A friend of mine has been having trouble with her back . She has had lots of different tablets with no effect , and two visits to a physio . The physio said that it was muscular but i pushed her to ask for an x-ray . This has shown 3 discs are narrowed .She has finally been referred to orthopaedics but will have to wait 4 weeks for an appointment.
She has been asking me about what treatment to expect but the only experience i have is that OH had his operated on because his disc was very bad .
I know that years ago they used traction , but what can she expect nowadays ?
Thanks in advance .

IME, NSAIDs and an exercise regime to strengthen the back muscles are the usual treatment, although if the case is severe an operation may be necessary in the future.

Has your friend had an MRI or is diagnosis purely from X-Ray, MRI (although daunting) may give a better picture of the condition of the discs.

If found not to be severe then she may be referred to a pain management clinic, although I have no idea what waiting times in the UK are like for this.

However I am not medical just work in this area, I am sure one of our qualified members will be along to share the depth of their knowledge. :)

Edit to add OH also had an operation for discs a few years ago, previous to agreeing to op he was treated with traction and with epidurals but in severe cases IME these are only effective for short periods of time.

She hasn't had an MRI - i hope the Consultant will send her for one .
The trouble is that she has been off work for weeks taking tablets that have done nothing at all . The physio insisted that it was muscular , yet she had sciatica which spread to her other leg whilst doing the physio's exercises .
Work are on at her  , yet she is going to be off work for a lot longer yet .
It is just very frustrating that she obviously needed an MRI in the beginning , yet she had to go through tablets , physio and an x-ray , plus weeks off work first .
She has got kids to look after and work to worry about .
Sorry , just ranting !!!

Hi, I have had a bad back for over 3 years now, at one point, I could only sleep on the sofa, because if I went to bed I couldnt get out of it and was too painful.  I have private medical insurance with work, so my doctor referred me to this Doctor, he first thought it was and probably was to start out with siatica (sp) so I had loads of cortisone injections, which did help and finally the pain down my back, in my right buttock and right leg finally went, but I still I had pain at the bottom of my back which gets me when I stand up or sit down or am on my feet for long periods of time.

He sent me for an MRI scan, this has shown that 3 of my vertabrae are what he calls worn (I am only 44).  I then had some injections into the spaces between these vertabrae under an x-ray machine so he could see where the needle was going, unfortunately this only helped for a couple of weeks.  My other options that are open to me currently are having the nerve endings cut around these areas to stop the pain or having my discs fused together.  Neither of these options appeal to me, and at the moment my back is bearable and if I am having a bad day, I have some long lasting anti-inflammatries that I can take.  But I can say that my back is alot better than it used to be and I can go to bed and get out of it ok now.

Jane

Hi I am probably an expert, from being a Nurse and also have had major back problems since my twenties!

I have had severe arthritis since my late twenties, a Spinal Fusion in 2000 when I was 40 years old, also, just to say in the last 3 years I have had 2 hips replaced and a knee replaced. I am 49 years old...but my body belongs to a 90 year old and I wish she'd have it back 'cos I'm really racked 'orf with it!!

I was working as a Nurse in A&E in 1996, I was attacked by a patient and he prolapsed 2 discs in my back...I had physio, traction, nothing worked, finally had an MRI and needed urgent surgery for a discectomy. I had to finish work and as my back was so arthritic the discs were flattened and hard and calcified...from then on it was all downhill!

Finally in 2000 I had a Spinal Fusion, this has made a major difference...the Op was horrendous, my back was purple from bra staps to my botty! My HB went down to 4.5 and I rejected having a blood transfusion. BUT...I am still glad I went through it and had it done. It isn't great now though, I can't walk very far...but you have to bear in mind that my arthritis is very severe! My pain levels from my back has improved though...so in all, I think it was worth going through.

Now, onto your friend...they should be referred to an Orthopaedic or Neaurosurgical back Consultant. They will try physio as standard, pain relief, maybe steroid injections and a pain clinic referral. They SHOULD do an MRI scan, but sometimes they will try the conservative treatment first. If they MRI shows any sign of severe wear and tear they will consider operating. This route also depends on where exactly the problem stems from. They might do a discectomy, depending on which discs are involved, or further more serious Ops. It's hard to say without a definitive diagnosis and only an MRI can provide that!

If she really is struggling she will need to plea her case to the GP or Consultant, although maybe now-a-days they are more inclined to send for an MRI? In 1996 I had to practically beg for mine...I knew I was in serious trouble but the idiot Consultant at the Hospital(where I worked incidentally!) didn't agree...I was lucky that I had BUPA and asked him if they would pay, could I go for one...he said yes...the Radioligist made an emergency appointment for a Neurosurgeon after the scan and I was in surgery within 48 hours...so much for not needing one eh?

Pain relief...I use a combination of drugs and each person is different and will respond differently to a pain relief regime...if it's severe there is no reason for anyone to deny her a Consultation with the Pain clinic. I also use a TENS machine and found it a life saver at times...you can pick them up for around £30-£40, I bought mine and it was around £80!!

If she wants someone to talk to, pm me and I will give you my e-mail address...it's hard to cover everything in a post and I forget stuff now I'm getting near to 50!!!

In her situation, I'd go and see a good Osteopath before I did anything else. :(

I spent a fortune on an Osteopath...a small fortune...which is why you need an MRI and the only way to get one is through the Consultant! They couldn't fix me, despite all the promises as I had a very dysfunctional back with severe arthritis and terrible facet joints! No amount of manipulation made the slightest difference...and when I say a fortune I spent at least £300! I think if you have muscular problem or just need manipulating back into proper aligment they are great...if you have severe underlying 'mechanical' issues they are a waste of time and money! In my humble, very time consuming and expensive experience! ;-)

Different people, different experiences!  Having been in pain for years and no help from the general medics, my Osteopath was my saviour! :)

I agree - she has already  wasted money on prescriptions that did nothing , and wasted time on physio who said it was muscular when it wasn't . I am afraid that i won't be sending her to an osteopath .
The x-ray showed that the gaps between her discs were narrowed , so an MRI is what she needs .
I don't think she will want more physio and exercises as she has no confidence in them now .
But i will tell her to expect a referral to a pain clinic .

Thanks for your replies .

Probably not relevant in this case, but I had a bad back for years and spent a fortune on chiropractors... since I joined the gym and worked my back muscles regularly (7 months now) I have had no back pain at all :) I lost 3 stone too and I am sure that helped a lot.

Unfortunatley some times the Consultant requires a physio regime first...maybe she could get a report from the Physio to save her going through it again? If it was at the same Hospital it may not be a problem as they can access the notes....just a thought?

Hi newfidreams,

As you have said I would not to completley rule out the surgical option, my OH struggled for years before I finally convinced him ( I knew the surgeon who performed the Op well and had full confidence in him).

I know he may have been one of the lucky few, but the Op really was life changing for him, he has not had a days pain from his back for years now, and is now able to do things he hadn't done for years. When his back was bad he could not do anything at all and yes as you say it was like living with a 90 year old. :)

> agree - she has already  wasted money on prescriptions that did nothing , and wasted time on physio who said it was muscular when it wasn't

It's usually best to try the conservative options first and often there are protocols that have to be met before further investigations such as MRI can be performed (£££'s springs to mind as they are not cheap scans). 
It may be muscular in that as your friend is experiencing pain they may have compensated by using muscles that are doing a job they are not designed for and as such they become fatigued easily and the 'correct' muscles for the job need retraining e.g leg muscles, not designed for back support, can become overactive with back pain and so the muscles that should be supporting the back become switched off and need strengthening up again.  This MAY have been what they meant by 'muscular'.