"8: I am experiencing a disturbing amount of pain. I might actually be dying. Please help."
December 7, 2011 9:58 AM Subscribe
Can you help me cope with my utterly terrible back and leg pain? I'm at my wits end, so I'm looking for any and all suggestions - physical or mental.
The pain began in June of this year, but has become more intense in the past month - I'm currently hovering around an 8 on the Allie Brosh's pain scale. An MRI revealed a bulging disc between my L4 and L5 vertebra, which is causing sciatic nerve pain, weakness, and slight numbness in my left buttock and leg, down to my calf. I can't sit, lay down, stand, or walk for more than 10-20 minutes before the pain becomes EXTREME and I need to change positions.
I have seen my GP about this and she's referred me to a pain specialist. I trust my GP implicitly. The pain guy is new, but seems good and came highly recommended. In addition to continuing my physical therapy, stretching at home, core strengthening exercises, and taking naproxen (all started in September), I will be receiving an epidural injection of steroids.
The problem is that my insurance company won't allow me to have the procedure right away. They have to review the doctor's records and decide whether or not the procedure is "medically necessary". This could take up to ten business days. I thought it was going to be done this week so I completely broke down when the pain people said they couldn't schedule me until the 19th. The doctors' recommendation is to just keep on keeping on - I'm doing all I can to help the pain until the procedure.
I'm not sure how I'm going to make it through this week, let alone next. I work in an office, so I have to be sitting at my desk most of the day. The pain is making it hard to concentrate. I haven't slept a full night in I don't know how long. Ice packs and heating pads offer some relief, but only when I'm laying down - which I can't do at work. Walking slowly also helps a bit, but I can't pace all day.
What can I do to ease my pain - mentally or physically - until I can get the injection*?
* I know the injection may not help as much as I want it to, but I'll cross that bridge when I come to it. I'm more interested in what to do right now.
The pain began in June of this year, but has become more intense in the past month - I'm currently hovering around an 8 on the Allie Brosh's pain scale. An MRI revealed a bulging disc between my L4 and L5 vertebra, which is causing sciatic nerve pain, weakness, and slight numbness in my left buttock and leg, down to my calf. I can't sit, lay down, stand, or walk for more than 10-20 minutes before the pain becomes EXTREME and I need to change positions.
I have seen my GP about this and she's referred me to a pain specialist. I trust my GP implicitly. The pain guy is new, but seems good and came highly recommended. In addition to continuing my physical therapy, stretching at home, core strengthening exercises, and taking naproxen (all started in September), I will be receiving an epidural injection of steroids.
The problem is that my insurance company won't allow me to have the procedure right away. They have to review the doctor's records and decide whether or not the procedure is "medically necessary". This could take up to ten business days. I thought it was going to be done this week so I completely broke down when the pain people said they couldn't schedule me until the 19th. The doctors' recommendation is to just keep on keeping on - I'm doing all I can to help the pain until the procedure.
I'm not sure how I'm going to make it through this week, let alone next. I work in an office, so I have to be sitting at my desk most of the day. The pain is making it hard to concentrate. I haven't slept a full night in I don't know how long. Ice packs and heating pads offer some relief, but only when I'm laying down - which I can't do at work. Walking slowly also helps a bit, but I can't pace all day.
What can I do to ease my pain - mentally or physically - until I can get the injection*?
* I know the injection may not help as much as I want it to, but I'll cross that bridge when I come to it. I'm more interested in what to do right now.
(The reason you want to go through your doctor is so that you don't end up at a woo-woo TCM clinic where they talk to you about your chi and try to sell you patent medicine. You want a professional that specializes in acupuncture for pain relief.)
posted by griphus at 10:08 AM on December 7, 2011 [1 favorite]
posted by griphus at 10:08 AM on December 7, 2011 [1 favorite]
Have you talked with your supervisor or HR department at work? If you truly are not capable of sitting at a desk all day - and I'm familiar with back pain and know that is an absolutely legitimate consequence - I would think you could be eligible for short-term disability until you are able to get your pain down to a manageable level.
posted by something something at 10:12 AM on December 7, 2011 [2 favorites]
posted by something something at 10:12 AM on December 7, 2011 [2 favorites]
Best answer: I worked with someone who had a similar issue (although he had surgery, not just an injection, and I don't know which vertebrae were in play) and he found some measure of relief by standing at his desk with a pair of crutches that he could kind of lean his armpits on while bending his knees and taking the weight off his back--this was a motion that was OK'd by his doctor as a temporary measure, IANAD, YMMV, etc.
posted by bcwinters at 10:13 AM on December 7, 2011
posted by bcwinters at 10:13 AM on December 7, 2011
This might sound crazy but stay very hydrated. I had L5 S1 laminectomy in 1999 and leading up to said procedure my spine doc told me to hydrate a lot. I guess being well-hydrated keeps things plumped up and so less it's less pinchy on the sciatic nerve. And it was helpful -- didn't cure it all but it did help. And if you have to be at work are you in a position where you could lay down every so often? A colleague of mine when in the same boat would just lay flat on the floor of her cube when she did phone calls instead of sitting or standing.
posted by macadamiaranch at 10:16 AM on December 7, 2011 [1 favorite]
posted by macadamiaranch at 10:16 AM on December 7, 2011 [1 favorite]
Best answer: I have a bulge in the disc between my L4 and L5. It's not as bad as yours (1-3 most of the time), but I know the symptoms you're talking about. It's just weird, like this feeling that you absolutely need to stretch, but stretching doesn't do anything. The only thing that seems to work for me when the pain gets uncomfortable is to change positions. Makes sleeping difficult. So yeah, I feel for you.
