At times, I find it difficult to participate in sexual activities with my wife because my back is so bad. To this end, I typically initiate intercourse in the morning before I get out of bed as my back usually feels good then.

Can you give me any recommendations about what I can do to ease the pain? And, can you possibly give me some clues as to what is causing my back pain? I recently heard the comedian Jerry Lewis had some kind of operation that helped him immensely with his back pain which he had for over twenty years. Do you know what his operation was and would it be suitable for me?

Should I have a myelogram, CT-scan, bone scan or some other test performed? Please provide me with some concrete answers as I am very tired.

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Doctor’s Response: Exercise can keep chronic back pain from worsening

If you have had three MRI scans that are all normal it is doubtful that your pain is due to any anatomic problem. Therefore, it is also doubtful that surgery will be an option for you. Surgery can only correct an anatomic condition. There are some types of arthritic conditions that affect the muscles. I would recommend being evaluated by a rheumatologist.

Also, even though exercise has not relieved your pain, it may keep it from getting worse. You should at least be stretching your hamstrings every day and doing some type of low impact aerobic program (i.e. walking).

The operation Jerry Lewis had was an implantable spinal cord stimulator. This is basically a salvage operation that seems to give about 50% of patients some pain relief. It is not a cure, but can cover up the pain. Unfortunately it is also quite expensive, and even if it is successful, the effects tend to wear off with time.

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In Spine-health’s Doctor Advice section, physicians respond to frequently asked questions about back pain issues. These responses represent the opinion of one physician, and do not necessarily reflect the views of the broader medical community. The advice presented has not been peer reviewed by Spine-health’s medical advisory board.