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Suggest Treatment For Severe Back Pain And Loss Of Mobility In An Elderly Person
Question: My wife, aged 63 years, has attained limited mobility in the past couple of years, mainly due to her lower back issues. She used to be very active, volunteering at the library, golfing, and hiking in the summers. One morning a couple of years ago, she was helping my daughter out of bed at the hospital directly after my daughter had undergone back surgery. And while assisting my daughter, my wife experienced a sharp stab of pain in her lower back. She's been in pain ever since. She's undergone several (3) MRIs, x-rays, bone scans since, during the past couple of years, but none of them showed any structural damage or abnormalities whatsoever. We sent all her MRI scans and other images to the Mayo Clinic, and they declined to schedule an appointment for her, since the scans appeared normal. Since her problems began, the only thing that has helped, at least somewhat, is physical therapy. She can't sit in any chair for over 10-15 minutes at a time. She experiences less pain while she is lying down or standing up. She stands up to eat. She lies on the floor to watch TV. She's in pain every day, and as I mentioned, the scans don't show anything.
Most recently, we've heard about some kind of "nerve block" injection. I have an uncle who not too long ago experienced many of the same problems my wife is experiencing, except that he encountered less lower back pain when sitting instead of standing. He underwent one of these so called"nerve block injections" after suffering through physical therapy and constant pain for over a year. He says that he became totally pain free after this injection. I guess his treatment was a collaborative effort between two doctors. I tried to contact each one of them, as I considered making an appointment for my wife to see them. Those doctors were in Mississippi, and my wife an I are in South XXXXXXX One of them has retired, and the other has passed away.
We've been to orthopedic specialists and neurosurgeons. They take a look at the scans and inform us that they don't see anything wrong. If you like, we can email you all the images I've described.
Any suggestions about where we can go, or who we can see next?
Regards,
XXXXXXX Dolen
Most recently, we've heard about some kind of "nerve block" injection. I have an uncle who not too long ago experienced many of the same problems my wife is experiencing, except that he encountered less lower back pain when sitting instead of standing. He underwent one of these so called"nerve block injections" after suffering through physical therapy and constant pain for over a year. He says that he became totally pain free after this injection. I guess his treatment was a collaborative effort between two doctors. I tried to contact each one of them, as I considered making an appointment for my wife to see them. Those doctors were in Mississippi, and my wife an I are in South XXXXXXX One of them has retired, and the other has passed away.
We've been to orthopedic specialists and neurosurgeons. They take a look at the scans and inform us that they don't see anything wrong. If you like, we can email you all the images I've described.
Any suggestions about where we can go, or who we can see next?
Regards,
XXXXXXX Dolen
Brief Answer:
Considerations
Detailed Answer:
Dear XXXXXXX
First off, let me say how sorry I am to hear that you and your wife have been dealing with this pain for such a long time. I can't imagine how frustrating it must be for both of you to not have a diagnosis let alone a treatment plan.
You mentioned that you've seen orthopedic specialists and a neurosurgeon and that imaging studies have been essentially normal. It might be time to see a pain specialist, or 'pain medicine physician'. These are physicians (often with anesthesiology residency training) who have additional fellowship training in treating cases of refractory or non-responsive pain. They may be able to provide another perspective that you haven't yet received from the previous doctors. The nerve block injection you describe from your relative's experience sound like it may be within the purview of a pain medicine physician. Unfortunately, it is not within the scope of this service to recommend particular providers, BUT I would begin by locating the closest pain specialist and asking to speak with their nurse or scheduler about the specifics of your wife's symptoms and see what they think. Also, most universities have physicians with this subspecialization who might be able to help. In the meantime keep up the physical therapy, as this is often a crucial component in pain management.
I wish you and your wife all the best and I am hopeful that you will find someone who can provide additional treatment to help with the chronic pain management.
Sincerely,
Dr Galamaga
Considerations
Detailed Answer:
Dear XXXXXXX
First off, let me say how sorry I am to hear that you and your wife have been dealing with this pain for such a long time. I can't imagine how frustrating it must be for both of you to not have a diagnosis let alone a treatment plan.
You mentioned that you've seen orthopedic specialists and a neurosurgeon and that imaging studies have been essentially normal. It might be time to see a pain specialist, or 'pain medicine physician'. These are physicians (often with anesthesiology residency training) who have additional fellowship training in treating cases of refractory or non-responsive pain. They may be able to provide another perspective that you haven't yet received from the previous doctors. The nerve block injection you describe from your relative's experience sound like it may be within the purview of a pain medicine physician. Unfortunately, it is not within the scope of this service to recommend particular providers, BUT I would begin by locating the closest pain specialist and asking to speak with their nurse or scheduler about the specifics of your wife's symptoms and see what they think. Also, most universities have physicians with this subspecialization who might be able to help. In the meantime keep up the physical therapy, as this is often a crucial component in pain management.
I wish you and your wife all the best and I am hopeful that you will find someone who can provide additional treatment to help with the chronic pain management.
Sincerely,
Dr Galamaga
Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.
Above answer was peer-reviewed by :
Dr. Yogesh D
Answered by
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