Really though... can't your GP get you a scrip for Vicodin or something? Mine gave me one without me asking for it, and my pain isn't nearly as bad as yours. This is what pain meds are for, and you're hopefully only looking at a week or three before you'll get some relief. Naproxen is great and all, but it's just an NSAID. You're probably in the market for something a little more serious.
posted by valkyryn at 10:18 AM on December 7, 2011
Really though... can't your GP get you a scrip for Vicodin or something? Mine gave me one without me asking for it, and my pain isn't nearly as bad as yours. This is what pain meds are for, and you're hopefully only looking at a week or three before you'll get some relief. Naproxen is great and all, but it's just an NSAID. You're probably in the market for something a little more serious.
posted by valkyryn at 10:18 AM on December 7, 2011
Can you find out how much the procedure would cost if you were to pay cash, and ask if there is any flexibility on that (amount, payment period)? It may be more reasonable than you'd think, and could be worth sparing yourself the agony.
posted by argonauta at 10:21 AM on December 7, 2011
posted by argonauta at 10:21 AM on December 7, 2011
What argonauta said. I wish your doctor had already brought it up. If it's a matter of a few hundred dollars, it sounds like you would gladly pay or borrow or get an advance on your next paycheck or whatever to get it done and over with.
(Googling is about as unhelpful as you'd expect; I guess some clinics consider this an in-office procedure costing about $200, and others consider it surgery and it costs $2000.)
posted by Lyn Never at 10:29 AM on December 7, 2011 [1 favorite]
(Googling is about as unhelpful as you'd expect; I guess some clinics consider this an in-office procedure costing about $200, and others consider it surgery and it costs $2000.)
posted by Lyn Never at 10:29 AM on December 7, 2011 [1 favorite]
I'm so sorry to hear this!
Seconding non-woo-woo acupuncture and asking for a scrip for some pain killers. I really hope you get some relief soon.
posted by Specklet at 10:29 AM on December 7, 2011
Seconding non-woo-woo acupuncture and asking for a scrip for some pain killers. I really hope you get some relief soon.
posted by Specklet at 10:29 AM on December 7, 2011
Yes, it sounds like you need something stronger than naproxen! I've had luck with Vicodin or Percocet for back pain. I've heard that Xanax on "as needed" basis can also help--it has a mild muscle relaxer in it. Acupuncture has also helped me.
And nthing that you investigate time off from work.
posted by Ollie at 10:30 AM on December 7, 2011
And nthing that you investigate time off from work.
posted by Ollie at 10:30 AM on December 7, 2011
Acupuncture really helped me. Yoga, specifically triangle pose, brought temporary relief, but acupuncture is what made my back pain go away. I felt better after the first session, then had two more within a week, and was almost completely back to normal.
Before the acupuncture, I couldn't walk for more than a block without having to sit down and rest, and I was sleeping with an ice pack on my leg to keep the pain to a dull roar.
Good luck, and I hope you get some relief soon.
posted by mogget at 10:35 AM on December 7, 2011
Before the acupuncture, I couldn't walk for more than a block without having to sit down and rest, and I was sleeping with an ice pack on my leg to keep the pain to a dull roar.
Good luck, and I hope you get some relief soon.
posted by mogget at 10:35 AM on December 7, 2011
Best answer: Since you said "any and all," I'll pass on this annecdata. My husband had what you had--not as severe--and didn't tolerate the painkillers well. He took the advice of a family member who's a doctor who is not your doctor, or mine, and who'd also had sciatica/back pain. Like this doc, my husband started taking some bike rides every day just to get some stretching exercise without putting weight on his legs. He also started swimming. His pain went away within a week.
posted by Elsie at 11:07 AM on December 7, 2011
posted by Elsie at 11:07 AM on December 7, 2011
I agree with the others for Acupuncture. Also, look for a gym that offers yoga classes and has a pool that is heated to therapeutic temperatures. Floating in warm water should give you a little relief.
posted by myselfasme at 11:09 AM on December 7, 2011
posted by myselfasme at 11:09 AM on December 7, 2011
Get Treat Your Own Back ($10 on amazon). It helped a lot, and I've similar chronic pain to you.
Also, if the medication isn't cutting it, ask for more until they'll approve the procedure.
Memail me if you want. I've been there and it sucks.
posted by guster4lovers at 11:21 AM on December 7, 2011
Also, if the medication isn't cutting it, ask for more until they'll approve the procedure.
Memail me if you want. I've been there and it sucks.
posted by guster4lovers at 11:21 AM on December 7, 2011
Response by poster: Thanks, everyone for the answers so far.
I had one early morning session of acupuncture with my woo-woo chiropractor (whom I quickly dumped) back in August and experienced "acushock" that lasted the rest of the day - nausea, dizziness, etc. It was pretty awful, but maybe a non-woo-woo acupuncturist could help.
bcwinters' suggestion of dangling from crutches is interesting and would probably help, but I have no crutches. I will be searching for a place to dangle, either at home or in the office.
I don't know why I hadn't thought to ask my doctor for stronger pain meds, so I've got a call in to her nurse to see if they can do anything.
Unfortunately, the procedure would cost between $2,000 and $3,000 if I don't first get the authorization from my insurance. And they haven't been able to say for sure whether or not they'd reimburse me if I pay out-of-pocket, so I'm reserving this option as an absolute last resort.
posted by youngergirl44 at 11:22 AM on December 7, 2011
I had one early morning session of acupuncture with my woo-woo chiropractor (whom I quickly dumped) back in August and experienced "acushock" that lasted the rest of the day - nausea, dizziness, etc. It was pretty awful, but maybe a non-woo-woo acupuncturist could help.
bcwinters' suggestion of dangling from crutches is interesting and would probably help, but I have no crutches. I will be searching for a place to dangle, either at home or in the office.
I don't know why I hadn't thought to ask my doctor for stronger pain meds, so I've got a call in to her nurse to see if they can do anything.
