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Suggest Ways To Manage Severe Pain When Diagnosed With Fibromyalgia And Bertolotti's Syndrome
Question: This is "out there" but I'm desperate. I have Fibromyalgia and Bertolotti's syndrome. I control my symptoms of Fibro, pre-diabetes,and high cholesterol with exercise. I have tried to have the Bertolotti's removed so I can more fully exercise, but it was deemed "not of benefit" by XXXXXXX Clinic. I'm intolerant of pain meds or flat out allergic. I'm stuck in a wheel chair in constant pain as the Bertolotti's has fused to the Sacroiliac. Ideas? suggestions? I'm in constant muscle therapy and chiropractic. I eat a strict vegan Ketogenic diet.
Brief Answer:
Agressive physiotherpay si the best option
Detailed Answer:
Hi,
Thank you for posting the question.
I have gone through your query in detail and understand the amount of pain that you have been going through.
Bertolotti's syndrome ,if already has caused fusion of the sacro-iliacs then it is very difficult to reverse the process,either by medicines or by surgery.
Even if you try to remove Bertolotti's fusion from the transverse process of L5 vertebra to the sacrum,it will provide hardly any benefit in long run.
So it is better not to think of the surgical option.
You mentioned you are intolerant and allergic to pain medicines.
Considering all the above factors, i feel that agressive physiotherapy is the only and best option for you.
Physiotherapy may include Lumbar traction,short wave diathermy,LASER therapy etc. You should consult a nearby physiotherpaist and continue with the physiotherapy for atleast 3 months.
I hope the answer was useful.
Feel free to ask me any further doubts that you may have.
Thank you.
Wish you a speedy recovery.
Agressive physiotherpay si the best option
Detailed Answer:
Hi,
Thank you for posting the question.
I have gone through your query in detail and understand the amount of pain that you have been going through.
Bertolotti's syndrome ,if already has caused fusion of the sacro-iliacs then it is very difficult to reverse the process,either by medicines or by surgery.
Even if you try to remove Bertolotti's fusion from the transverse process of L5 vertebra to the sacrum,it will provide hardly any benefit in long run.
So it is better not to think of the surgical option.
You mentioned you are intolerant and allergic to pain medicines.
Considering all the above factors, i feel that agressive physiotherapy is the only and best option for you.
Physiotherapy may include Lumbar traction,short wave diathermy,LASER therapy etc. You should consult a nearby physiotherpaist and continue with the physiotherapy for atleast 3 months.
I hope the answer was useful.
Feel free to ask me any further doubts that you may have.
Thank you.
Wish you a speedy recovery.
Above answer was peer-reviewed by :
Dr. REMY KOSHY
I haven't tried those before. The fusion is only the past few months.(8/16-11/16)
I'm having a hard time accepting because the focus for so many years has been to "maintain articulation" and "keep it moving so it doesn't fuse". So I'm very confused. adding to the confusion, Bearing weight through the fused joint is excruciating.
I think I know where to go to get those treatments. NOT the pain management clinics around here. :-) What are my goals? What can I expect for exercises? How do I know it has failed? What is typically the best case scenario? should I stop the Chiropractic?
I lots of questions but this is a complete flip in thinking for me and my treatment.
I'm having a hard time accepting because the focus for so many years has been to "maintain articulation" and "keep it moving so it doesn't fuse". So I'm very confused. adding to the confusion, Bearing weight through the fused joint is excruciating.
I think I know where to go to get those treatments. NOT the pain management clinics around here. :-) What are my goals? What can I expect for exercises? How do I know it has failed? What is typically the best case scenario? should I stop the Chiropractic?
I lots of questions but this is a complete flip in thinking for me and my treatment.
Brief Answer:
Query answered
Detailed Answer:
Hi,
Actually,i could have guided you better if you could post a recent X ray and an MRI of the Lumbosacral spine and the sacroiliacs.
If the fusion is recent then you can expect good results.
Your goal should be to maintain as much mobility at the joints as possible and this can be achieved "only through physiotherapy and exercises".
Stretching exercises of back and hip region should be done daily for minimum of 30 minutes every morning,empty stomach.
