Back Problem; Help Needed NOW!

December 20, 2023 1:04 PM

I am in excruciating back pain and don’t see my medical professionals until January 12th. I need to make it through the next few weeks. I’d like to learn how MeFites handle back pain.

Currently I am using Flexeril, Advil, yoga and a TENS unit to try and cope. Unfortunately, I cannot use the Flexeril when I drive to work, and I cannot really get on the floor and do the most helpful yoga asanas at work. Right now, the pain is so intense that I’m needing to use all of the above to just tolerate the pain at a 9 on the 1-10 scale.

I’ve had arthritis in my back for years. I had a cervical radio frequency ablation about five years ago, and that took care of the pain in my neck. It was a godsend. Now the pain in my low back and right hip has progressed to the point where I am seeking treatment at our local medical school’s Neuroscience and Pain Center.

I’ve just had an MRI and was diagnosed with moderate foraminal spinal stenosis and multilevel high-grade facet arthropathy. I’m set to have laser light therapy in January with the nurse practitioner who is my primary provider at the pain center. Then in March, I will begin the process to get radio-frequency ablation for my lumbar pain with an anesthesiologist at the pain center.

I work 40 hours a week in an office as a mediator. I have a sit/stand desk, and I can walk during my half-hour lunch break. I’ve used up most of my sick leave due to taking time off for overwhelming pain. I know YANMD. Any ideas for things I can do to handle the pain on a regular basis until I get the radio-frequency ablation would be helpful. I’m not looking for drugs or specialists to see. I’m looking for life-hack type ideas, if that makes sense.

posted by furtheryet to Health & Fitness (14 answers total)

Lidocaine patches have done wonders for me, and for my mother when she was suffering severe pain from a tumor. You can find some form at most drugstores, or you might be able to get your doctor to call in to a pharmacy for the prescription strength.
posted by CiaoMela at 1:08 PM on December 20, 2023

Also, how much advil are you taking? Maybe you can ask your doctor if they recommend taking prescription-strength levels. IANAD but I took OTC advil after giving birth and followed my doctor's dosing guidance, which was much higher than the typical dosage.

Or try Aleve (naproxen sodium) instead.
posted by CiaoMela at 1:10 PM on December 20, 2023

I've found heating pads really helpful - though I've also burned myself pretty severely with one, so be careful if you go that route.
posted by FencingGal at 1:21 PM on December 20, 2023

I've been at a 9/10 and there's enduring that pain but you're not going to have a good time. If what is holding you up from contacting your provider is that they're on vacation, pain at a 9/10 is absolutely where you can make an emergency call at least to get an Rx or other advice over the phone.
posted by zippy at 1:25 PM on December 20, 2023

When I was in excruciating pain for a number of months due to sciatica, the Curable app was helpful to me -- using it it reduced the pain by about 30-35% in my perception, which really helped. I was skeptical but the scientific premise behind it was interesting to me and made sense, and while it was not a wonder cure or anything, it took the edge off the pain enough that it made a difference between literally yelping in pain every time I got up from a sitting position to not yelping in pain. Eventually steroid shots and PT took care of the sciatica, but I found the experience valuable and would use it again if dealing with ongoing pain.
posted by virve at 2:01 PM on December 20, 2023

I have also undergone RFA in the facet joints of my lumbar spine due to chronic back pain - if you can get to a walk in clinic and ask for a toradol injection, it might bring some fast relief as an alternative to Advil or other antiinflammatories. I find that the injection is better than the toradol pills, but the pills are good as a supplement. You may need a couple of injections a week to get you through to your appointment, if you find it helps. Also, seconding the Rx strength lidocaine patches and heat. Best of luck to you!!
posted by tacopasta at 2:03 PM on December 20, 2023

2nding toradol injections. They have been a life saver for me when I was having chronic incredibly painful back pain due to a chronic joint condition. And they should be easy to get through either your PCP or an urgent care/walk in clinic. Hopefully there's a walk in clinic near you that has appointments so you don't have to sit around.
posted by litera scripta manet at 2:19 PM on December 20, 2023