Unfortunately, the procedure would cost between $2,000 and $3,000 if I don't first get the authorization from my insurance. And they haven't been able to say for sure whether or not they'd reimburse me if I pay out-of-pocket, so I'm reserving this option as an absolute last resort.
posted by youngergirl44 at 11:22 AM on December 7, 2011
I've also had great success with the exercises in "Treat Your Own Back." It was prescribed by my PT. I had sciatica for a year and it diminished within a week of doing the exercises and was gone within a month. Getting my low back pain in check took a lot longer, but the exercises always bring some immediate relief. I continue to do them. My PT says bulging discs are "high maintenance."
posted by purple_bird at 11:32 AM on December 7, 2011
posted by purple_bird at 11:32 AM on December 7, 2011
Response by poster: (Gar - didn't mean to post yet)
I've been trying to keep active in spite of the pain - exercise releasing endorphins and whatnot - but can't bike because of the pain in my buttock and running with a bulging disc is a no-no. DUH. SWIMMING. Low impact and like dangling in the water! I can't afford the annual membership to the gyms in my area with pools, but I'm sure I could swing a month or two. Thanks, Elsie and myselfasme.
And regarding short-term disability or medical leave - I lost my assistant to another position in the company earlier this year, so I'm currently working without a backup. My boss has been pretty understanding, having recently gone through something similar with his neck, but this is the world of accounting and it's year end. I'm taking a day off here and there, but my work ethic and the time of year won't really allow for more than that.
posted by youngergirl44 at 11:33 AM on December 7, 2011
I've been trying to keep active in spite of the pain - exercise releasing endorphins and whatnot - but can't bike because of the pain in my buttock and running with a bulging disc is a no-no. DUH. SWIMMING. Low impact and like dangling in the water! I can't afford the annual membership to the gyms in my area with pools, but I'm sure I could swing a month or two. Thanks, Elsie and myselfasme.
And regarding short-term disability or medical leave - I lost my assistant to another position in the company earlier this year, so I'm currently working without a backup. My boss has been pretty understanding, having recently gone through something similar with his neck, but this is the world of accounting and it's year end. I'm taking a day off here and there, but my work ethic and the time of year won't really allow for more than that.
posted by youngergirl44 at 11:33 AM on December 7, 2011
If your doctor can't loan you crutches, you might call Goodwill or other local thrift stores who often seem to have them. I hope you feel better soon!
posted by Glinn at 11:34 AM on December 7, 2011
posted by Glinn at 11:34 AM on December 7, 2011
One odd thing that seemed to help me slightly with the horrific nerve pain caused by spinal compression, was hot coffee. Why, I have no clue, and it might be specific to my situation - or all in my head - but there you have it.
Keep your mind busy. Watch a movie, listen to the radio, sketch, do anything to avoid having nothing else to think about. That way lies madness.
And yes, make sure the pain specialist or GP is aware that whatever's happening now really isn't enough, especially if you are not the type of person to show weakness well. The level of your pain might not be entirely obvious.
posted by HFSH at 11:36 AM on December 7, 2011
Keep your mind busy. Watch a movie, listen to the radio, sketch, do anything to avoid having nothing else to think about. That way lies madness.
And yes, make sure the pain specialist or GP is aware that whatever's happening now really isn't enough, especially if you are not the type of person to show weakness well. The level of your pain might not be entirely obvious.
posted by HFSH at 11:36 AM on December 7, 2011
Along the lines of swimming, hot tub - a friend with a lesser degree of chronic pain swears that a daily soak does wonders, it takes off a lot of pressure apparently. I imagine even non-daily would help some.
posted by mrs. taters at 11:41 AM on December 7, 2011
posted by mrs. taters at 11:41 AM on December 7, 2011
Ask for gabapentin along with your stronger pain meds. It's not technically a pain pill, but I've found it helps extend the length of time my pain pills last. I've found that if I wait until I'm in agony to take a pill it's harder to get the pain to settle down.
Don't be afraid to take an 800 mg dose of ibuprofen if your doc won't prescribe vicosen or something similar. Ask for an anti-inflammatory prescription to get you through until you get the steroid shot. Keep icing. It's not a fix, but your goal is to use multiple strategies to all lower the pain incrementally.
Focus on your breathing. Breathe deep and noisily. Listen to yourself and concentrate on breathing through the waves.
Try distraction. Listen to your headphones if you're allowed at work. And listen to your body. Get up and change position frequently. Get a rollerball massage thingie and run it over yor leg (I find physical distraction away from the site of the pain helps a tiny bit). Good luck.
posted by thelastcamel at 11:42 AM on December 7, 2011 [1 favorite]
Don't be afraid to take an 800 mg dose of ibuprofen if your doc won't prescribe vicosen or something similar. Ask for an anti-inflammatory prescription to get you through until you get the steroid shot. Keep icing. It's not a fix, but your goal is to use multiple strategies to all lower the pain incrementally.
Focus on your breathing. Breathe deep and noisily. Listen to yourself and concentrate on breathing through the waves.
Try distraction. Listen to your headphones if you're allowed at work. And listen to your body. Get up and change position frequently. Get a rollerball massage thingie and run it over yor leg (I find physical distraction away from the site of the pain helps a tiny bit). Good luck.
posted by thelastcamel at 11:42 AM on December 7, 2011 [1 favorite]
Best answer: You've got many of the symptoms I have.
I have 3 bulged discs in my back (L3-L4, L4-L5, L5-S1) and about 4 in my neck. I have constant back pain going back over 10 years and am in my mid 20s. About 2 years ago, I began to experience pins and needles, shooting nerve pain and general numbness in my left leg and occasionally my arm. Annoying as fuck, and painful to boot!I Can't get comfortable, can't get to sleep, can't sit still. Back pain is a bitch!
