Today is the first day since last April that I have not taken any form of pain killer after waking.
The medications have ranged from OTC acetaminophen, naproxin, ibuprofin to prescription Tramadol and Vicodan. — I have mentioned before that I have experience severe back pain since April last year. (My how time flies!) It got really bad during our last trip to Scotland in May. Of course. a lot of walking is involved while touring and I spent too much time sitting and waiting while my family toured and walked.
The pain was two types: the shooting lightning strikes down the backs of both legs – buttocks, hamstrings, calves; and a slightly less severe pain that just settles in the same places and also the lower back. For months I have not been able to stand long enough to make a piece of toast in the kitchen. Before last May, I was accustomed to walking three to four miles every day. Since then, when I use a hiking stick or sometimes two sticks, I could walk around the block. On my best days I could walk a mile.
Since then, I have tried many alternatives. My PCP provided a list of stretches for the back, some of which relieved some of the pain for a short while when I rose in the morning. He also tried a course of Prednisone tablets. This relieved the shooting sciatic pains for a month or so but the rest of the pain just seemed to settle in and take control. We tried a muscle relaxant with no good result.
I visited a chiropractor for two months twice a week with little or no relief. He finally told me that he could not find a way to help me.
Finally, both the chiropractor and my PCP referred me to a physiatrist. This is a traditional doctor MD who specializes in physical medicine and rehabilitation. They are often spine specialists and avoid recommending surgery except as a last resort. I must admit that I had never heard of this specialty. We learn a lot in our health journeys, perhaps especially as we age.
The doctor I chose three months ago has proven to be very helpful. First he order a spine specific CT scan. Bearing in mind that I have already been told that I have arthritis in all of my joints and that I have DISH (Diffuse Idiopathic Skeletal Hyperostosis) which is a disease common to 90 year olds and which gradually turns your ligaments to calcium, the CT scan report says:
- Mild scoliosis (this is from birth but not causing a problem).
- Mild arthritis
- Bulging disks
- Retrolisthesis – movement of the vertebrae from their proper place in the lumber region which causes:
- Stenosis – abnormal narrowing of the tube through which the spinal cord passes.
In my case, the stenosis is considered severe. Apparently, the normal opening for the spine is greater than 15mm but mine on the last vertebra is 5mm. This is what is causing all the discomfort.
The physiatrist immediately started me on physical therapy and gave me a few days of a drug called methylprednisolone.
The physical therapy has been going for about eight weeks, once a week. We have made definite progress and mostly removed the pain from my calves, partly removed the pain from my hamstring and removed most of the pain from my right leg. The left leg and rarely the right leg still gets shooting pain in the hamstrings and occasionally severe pain in the calf. My buttocks still get quite a bit of pain. I still could not stand for more than about three minutes.
The methylprednisolone removed the pain almost completely for a few days but it gradually returned full force. The drug also made my stomach very sick for a week. The doctor told me that the results with drug indicated that I could be a candidate for spinal injections.
Yesterday, I received corticosteroid injections in my spine. Today I have only the smallest pain with not much problem standing or walking. WOW!!! Unfortunately, there is no way to predict how long the therapy will work. The doctor already told me to schedule more injections before I go to Europe in late April. I will continue the physical therapy because I am learning to sit, stand and stretch in ways to keep it from getting worse again.
This is not the end of the journey but I certainly appreciate a pause, however long, in the discomforts.
May we all have the best possible outcomes,