Getting serial Xrays done every 3 months and comparing it with the previous ones, will give an idea whether it has failed or improved.
You can stop the chiropractic but do continue the exercises at home.
Typically,the best case scenario is a painless joint with some amount of residual stiffness.
Thank you.
Query answered
Detailed Answer:
Hi,
Actually,i could have guided you better if you could post a recent X ray and an MRI of the Lumbosacral spine and the sacroiliacs.
If the fusion is recent then you can expect good results.
Your goal should be to maintain as much mobility at the joints as possible and this can be achieved "only through physiotherapy and exercises".
Stretching exercises of back and hip region should be done daily for minimum of 30 minutes every morning,empty stomach.
Getting serial Xrays done every 3 months and comparing it with the previous ones, will give an idea whether it has failed or improved.
You can stop the chiropractic but do continue the exercises at home.
Typically,the best case scenario is a painless joint with some amount of residual stiffness.
Thank you.
Above answer was peer-reviewed by :
Dr. Nagamani Ng
I uploaded the screen shot of the joint from the ct on 10/21/16. and the x-ray in May. I have another in august which shows the L5 and S1 breaking and beginning the fusing process.
We have been focusing on strengthening not stretching as there is very little muscle tone. My legs kind of "flop" around and stretching is very easy. I can move the legs in any manner I wish with strength if they are not bearing weight. I will talk it over with my muscle therapist.
Is there anything specific we should do or avoid?
Should I push through the intense pain from bearing weight through the joint or focus on exercises without bearing weight through the joint?
Ice and rest on my bertolotti's with some turmeric have been "calming down" the burning and weakness inducing pain when I walk/sit/stand "too long".
I'm sorry for the quotes around all the words but I don't really understand what's happening. It feels like I'm "standing" on my right hip bone and through my hip joint into my femur down my right leg. Everything is COLD. Rather uncomfortable. I'm supposed to have diabetic neuropathy from mid calf down to my toes on both feet. I only feel cold and patches of itching and patches of freezing burning. Exercise normally controls the neuropathy/calms the neuropathy, but ... Any advice on types of muscle groups to exercise, you would recommend would be greatly appreciated...... all my stretches are full range of motion with no stretch unless the fibro is in flare from weather patterns affecting the Facet Arthritis.
Thank you for reading this long and all of your advice. XXXXXXX XXXXXXX
We have been focusing on strengthening not stretching as there is very little muscle tone. My legs kind of "flop" around and stretching is very easy. I can move the legs in any manner I wish with strength if they are not bearing weight. I will talk it over with my muscle therapist.
Is there anything specific we should do or avoid?
Should I push through the intense pain from bearing weight through the joint or focus on exercises without bearing weight through the joint?
Ice and rest on my bertolotti's with some turmeric have been "calming down" the burning and weakness inducing pain when I walk/sit/stand "too long".
I'm sorry for the quotes around all the words but I don't really understand what's happening. It feels like I'm "standing" on my right hip bone and through my hip joint into my femur down my right leg. Everything is COLD. Rather uncomfortable. I'm supposed to have diabetic neuropathy from mid calf down to my toes on both feet. I only feel cold and patches of itching and patches of freezing burning. Exercise normally controls the neuropathy/calms the neuropathy, but ... Any advice on types of muscle groups to exercise, you would recommend would be greatly appreciated...... all my stretches are full range of motion with no stretch unless the fibro is in flare from weather patterns affecting the Facet Arthritis.
Thank you for reading this long and all of your advice. XXXXXXX XXXXXXX
Brief Answer:
Query answered
Detailed Answer:
Hi XXXXXXX
Its ok if you post a lengthy question.Infact,it makes us understand your problems better.
You should push through the intense pain and continue the exercises till the range that you can tolerate. You should do almost all the back and hip strengthening exercises so as to maintain full range of movements.
I have gone through the attached X ray and CT. The bones are severely osteoporotic and there appears to be a bony fusion between transverse process of L5 and sacrum.
Once bony fusion occurs,recovery is never 100 % even if you get surgery done over your spine.
You should avoid bending forward and lifting anything heavy as far as possible.
Thank you.
