Back Pain Drug Therapy

Back Pain

Drug Therapy/Pain-Killers

The first line of treatment for any pain be it joint pain, back pain, or muscle spasm, is usually pain killers unless it's unusually severe. 

Aspirin or NSAIDS

Nine times out of ten you'll get a recommendation to try aspirin or another of the family of medications called nonsteroidal anti-inflammatory drugs, or NSAIDS, for short. These drugs reduce pain sensations and also block the release of Prostaglandins, a group of hormonelike substances that can promote inflammation. 

Disadvantages of NSAIDs

NSAIDs are effective in the temporary treatment of moderate pain but have the potential for  long-term side effects. 

	Cause stomach disorders
	Long-term use may cause kidney disorders
	May induce high blood pressure.
	Over the long term they may even accelerate the course of joint degeneration.
	The NSAIDs typically cause some stomach upset.
	Cause ulceration and bleeding in the stomach.
	Cause tiny pinpoint perforations in the surface of the small intestine. This can induce "leaky gut syndrome," which is thought to be part of the mechanism of allergy, autoimmune disease, and even arthritis itself.
	Long-term use of NSAIDs may weaken the intestinal barrier. This allows allergenic substances to pass that may actually promote inflammation in the joints.

COMMON NSAIDs

Aspirin
Bufferin
Flurbiprofen (Ansaid)
lndomethacin (Indocin)
Ketoproten (Orudis)
lbuprofen (Motrin, Nuprin, Advil)
Naproxyn (Naprosyn)
Voltaren 

Other medications used:

Steroids

Steroid injections work quite well in the short term. They can relieve pain quickly and completely. Unfortunately, the effect wears off, and the second injection is a little less helpful, the third a little less than that, and so on. You can only give a limited number of steroid injections to a joint, after which you run the risk of actually killing off tissue and weakening bones.

Codeine/Tylenol combination (Tylenol 3): 

This certainly blocks pain, but does nothing for the underlying causes of chronic pain. It is a powerful narcotic. You can build up a tolerance to it and require a higher dosage for the painkilling effect. People also experience a dulling effect on mental processes. There is also a high risk of addiction.

Advice prior to microdiscectmy

If you do not have a recliner-GET ONE it was so awkward for me to move around in the first 48 hours and the recliner is great because I found it so hard to get in and out of bed , I got one on Kijiji for $40 I also used the patio bistro table beside the recliner so I had EVERYTHING at my finger tips such as coffee, tv remote, book, wii remote, xbox remote, chap stick, water, and munchies along with medicine

Sleep when you can...you won’t always have the opportunity power naps are wonderful and I recommend having plenty pillows for your back stomach legs etc

Don’t plan on getting more than an hour or two in a row of sleep...it’s very hard to get comfortable for a few days after surgery and it is completely normal to feel tired all the time it's the med's!!!

Have someone stay with you for the first week-trust me you will need to rely on them for things you can't do, even the little things like getting the pots and pans to be able to cook something. You will not be able to drive for at least 2-3 weeks because of the med's but more than anything the incision pain of getting in and out of the car as well as all the bumps on the road. You will not be able to dress yourself below your waist for the first couple days.

Stock up on food and have EVERYTHING at your waist level or higher and have everything on the first shelf of your fridge. FRUITS AND VEGGIES, CRACKERS quick and easy foods

Be sure to ask the nurse for warm blankets when you are in the recovery room, it's freezing!!!

Your throat will hurt (from breathing tube) in the recovery room...I found that having chicken noodle soup and jello for the first two days after helped a lot

DRINK LOTS OF WATER

Be prepared to be constipated after surgery...start taking a stool softener/laxative when you get home and have a bottle of prune juice just in case it's needed eat lots of veggies and fruits it helps stay away from foods like pasta and red meats once you "go" you will feel like a million bux!

