Back to Back Trouble. The Back Pain Support Thread.

[Matildathecat]

This is a support thread for people with back pain (that does not even cover the description of hell that back pain causes). It's for all types of back pain, for long term posters with chronic pain (including those on the upwards journey to recover), short term advice through tough acute episodes and all the in betweens.

We moan, winge, share successes, guide each other and hand hold through the maize of a million medical routes and options, treatments, investigations. We internet shop as a form of pain relief, drink wine, take strong painkillers, eat cake and we go through lots of heat packs!

We don't always have the answers but we do have a lot to say about it all

Here are the links to our previous threads:

www.mumsnet.com/Talk/general_health/1871592-The-Back-Story
www.mumsnet.com/Talk/general_health/1992406-The-Back-Story-Continues
www.mumsnet.com/Talk/general_health/2023274-More-Terrible-Back-Stories
www.mumsnet.com/Talk/general_health/2049637-Back-Again-Back-Pain-Support-Thread?msgid=47419209#47419209

And some other useful links and info:

www.patient.co.uk/health/cauda-equina-syndrome-leaflet

We have done the hard work for you and learned about effective drug combining. Using NSAIDs, a stomach protector, paracetamol with or without codeine (it enhances the codeine), nerve pain meds such as gabapentin and/or amytriptiline can all be more effective than simply taking huge doses of opiates. Of course most people won't need all of this but for severe prolonged back injuries this is helpful to know.

Heat, gentle exercise, TENs, medication patches, diazepam and accupuncture, we've tried them all.

So if you are suffering come and join us, were a social lot.

longtime you have posted before, and I am so sorry for not remembering your details. I agree with what's already posted that the type of pain is relevant to help give accurate support re medication that helps, as well as when the pain increases and what else is going on for you i.e. going children, work, driving etc.

My main day to day painkiller is tramadol slow/modified release x 100mg in the morning, along with 250mg of naproxen and 1000mg of paracetamol x 3 daily. When I get to the evening, I then take either another 50-100mg of normal release tramadol or 60mg codeine when I get home, followed by another 60mg of codeine before bed if the pain has not subsided enough. I tend to avoid tramadol in the evening if I can because it also keeps me awake, so tend to use codeine in the evenings. But, codeine makes me a bit more 'out of it', although, the side effects are much much less these days, but prefer not to take it if I need to communicate in the daytime (i.e. at work). Once I got past the side effects of tramadol (which, actually, are quite nice if it doesn't make you feel sick, but not conducive to work/functioning on any level outside of goofing in front of the TV) it's fine for me to function on and I get no side effects now on the level I am on,. apart from the odd spinny head about 4 hours after taking the MR occasionally

Sometimes, I think tramadol is not doing that much, and I get a lot of breakthrough pain, and so occasionally I top up in the day time with 30mg of codeine if I can't manage, rather than take more than 100mg tramadol as I become a bit too fluffy and smiley otherwise , but actually, when I stop using tramadol, the pain the following day increases significantly and I remember how much pain I am in without it!

Are you remembering to take paracetemol with your stronger meds? It is really important to run this alongside another medication that does not already contain it, as it supports and compliments the work of the other drugs - it enhances their effectiveness. If you are not using paracetamol regularly, add this to your medication regime before you think of changing the opiates. As matilda said, the key is to effectively use the meds to their optimum levels as a group, rather than upping the levels of each drug. Although, sometimes that might not be avoided.

Hi, I hope you don't mind me posting here but I am looking for advice for 16 year old DS. He has been in pain since January and finally got the results of his MRI Scan today - herniated L4/5 disc. I'm going to scan the previous threads for some hints and tips for him. He's really struggling with this news today. I think he thought they were going to tell him there was a quick fix and there isn't.

He's on Gabapentin and Ibuprofen and sees an Osteopath and has weekly acupuncture but I realise I need to be much better informed about this to fight his corner.

Oh Lordy, Best, that's a tough one. One of our regular posters first had her disc go at around this age. I will see if she's around in the next day or two. She did get better, though for a very long time.

Main thing is to rest it as much as possible, preferably lying down. Avoid sitting wherever possible. Re meds, gabapentin great for the nerve pain, naproxen good for inflammation ( is he on a stomach protector? Vital). Opiates such as cocodamol are good for the terrible aching. What kind of pain is he in? How frustrating for a young lad.

I don't know about osteopaths, some people swear by them. The consensus on here seems to be about finding the right person! be it physio! chiro or osteo. When it comes down to it in acute situations they are doing similar things. They are either good or not.

We all love heat. Not ideal in this hot weather but never mind, it still helps.

The good news is this, eventually nearly all discs recover. I have this on good authority. Injections can help some people in the meantime.

Keep posting. It must be hard to see your child in so much pain. Also, bear in mind we are tending to be a group who had difficult or poor outcomes. There are many more people out there who've recovered and getting on very nicely.