I've done the PT, the spinal injections, the anti inflammatory drugs (which ruined my stomach) from little to no avail.
Here has what has been useful to alleviate some of the pain:
*Drugs, these have been great. For the leg pain you are describing get in touch with your doctor now about gabapentin. It is a life savor at quieting the nerve issues you are describing (pain,numbness,not being able to be comfortable). It has made a huge difference, and I wouldn't want to live without it. It is non narcotic, safe, and been around for a long ass time. I also smoke cannabis in the evenings/weekends as that aids tremendously in ignoring my pain so I can get shit done. Also, I would talk to a doctor about muscle relaxers. I 've taken flexeril, and soma (which I've been on for years). These do help. Narcotics are great but dependency and the need for higher doses can add problems.
*walking, don't know why or how it works, but it aids a bit in the discomfort. If I can't quiet my legs or pain, I will walk for a couple miles and it is better.
*heatpad. I love the heatpad and it helps out when the back is being a pain in the ass.
I also have a bunch of other little techniques, but they are just little things.
Seriously though, talk to your doctor about gabapentin. It really has made a huge difference with the symptoms you are describing that I have.
posted by handbanana at 11:42 AM on December 7, 2011 [1 favorite]
I have 3 bulged discs in my back (L3-L4, L4-L5, L5-S1) and about 4 in my neck. I have constant back pain going back over 10 years and am in my mid 20s. About 2 years ago, I began to experience pins and needles, shooting nerve pain and general numbness in my left leg and occasionally my arm. Annoying as fuck, and painful to boot!I Can't get comfortable, can't get to sleep, can't sit still. Back pain is a bitch!
I've done the PT, the spinal injections, the anti inflammatory drugs (which ruined my stomach) from little to no avail.
Here has what has been useful to alleviate some of the pain:
*Drugs, these have been great. For the leg pain you are describing get in touch with your doctor now about gabapentin. It is a life savor at quieting the nerve issues you are describing (pain,numbness,not being able to be comfortable). It has made a huge difference, and I wouldn't want to live without it. It is non narcotic, safe, and been around for a long ass time. I also smoke cannabis in the evenings/weekends as that aids tremendously in ignoring my pain so I can get shit done. Also, I would talk to a doctor about muscle relaxers. I 've taken flexeril, and soma (which I've been on for years). These do help. Narcotics are great but dependency and the need for higher doses can add problems.
*walking, don't know why or how it works, but it aids a bit in the discomfort. If I can't quiet my legs or pain, I will walk for a couple miles and it is better.
*heatpad. I love the heatpad and it helps out when the back is being a pain in the ass.
I also have a bunch of other little techniques, but they are just little things.
Seriously though, talk to your doctor about gabapentin. It really has made a huge difference with the symptoms you are describing that I have.
posted by handbanana at 11:42 AM on December 7, 2011 [1 favorite]
Best answer: Im absolutely flabbergasted that your doc hasn't prescribed stronger pain meds. I just went through this same thing -- herniated L4/L5 -- and the very first thing my doc did was give me hydrocodone (for nighttime pain), skelaxin (sp? daytime pain), and, more importantly, started me on a gigantic dose of prednisone. I think i was at 30 mg. for the first few days, then tapered down over the course of about 10 days or so. It's true that steroids suck - there are lots of annoying side effects, like the fact that it made me crazy -- but it helped. It helped right away. I can't emphasize that enough.
I'm definitely not a doc but I urge you to go back ASAP. I was literally like you -- couldn't stand, sit or lie comfortably, and in such a state of pain that I burst into tears at the doc's office. Don't be afraid to make it clear to them how much you're hurting.
My doc also set me up for physical therapy which I started after 1 week of prednisone. By then the worst of the pain had gone, since the prednisone helps bring down the inflammation, which is what is pressing on your nerve and making everything hurt so much. I did 12 sessions of PT over 6+ weeks and it really got me back on my feet.
Lastly -- swimming, yeah, give it a try but you may find that it doesn't help, at least not at this stage. I, too, thought that would be a miracle cure for me, but it turns out that unless your core is very strong, the act of swimming face down (say, doing the crawl, or with your arms on a kickboard) can increase the curve at the lower back which can actually cause more pain. I found my best relief by sitting in a hot tub, and also doing a "water aerobics" class which had lots of underwater movement but no actual swimming.
Good luck, you poor sweetie. This really sucks, but you will get better.
Good luck.
posted by BlahLaLa at 11:42 AM on December 7, 2011 [1 favorite]
I'm definitely not a doc but I urge you to go back ASAP. I was literally like you -- couldn't stand, sit or lie comfortably, and in such a state of pain that I burst into tears at the doc's office. Don't be afraid to make it clear to them how much you're hurting.
My doc also set me up for physical therapy which I started after 1 week of prednisone. By then the worst of the pain had gone, since the prednisone helps bring down the inflammation, which is what is pressing on your nerve and making everything hurt so much. I did 12 sessions of PT over 6+ weeks and it really got me back on my feet.
Lastly -- swimming, yeah, give it a try but you may find that it doesn't help, at least not at this stage. I, too, thought that would be a miracle cure for me, but it turns out that unless your core is very strong, the act of swimming face down (say, doing the crawl, or with your arms on a kickboard) can increase the curve at the lower back which can actually cause more pain. I found my best relief by sitting in a hot tub, and also doing a "water aerobics" class which had lots of underwater movement but no actual swimming.
Good luck, you poor sweetie. This really sucks, but you will get better.
