Explore non-surgical options for back pain

August 3, 2011 By

DEAR DR. GOTT: My 79-year-old mother has lumbar spinal stenosis that leads to hip pain. She has seen ads and articles about minimally invasive procedures to relieve this problem. In a recent column, you stated that laser spine surgery “has not undergone controlled clinical trials.” What does this mean? Hasn’t it been tested for safety or effectiveness?

Also, are you familiar with MILD (minimally invasive lumbar decompression), which is an image-guided procedure to remove bits of bone and tissue that impact the spinal cord?

My mother has had a couple of steroid shots and has seen a chiropractor for this and other concerns. She is wondering about these minimally invasive procedures in the future rather than the major open surgery.
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Persistent Back Pain Need Specialist

January 14, 2009 By

DEAR DR. GOTT:
My son will be 35 soon. He has been suffering from low back pain for about four years. He has a small remodeling business, so does hard labor. He has had to make adjustments so as not to lift anything too heavy. He is very industrious and not working is not an option for him.

My son has incurred a large amount of debt from doctor visits, testing and treatment. He has seen neurologists, orthopedic specialists, pain specialists and chiropractors. He has tried acupuncture, exercise, prednisone, Oxycontin, Percocet, injections into his spine, and others. The narcotics helped the most but he does not want to be on them again because they caused severe withdrawal symptoms which he does not want to go through again.

None of his physicians have given him any hope. [Read more...]

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Daily Column

April 23, 2008 By

DEAR DR. GOTT:
I have lower back pain and would like your opinion about what I should do. I had an epidural injection in April 2006 but still have pain. I also saw a chiropractor but couldn’t afford to keep going. I have enclosed the results of an MRI of my lower back I had done in September 2006.

I am a 57-year-old female.

DEAR READER:
According to the report you sent me, the MRI impression was “multi-level degenerative disc changes”. Taking a closer look at the findings, I note that most of your lower back appears normal. Two of the discs show mild narrowing and mild to moderate desiccation (drying). One disc also shows a “small subligamentous central disc protrusion with slight effacement of the thecal sac”. This lovely little gem of “medicalese” simply means that one of your discs has been squashed causing the soft inner part to “bulge” which has thinned an area of the membrane that covers the spinal cord and contains the spinal fluid.

All in all, your MRI is not bad. I am, however, concerned about the disc protrusion that has caused thinning of the thecal sac. Without treatment this could worsen and lead to a hole in the membrane causing the spinal cord to be exposed allowing it to be easily damaged.

You are experiencing pain which has been ongoing for more than two years. In my opinion, you need to make an appointment with the physician who ordered the MRI. He or she should then order a follow-up MRI to see if there is new damage and to asses the extent of the existing damage. At this point you should also ask what treatment options he recommends.

Don’t let your lack of funds prevent you from seeking appropriate medical treatment. If you let this go, there is a chance of permanent damage and disability. If your physician is unwilling to make payment arrangements and/or lower his fees, find someone who will. You may also wish to try to get temporary medical assistance through your local department of social services.

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