Query answered
Detailed Answer:
Hi XXXXXXX
Its ok if you post a lengthy question.Infact,it makes us understand your problems better.
You should push through the intense pain and continue the exercises till the range that you can tolerate. You should do almost all the back and hip strengthening exercises so as to maintain full range of movements.
I have gone through the attached X ray and CT. The bones are severely osteoporotic and there appears to be a bony fusion between transverse process of L5 and sacrum.
Once bony fusion occurs,recovery is never 100 % even if you get surgery done over your spine.
You should avoid bending forward and lifting anything heavy as far as possible.
Thank you.
Above answer was peer-reviewed by :
Dr. REMY KOSHY
So just to clarify...I keep things simple...
The bones and the fusion need strengthening? That is my primary focus.
A secondary focus is to regain as much muscle tone through pelvis and legs as possible.
What about flexion or bending backward?
I have pretty much written off any surgery. I'm willing to risk paralysis if it means no more pain while sitting, however... no one else is. :-) Not the facet arthritis removal, nor the disc replacement nor the resection. My current exercises with steroid injection have gotten me to walking about 50 yds and sitting upright for 3 hours, but sitting forward(computer work) for less than 2 hours.
Do the steroid injections interfere with fusion healing strengthening? How "tenuous" or strong is the fusion? Could I ride a horse without breaking the fusion? Am I doing damage sitting forward working on the computer? That pain is Migraine inducing. I would like to do EITHER of my previous careers again. Dressage trainer or Computer System Business Analyst I will take 50% recovery to normal human... 90% would be better but... I'm greedy. :-) PS... I can do either of those if I were paralyzed, but not even part time like this.
Thank you for answering all my questions and the suggestions. I think I've found a physiotherapist at my local nursing home. I have a call in with the therapies you mentioned. XXXXXXX XXXXXXX
The bones and the fusion need strengthening? That is my primary focus.
A secondary focus is to regain as much muscle tone through pelvis and legs as possible.
What about flexion or bending backward?
I have pretty much written off any surgery. I'm willing to risk paralysis if it means no more pain while sitting, however... no one else is. :-) Not the facet arthritis removal, nor the disc replacement nor the resection. My current exercises with steroid injection have gotten me to walking about 50 yds and sitting upright for 3 hours, but sitting forward(computer work) for less than 2 hours.
Do the steroid injections interfere with fusion healing strengthening? How "tenuous" or strong is the fusion? Could I ride a horse without breaking the fusion? Am I doing damage sitting forward working on the computer? That pain is Migraine inducing. I would like to do EITHER of my previous careers again. Dressage trainer or Computer System Business Analyst I will take 50% recovery to normal human... 90% would be better but... I'm greedy. :-) PS... I can do either of those if I were paralyzed, but not even part time like this.
Thank you for answering all my questions and the suggestions. I think I've found a physiotherapist at my local nursing home. I have a call in with the therapies you mentioned. XXXXXXX XXXXXXX
Brief Answer:
Query answered
Detailed Answer:
Hi XXXXXXX
Welcome back.
Primary focus should be on lower back muscle strengthening. Bones also need to be made more strong by taking calcium and vitamin D3 supplements.
Flexion and bending backward will be limited due to the fusion.
Steroid injections do not interfere with fusion healing / strengthening. They just reduce the inflammation and pain temporarily.
The fusion is almost strong as a bone now.
Yes,you can ride a horse without breaking the fusion.
You are not damaging by sitting on computer but sitting for prolonged periods of time will make your back more and more stiff.
Thank you.
Query answered
Detailed Answer:
Hi XXXXXXX
Welcome back.
Primary focus should be on lower back muscle strengthening. Bones also need to be made more strong by taking calcium and vitamin D3 supplements.
Flexion and bending backward will be limited due to the fusion.
Steroid injections do not interfere with fusion healing / strengthening. They just reduce the inflammation and pain temporarily.
The fusion is almost strong as a bone now.
Yes,you can ride a horse without breaking the fusion.
You are not damaging by sitting on computer but sitting for prolonged periods of time will make your back more and more stiff.
Thank you.
Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..
Above answer was peer-reviewed by :
Dr. REMY KOSHY
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