Good luck.
posted by BlahLaLa at 11:42 AM on December 7, 2011 [1 favorite]
Er, vicoden. Damn you autocorrect.
posted by thelastcamel at 11:44 AM on December 7, 2011
posted by thelastcamel at 11:44 AM on December 7, 2011
Best answer: Ah forgot to mention my TENS machine. Basically it shocks the muscles into moving. Imagine a good strong deep massage.... awesome for bad days.
posted by handbanana at 11:53 AM on December 7, 2011
posted by handbanana at 11:53 AM on December 7, 2011
I have been through this, so I know your pain. I'm so sorry for you.
For me, mostly what helped me get through the intensely painful period was medical leave and narcotic painkillers. It is also likely that your seated, desk job is actually making the problem worse. Does it get any better if you stand up and walk around? I know you feel like you are in a bind at work, but this is your health and you need to take care of it.
I second all the recommendations for gabapentin, that helped me as well.
For me, the steroid injections never really did much. The three things that actually helped heal the injury were rest (primary), physical therapy, and eventually, surgery.
posted by mmmmbobo at 12:25 PM on December 7, 2011 [1 favorite]
For me, mostly what helped me get through the intensely painful period was medical leave and narcotic painkillers. It is also likely that your seated, desk job is actually making the problem worse. Does it get any better if you stand up and walk around? I know you feel like you are in a bind at work, but this is your health and you need to take care of it.
I second all the recommendations for gabapentin, that helped me as well.
For me, the steroid injections never really did much. The three things that actually helped heal the injury were rest (primary), physical therapy, and eventually, surgery.
posted by mmmmbobo at 12:25 PM on December 7, 2011 [1 favorite]
I'll chime in with those who suggest swimming and/or hot tubs, if your doctor allows it. Floating in a pool gives me tremendous relief from my chronic back pain. A hot bath or hot tub gives me somewhat less relief than actually floating, but it does help quite a bit.
One caveat: if your pain is severe enough to limit your mobility, you may need someone to help you in and out of a pool, hot tub, or bathtub.
posted by Elsa at 12:56 PM on December 7, 2011
One caveat: if your pain is severe enough to limit your mobility, you may need someone to help you in and out of a pool, hot tub, or bathtub.
posted by Elsa at 12:56 PM on December 7, 2011
There's a relatively new anti-inflamatory nasal spray called Sprix which claims "Non-narcotic relief of opioid level pain". I used it recently, and it seemed helpful.
posted by ShooBoo at 12:58 PM on December 7, 2011
posted by ShooBoo at 12:58 PM on December 7, 2011
I don't tolerate pain medicine well, especially if I have to work. Lidoderm patches, which slowly release lidocaine, have really helped with my lower back pain. They were developed for shingles, so they should help nerve pain, too. ( They are prescription only and nothing like the crappy "arthritis pain" patches you can get over the counter.). Either your pain doc or regular one should be able to prescribe them.
posted by hydropsyche at 1:20 PM on December 7, 2011
posted by hydropsyche at 1:20 PM on December 7, 2011
One thing that helped me at home (won't help you at work but it might give you some relief at home) is reclining. Not lying down, not sitting, but reclining. I don't remember who told me this because it was a long time ago, but sitting and lying down put a lot of stress on your back, but if you recline, it takes a tremendous amount of strain off of your spine. I'm not sure if they're right scientifically, but it's sure helped with my back pain. I have a degenerative disc so YMMV. I also have ten pillows on my bed so I can get into just the right position because I'm poor that way.
Be careful with Vicodin at work... I was fired from a position for being on pain meds. Just sayin'.
posted by patheral at 1:50 PM on December 7, 2011
Be careful with Vicodin at work... I was fired from a position for being on pain meds. Just sayin'.
posted by patheral at 1:50 PM on December 7, 2011
Regarding Lidocaine, I am scripted it and it is useful, BUT it does not work on nerve pain, or any pain for that matter not covered by the patch. Its useful for the back, and what not, but it is a regional delivery medication.
Also, never fall asleep with one of those patches on, you will wake up rather sick for about an hour until the serum levels go down.
posted by handbanana at 1:56 PM on December 7, 2011
Also, never fall asleep with one of those patches on, you will wake up rather sick for about an hour until the serum levels go down.
posted by handbanana at 1:56 PM on December 7, 2011
If you're in a city, consider shopping around to different places for the cost of the shot. My brother has been laid up with a herniated disc for almost 2 years, the first year of it not covered by insurance (insert rant here), and he found that different medical practices charged wildly differing amounts for the procedure.
Good luck, I hope this gets resolved ASAP.
posted by rosa at 2:24 PM on December 7, 2011 [1 favorite]
Good luck, I hope this gets resolved ASAP.
posted by rosa at 2:24 PM on December 7, 2011 [1 favorite]
I have a pinched nerve and had the "level 8" pain with numbness you described. It was especially bad while sitting at work and while laying in bed. My dad, who is a chiropractor, asked me if I keep my wallet in my back pocket.
"Yes. But that can't be it," I told him.
But I took it out of my back pocket and started keeping it in my front pocket and the pain went away completely within two days.
I'm not saying that your problem is due to something in your back pocket, of course, but perhaps there's something environmental that is making the pain worse or more frequent.
posted by tacodave at 4:07 PM on December 7, 2011
"Yes. But that can't be it," I told him.
But I took it out of my back pocket and started keeping it in my front pocket and the pain went away completely within two days.
I'm not saying that your problem is due to something in your back pocket, of course, but perhaps there's something environmental that is making the pain worse or more frequent.
posted by tacodave at 4:07 PM on December 7, 2011
I use a kneeling chair at my desk. I used to sit on a yoga ball, but had to raise it to make it work with the desk. Try these.
A good physical therapist is next. Find out who is the most recommended sports therapist in your area. A real therapist is a hundred times more useful than a therapist who seems good. Thisis a tough distinction to make on your own. My excellent results are because I finally switched to someone who checked my motions, manipulated me, asked about symptoms, then started trying stretches and exercise. When you are injured as badly as you are, the exercise may be as simple moving an arm while lying down you have to convince interstitial muscles that it is safe to move.
