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Suggest Treatment For Pain When Having Degenerative Disc Disease
Question: I am a 33 year old female and I have been told I have the spine of and 80 year old person. I have searched high and low for a cure to this painful disease. It has stopped me from reaching for the stars in life and has forced me to focus on just getting through the day without breaking down. Every moment of the day, every movement I make, even sitting or sleeping I am in constant pain. I keep waiting for the day there may be some treatment for me. I have tried just about everything and have seen every kind of doctor. I have been diagnosed with Progressive Global Degenerative Disc Disease, Disc Desiccation, Facet Joint Disease and Fibromyalgia (doubts about that one). My recent MRIs dated 7/12/13 and 7/15/13 reflect I Currently have 12 Herniated Discs some with desiccation. Starting with my Cervical area, C4-C5 small central herniation, C5-C6 leftward herniation creates mass effect on left hemi cord, C6-C7 broad hernia. There is degenerative disc desiccation at C4-C5,C5-C6 and C6-C7. I have seen two different surgeons about my neck, however; they recommended no surgery since my problem is so global. Moving on to my thoracic, T2-T3 herniation towards the left (worse in the interval). This creates mass effect on the left hemi cord. T3-T4 rightward hernia continues to create mass effect on the right hemi cord. T5-T6 rightward herniation is stable. T6-T7 broad herniation creates mass effect on the anterior hemi cord (worse in the interval). T7-T8 broad herniation is stable. T8-T9 has a small rightward hernia. T9-T10 leftward hernia which is stable. Finishing with my Lumbar; Degenerative Disc Disease at L2-L3 and L4-L5. L2-L3 has and annular tear with a herniation in the midline and towards the right side. L4-L5 there is Degenerative Disc Disease. Degenerative signal changes present within the interior of the disc and there is mild narrowing of the interspace. Broad based bulging of the disc is present with a asymmetric prominence consistent with a herniation to the left side. A moderate stenosis of the spinal canal is present and there is mild to moderate narrowing of both neural foramina. L5-S1 has transitional features. Enlarged left transverse process does articulate with the upper sacrum. No arthritic facet disease is present at this level where the facet joints are hypoplastic. Is there ANYTHING on the for front??? I have been on pain medications for about 8 years. The last 5 years or so it has been MS Contin 30mg twice a day and Roxicodone 15mg four times a day. Lyrica for the nerve pain. These medications at least allow me to function around the house and have some semblance of a life. However, the medication does not seem to be working as well as it use to. Maybe I am just getting worse. I have heard people become tolerant to the pain medications they are on. Is this true and do you think this is what is happening to me? I hope you can help me with some of my questions. Thank you so very much for your time.
Brief Answer:
Seems opioids have developed tollerance
Detailed Answer:
Hello. I have been through your question and understand your concern.
Unfortunately, the situation seems to be serious. The global degenerative disc disease is a progressive condition. I do not fully agree with the previous doctors that surgery has little or no benefits, thus not indicated. If the spinal cord is compressed you might get some benefit from decompression, or at least the situation will not progress at that level.
Considering your main concern, which is pain; as I understood from your accurate and detailed report has been stable under treatment and now has gotten worse. The treatment you are having is the strongest one can have for treating pain. The problem with this type of drugs is that being opioid, sooner or later, these develop some degree of tolerance.
Still, you should have another MRI planned to see the if the spinal changes are the same or have progressed in some way.
In case there is a clear clinical and radiological indication (which can be seen in the MRI) for another cortisone injection in any of the facet joints, the insurance can reconsider it.
At last, you should also plan another neurosurgical consult after the MRI. Still, if your spinal cord is suffering surgical indication must be reconsidered from the neurosurgeon, especially now that you are refractory to pain treatment.
Hope this helps with some of your questions, please feel free for further questions.
Wish you good health.
Seems opioids have developed tollerance
Detailed Answer:
Hello. I have been through your question and understand your concern.
Unfortunately, the situation seems to be serious. The global degenerative disc disease is a progressive condition. I do not fully agree with the previous doctors that surgery has little or no benefits, thus not indicated. If the spinal cord is compressed you might get some benefit from decompression, or at least the situation will not progress at that level.
Considering your main concern, which is pain; as I understood from your accurate and detailed report has been stable under treatment and now has gotten worse. The treatment you are having is the strongest one can have for treating pain. The problem with this type of drugs is that being opioid, sooner or later, these develop some degree of tolerance.
Still, you should have another MRI planned to see the if the spinal changes are the same or have progressed in some way.
In case there is a clear clinical and radiological indication (which can be seen in the MRI) for another cortisone injection in any of the facet joints, the insurance can reconsider it.
At last, you should also plan another neurosurgical consult after the MRI. Still, if your spinal cord is suffering surgical indication must be reconsidered from the neurosurgeon, especially now that you are refractory to pain treatment.
Hope this helps with some of your questions, please feel free for further questions.
Wish you good health.
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
Tell me, is there ANYTHING that is in a research stage that can help me? Are they trying to find a cure to disc degeneration? I keep waiting and waiting for the day I don't have to be on pain medication but fear it will never come. Is there any hope for me?
Brief Answer:
allogenic mesenchimal stem cells study
Detailed Answer:
Hello again dear. I think you should be patient because there are some trials with hopeful reaults.
The most prominent study is about Allogenic mesenchymal stem cells where autologous or donor stem cells are implanted in the degenerative site. The definitive results are still to come though.
Hope this helps. Wish you the best health.
allogenic mesenchimal stem cells study
Detailed Answer:
Hello again dear. I think you should be patient because there are some trials with hopeful reaults.
The most prominent study is about Allogenic mesenchymal stem cells where autologous or donor stem cells are implanted in the degenerative site. The definitive results are still to come though.
Hope this helps. Wish you the best health.
Above answer was peer-reviewed by :
Dr. Bhagyalaxmi Nalaparaju
If I were your daughter... Would you recommend waiting on surgery if possible and hold out for this new stem cell treatment? I don't want a back full of metal by the time I am 40 that may not even improve my life
Brief Answer:
Surgery is still an option
Detailed Answer:
Hello dear. I know it is difficult to manage pain and it becomes troublesome and debilitating.
I am a surgeon. Thus I think as a surgeon. Surgery is very invasive. But, if there is some clear indication, meaning that if your spinal cord is suffering which can be seen in the MRI or in a Neurological consult (better if seen in both) I would do surgery. Maybe it will not solve the pain problem, but it wont let things progress.
I do not believe stem cell therapy is reliable at the moment. I would wait for the trials.
Since than, I would continue the same.
Best wishes for you having the best health.
Surgery is still an option
Detailed Answer:
Hello dear. I know it is difficult to manage pain and it becomes troublesome and debilitating.
I am a surgeon. Thus I think as a surgeon. Surgery is very invasive. But, if there is some clear indication, meaning that if your spinal cord is suffering which can be seen in the MRI or in a Neurological consult (better if seen in both) I would do surgery. Maybe it will not solve the pain problem, but it wont let things progress.
I do not believe stem cell therapy is reliable at the moment. I would wait for the trials.
Since than, I would continue the same.
Best wishes for you having the best health.
Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.
Above answer was peer-reviewed by :
Dr. Raju A.T
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