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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest Treatment To Alleviate The Pain In Back?

Hi I am a 35 year old, post-op transsexual, who prior to surgery was diagnosed with Kyphosis aftre an accident in which I had a unstable burst T12 fracture. Subsequent MRI's showed the following:

"Marked Degeneration of the Spine, Limbus Vertebra at L3, Schmorls Nodes throughout, Failure of segmenatation at the Lumbosacral Junction with Dystrophic facet joints at this level, congential fusion of T12 and L1 with Posterior Hemi-vertebra at this level"

I have been struggling with pain for a number of years while awaiting orthopaedic review, as the orthopaedic consultant wanted to wait until after any definitive gender surgery was carried out before re-assessing things. However since the gender re-assignment surgery, the pain has gotten worst and I have found myself virtually housebound, as my mobility is severly restricted by the pain.

The pain altrenates depending on what posture I adopt, while sitting it is in my upper back and lower legs, while standing it is in my upper & lower legs, and pelvic and lumbar region of my back.

I am currently being treated with pain relief alone, MST tablets 20mg BD, and Oramorph 10ml 4 times a day, Arcoxia anti-inflammatory, amitryptyline for nerve pain, and paracetemol.

I also take 6mg/day estradiol valerate as part of my hormone regimen.

I am looking for any advice that can be provided on things I can do to try to help myself, I have difficulty sleeping, managing on average only 3 hours a night, every other day, as I find that on waking after sleeping on my back that the problem is worst.

Any advice on anything I can try to alleviate the problem would be greatly appreciated.

Thanks

Karen
                                                  
Wed, 8 Apr 2015
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Physical Therapist or Physiotherapist 's  Response
Here from your explanation and mri report I suggest you need surgical correction at your spinal level. For this as you have told you have all ready consulted doctor and he has given you some time to wait till this time I suggest to visit one more orthopedic doctor and neuro spinal Surgeon to discuss your case further in detail and take secondary opinion. Based on the common opinion I suggest to go ahead with treatment planning.
Now till the time you go for surgery at home you can do some conservative primary treatment that is taking physiotherapy treatment and physiotherapy specialise spinal exercise program design as per your problems and issues.
You can also use hot pack and cold pack on your back painful area to have some more relaxing effect on your soft tissue.
Also take postural suggestion for sitting, standing, as well sleeping from physiotherapist to help you in your daily life.
Take care.
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Suggest Treatment To Alleviate The Pain In Back?

Here from your explanation and mri report I suggest you need surgical correction at your spinal level. For this as you have told you have all ready consulted doctor and he has given you some time to wait till this time I suggest to visit one more orthopedic doctor and neuro spinal Surgeon to discuss your case further in detail and take secondary opinion. Based on the common opinion I suggest to go ahead with treatment planning. Now till the time you go for surgery at home you can do some conservative primary treatment that is taking physiotherapy treatment and physiotherapy specialise spinal exercise program design as per your problems and issues. You can also use hot pack and cold pack on your back painful area to have some more relaxing effect on your soft tissue. Also take postural suggestion for sitting, standing, as well sleeping from physiotherapist to help you in your daily life. Take care.