Swimming is good. See your PT first to find out what is safe and useful for you, specifically, at this moment.
Hot tubs are good.
Pain medication is close to last on my list. The pain is there for a reason. Work on the underlying issues and you will be happier. By all means, medicate for immediate needs, but do not use meds as a solution, just a stopgap.
Best of luck.
posted by lothar at 4:13 PM on December 7, 2011
A good physical therapist is next. Find out who is the most recommended sports therapist in your area. A real therapist is a hundred times more useful than a therapist who seems good. Thisis a tough distinction to make on your own. My excellent results are because I finally switched to someone who checked my motions, manipulated me, asked about symptoms, then started trying stretches and exercise. When you are injured as badly as you are, the exercise may be as simple moving an arm while lying down you have to convince interstitial muscles that it is safe to move.
Swimming is good. See your PT first to find out what is safe and useful for you, specifically, at this moment.
Hot tubs are good.
Pain medication is close to last on my list. The pain is there for a reason. Work on the underlying issues and you will be happier. By all means, medicate for immediate needs, but do not use meds as a solution, just a stopgap.
Best of luck.
posted by lothar at 4:13 PM on December 7, 2011
There's a book called "pain free" that I cant recommend highly enough.
posted by fshgrl at 5:25 PM on December 7, 2011
posted by fshgrl at 5:25 PM on December 7, 2011
N'thing the above:
- Gabapentin - I take it for nerve pain in my feet. As stated above it's not technically a pain killer but is prescribed for nerve pain and it works.
- Acupuncture - my mum has fibromyalgia and it really helped her.
Good luck with it all. Chronic pain sucks.
posted by deborah at 6:41 PM on December 7, 2011
- Gabapentin - I take it for nerve pain in my feet. As stated above it's not technically a pain killer but is prescribed for nerve pain and it works.
- Acupuncture - my mum has fibromyalgia and it really helped her.
Good luck with it all. Chronic pain sucks.
posted by deborah at 6:41 PM on December 7, 2011
Best answer: Please forgive my lengthy reply, all statements are as I understand the situation. I am not a consultant spinal surgeon, osteopath or medical professional of any sort, however I do know what it is like to have that back that overwhelms the mind with a white hot fury.
I had a spinal disc bulge at L5 (affecting S1 nerve), which was provided a spectrum of pain that was mind bending in its variety and intensity. After a year of treatment, including physio, tai chi, swimming and weekly (followed by monthly) osteopathy I was given the all clear. Pain had receded completely and I had pretty much normal mobility. I didn't take any pain killers, but I should have taken some anti inflammatories as well as the icing I was doing. The pain certainly affected my capacity to enjoy life and confined my capacity for joy when it was bad. The good news is, this will likely pass if you look after your back!
There is no blood supply to the disc, so healing is very slow and the bulge will never go away completely. Walking around helps to promote oxygen movement in the spine as it rotates around its axis. It also helps with the inflammation of the surrounding tissues that causes compression on the nerves that translates to the sciatic leg pain, as well as topical pain. Depending on where the nerve goes through the piriformis muscle in the buttock (it can lie on the side or travel through the middle) the nerve will be further compressed here. Some pain comes from the compression on the nerve due to the muscular spasming that is the bodies reaction to spinal damage. The body is trying to stop the spine from moving and nerves are not flexible, so a small change in their path causes an inordinate amount of pain (nerve pinch). In my case the piriformis was as hard as a rock, trying to stabilise the base of the spine. Osteopathy and piriformis stretches helped with this.
At work I would suggest a standing desk if you can swing that one, certainly sort this out at home. You just need a box on top of your desk to raise the monitor and keyboard to the correct height. When I sit at a desk I swap between a kneeling and long backed office chair at least every half hour. It is not a good idea for the body to spend any length of time in the same position. It is also bad for the eyes to be kept at the same focal length for any length of time. I try to get up and move about every 20 minutes, when I remember!
Also, I would recommend lying flat on the floor with the knees bent in a Alexander technique-like way, twice a day for 15-20 minutes. I don't use the books under the head, YMMV. I can also give you some muscle activation exercises that my osteopath recommended which I find are great for re-developing the muscles around the base of the spine if you want to MeMail me. I have over-done the core muscle development to the extent that I was taking too much strain from the back and it was becoming weak.
My osteopath estimates that he gets 60% of his business from desk workers who are sitting incorrectly (i.e. what most people consider normally). I like him a lot, but I don't want to have to pay him my hard earned money unless it is necessary!
I have a co-worker who also has the same issue. He manages the pain with drugs and gets steroid injections every six months. He doesn't use the ergonomic tricks, stretches or exercises and seems to be in a constant cycle of pain and relief. The injections are a short cut to relieving the symptoms, but they will return unless you remember that your back is still severely damaged even though you can't feel it.
Tai chi is a good discipline for keeping the spine straight and is performed standing. Qi gong is more health oriented, but involves less stepping. Both are great forms of mild exercise for anyone with a back issue. It certainly helped me to be active and focus on the improvement in my tai chi as I began to learn the movements and sequences. I felt a lot less helpless and it gave me something to look forward to and practice to distract me from the pain. I was not doing any partner exercises or pushing hands etc.
posted by asok at 4:12 AM on December 8, 2011
I had a spinal disc bulge at L5 (affecting S1 nerve), which was provided a spectrum of pain that was mind bending in its variety and intensity. After a year of treatment, including physio, tai chi, swimming and weekly (followed by monthly) osteopathy I was given the all clear. Pain had receded completely and I had pretty much normal mobility. I didn't take any pain killers, but I should have taken some anti inflammatories as well as the icing I was doing. The pain certainly affected my capacity to enjoy life and confined my capacity for joy when it was bad. The good news is, this will likely pass if you look after your back!
