Neck and bck pain

    
      Re: Neck and bck pain
    


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Posted by ccf neuro M.D. on April 18, 1997 at 14:40:48:

In Reply to: Neck and bck pain posted by Marjorie Benyhoff on April 11, 1997 at 21:45:14:

:
  I have had surgery on my back, for a herniated disc- lL-4 , L-5.    I am always in pain and take pain relievers daily.  I go to a chiropractor three times a week.  Also have a herniated and a bludged disks in my neck, so surgery.  How much  TX. is o.k. when going to a chiropractor?  When is neck surgery indicated.  My injuries are 7 yrs. old.  Thanks.  M.B.
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From your desription of your symptoms, it sounds like you have developed what is loosely termed a chronic pain syndrome. Surgery on the neck or back should never be done for the purpose of relieving pain--- there is an old neurosurgical addage that goes "no matter how bad someone's back pain is--- remember, you can always make it even worse by operating on them." Surgery is indicated if there is nerve root compression resulting in loss of strength and sensation in the distribution of a spinal nerve that is being "pinched" by either a bone spur or a herniated disk. Many herniated disks do NOT cause symptoms, and the temptation to operate on something just because it is there on an MRI scan is rarely if ever a good idea. My point being, don't expect someone to operate on you for your pain and don't try to encourage someone to--- because sooner or later you'll find someone who will and will end up regretting it. Chiropractic manipulation may be worthwhile if you feel it improves your discomfort. Daily pain
medicines are the worst possible idea I can think of for someone with daily pain for seven years. Your body becomes tolerant of any opiate pain medicine such as Percocet, Darvocet, Fiorinol, etc. and the daily consumption of such medications for any longer than 3-4 weeks will typically CAUSE pain, not only in the area that prompted the administration of the pain medication, but in other parts of the body as well, as the body's "pain thermostats" get turned higher and higher up so that you become more and more sensitive to pain. You then require more and more pain medication to block the larger and larger number of pain-generating receptors on nerve endings that your body manufactures in order to overcome the blockage of them by the pain medicine drugs you are taking. The best and most effective treatment regimen for chronic pain is in a PAIN MANAGEMENT PROGRAM. If the pain is making you depressed or anxious or tired all the time, I would specifically recommend a PSYCHIATRIC PAIN MANAGEMENT PROGRAM, not
because people with these problems are crazy but because treatment of the secondary psychological effects of the pain is just as important as treating the pain itself, as mood and pain go hand in hand and influence each other very strongly. There is no easy fix for chronic pain, but through a pain management program it is treatable, and, as its name implies, ultimately managable---- if you are willing to make it so and make a good faith, wholehearted effort to participate in the program. If the Cleveland area is near you and you are interested in contacting the pain management center, you may call 1-800-223-2273 and ask to be connected to it by the operator. Another possibility is the Spine Center, also reachable at the same number. Any large teaching hospital near you should also have such programs.