Angry Missy's Spinal Woes

[angrymissy]

I was in a car accident in early june and got whiplash and some nasty lower back pain. I thought it was resolving itself. I did Chiro, PT and took percocet on and off until about 3 weeks ago. Then yesterday, I coughed hard and felt the muscle move, spasm and contract, and I've been a fucking hunchback for 2 days now. I can only walk hunched over and can only sleep like 15 minutes at a shot.

All I have med wise is Tramadol 37.5/325. THEY ARE NOT DOING SHIT. I called the doc office asking about getting something stronger, and got a call back saying the doc can't write me any more pain meds and I have to see a pain management doctor. They can fit me in in TWO WEEKS.

Can I take more than 1 Tramadol at a time?
Can I take flexeril with Tramadol? It was prescribed to me this way, but drug interaction checker says major drug interactions.
Is flexeril gonna be more helpful?
What else can I do for severe lower back pain/spasm? I've been treating it with a heating pad that doesn't seem to be doing much. Jeff has some lidocaine patches, they didn't seem to work but I took them off quickly.

Now I'm also worried my doc thinks I'm a drug seeker or some shit. I just want relief from this pain while it heals. By the time I get to the pain dr, the pain will probably have resolved itself.

I'm a freaking mess!

[Dr Steve]

I was in a car accident in early june and got whiplash and some nasty lower back pain. I thought it was resolving itself. I did Chiro, PT and took percocet on and off until about 3 weeks ago. Then yesterday, I coughed hard and felt the muscle move, spasm and contract, and I've been a fucking hunchback for 2 days now. I can only walk hunched over and can only sleep like 15 minutes at a shot.

All I have med wise is Tramadol 37.5/325. THEY ARE NOT DOING SHIT. I called the doc office asking about getting something stronger, and got a call back saying the doc can't write me any more pain meds and I have to see a pain management doctor. They can fit me in in TWO WEEKS.

Can I take more than 1 Tramadol at a time?
Can I take flexeril with Tramadol? It was prescribed to me this way, but drug interaction checker says major drug interactions.
Is flexeril gonna be more helpful?
What else can I do for severe lower back pain/spasm? I've been treating it with a heating pad that doesn't seem to be doing much. Jeff has some lidocaine patches, they didn't seem to work but I took them off quickly.

Now I'm also worried my doc thinks I'm a drug seeker or some shit. I just want relief from this pain while it heals. By the time I get to the pain dr, the pain will probably have resolved itself.

I'm a freaking mess!

#1 you have my cell number, Missy, USE IT. :smile: you know how slack I am in getting this stuff done on rf.net. I stink

#2 don't worry about sounding like a drug seeker; doctors who undertreat their patients' pain create people who seem to be drug seekers. We call them "pseudoaddicts". You're not seeking drugs, you're seeking RELIEF. That's a way different thing. If your doctor won't take your pain seriously, you may need to find another doctor (easier said than done these days, but still...)

First I'd want to make sure it was all soft-tissue injury; best way to do that is through imaging. If you have no slipped disk or instability in the spine, you can do some pretty heavy physical therapy.

With regard to the pain, I'd treat it from several angles:

a) opioid pain medications...standard therapy for severe acute and chronic pain. Tramadol works on the opioid receptor but is not itself an opioid. The maximum listed dose for Tramadol is 400mg per day. I'm not saying to take that much; I'm just saying what the book says is the maximum dose.


b) nonsteroidal antiinflammatory drugs...great for bone pain and pain from inflamed bones and muscles. The standard drug in this class is Ibuprofen; the standard dose is 600mg (3 Advil tablets) with food up to 4 times a day. Again, I'm not telling you to take this, rather what's out there. Discuss with your regular medical provider please.

c) Muscle relaxers...this can be in the form of medication (Skelaxin, Robaxin, (avoid SOMA)) or ice/heat/cervical collar or physical therapy

#3 by the time I answer this, the pain has probably already resolved. :-(

[Radioguy]

I'm trying hard not to threadjack Missy here, but I did want to know how many you feel Ultram (Tramadol) actually benefits? I find it induces some of the sensations of opiates, but not pain relief. To me, and others I've spoken with, it seems like a placebo with more psychological effect than physical.