Hardest thing to do after surgery...change positions in bed...laying on side and back became the most comfortable sleep however you can, I sometimes slept in my recliner because it was the only thing that kept the pressure off my incision

Have activities to do while you are at home for me within the first week it was mostly XBOX and Wii :)

Don't be shy to take your medicine, for the first couple of days take it every 4 hours it will help then after the first week try and cut back but don't stop completely

Get plenty of slip on shoes ie) runners, flip flops, slippers or my fav crocs :) You will not be able to put socks on or tie shoes for several weeks.

Wear loose clothing big baggy tee-shirts and pajama pants were my best friend for the first week after that you can get into track/yoga pants but just keep everything low rise or draw string and loose shirts.

Get some Polysporin to apply to the incision as needed I used it about three times a day sometimes more whenever it felt tight also use ice after all your walks to take any swelling and inflammation down

The first 3 weeks are the hardest just remember that!!! Your incision is healing

Walk even if two minutes every hour, every little bit helps and it will build your tolerance up, after about 3-4 days you will be able to walk 200-500 feet DON'T OVER DO IT LISTEN TO YOUR BODY 
 
Even when you feel back to your normal self do not attempt to clean your house or do laundry have your family help you trust me your back thank you!!! 

6 weeks post op Microdiscectomy

I have to say I'm feeling 80% back to my normal self. 

Life has become much easier and I'm finding myself getting back into routine. I can reach a bit lower in the fridge still without bending, I can cook and clean things at my waist level. Driving is much easier now except that I can't drive for longer than 20 minutes or so my nerve starts to bother me. I am pleased with the residual nerve pain it is NOTHING like before and I have to live with this for the rest of my life then I consider the surgery a success at this point

Tho I do not have a job to go back to I am looking for one and even I get get a part time job I'm ok with that, I have been reading some reviews online from people like me who have had a microdiscectomy and they wish they would've waited just a few weeks-months longer to return back to work. I am not rushing by any means I know that we are born with one back and I plan on taking it easy for a good year.

I had my cousins bridal shower and stag and doe this past Saturday and I thought for sure I would've needed three days to recover from that. I was actually ok just stiff and sore muscles from all the sitting and standing. Being part of the bridal party I felt bad because I could'nt help with some things but I did what I could when I could. I only took one T3 in the middle of the day. and I iced between events with a hour lay down on my recliner. 


I still walk 1-2 miles per day. If I don't walk I have nerve flair ups and stiff muscles so I try to keep active as much as I can when I shop I park "in china" the end of the parking lot and walk as far as I can to the front door. Walking is a huge part of recovery and I thank god that I can at least get back to that. I don't walk the dog yet because I'm scared that she will pull me, plus I cant bend over to pick up the doggy doo-do but I suppose in time I will.





I'm heading to the cottage exactly one year post injury and I'm just excited because it is the first real road trip in a year besides the change of scenery will do me good. Were gonna take breaks every half hr to hour for me to get out of the car and stretch. I'm bringing my T3's but I plan on having a relaxing care-free wknd away from home  :)


I'll write another post after I see the surgeon on Oct 12th. 

1 month post op Micodiscectomy

Week 2

• Minimal T3's taken 
• Less nerve pain it comes and goes 
• Ice after every walk 
• Walking up to a half mile everyday if not more
• Walking around the house much more often
• Getting in and out of bed is still getting much easier
•  Incision is very itchy put Polysporin on at least every three hours or so
• tried driving, hmm not ready for that yet :( 
• Surgical tape came off 

Week 3

• Sleeping good
• walking around a lot more 1/2 mile to a mile everyday
• standing more 15 min each time
• resting less only when needed listen to my body!
• very stiff muscles in legs and back
• sore ankle
• started to take Naproxen for anti- inflammatory when needed for my ankle and tight muslces
• driving short distance only like 5 min drives to go get coffee
• Swelling around incision- ice on ice off every hour or so
• PUT MY OWN SOCKS ON :)

Love the above pic this was me Xbox, tv remote, cell phone, coffee, soup and sandwich lol right at my finger tips. 