There is no blood supply to the disc, so healing is very slow and the bulge will never go away completely. Walking around helps to promote oxygen movement in the spine as it rotates around its axis. It also helps with the inflammation of the surrounding tissues that causes compression on the nerves that translates to the sciatic leg pain, as well as topical pain. Depending on where the nerve goes through the piriformis muscle in the buttock (it can lie on the side or travel through the middle) the nerve will be further compressed here. Some pain comes from the compression on the nerve due to the muscular spasming that is the bodies reaction to spinal damage. The body is trying to stop the spine from moving and nerves are not flexible, so a small change in their path causes an inordinate amount of pain (nerve pinch). In my case the piriformis was as hard as a rock, trying to stabilise the base of the spine. Osteopathy and piriformis stretches helped with this.
At work I would suggest a standing desk if you can swing that one, certainly sort this out at home. You just need a box on top of your desk to raise the monitor and keyboard to the correct height. When I sit at a desk I swap between a kneeling and long backed office chair at least every half hour. It is not a good idea for the body to spend any length of time in the same position. It is also bad for the eyes to be kept at the same focal length for any length of time. I try to get up and move about every 20 minutes, when I remember!
Also, I would recommend lying flat on the floor with the knees bent in a Alexander technique-like way, twice a day for 15-20 minutes. I don't use the books under the head, YMMV. I can also give you some muscle activation exercises that my osteopath recommended which I find are great for re-developing the muscles around the base of the spine if you want to MeMail me. I have over-done the core muscle development to the extent that I was taking too much strain from the back and it was becoming weak.
My osteopath estimates that he gets 60% of his business from desk workers who are sitting incorrectly (i.e. what most people consider normally). I like him a lot, but I don't want to have to pay him my hard earned money unless it is necessary!
I have a co-worker who also has the same issue. He manages the pain with drugs and gets steroid injections every six months. He doesn't use the ergonomic tricks, stretches or exercises and seems to be in a constant cycle of pain and relief. The injections are a short cut to relieving the symptoms, but they will return unless you remember that your back is still severely damaged even though you can't feel it.
Tai chi is a good discipline for keeping the spine straight and is performed standing. Qi gong is more health oriented, but involves less stepping. Both are great forms of mild exercise for anyone with a back issue. It certainly helped me to be active and focus on the improvement in my tai chi as I began to learn the movements and sequences. I felt a lot less helpless and it gave me something to look forward to and practice to distract me from the pain. I was not doing any partner exercises or pushing hands etc.
posted by asok at 4:12 AM on December 8, 2011
HSFH suggested coffee - I forgot to mention that too. The reason it works is because it dilates the blood vessels, which allows more blood to flow, which eases tension and reduces pain. I find it works better with my muscular pain, but YMMV.
posted by guster4lovers at 7:53 AM on December 8, 2011
posted by guster4lovers at 7:53 AM on December 8, 2011
Best answer: youngergirl44,
check your MeMail.
For the rest of you on this thread, try researching myofascial trigger points. To date, trigger point therapy / release (which can be done cheaply at home once the techniques are understood), is the ONLY clinically proven scientific method of musculoskeletal pain relief.
Then check out Paul Ingraham. He is the author of an enormous website that is primarily about pain relief related to myofascial trigger points. He has spent something like 2 decades on this site, and written hundreds of thousands of well-researched references. Perhaps understandably due to this time commitment, his ebooks are paywalled, but there is such an enormous amount of free information (under "Articles") also available that you probably won't ever have to access the paywalled stuff to gain a basic working knowledge of what you can do to help yourself.
posted by lonefrontranger at 9:15 AM on December 8, 2011 [3 favorites]
check your MeMail.
For the rest of you on this thread, try researching myofascial trigger points. To date, trigger point therapy / release (which can be done cheaply at home once the techniques are understood), is the ONLY clinically proven scientific method of musculoskeletal pain relief.
Then check out Paul Ingraham. He is the author of an enormous website that is primarily about pain relief related to myofascial trigger points. He has spent something like 2 decades on this site, and written hundreds of thousands of well-researched references. Perhaps understandably due to this time commitment, his ebooks are paywalled, but there is such an enormous amount of free information (under "Articles") also available that you probably won't ever have to access the paywalled stuff to gain a basic working knowledge of what you can do to help yourself.
posted by lonefrontranger at 9:15 AM on December 8, 2011 [3 favorites]
hit post too soon; I should add to this that after 2 years of playing what amounted to orthopaedic wack-a-mole, the only thing that solved my L5 pain was researching and addressing the severe trigger points I had located in & around my low back and upper glutes.
After gaining a working understanding of the mechanics of where the pain in my L5 was coming from, I booked an hour with my PT/massage therapist, told him exactly what he needed to concentrate on finding / releasing, and then I did several rounds of followup by myself, using a $5 dog toy (Kong) to roll them out, and then a $20 "back buddy tool" I purchased on Amazon. You don't really need one of these, it's just a bit more useful for reach and leverage.
It worked for me. According to the research & information on Paul Ingraham's site, it will probably work for about 70-80% of the low back pain sufferers out there.
However, as he clearly states on his site, none of this represents a "miracle cure". It is only a therapeutic relief method, the only therapeutic method that's got a clinical basis in fact. However, if you've got trigger points, they will probably come back, and they will need ongoing work to maintain.
posted by lonefrontranger at 9:34 AM on December 8, 2011
After gaining a working understanding of the mechanics of where the pain in my L5 was coming from, I booked an hour with my PT/massage therapist, told him exactly what he needed to concentrate on finding / releasing, and then I did several rounds of followup by myself, using a $5 dog toy (Kong) to roll them out, and then a $20 "back buddy tool" I purchased on Amazon. You don't really need one of these, it's just a bit more useful for reach and leverage.