Please excuse the ipad added !!!!!!!!s. Grrr.

best oh your poor DS . I don't know huge amounts about horrific pain as a teen and the best course of action, as, I have had to manage as an adult with work/children/etc. But, if I could chose one thing to do, that I would be able to do without it affecting the children, work, life etc is rest. I would rest as much as I possibly, possibly could, laying semi supine. And for the time in the day that I was mobile I would be doing pilates based exercises to strengthen the core, which will give the disc as much of a chance of recovery as possible. I would also absolutely advocate the Sarah Keys' Back Sufferers Bible. Especially for someone young with huge potential for self recovery, this book talks in detail about how to manage acute, sub-acute and chronic pain with the view of fixing/reversing the damage by opening up the vertebrae, getting fresh clean nutrients into the disc space which is difficult when there is swelling. Even if he choses to not read it himself you may be able to help guide him by reading it.

Is your DS at school/college/work? How much time can you negotiate for home tutoring/work at home etc if he is at school or college, which he could do while laying flat? Work is harder to accommodate, but where possible, time off to lay flat is recommended by me.

Painkillers are to be used at optimum levels, rather than necessarily in high doses. co-codemol, naproxen together work well. Gabapentin suggests he has nerve pain? That sucks and is really difficult to control but many people here have success with gabapentin, although it takes time to build up in his system.

I agree with matilda that hope is on his side, many people recover completely from disc problems, or certainly for many many years, when it may go at an age when it might have done it anyway. And I think, that his youth and body's ability to self heal will be a huge advantage, compared to someone in their 30's onwards who has already had a while of placing strain on their backs and when the discs start to dry up.

and, famous people I have pulled out of my hat who have had back problems and recovered:

Frank Turner! (he is an awesome singer in case you didn't know!) Problematic disc, don't know details, but wore a back brace, took painkillers and had spinal injection(s).

Ben Ainsley the 3 x Olympic Gold Medal dingy sailing champion in 2012 and before. He had a prolapsed disc and had a discectomy in December 2011, was sailing again in March 2012 and won 3 Gold medals in July (June?) 2012. So, 6 months later and he was back to 'normal'.

Andy Murray the Tennis Player - he had a discectomy this year, which he referred to as 'minor surgery' (ha!) and is back playing tennis again.

While it's worth noting that these people were likely diagnosed, and treated very quickly with the best available private treatment (evidence shows that the quicker diagnosis and correct treatment, whether that's straight to surgery or other treatment options the more likely that complete recovery occurs) what it does show is that almost full recovery is entirely possible. Although, I say 'almost' because I think once there has been a back problem, it is always something we are aware of, and likely he will need to be consciously aware of maintaining it in the future. That may not be a bad thing as he will have fabulous stomach muscles and brilliant posture!

Thanks all, I will catch up with all your posts tonight.

Ooo I didn't know about Andy Murray, minor kind of these days as it's keyhole and only a day thing with short recovery, but my physio said it's pretty major.

Best - I'm the 16 year old with the herniated disc, well it was 15 years ago and apart from minor niggles I recovered probably until my second baby was born at 29. I'm pretty sure I would've stayed with the minor niggles only without pregnancy.

I didn't get a scan but my current herniation is L4/5 so it is likely it was the same one at 16. I was diagnosed by a physio and responded very well to that treatment. I'm sure I also recovered well being so young, active and having more time to rest and not lift small but heavy people etc. 90% of discs will get better with phsyio, medication and time. The other 10% need surgery - me now.

Do you have any indication of what the next step is following the scan? Any referrals recommended? How big the herniation is and the position, so which nerves are being compressed and how long has he been suffering? The short term is managing the pain and getting the right treatment to give his body the best chance of recovery. Long term it is about jumping through the right hoops to get the more specialist help - pain clinic is one option if it's long term and physio hasn't worked and then surgery is the final step, although I jumped straight to the surgeon after my scan due to the size and amount of compression. Was the scan done privately? If not it sounds like your GP is already on the ball and also knows about naproxen, gabapentin, codeine... But if the GP is being rubbish ask for more pain relief and a physio referral. Personally I feel osteopathy and acupuncture is a waste of time and money, I'm very cynical despite some good short term results after seeing an osteopath, I just don't believe they can help a disc reabsorb :(

Thanks all, he has been referred to the surgical team for consideration although the referring physio at the Musculoskeletal team we saw was very negative about the potential success of surgery. In fact she was very negative full stop and DS was terribly upset. I wasn't happy.

He does lie down a lot but it is difficult to keep him away from the computer chair.

He finished GCSEs in June and starts 6th form college in September so is having a good long rest. The course he is doing is quite hands on rather than academic so he will need to be at the college rather than home study.

I don't think the acupuncture is doing much either to be honest but DH is a believer.

From the MRI scan, there was only a slight bulge so I hope that is a good sign. The GP has been pretty good to be honest but once I have read all your posts properly and made notes I will take him back. He is going to get more physio and some hydrotherapy too.

I was wondering myself whether Pilates/yoga would help. Any recommendations for this?