 Week 4

• Gets easier each day 
• In and out of bed is now a breeze and I'm sleeping like the old days
• Naproxen as needed 
• T3's as needed at night for incision pain 
• Walking is a breeze now 
• Driving is getting much easier however I don't go much further than 10 minutes from home 
• Nerve pain now back of left leg 
• Sitting at computer for 15 minute intervals and getting up to do laps around the island 
• Walking 1/2 mile to mile sometimes more everyday 

 Here's a picture from Week 5 

 

I will post on a monthly basis and let you know how I'm coming along.  I have booked my post-op visit with the surgeon on October 12th 2012

The first week post-op Microdiscectomy

DAY 1 
After only going to bed at 3am I awoke at 5am I felt I couldn't sleep anymore. I laid there and I did eventually fall back asleep until 8am. The frustrating thing that had me up every hour on the hour during that time was having to pee.

I awoke to eat, kept it light. Had raisin bread, tea and yogurt  and three heaping spoon fulls of jello.

Very stiff and getting in and out of bed is getting slightly easier but not by much! Sleep for most of day on and off again waking up every hour on the hour :(  Very hard to get comfortable. Can't sit, stand, lay very restless.  2 T3's every 4 hours.

As I've been told it gets easier everyday so I guess we'll see.

DAY 2
Finally got 4 hours of uninterrupted hours of sleep. 

I took two very small walk from the end of the driveway to the corner of the street which would be about 200-500 ft. Still very stiff and it's hard to walk on elevated levels up and down steps or even on grass. I had such difficulty trying to sit or lay down other than somewhere on the couch which is a BIG no no so I got a recliner on KIJIJI for 40 bux. It took all the pressure off my legs and back and I was able to rest peacefully for hours at a time. My back is freaking itchy as hell I think it's from the iodine that they used around the incision but just in general I have not showered and I have not been permitted to have a shower until day 3 after surgery. I spend my day going for little walks around my kitchen island and alternating between bed and the recliner. Seems to be getting better and easier but it's hard to tell. I wish I could see the incision. The dressing has to stay on for at least 5-7 days. 2 T3's every 4 hours.

DAY 3
Slept for a continuous 5 hrs then did nothing at all but lay on my recliner, trying to cut back on T3's but I'm so stiff in the morning that I usually always have to take at least one. NO NERVE PAIN.  I showered except I did need assistance only because I couldn't bend to wash anything below my waist. I tried to not get my dressing wet but of course it did and we needed to use the hair dryer on it and dry it out just a little. I went for two short walks to the corner about 200-500 feet.  Yesterday by 3pm I had taken 8 T3's today only 3 so far. I am very sore and will probably have to do with some more before the days end. 4 walks total to the corner. Getting easier. NO NERVE PAIN

DAY 4

Went for a walk to the corner as soon as I awoke. Slept really good! Had a muscle spasm in the back of my knee very quick and went away quite fast. I managed to put my own under wear and pants on :) Which I barley able to do prior to surgery. Constipated, I feel like every time I eat something it just sits like a float in my throat... grossest feeling in the world. I have not gone number since prior to the surgery that's been almost 6 days :( I sent my boyfriend to the pharmacy for some Glycerin Suppositories (I called it the pooh pill)  I managed a little relief but not much. I have been taking Docusate Sodium tablets since day two post-op but I think they should've been given to me at the hospital as well. All those drugs keeping every bit of pooh inside me eww disgusting feeling.

Day 5
The dressing came off my wound. It's much easier to move around. Not much pain at all just simply the stretching of the incision every once in awhile. I slept very good Best sleep so far by a long shot!
My aim is to try and stay off the med's today. I walked around the block today (almost 1/2 mile)  it started out really well then towards the end I slowed down to a snail crawl. Very tight and sore muscles. Minor nerve pain at the back of my right knee. By 2pm I was soo sore so I took 2 T3's nerve pain, back very sore, leg muscles on fire. Needed to rest and I did so in the recliner for the rest of the day and eve.