It worked for me. According to the research & information on Paul Ingraham's site, it will probably work for about 70-80% of the low back pain sufferers out there.
However, as he clearly states on his site, none of this represents a "miracle cure". It is only a therapeutic relief method, the only therapeutic method that's got a clinical basis in fact. However, if you've got trigger points, they will probably come back, and they will need ongoing work to maintain.
posted by lonefrontranger at 9:34 AM on December 8, 2011
I am a patient at one of the country's leading chronic pain care treatment centres (and it's not an overstatement to say that my doctor is world-renowned - the guy does conferences all over the world), and this is what they told me in regards to work + opiate pain killers:
Have them document the hell out of everything. They have kept records as to my functioning level and when I needed a work-related physical report, they filled it out for me. They have a letter on file documenting that I function better on pain meds than off, due to the horrific effects of chronic pain on my body. That has been incredibly helpful. You just have to push for it to happen if you're not lucky enough to have such an amazing pain care centre.
posted by guster4lovers at 10:38 AM on December 8, 2011
Have them document the hell out of everything. They have kept records as to my functioning level and when I needed a work-related physical report, they filled it out for me. They have a letter on file documenting that I function better on pain meds than off, due to the horrific effects of chronic pain on my body. That has been incredibly helpful. You just have to push for it to happen if you're not lucky enough to have such an amazing pain care centre.
posted by guster4lovers at 10:38 AM on December 8, 2011
I have had sciatic area pain that keeps me from sleeping most nights. The one and only thing that has helped me is doing about 5 minutes of a couple of different bellydance hip moves before bed. It sounds odd, but it really helps align core muscles that you cannot reach with most other exercises. I am sure you could go on youtube and find a couple of examples that would help.
posted by Vaike at 10:41 AM on December 9, 2011
posted by Vaike at 10:41 AM on December 9, 2011
Response by poster: Thank you, thank you, thank you to everyone who posted here or sent me a PM. All of the suggestions were really helpful and I made it through to the injection yesterday without totally losing my shit. Here's what got me through:
* Vicodin & Tylenol 3 - I'd never taken either of them before (really any Rx pain meds, except for my migraine medicine) so maybe that's why I didn't even think to ask for some. The Vicodin was great until I rode in a car (hello, motion sickness), and half a pill was enough to subdue the pain and remain functional at work. Once the vicodin started making me ill, I tried the T3. It helped a little with the pain, but didn't give me any adverse side effects.
* Heating pad & TENS machine - For about 20 minutes at a time every hour or so after work.
* Dangling - I didn't end up getting any crutches, but found that I can raise the arm rests on my desk chair and dangle from there while at work (lowering them back to the proper level afterward). At home, I've been using the inside corner of my kitchen counter to dangle.
* Stretching - Anything stretching my hamstrings feels awesome, so I've been increasing those stretches (given to me by my physical therapist). He also showed me a stretch using a large bath towel or beach towel, folded in half lengthwise and rolled up. Since my pain is on my left side, I lay on my right side with the towel roll perpendicular to my spine, at about my natural waist, so it increases the amount my spine bends to the right while laying down. I then rotate my right shoulder forward, as if I were turning to my left, keeping my hips facing straight. This helps lessen the pressure on the nerves as they exit the spine and provides almost immediate (albeit temporary) relief. The piriformis stretch also helps a great deal.
The procedure yesterday went well, but I'm still feeling a fair amount of pain. I'm hoping this will lessen over the next day or so, as the cortisone does its thing. I'm going to continue reading through some of the links here and researching acupuncture options in my area. I'll also probably be signing up for a water aerobics class with the Chicago Park District in January.
Again, thanks - gold stars for everyone!
posted by youngergirl44 at 1:36 PM on December 20, 2011 [1 favorite]
* Vicodin & Tylenol 3 - I'd never taken either of them before (really any Rx pain meds, except for my migraine medicine) so maybe that's why I didn't even think to ask for some. The Vicodin was great until I rode in a car (hello, motion sickness), and half a pill was enough to subdue the pain and remain functional at work. Once the vicodin started making me ill, I tried the T3. It helped a little with the pain, but didn't give me any adverse side effects.
* Heating pad & TENS machine - For about 20 minutes at a time every hour or so after work.
* Dangling - I didn't end up getting any crutches, but found that I can raise the arm rests on my desk chair and dangle from there while at work (lowering them back to the proper level afterward). At home, I've been using the inside corner of my kitchen counter to dangle.
* Stretching - Anything stretching my hamstrings feels awesome, so I've been increasing those stretches (given to me by my physical therapist). He also showed me a stretch using a large bath towel or beach towel, folded in half lengthwise and rolled up. Since my pain is on my left side, I lay on my right side with the towel roll perpendicular to my spine, at about my natural waist, so it increases the amount my spine bends to the right while laying down. I then rotate my right shoulder forward, as if I were turning to my left, keeping my hips facing straight. This helps lessen the pressure on the nerves as they exit the spine and provides almost immediate (albeit temporary) relief. The piriformis stretch also helps a great deal.
The procedure yesterday went well, but I'm still feeling a fair amount of pain. I'm hoping this will lessen over the next day or so, as the cortisone does its thing. I'm going to continue reading through some of the links here and researching acupuncture options in my area. I'll also probably be signing up for a water aerobics class with the Chicago Park District in January.
Again, thanks - gold stars for everyone!
posted by youngergirl44 at 1:36 PM on December 20, 2011 [1 favorite]
This thread is closed to new comments.
posted by griphus at 10:05 AM on December 7, 2011