Agree with looking into injections. I once had a back spasm so bad, I couldn't move at all - I went to the hospital in an ambulance. They gave me an injection, and that enabled me to walk. It sounds like you have more going on than spasms, but with the amount of pain you're in, it does seem worth a try.
posted by FencingGal at 3:47 PM on December 20, 2023

I have been experiencing neuropathic (nerve) pain in one leg for the past few weeks. Probably - sciatic nerve. The only thing that has taken the edge off is Lyrica. It's prescription, and can be habit forming but at least it's not an opiate.
posted by Dag Maggot at 4:25 PM on December 20, 2023

When I was suffering from some post-surgical pain, I found (to my surprise) that ibuprofen worked fairly well. I don't remember the dose, but think it was something like 800 mg several times per day, and it cut my pain down to about half. Not exactly a miracle cure, but enough to take the edge off.
posted by alex1965 at 8:23 PM on December 20, 2023

I have chronic pain (including episodes of pain where I was rolling around in bed screaming from the pain)

I have had great results (at least 30% to 40% reduction in overall pain levels) from Palmitoylethanolamide (PEA), which I get from a compounding chemist without a prescription. The only side effects I have had from PEA is that if I significantly exceed the recommended dosage (which is safe to do) I get diarrhea and abdominal cramps. It does take time to reach maximum efficiency though, as it works by causing your body to produce less of a compound that causes pain and inflammation - so if you try PEA, give it at least an 8 week trial to see what maximum benefit looks like for you.

I know someone who is a paediatric rheumatologist at a major teaching hospital who recommends PEA to all of her patients. It is also often recommended by speciality pain clinics.

From the patient information (courtesy of the paediatric rheumatologist):

"Palmitoylethanolamide (PEA) is a glial cell modulator. Glial cells are Central Nervous System cells which release many inflammatory substances that act upon neurons, amplifying pain (Watkins and Maier, 2002). With time, PEA modulates (or tones down) pain.

PEA is well tolerated with no side effects and is very helpful for neuropathic pain, headache and osteoarthritis. It is anti-inflammatory and neuro-protective.

"Compare the effect of Palmitoylethanolamide (PEA) versus ibuprofen, which is a nonsteroidal anti-inflammatory drug (NSAID) used for pain relief in the temporo-mandibular joint (TMJ), osteoarthritis or arthralgia.

Results show pain decrease after 1 week of treatment was better with PEA than ibuprofen. After 2 weeks treatment, pain reduction was twice as good with PEA compared to ibuprofen.

Palmitoylethanolamide (PEA) has been demonstrated to bind to a receptor in the cell nucleus. PEA performs a great variety of biological functions related to chronic and neuropathic pain and inflammation, as demonstrated in clinical trials. These include peripheral neuropathies such as diabetic neuropathy, chemotherapy-induced peripheral neuropathy, carpal tunnel syndrome, sciatic pain, osteoarthritis, low back pain, failed back surgery syndrome, dental pains, neuropathic pain in stroke and multiple sclerosis, chronic pelvic pain, post-herpetic neuralgia, and vaginal pains."
posted by chariot pulled by cassowaries at 9:29 PM on December 20, 2023

The one time I’d describe my back pain (from spondylolisthesis at L5-S1) at a 9 out of 10, I went to the emergency room. The sciatica from the impingement was lightning. I shook uncontrollably. The only thing that had been more painful for me was breaking my leg in 25 places.

If you’re feeling the worst pain you’ve ever felt, it warrants emergency treatment. I was given morphine while going through all the imaging. Then they gave me a toradol injection which really helped until I could get back in with my regular pain management guy who did the cortisone shots.
posted by ImproviseOrDie at 1:52 AM on December 21, 2023

Gabapentin? A doctor prescribed that to me recently for radiating nerve pain originating from my cervical spine. I didn't end up using it because the pain didn't feel bad enough to justify taking it. But apparently it's a common prescription (I think Lyrica is similar). A short course of prednisone is actually what calmed things down significantly by treating the inflammation.
posted by knownfossils at 8:32 PM on December 21, 2023

Oh sorry just saw you weren't looking for drugs! Whoops. Well good luck anyway!
posted by knownfossils at 8:33 PM on December 21, 2023