DAY 6
I drank almost half a bottle of prune juice still having the feeling of being constipated :( The nerve pain ahs backed off slightly however I'm resting more than trying to walk further and further each day. I just don't want to push it even it it takes a little longer to heal that's ok - hell I've been off work for 10 month already what the hell is another 3 months...

It's is 230pm and I have not had any T3's since 7pm the night before. :) I showered myself and put my own clothes own minus socks... 2 walks to the corner maybe 600-800 feet total. Nerve pain back of right leg.
I did not take any pain med's today.

DAY 7
Very little nerve pain and when it does come it comes and goes I just try to use ice. No pain med's Walked only twice to the corner again 600-800 feet it's getting easier and easier every time I do it!  I managed to walk up and down my porch steps today with no problems. Walk around in the yard in the grass is getting easier too. I showered and dressed myself but still no socks... I dream of the day I can finally put my own socks on :)

 I dream of the day I can finally put my own socks on :)

Mico-discectomy Day - Sharnig my experience

Mico-discectomy Day Aug 13th 2012

I wheeled into the Operating room at 2pm I remember being introduced to two nurses that were preparing the room for me. 10 minutes later after asking me some questions like who I was and what I was doing in the operating room they put a gas mask over my mouth and nose and I began to breath. I was also given something in my IV as I felt a burning sensation. I remember breathing into the mask for at least a couple minutes or so it seemed! I tried doing the count 10,9,8,7,6,5,4,3,2,1 except I still wasn't out yet... I kept counting and counting until nothingness!

I awoke in the recovery room very sleepy and groogy. A lady in the bed next to me asked the nurse what time it was and the nurse said 545pm.

My boyfriend came into the recovery room between 630-7pm He filled me in on his side of the experience.

He said the liaison nurse came to see in the waiting room at 330pm to let him know that surgery was just about to begin. The liaison nurse then came to visit again at 430pm and mentioned I was in surgery and the fragment was just about to be removed that she seen on the monitor in the operating room.

530pm my surgeon went to go see my boyfriend to let him know that it went well and that I was in recovery and that I would remain there for about 2-3 hrs. At 630pm he called the recovery room and asked the nurse if he could come see me and they let him in.

What I remember in the recovery room is not much either but I can tell you that in the time I was there the nurse gave me 2 morphine injections thru my IV and a total of 4 T3's

I was dis-charged at 10pm. when leaving I had the option of a wheel chair but I couldn't believe the improvement already with having the pressure taken off my sciatic nerve. I wasn't limping anymore!!! I walked out confident and walked out alone with no wheelchair- now it sounds like I walked right out of the hospital but this walk took me probably 20-30 minutes to get from one end of the hospital to the other!!!

Getting into the car was tricky as I did not want to stretch or bend the incision. Once I was in and I out all my pillows in place I was good. Got home at 11pm the hospital was a hour out of town. I was soo hungry and didn't think I could handle solid foods yet so I ate just chicken noodle soup and crackers and drank lots of water. I didn't go to be till almost 2 or 3 am because I had felt like I was sleeping all day...

My only comment that night was NO NERVE PAIN :)

The story that led me to go for my microdiscectomy

Here I start my story of my almost full year of living with sciatic pain in my right butt cheek and down my entire right leg. This injury I believe initially happened almost 5 months prior to tweaking my back. I'll explain it as best as I can.

The initial injury occurred Spring of 2011 when I was hanging on a tree branch. The branch snapped and I landed flat on the ground. I wouldn't say that I feel high off the ground at all, just hard and flat! I managed to get up and walk away no problems except for feeling a bit winded. Now I should've noticed the signs right away with random days of back pain at the office and yes I probably should have gone to the doctor but I decided to take care of the pain on my own with some stretches and Tylenol back pain medicine.