So, hook Missy up with the right stuff. ;)

[zildjian361]

Missy pain meds dont make the real problem go away. i take Predisone 10 mg aday for rhumatism should be off them in a month. ask about them, they made all my stiffness pain go away in 2 days. be healthy:smile:

[Knowledged_one]

the flexaril will just make you sleepy, i used to take that, Percocet (10/650) and Neurontin at the same time

Just be careful, it to me sounds more like somethign the flexaril will help deal with while the pain sucks. And i would call the doctor and tell them you are taking 800mg of Ibuprofen (trust me thats better then sorry ass tramadol) because the tramadol doesnt help.

And you are right the hardest thing to do when asking for pain meds is not to seem just out for the meds. The best thing for me is i know keep with me my mediical records showing medication used to treat it and what the condition is. If worse comes to worse go to the emergency room tell them what the case is - when i got so bad and that happened they gave me a small presccription for percocet (like 15) and prednisone. Its a bad alternative i know to go to the ER but it can be worth it in the end

And i always say this, im sure you know or your husband knows someone who either has or can get percocets for you, dont be afraid to ask your friends

[Dr Steve]

I'm trying hard not to threadjack Missy here, but I did want to know how many you feel Ultram (Tramadol) actually benefits? I find it induces some of the sensations of opiates, but not pain relief. To me, and others I've spoken with, it seems like a placebo with more psychological effect than physical.

So, hook Missy up with the right stuff. ;)

Tramadol is actually ranked in the top 10 medications used to palliate pain in the world, but I don't disagree with you. It's really variable whether someone gets any relief with Tramadol. I tend not to use it at all in my practice, but I see people who are on it from time to time. A lot of doctors prescribe it because they want to help someone's pain but feel uncomfortable prescribing opioids (narcotics) for one reason or another. I'm not a big fan because most of the people I've tried on it in the past returned complaining it really didn't help.

[Dr Steve]

And i always say this, im sure you know or your husband knows someone who either has or can get percocets for you, dont be afraid to ask your friends

Just to be clear from my perspective, I can't condone taking medications without a prescription from a licensed medical provider. I know I'm being a stick in the mud, here. I just wouldn't want anyone to mask their pain with borrowed narcotics from a well-meaning friend when there's something more serious going on that gets missed.

Anyway, just have to toss that in from time to time.


Proceed. :smile:

[Dr Steve]

Missy pain meds dont make the real problem go away.


totally agree with you; pain relief is only part of the equation. A workup to make sure that there's nothing more sinister going on is always important. If in the end it's just soft-tissue injury, then one can only wait until the body heals itself. in the meantime there's no reason to suffer needlessly. Pain medications improve quality of life when used appropriately and that's a pretty important function.

[angrymissy]

Well this was good timing as my back went out again on Friday. I was laid up for 3 days and am more mobile today, but still have horrible pain radiating down my leg. I am seeing the pain doc and they at least wrote me a small percocet script or I'd probably not have made it through the past 3 days. The pain is so bad that I still have pain through the percocet. I also got Skelaxin which does not do shit. I just got an MRI today and see the pain doc again tomorrow. I am now self diagnosing myself by looking at my MRI images through a nifty CD the place gave me. I don't have the dr report yet, hopefully I'll get that tomorrow. I cannot live like this, it's awful. Pain doc seems to know what they're doing though.

I have bad allergies right now, and every sneeze puts my back into ridiculous pain.

[Bob Impact]

"Spinal Woes" sounds like the worst thing ever... sorry to hear it Missy.

[Radioguy]

I am now self diagnosing myself by looking at my MRI images through a nifty CD the place gave me.

