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January 8th, 2009
10:32 AM ET

What can I do for relentless back pain?

As a new feature of CNNhealth.com, our team of expert doctors will answer readers’ questions. Here’s a question for Dr. Gupta.

Asked by Jerry, Naperville, Illinois

"I had neck surgery with fusion a year and a half ago for triple-herniated cervical discs. About two months post surgery, I started having whole-body neuropathy pain that continued to get worse. The numbness, pins and needles, electrical discharge and cramping make life terrible for me and my family. I take pain pills as well as pain injections but nothing seems to help. I cannot imagine living like this another 30 years. Any ideas or suggestions? I am age 59, male, and in otherwise good health."

Answer:

Jerry, I am so sorry to hear about your terrible pain. As you may know, I am a neurosurgeon and specialize in diagnosis and treatment of spinal disorders. Let me first say that there is almost no reason to continually suffer in pain.

For those who are not familiar with the condition, herniated cervical discs can cause several different types of problems. Besides pain, which is what usually brings someone to my office, patients may also have arm weakness or numbness. In addition, cervical spine or neck problems can cause pressure on the spinal cord, which can cause difficulty walking and reflex problems, which can be diagnosed by your doctor.

In your case, Jerry, it sounds as if there were three separate areas causing troubles, and the surgeons need to make a decision as to whether decompress and fuse from the front of the spine or the back of the spine. Unfortunately, it sounds as if you may have a persistent compression of the spinal cord, based on what you are describing. First step is to get an updated imaging study.

If an MRI cannot be performed, then another study such as a CT myelogram might help determine whether another operation may be of benefit. It sounds like oral medications and injections have not been of much help, and I would recommend seeing someone in a pain clinic and possibly a neurosurgeon who specializes in the treatment of pain. Nowadays, there are operations such as spinal cord stimulators and pain pumps, which may be of some help to you as well.

Good luck Jerry. Be strong and don't give up hope.


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soundoff (37 Responses)
  1. CARL SCANLON

    Hi Jerry, I know that this doesn't help but I too suffer like you and don't know where to turn. It sounds like I am in even worse shape and I have wanted to ask a similar question of Dr. Gupta. If you haven't, you should have that updated MRI and try a spinal cord stimulator or pain pump. I have also tried some alternative therapy such as acupuncture, aquatherapy. They work at reducing the pain.
    Good luck to you and hang in there. New technology is on it's way to help.

    January 8, 2009 at 13:03 | Report abuse | Reply
  2. Geneva Bivens

    As Carl mentioned in his comment, do yourself a favor and try acupuncture at the very least. I have severe damage to thoracic spine and I am in severe, constant pain. My only relief is acupuncture. Prescription medications have not touched my pain.

    January 9, 2009 at 08:16 | Report abuse | Reply
  3. Katheine J, MPH

    I had an anterior cervical disectomy and fusion at C6/C7 this year. I, too, am in a lot of pain with neuropathy and cramping...and I'm 23. So I completely feel your pain. (Literally) I don't know if your herniation was acute or more long term, but we're on the same boat.

    I know some surgeons don't go for it, but I've found that physical therapy works wonders...if you're willing to work with it. Obviously a scan could also pick something up. If you figure out how to stop spasms or twitches, I'd love to hear it, too!

    Also, I've noticed that neurosugeons and orthopedic surgeons have different takes on the rehab issue. If your surgery was done by one, try to get a referral to the other. If it has to be done by a PCP because of insurance, do that....but don't feel bad asking your surgeon to refer you to a different specialist.