Thanksgiving weekend of 2011 and the dog jumped on the bed early in the morning when I was still half asleep I flung up as quick as I could and yelled at the dog and at the same time screamed out loud in agonizing pain. I can't even begin to explain how much pain. I felt immobilized, my back was tight as hell I couldn't straighten it out, I for sure could not bend over, I moved slower than a snail and it hurt like hell every step I took. We were a hour from the closest hospital and I knew that sitting in a car was the last place I would wanted to be however I decided to stick out the car ride home- it nearly took us 5.5 hrs as we got caught on in traffic :( I was screaming and crying the whole way home not knowing what the hell was wrong with me, it was a pain I had never in my life experienced. If someone said out of 10 how would you rate your pain I would've said at the time 1 million. By the time we got home, I went straight to bed. I figured maybe resting a good nights sleep I would be back to normal the next morning.



Boy was I wrong... I barley slept at all having muscle spasms in my right leg calf and thigh all night, in the morning I tried to walk to the car down just three steps was nearly impossible crying and screaming and there was no way in hell I could bend again to get back in the car, however I tried. My boyfriend called the ambulance and we went to the hospital.

The nurse that examined me had said it was sciatic pain... now sciatic pain just so you know is a symptom not a injury itself... they made me take an x-ray which came back normal and they gave me 2 Tylenol 3s and told me "it's just sciaitic pain my advice is just get back to your normal routine, do not lay in bed" at that point I was pretty pissed off because this doc still couldn't tell me anything and getting back to my normal routine seemed impossible- as all I could do was lay in bed.

A few days later I visited my family doctor and he had said the same thing only he tried to move around some muscle groups and pushing around different spots on my back. He prescribed me some T3's and Naproxen tablets 500mg twice daily and booked a MRI appointment for me and a referral for physio therapy. Now these med's really were not helping at all. I got my boyfriend to go out and buy some RubA535 as well as Voltaren to use on my tight muscles in my leg. I was getting severe leg spasms every 2-3 hours. I could not sit, stand, lay, walk. Nothing.... I had to wait 3 months for my MRI.

After about 6 weeks of this pain I continued with physio twice a week for 8 months. My MRI revealed that I had a herniated disk in L4/L5. This herniation was pinching on my sciatic nerve. Now around March and April it was getting slightly better with physio but I still was no where near my normal self and still could not resume my normal routine. I had acupuncture needles in my butt/low back and right leg nearly every 2-3 weeks while he taught me stretches and exercises that I could do at home. After each physio visit I sat on the TENS machine for 15 minutes 4 pads on my upper butt and low back.

After my MRI results were sent to my family doctor he had referred me to a few spinal clinics for a surgery consultation. Now this was the last thing on my mind but I knew that I better search out all possible options. The average disk herniation will heal itself in 6-8 weeks. Now with mine I had a fragment about the size of a dime compressing my sciactic nerve. I was lucky and got a appointment in to see a surgeon in Hamilton in February of 2012 only 4 months after the initial injury.I continued with physio still twice a week.

By this time I still was not back to normal routine, in fact bending was still out of the question. Walking far or more than 5 minutes, driving impossible. Muscle spasms now seemed to be minimal due to acupuncture and TENS.

After speaking with the Nero surgeon she recommended that we wait and see another 5 months of physio would do for me as I had come quite far from day one. I continued with physio and massage treatments for 5 moths to visit her again and she booked my surgery date for Aug 2012 to have a Microdiscectomy.

I figured there was no point in going to physio anymore so I stopped. and just waited for my surgery date.

This is the story of my life pre-surgery that led me to the decision to go for it. I was researching online for weeks about people's reviews mostly negative. If you are suffering from any of the above keep reading my posts to see how the process is coming along!

Thanks for reading if you have any questions please message me.