You can do nifty things with those. This is my actual brain:

http://img200.imageshack.us/img200/2095/brain5150.gif

[spoon]

You can do nifty things with those. This is my actual brain:

http://img200.imageshack.us/img200/2095/brain5150.gif

no periventricular ir juxtacortical lessions

congrats, no ms

[Radioguy]

Go through that frame by frame, did ya? Do I look left-handed or right-handed?

[angrymissy]

I tried to make the cool animated one but it kept all my personal info on there. This is my spine. Is the white area on the way right my ass fat? Gross.

http://i34.tinypic.com/kbdr41.jpg

[spoon]

The funny thing is, the first time I saw this thread I thought it said "Angry Missy's Anal Woes"! What a pain in the ass it was to discover it wasn't. <-- for funkman, to arthur! :drunk:

[~Katja~]

The funny thing is, the first time I saw this thread I thought it said "Angry Missy's Anal Woes"! What a pain in the ass it was to discover it wasn't. <-- for funkman, to arthur! :drunk:
boy what a mistake we made... you could have been the punny guy on the .net team and bring the win home

[TheMojoPin]

"Angry Missy's Anal Woes"!

It's not nice to talk about Jeff that way.

[spoon]

boy what a mistake we made... you could have been the punny guy on the .net team and bring the win home

Listen you, if not for your Stanley Cup answer, we'd be going at it too. You guys stink!!!

And Cigars and Scotch took care of the bad jokes for everyone.

[led37zep]

And Cigars and Scotch took care of the bad jokes for everyone.

Cigars and Scotch: "Hmm, that's either a gay man with a mouth full of anal nitrates....or the truth.

I'm going with the truth."

[topless_mike]

Cigars and Scotch: "Hmm, that's either a gay man with a mouth full of anal nitrates....or the truth.

I'm going with the truth Fez."

http://aerophilately.net/plncrsh2.gif

[led37zep]

http://aerophilately.net/plncrsh2.gif

True to form of Cigars and Scotch.

My job here is done fellas.


Good day.

[topless_mike]

missy,
i may be wrong, but also what about stretching?
maybe something as laying across a yoga ball on your tummy or back or something?

doc? could stretching help?

[August_West]

missy,
i may be wrong, but also what about stretching?
maybe something as laying across a yoga ball on your tummy or back or something?

doc? could stretching help?


A visual of
Missy laying across a yoga ball just gave me a hard on.

[EliSnow]

missy,
i may be wrong, but also what about stretching?
maybe something as laying across a yoga ball on your tummy or back or something?

doc? could stretching help?

If she's doing PT, they should be teaching stretches, but here's at least one that work for me:

http://2.bp.blogspot.com/_Cw4opilexJI/SmRPhyRwp6I/AAAAAAAADbA/9kjBlF6BUSk/s400/cobra+pose.jpg

There's another which has you laying on your back right knee bent to the left, right arm extended straight right, and looking right, then switch.

Can't remember the name right now.

[angrymissy]

My PT person sucked. They had me go on a bike for a few minutes, then zapped me with that machine thing.

When my back heals up a bit I'm going to do yoga and try acupuncture.

[stinkbud]

Wow missy, looks like you need help.

I am a chiropractor and I have some experience with treating patients under anesthesia. I have seen amazing results. The way it works is that when you are under twilight sedation, your muscles are not guarding while you are being treated. As a result chronic adhesions that form in the joints are able to be broken and range of motion is improved.

I have had patients make very impressive recoveries after a series of three MUA sessions. It is worth looking into.

I am not sure where you are located and I wouldn't want to recommend anyone I don't know, but PM me if you want and maybe I can help find someone to work with you.

I am also on paltalk....same nick there. If I can help I will.

[EliSnow]

My PT person sucked. They had me go on a bike for a few minutes, then zapped me with that machine thing.

Electro-stimulus? I always liked that.

Are you icing it at night?

[angrymissy]

Wow missy, looks like you need help.