    January 9, 2009 at 17:29 | Report abuse | Reply
  4. Andrea

    Jerry, I am so sorry that you have to be in pain! Pain is something that most people will never experience to the level that we and a very select few percentage of the Population will ever have to deal with! They should be grateful, but they also can not and will never be able to understand how it is to have to endure it! Has anybody ever tried to put you on Fentanyl Patches? Although they are my worst enemy, they may work for you. Be very careful, they are much, much stronger then morphine! My plight started in July 2006, when I stumbeled to the Bathroom in the middle of the night, got disoriented and fell down a flight of stairs and rolled like a stinking pumpkin! My doc at the time saw nothing on the X-Ray, and thought I must be looking for the pain meds. Long Story short, I have since been diagnosed with Hypothyroidism, Arthritis, Osteoporosis, severly bulging & herniated discs, and a few more minor things like depression. The Thyroid Condition caused the Osteoporosis and the other conditions, and unless regulated they will all get worse! By the way, I had found out about 3 month after that fall that I had a Compression Fracture of T-8, which is now very improperly healed but nothing can be done, or so I am told, and due to the fall and the Osteoporosis I have lost 30% in Body Height in that Vertebrae. I am currently taking Neurontin which has helped alot on the in between days where I have to put on a new Patch. The Fentanyl Patch that I am on is 100 mcg., supposed to be good for 3 days, but because of the Thyroid condition I sweat alot which makes me draw the meds faster. I have to change this stupid thing every 2 days! Yes, I have tried physical Therapy, had a complete Backbrace, done the ESI's, all to no avail! Those without pain should count their Blessings, as I would not wish this on my worst enemies! As to my job and age...I am a Stay at Home Mother of 4 wonderful children and I am 32 Years old!

    January 9, 2009 at 22:24 | Report abuse | Reply
  5. Marcos Ochoa

    Dear Jerry
    I can recomend a clinic Mexico, the name of this clinic is Centro de la Columna Vertebral. They have a conservative treatment for herniated disk pain, and they can save you from another surgery.

    January 10, 2009 at 13:17 | Report abuse | Reply
  6. Richard L. DonTigny, PT

    By way of a brief introduction, I am a retired physical therapist who has spent over 40 years researching the dynamics of the pelvis and their relationship to low back pain.

    I have recently published an integrated interdisciplinary analysis of pelvic dynamics to include the anatomy, structure, movement, function, kinesiology, biomechanics and biotensegrity. (1-2007) This analysis has led me to find and describe one basic dysfunction that appears to be the mechanism of idiopathic low back pain syndrome (ILBPS).
    Presently interrater reliability of most of the tests presently used to diagnose LBP average a low 25%. In other words the practitioner who uses these tests will be compelled to miss the diagnosis about 75% of the time. I have developed a simple method of assessment that will give an accurate diagnosis in about five minutes. An equally simple manual treatment can have at least 85-90% of all patients with low back pain free of pain within about 20 minutes. Recurrence is corrected and prevented by appropriate corrective exercises. The same corrections will work in essentially all cases of ILBPS.

    I have published and lectured extensively and now have put much of this information on-line at http://www.thelowback.com. as a public service. Please follow precisely.
    Google me at DonTigny+RL

    1. DonTigny RL: A detailed and critical biomechanical analysis of the sacroiliac joints and relevant kinesiology: the implications for lumbopelvic function and dysfunction. In Vleeming A, Mooney V, Stoeckart R (eds): Movement, Stability & Lumbopelvic Pain: Integration of research and therapy. Churchill Livingston Elsevier, Edinburgh, 2007, pp 265-278

    January 10, 2009 at 18:47 | Report abuse | Reply
    • Bill Sawyer

      Hi Richard.Short history.I'm 52, bad car accident at 18,compression fracture L5 S1.Always had a little soreness, until 5 yrs ago while playing Hockey. Hit a rut in the ice and felt something, lower right side.Since then, iv'e been chasing pain relief through every Therapy known to man.Prolo, S.I.injections, nerve blocks.Nothing seems to work. The Dr. who gave me the Prolo said my left side was locked and right side was Hypermobile.[thats loose right?] Just started doing some of your corrective exercises. Do i continue doing them when i'm having a good day?Sometimes i hear a pop in my right side, would that be my S.I. going back into place?Also, should i do exercises when the pain is unbearable.[can't imagine trying them when i'm like that].....Thanks very much for your time..[ just want my life back.]
      Bill

      February 3, 2011 at 16:03 | Report abuse |
  7. mnm, FL

    I work for a spinal pain management group and these specialists are entirely focused on patients with your same situation. The pain pumps and nerve stimulators are so successful for so many of our patients that we are having trouble keeping the scheduling on par with the demand. But we are taking our time since spinal pain is something that needs a whole patient review and care. Be sure to find the right doctor and that he/she and his/her staff is thorough and knowledgeable when helping you. Good Luck!

