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After PT and epidurals, what now?

BACKGROUND: (1) Female, age 66, back pain for 25 years, controlled with Tramadol, Celebrex, and Tylenol. (2) Had a stroke at age 51 because of Factor V Leiden (blood coagulation variance), forcing me to stop teaching (one vocal cord paralyzed and other problems); take Gabapentin for nerve pain in affected areas.  (3) Both knees have been replaced; both shoulders should be replaced but haven't been.  (4) I was doing pretty well, going about my life, reading, doing things with family, putting up with pain and adjusting activities accordingly.  (5) About 6 months ago, I started have shooting pains down one leg and greatly increased arthritis pain.  Also had numbness and tingling in all extremities, to varying degrees.

CURRENT: (1) Saw an orthopedist and then a physiatrist, who prescribed MRIs (upper and lower spine). physical therapy, 3 epidurals, and also a "nerve study" (EMG) of upper extremities. The PT helps so long as I keep at it; the epidurals did not help. (2) Diagnosis:  Osteoarthritis, scoliosis, degenerative disc disease, with some narrowing of spinal cord space (upper and lower), two bulging discs, sciatica, and a nerve impingement.  (3) I will be seeing my physiatrist again next week, as well as a neurosurgeon. (4) I have aching pain that prevents my walking very far or standing very long, and I have sciatica symptoms pain sometimes (when bending too much or putting weight on left side first when sitting down).

MY QUESTIONS:  (1) To those of you with similar conditions—How did you proceed after epidurals did not help?  (2) I am fearful of surgery...which kinds are pretty safe, and which are riskier?  (3) How hopeful can someone in my situation be about living out her life with only bearable pain and no wheelchair?

i know that these forums are not for dispensing medical advice—but I am interested in other people's experiences and outcomes.  Thanks so much!


  • dilaurodilauro ConnecticutPosts: 13,526
    For starters you might want to repeat some of these conservative treatments and/or ask your physiatrist what other treatments are available ? (ie acupuncture)

    I dont want to minimize your condition, but overall its not all that terrible.   The worst part if the nerve impingement.   That generally is a condition where surgery is opted sooner than later.  The last thing you would want to happen is for the disc to continue to impinge the nerve and then there is a potential for permanent nerve damage.

    What surgical options have been made to you?  Any surgery can have its pros and cons.   The important thing is if the surgery is designed to reduce your pain, then that might be your best option.

    I started with spinal conditions back in 1975, had my first lumbar surgery in 1978.  Since then I have had 4 lumbar surgeries, 2 ACDF's , Both shoulders totally replaced with implants, both hips totally replaced with implants and a reconstructive Achilles tendon. Osteoarthritis has ripped through my body and my spine is almost fused just from the arthritis

    I'm 66 now and still kicking along. Following doctors recommendations, going through all those surgeries, maintaining a positive attitude have all be some factors that keep me going..
    Ron DiLauro Veritas-Health Forums Manager
    I am not a medical professional. I comment on personal experiences 
  • hvillshhvills Suzhou, ChinaPosts: 971


    If you have not yet tried it you might want to talk to your doctor about trying one or more of the Biologic treatments  available to arthritis patients.   Biologics is a relative new class of drugs for treating arthritis... you can read about it on this site or Wikipedia... just enter arthritis biologics.   In my case I use Enbrel and it has worked wonders in relieving years of arthritis pain.  It won't solve your nerve impingement issues... but it could significantly help your joint pain.

    Harry - 65 year old male...
    PLIF L4-L5-S1 due to disc degeneration... May 23, 2013
    PLIF L5-S1 due to failed fusion and broken screw... Jan 19, 2015
    Microdiscectomy, decompression L3-L4 due to herniated disc... Jan 19, 2015
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  • MamaGooseMMamaGoose VirginiaPosts: 10
    Ron and Harry, thank you both for taking time to respond. Your comments are helpful—and they give me things to study up on so I can be better informed when I talk to the doctors.
  • jimandjrjimandjr Dallas TXPosts: 745
    Ablations are my day surgery of choice since 2014. I have had countless ablations from top to bottom since 2014. 
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