Dr. Gott: Disabling Back Pain Presents Dilemma

Dr. Gott PhotoDear Dr. Gott: I read your column about a person who seems to have the same progressive disorder of the spinal discs that I have. I have enclosed the doctor’s report of my MRI. I am a 74-year-old man. I currently take one Ultram tablet three times a day and one Lyrica tablet twice a day. I have also had two hip replacements in the past 20 years.

When I get up in the morning, my left leg feels like someone has attached an electric wire to it. I also have a great deal of pain in my shoulders. The electrical feeling in my leg and the pain in my shoulders last until I take the Ultram, but then I still have some trouble standing or walking for too long. The Lyrica seems to help, because, by about 10 a.m., I am able to get up and move around somewhat better.

Because of all the pain, I tried a pain clinic, where I was prescribed gabapentin three times a day. I later stopped it because I felt very confused. I didn’t know who or where I was. Quality of life is important to me. They also tried giving me an epidural block, which did not work.

My primary-care physician told me that I will have to have surgery when my bowels become involved. I feel that I am getting too old to have surgery. Knowing what I have told you and your past dealings with similar patients, I would like to know what your opinion is. Should I live with the pain or take a chance with surgery?

Dear Reader: You have enclosed the results of your MRI, which shows severe degenerative disc disease in several areas of your spine. The report recommends surgical decompression should noninvasive treatments stop working. I believe that you have reached that stage.

Surgery is the final option for most conditions. Spinal surgery is especially worrisome. Despite its vast advances over the years and its relatively low incidence of serious side effects, most people are uncomfortable with it. All surgery has risks, but spinal surgery is perhaps the second most detrimental (following brain surgery), including permanent nerve damage, which may result in loss of feeling, paralysis and more. I suggest you speak with a neurosurgeon or orthopedic surgeon who specializes in the spine.

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