I have had a long road of back pain / meds / surgery / injections etc. you back pain suffers know the drill. This summer I had the facet injections and blocks in order to see if I was a candidate for RF Rhizotomy. It was determined by two specialists I was.
Before diving into another invasive procedure, I visited a pain management doctor. ONE of the many things we did was try Celebrex. Now I was very skeptical as it had done nothing prior to surgery. But once my spondy was fixed I though - let's try it again.
I have to happily report that this NSAID really did work. So much so I was able to lay off the Vicodin and/or Norco as a supplement to "stay ahead of the pain". Now I've even reduced from two times a day to one in the morning and - while I still do have low back and facet pain - it is very tolerable!! NSAIDs are not without problems, and hence the lowest dose, but I am pretty darned impressed with Celebrex and my arthritic facet joints.
I wonder who else has also had good luck with Celebrex. Clearly I can't wait for it to go generic because Big Pharma is making a killing at $220 a month for an NSAID. But that said, I'm enjoying the decreased inflammation.
I am really glad to hear you have found something that works on your pain as well as the Celebrax. I have taken it but with my stomach ulcers it was causing me more harm than good. I was taking the Bextra for a period of time and it worked well until they took it off the market. Nsaids are really great for pain and swelling if you do not have gastronomical problems. I did well on the Bextra and was switched to Celebrax but as I said it was not for me with the stomach ulcers.
Celebrax offers coupons. Here is a site for one I found.....
Thank you for sharing your good luck with a NSAID. You're right they do come with some concerning side effects. When one has pain we weight the pros with the cons of medication. Most of us do what you have done, take the medication. I am glad that it has been effective for you.
My sister, also a nurse, uses Celebrex daily. She was informed several years ago that she should have a TKR. She is just 49 and has chose to put off the surgery for as long as medically possible. The Celebrex keeps her maintain her activity level and the pain tolerable, without it she cannot make it through her supervisory shift. She takes no other pain medication, so yes it has been very effective for her also.
Jim my brother uses Celebrex and he has a lot of success with it. I myself took Vioxx for 4 year for fibromyalgia and had tremendous success until it was taken off the market. I can't take Celebrex because I think it has sulfa in it and I am allergic. It has been known to have serious side affects however again some people do very well on it. I wish I could try it.
What is RZ Rhizotomy? I've had 7 back and cervical surgeries so I am well aware of what that pain is like. I take narcotics for the pain and would love another alternative. My doctor recently prescribed for me Voltaren in topical form so I wouldn't have to add another pill. It too is an anti-inflammatory. I wouldn't be able to use it instead of the narcotics but it does help when the pain is really bad. Good luck!!!!!
I was on Celebrex for a short time, but, although it was helping my severe arthritis pain, I had to be taken off of it because it was raising my blood pressure to a dangerous level (160/105). Apparently this can be a side effect of all types of NSAID's so have been told I have to be VERY careful about taking any of them.
Voltaren is diclofenac an NSAID that has been around a while. comes in patches and may help. I tried the diclofenac patches right on the spine (over the affected facets) for a short while. I then stopped to 'test' results with the Celebrex only. I am happy enought with Celebrex only I decided not to add another NSAID to the mix.
RF Rhizotomy is a procedure similar to a nerve block but they actually use RF frequency radio waves to "Burn" the medial branch of the facet nerve in order to destroy it and thus stop pain transmission. Can help from 2 months to 2 years and may have to be repeated. It is fairly invasive and of course, like everything else with back pain, has mixed results.
I was headed there when I gave the celebrex another try. My facets are pretty arthritic and I may need this one day, but with back pain you do what you can that will control pain, and "wait out the science" to see what improvements come along next year. I know if things get worse I can always Rhizotomize those nerves.
Thanks for everyone's opinion and story. Chronic Pain will really affect you - so let's do our best to keep a positive attitude!
Your input has been so valuable. You've discussed some important factors.
