Q: I have been experiencing mild to severe back pain for over a year. In the summer of 2010 arrangements were made through my doctor for an X-ray and an MRI test. The results showed degenerative disc disease, severe arthritis and a pinched nerve.
In the fall of 2010 an appointment was made to see a physician in pain management. A needle was inserted in my lower back with a combination of steroids. This treatment had a negative result. We rescheduled two weeks later with the same treatment performed and being negative again. At that point I was discouraged and did not reapply.
Do you know of any treatment for a pinched nerve and/or back pain? Any help or suggestions would be greatly appreciated. Thank you.
A: Degenerative disk disease (DDD) is a condition in which pain is caused by a damaged spinal disc or discs. The easiest way to understand what a spinal disc does is to think of it as a shock absorber that helps cushion the spinal bones during movement and prevent them from rubbing together. These discs are comprised of a tough outer layer and a softer, jelly-like inner core; however, the normal aging process gradually causes the discs to dry out and become more solid and less flexible. This process can cause the outer layer to thin (degenerate) which can allow the inner core to leak or bulge out and press on the surrounding tissues and nerves. When this occurs, problems arise.
Symptoms of herniated disks can appear in otherwise healthy individuals while in their 30s and 40s and can include numbness and tingling of the extremities, weak leg muscles or foot drop, pain that worsens with movement or when sitting. Risk factors include the aging process, trauma, and discs that dry out and cannot absorb shock and stress as well as when the person was younger.
Treatment might include chiropractic intervention, massage, acupuncture, biofeedback, gentle exercises to strengthen the back, the application of ice and/or heat, physical therapy, and brief bed rest. Ice is often used initially for about 20 minutes at a clip, two to three times a day. As I often state, a bag of frozen peas (or any other vegetable) wrapped in a towel and applied to the area of pain is readily accessible and can lessen symptoms. Place those peas back in the freezer for your next home treatment. After two or three days, however, the ice should be replaced with heat – either from a heating pad, hot pack or even a shower that will relax the muscles. It is more difficult to recuperate if lengthy bed rest is undertaken since an individual usually feels better and has fewer symptoms by resuming activities as soon as possible. Over-the-counter pain relievers (non-steroidal anti-inflammatories) or stronger prescription drugs might follow but should all be under the direction of a physician. In fact, you might ask your physician about seeing a physiatrist, who can combine medication with rehabilitation.
On the home front, the massage I mentioned above might be utilized, as it can help increase a person’s range of motion, while reducing the stiffness involved. Place a small rolled towel or blanket in the curve of your back when sitting. When lying down, place a small pillow between or behind your knees. Avoid bending and lifting that places extra stress on the back. If lifting becomes necessary, bend from the knees, not from the waist. Under your doctor’s or physical therapist’s direction, incorporate gradual back-strengthening exercises.
Readers who would like related information can order Dr. Gott’s Health Report “Managing Chronic Pain” by sending a self-addressed, stamped number 10 envelope and a $2 US check or money order to Dr. Gott’s Health Report, PO Box 433, Lakeville, CT 06039. B e sure to mention the title when writing or print out an order form from our website www.AskDrGottMD.com.