I am a chiropractor and I have some experience with treating patients under anesthesia. I have seen amazing results. The way it works is that when you are under twilight sedation, your muscles are not guarding while you are being treated. As a result chronic adhesions that form in the joints are able to be broken and range of motion is improved.

I have had patients make very impressive recoveries after a series of three MUA sessions. It is worth looking into.

I am not sure where you are located and I wouldn't want to recommend anyone I don't know, but PM me if you want and maybe I can help find someone to work with you.

I am also on paltalk....same nick there. If I can help I will.

So does my back look fucked? From my internet self diagnosis it looks like I have herniated discs.

[stinkbud]

I was trained to read X-Rays very well. While I have some experience with looking at MRI's and I know my anatomy pretty well, I am no radiologist and I would never attempt to diagnose an MRI without consulting with a colleague in radiology. That being said, it does look like there could be something going on there at L4 and possibly L5, but without the full series its hard to say if its bulging or herniated. Did you get a radiologist report with the films?

Are you getting any pain or numbness down your legs?

My practice is pretty much all personal injury and what you are going through is what I see all the time. I would strongly recommend the MUA route because anesthesia notwithstanding, it is about as non-invasive a therapy that you can get. If you are in NYC then you have no-fault benefits available to you. The problem is the MUA procedure is a three day series and the OR fees alone can eat up your medical benefits ($25,000 per patient I believe). That's why I don't do them anymore unfortunately. If your case is closed but not settled, I know a colleague who can work with you. He just waits to arbitrate against the insurance company to collect.

You can also look into spinal decompression. Plenty of chiros out there have these fancy computerized machines that do it (many people in my profession love their expensive toys). Basically, they strap your waist to a computerized mechanism which delivers a specific amount of spinal traction. These machines DO work well, but you will probably have to pay out of pocket for them as they are not covered under no-fault. It is expensive but very effective.

[Knowledged_one]

Just to be clear from my perspective, I can't condone taking medications without a prescription from a licensed medical provider. I know I'm being a stick in the mud, here. I just wouldn't want anyone to mask their pain with borrowed narcotics from a well-meaning friend when there's something more serious going on that gets missed.

Anyway, just have to toss that in from time to time.


Proceed. :smile:

I understand with that 100% but if you cant get into see a doctor or have a doctor who is unwilling to provide the necessary pain meds sometimes you have to step outside the lines to get the help. And like i said that would be the last option on my list, as i said i actually went to the ER before asking friends for help

[Knowledged_one]

So does my back look fucked? From my internet self diagnosis it looks like I have herniated discs.

If that was the case i dont think you would be walking much because your entire disc would have ruptured.

Honestly i went through the same thing, walking stooped over with my leg twisted inwards. Having to lie on the floor at work to get things done because i couldnt sit in a chair. And my leg was so numb that i felt like my right leg was on a foot of cotton. I actually got scared because i couldnt feel it when my leg hit stairs and was afraid i would fall

[stinkbud]

If that was the case i dont think you would be walking much because your entire disc would have ruptured.

Honestly i went through the same thing, walking stooped over with my leg twisted inwards. Having to lie on the floor at work to get things done because i couldnt sit in a chair. And my leg was so numb that i felt like my right leg was on a foot of cotton. I actually got scared because i couldnt feel it when my leg hit stairs and was afraid i would fall

Not entirely true..a herniation is when the annulus fibrosis (fibrous rings that make up the outside of the disc) tears and the soft nucleus inside the disc begins to leak out. If the annulus tears but not enough to rupture, the disc bulges out of place, hence the term "disc bulge". Both injuries can vary in the severity of pain you get, depending on how badly the spinal nerves are being compressed, if at all. I have had many patients with bulges and herniations with no nerve involvement.

[angrymissy]

Yeah, I just got the report and I have herniation and one is pressing on a nerve:

Can anyone translate?

