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Pain Management

Chronic low back pain

08/18/2009

Question:

I have chronic low back pain from years of abuse and unattended injuries. I now have two herniated discs, facet arthritis and a vertebrae that`s slipped forward - I can`t recall the correct term for it. I`ve had injections and physical therapy. My doctor says I`m a candidate for surgery, but I`m scared of back surgery. I`m now on Cymbalta 120 mg per day and Lortab 7.5/500 mg 3 times a day to keep the edge off. I`ve read about a patch (Duragesic, I think?)that`s good for several days. Do you think this could be helpful for me? I don`t have another "maintenance" appointment with my back doctor until late September. By the way, I`m 40, work full time and am attempting to live life to the best of my ability despite my chronic pain.

Answer:

It is very encouraging that you are trying hard to continue on with your life. From what I understood, you may have Spondylolethesis, which is a mechanical problem. If the flexion-extension X-ray showed instability of the spine, then you will probably have to have surgery.  Long acting opioids are not recommended(Duragesic) at this time, especially at your age. There are new minimally invasive procedures that are now available to help with your condition, and this will help you avoid a big back surgery.

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Response by:

Hammam  Akbik, MD, FIPP Hammam Akbik, MD, FIPP
Formerly, Assistant Professor of Anesthesia
College of Medicine
University of Cincinnati