    January 12, 2009 at 22:09 | Report abuse | Reply
  8. OtterMama

    It's amazing how modern medicine has yet to solve your health problem. Have you considered Chiropractic care? We attend one, and absolutley love it. They work with your body, helping it to heal from the inside out. Adjustments and excercises help to realign the spine to it's proper curvature. This reduces strain on the spinal cord that results from inproper alignment. They can also address dietary and toxicity issues that may further aggravate your problem. Something to look into!

    January 19, 2009 at 12:33 | Report abuse | Reply
  9. Mike Johnson

    I have a sciatic nerve problem which is producing a great deal of main in my heel when I walk. I have been told that The DRX9000 for decompression could help this problem. do you have an opinion?

    January 19, 2009 at 14:21 | Report abuse | Reply
  10. Bonnie Minsky MA, MPH, CNS, LDN

    Hi Jerry.

    In your case, you may be too far gone for dietary changes to make a difference. However, I have seen many clients with chronic back pain see a degree of relief when they discover and eliminate foods that create inflammation.

    January 22, 2009 at 10:23 | Report abuse | Reply
  11. moses smith DC

    Go to a chiropractor. In my clinic, I regularly treat similar conditions with good success.

    January 29, 2009 at 13:02 | Report abuse | Reply
  12. Kathi

    I suffered the same from a back surgery 4.5 years ago and have been dealing with this issue with medication and lumbar sympathetic blocks. My condition was diagnosed as RSD or CRPS (Reflex sympathetic dystrophy or Chronic regional pain syndrome.) I too could not live with the pain any more. I had a spinal stimulator put into my back last march. It has saved my life. I do not wake up every morning in pain. I can work full time again and enjoy life. I fould a doctor at Rush (chicago's) pain center who was performing these implants. Not all pain doctors know of this option.

    January 29, 2009 at 15:24 | Report abuse | Reply
  13. Holly

    You wrote you had "pain injections." I am wondering what you meant: epidural steriod injections; facet joint injections; discography; select nerve root blocks or something else? Was your procedure done under x-ray guidance? Was your it done by a Fellowship-trained physician who has spent one full year learning about back and neck procedures? If you answer NO to the last two questions, then I am not surprised that you had no success with the type of "pan injection" you underwent.
    Back and neck pain patients seek conservative management should seek treatment and diagnosois from fellowship trained (ACGME Accredited Fellowship in Interventional Spine and Pain Management) doctors. If anyone wants to sick needles in you without first looking at your MRI, run for the hills. They are a lot of "spine specialists" who learn their skills by taking a weekend course. I am not kidding.
    Every patient must realize he or she is a consumer. Many folks research their cars and TV shows more than they do their medical care.

    March 5, 2009 at 21:00 | Report abuse | Reply
  14. mom

    My daughter is a light weight rower – she has been rowing for 5 years and recently has developed severe back pain . The school Dr had a spect scan done and no fracture showed up. He has said that an injection will NOT help since there is No specific spot of the pain - she needs to rest for a month... there in lies the problem.. she has worked like a dog for the opening of the crew racing season and she is upset. Over the counter drugs do not seem to be alleviating the pain and she wll start therapy on Monday. Do you have the magic answer, or can you suggest specific things she could do to get pain free sooner. Thank you

    March 7, 2009 at 16:42 | Report abuse | Reply
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    sometimes i get backaches due to long hours of working at computers.,`~

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    i have backpains after work. what i do is get some relaxing massage and yoga."~"

    June 28, 2010 at 23:55 | Report abuse | Reply
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Get a behind-the-scenes look at the latest stories from CNN Chief Medical Correspondent, Dr. Sanjay Gupta, Senior Medical Correspondent Elizabeth Cohen and the CNN Medical Unit producers. They'll share news and views on health and medical trends - info that will help you take better care of yourself and the people you love.