Disc desiccation is present at the L4-5 level with an associated 1.3 x 0.4cm central posterior extruded disc herniation causing mass effect on the ventral thecal sac and mild spinal canal stenosis. The herniated disc also comes in contact with the L5 nerve roots in the lateral recesses bilaterally. The disc material extends approximately 0.2cm below the level of the disc space. There is degeneration of the articular facets with a .4cm cyst formed adjacent to the anterior aspect of the left apophyseal joint, extending into the ligamentum flavum.

Disc desiccation is also present at the L5-S1 level with an associated 1.4x.3cm central posterior protruded disc herniation and associated annular tear. There is mild mass effect on the ventral thecal sac.

I also have two small herniations in my neck.

Am I screwed? I guess the horrific pain shooting down my legs is because the disc is pressing on the nerve? HTF do I get rid out that?

[stinkbud]

Yeah, I just got the report and I have herniation and one is pressing on a nerve:

Can anyone translate?

Disc desiccation is present at the L4-5 level with an associated 1.3 x 0.4cm central posterior extruded disc herniation causing mass effect on the ventral thecal sac and mild spinal canal stenosis. The herniated disc also comes in contact with the L5 nerve roots in the lateral recesses bilaterally. The disc material extends approximately 0.2cm below the level of the disc space. There is degeneration of the articular facets with a .4cm cyst formed adjacent to the anterior aspect of the left apophyseal joint, extending into the ligamentum flavum.

Disc desiccation is also present at the L5-S1 level with an associated 1.4x.3cm central posterior protruded disc herniation and associated annular tear. There is mild mass effect on the ventral thecal sac.

I also have two small herniations in my neck.

Am I screwed? I guess the horrific pain shooting down my legs is because the disc is pressing on the nerve? HTF do I get rid out that?

You aren't screwed, you just need treatment.

Dessication means that the discs aren't hydrated like they should be. The fluid that bathes the discs is where they get their nutrients. When they are injured, the muscles surrounding the joint complexes get spasmed and everything stops moving, a phenomenon called muscle splinting. Now the bones are unable to move properly and this stops the discs from absorbing the fluid, thus you get dessication. By getting the joints moving again, you are able to facilitate rehydration of the discs, thus they get the nutrition they need to heal. In other words, when you are sick, you need food or else you get sicker and when you get the food you need, you get better.

At the L4-5 level, the herniation is compressing the thecal sac (this is a fancy term for the sac that protects the bundle of nerves in your spine, the spinal cord ends at around L2). It is also in contact with both of the nerves exiting the spine at that level. Not good, but nothing that will kill you. When you move your legs or bend or even strain, then you are pulling those spinal nerves slightly and there is the cause of that leg pain. I am not sure about that cyst at the joints, but you are probably dealing with early degenerative changes as a result of the herniation. Apophyseal joints are the names of the joints connecting your vertebrae and the articular facets are the surfaces of those joints. Ligamentum Flavum are ligaments inside your spine.

L5-S1 is not as bad as it isnt compressing the spinal nerve roots, but it is pressing on the thecal sac.

Are you still seeing the Chiro? At this point it is imperative that you continue getting adjusted. By restoring regular joint function, the discs have a chance to heal and get rehydrated. You probably need three to four visits a week. I know it sounds like a lot but trust me, it helps. If after a month or so of treatments, you aren't getting better, then look into more intesive therapies like MUA or decompression. You should also get evaluated by a neurosurgeon. I don't think you are going to need surgery, but disc injections may be helpful if non-invasive treatments don't work. I think the MUA will be good for your problems based on my own experience with my patients.

Ultimately, you will need to see a chiro for the rest of your life. Not three times a week forever, but probably once a month or so when you get better. Basically you will need maintenance care. Think of it as a monthly tune-up for your back to prevent getting to where you are now again. If it ever flares up, then you go more often till its better again.

Mind you, I am speaking from the perspective of my profession but I am also speaking from experience.

Like I said, if you need any help or advice let me know.