What about swimming? Does anyone find this helps? Any dietary recommendations? DS would live on cereal if he could.

queen having had it. It's not minor. Micro discectomy is not really keyhole. It's not open surgery like it used to be, but it's still not as minor as keyhole surgery, cutting through muscle, cutting away bone and disc - I am impressed with the size of my scar though, only about an inch and a half, maybe a little bigger, open surgery is like 3 inches. But And I would prepare for staying in overnight, as I don't know anyone who was allowed to go home the same day. There is no way I would have been able to get up and move the same day, and I had my surgery first thing at 8:45am. It's Andy Murray's own incentive to tell the media it's minor so he does not appear to be out of action for to long. That's why you didn't know, it was kept quiet! Although, i expect his was as minor was possible, with the best possible surgeon and care available.

Altough, I was so pleased I came home the next day, would hate to be in hospital longer, everything I needed to recover was available at home - my bed, partner, decent food, a sick bowl close to hand, painkillers!

pav, my consultant told me that microdiscectomy is a day procedure at our hospital, assuming things have gone according to plan. I was a bit gob-smacked too, but it does seem that's the protocol in a number of hospitals.

That's insane! I was only coming up from recovery at just past 12:30 and had my first attempt at weeing post removal of catheta at 3:30pm! That was on a portable commode next to th bed and two staff monitoring me (Undignified). Didn't walk to the loo til next morning. And still had oxygen tube on til very late. I remember them swapping the mask for a tube so dd didn't feel freaked out by wires etc everywhere. Maybe they into account that I have a lot of stairs but doubt they would be so considerate I think it's normal procedure here. But while I was very ready to come home when I did, definitely not on day of surgery.

Bizarre, the variations of protocols. I was in hospital for two nights and on a morphine pump for 24hours. Not very minor and certainly very sore.

best, I had a long conversation with a neurosurgeon recently about the benefits of surgery for disc prolapse. Basically if there is a large bulge and severe leg pain then surgery is indicated and about 90% successful. With smaller bulges it is far less certain. If there is mainly back pain vs leg pain, surgery is unlikely to beMuch help. It's very important to grasp this because otherwise your ds may be swayed towards surgery and the inherent risks it carries when it is relatively unlikely to help him. So be very learn about exactly what problems he has before eyeing the surgical team. I now, far too late, realise that I was an unsuitable candidate for surgery and would have been better off waiting for the disc to settle on its own.

Please excuse typos, ipad keyboard gone weird. Do hope it isn't dying.

Btw, re computer chair, I couldn't sit hence ipad which can is be used lying down. Is that an option?

Back and leg in serious trouble. Leg also very unstable. Oh god, we are going to a wedding reception and staying in hotel overnight. Yet another pleasant occasion ruined. Lying down and swallowing drugs but feeling pessimistic.

Sorry, be very clear...

Bloody ipad, hope it isn't dying.

I am a very keen swimmer and have a series of exercises to do in the water. I can't swim like a used to and want to but I can manage to do front crawl with a float between my legs. Being in a long straight line is good. Using your abs doing proper crawl is very god for the cord.

Pilates is a good idea but must be very gentle and careful while the disc is still unstable. The physio should be recommending the correct exercises however, walking is good, walking in the water even better.

Arghhh! Very good for the core..

He does have sciatic pain in his leg. I had hydrotherapy for leg injuries and it was fantastic so I will take him to the pool this week. The physio we saw this week recommended walking as the best exercise for him.

Best - did you say how long he's been suffering? And is the referral private? This sadly may alter the outcome and I feel more assured I need surgery because it's the NHS who operate only when it's necessary, generally, due to financial constraints. My bulge is massive but it's central so more room to protrude. The more important aspect seemed to be how long it had been there. It should reabsorb but this takes time. Sitting down is not good at all, especially long periods. Core strength and posture are really important and bad posture (like sitting at a computer as many of us do) can cause weakness leading to disc ruptures.

Since about February Queen. The referral is NHS.

matilda sorry you are feeling crap. How did the wedding go, not too awful in terms of pain I hope although, given how you suffer with payback, expect the answer to that it likely to be negative

hiya all, thanks for all the kind postings above, all went as well as it could.
Going back up for support and because a party is on the saturday for dh's mum's birthday, dh's sister wanted her to go ahead and have it as planned. Very sad but what can you do or say? all the family i met for first time were lovely- so sweet and friendly to me.
hope you all are having a good pain-free night's sleep, will post more tomorrow/ next day.

Glad it was ok, Maizie. Sounds pretty hard.

I've been at my son's graduation today. I missed ds1's graduation due to my back so this became super important to me. It was lovely. A bit hard but so glad I was actually able to enjoy the whole occasion. Medication plus was key to this.

Tomorrow is another day. Not a good one, I suspect but right now I'm willing to accept the pay off. Hope all back pain sufferers are doing ok. Keep posting for support. I think it helps.

Oh dear, the payoff started a bit earlier than I was expecting. 4am to be precise. Then 5.30 am. So it's going to be a heavy drug day. So frustrating that I can't just have a nice enjoyable day without suffering afterwards.

Hope everyone else is doing better and enjoying the sun.

Has anyone got any experience of MST?

Morphine sulphate. Think it's a slow release morphine? Only seen it used in general medicine years ago. Have you tried butran patches? queen swears by them. Think I'd be inclined to try those first.

How are you doing?