Keeping a positive attitude can be difficult when you suffer with chronic pain but it is so very important. As you know depression can go hand in hand with chronic pain. It can creep up on us without warning. It's important to maintain as much activity as possible, keep that positive attitude and treat ourselves well.
Hypertension was a problem for me until my CP was controlled. Untreated pain had my B/P averaging 180/110. Once the pain was recognized by a physician and was managed I no longer had to take a hypertensive agent. Now only a nasty flare will elevated it and than I must take the medication again.
Among other things I too have facet disease. I am sorry that you have to experience the pain that often accompanies it.
Thanks Tuckamore: You know what I found interesting about facet pain?.... HOW to tell I had it!!
I knew very well what spinal nerve impingement felt like. I had a Grade II Spondylolesthesis (congenital) then after surgical correction (Dr. George Frey - Swedish in Denver - fantastic Dr. and Spine team -coloradospineinstitute.com) I knew that pain had diminished dramatically. However just 2 months after surgery I bulged discs at the two levels above the fusion. Pretty common when you have multiple levels of degenerative disc disease and stabilize a level the movement stress is transferred to the other weak levels.
So spinal nerve and disc pain - I'm able to identify well.
However, when doctors mentioned facet pain I frankly did not know HOW to point to my back and say - yes there it is! My back just hurt A) sharply and specifically when these discs pushed on the spinal nerves, but B) just generally diffuse low back pain. I have for years considered this muscle spasm from the low back disease. However, MRI did show my facets were pretty arthritic from the years of instability with the Spondy. For some reason I had in my mind those small joints could not possible be causing the pain I was experiencing.
I took muscle relaxants for years trying to relieve this diffuse low pack pain that I can only describe as "chronic ache, muscle tightness, worse in evening, dramatically increases when I flex or extend the low back especially after about 5 PM".
As part of the ongoing process to determine what this was, it was not until I decided to have the facet injections done that my "brain" said - "hey...that particular pain is reduced" - that must be how facet pain feels. It was sort of a revelation. I then pursued facet relief. Part of the reason this was so dramatic is that the injectionist only injected my Left side. So it was pretty obvious when I had Left side relief, and still had the pain on the Right side! While I'm sure there is a muscle spasm component to this low back diffuse pain, it was mostly these facets.
I do think this is a common syndrome. A small pain generator causing diffuse pain. If you have never experienced that before, there is no experience to say - that's facet pain. The back is SO complex and has so many pain generators that it is hard for our bodies/minds to say "that pain is this, or that pain is that". So the Joint Injections really were diagnostic for me.
However they were not therapeutic for me. Weeks after the injections I hurt again. I did learn that there is a very specific protocol for diagnosing facet disease. Joint injections is ONE step, then a physician needs to do the Medial Branch Block as those small facet joints can generate pain in a couple of ways. Only after MBB (and perhaps two confirmatory procedures) will a good physician then suggest an RF Rhizotomy (or burning of the Medial Branch) to stop the pain.
So for people with low back pain I personally believe it is very hard if not impossible to go to a doctor and say "I have facet pain!". I believe it is a diagnosis of exclusion with tests and blocks.
What has surprised me in all this is the effectiveness of the NSAID. I had my mind all ready for the Rhizotomy. But within the same office they have recently brought on a new MD Physiatrists that focuses on multiple modalities of pain management. So before the Rhizotomy I decided let's give all this one more try. (mind you I had tried every drug, acupuncture, PT, etc. etc. you name it) So I was totally focused on invasive means of pain relief! "Burn those nerves so I can stop hurting!!"
So that is why I posted here. I was so completely surprised that an NSAID relieved this pain within days. Now ...many days I don't even take a narcotic because I just don't need it.
The doctor did recommend many things besides the Celebrex. Diclofenac Patches, Omega 3 FA supplements, very strict core strengthening etc. In the month after this visit, I've done it all and also experimented with excluding some of the items to see WHAT works. It was the Celebrex that gave me the most relief. Remember the main reason I was so skeptical was that I had tried Celebrex PRIOR to surgery and it did nothing. But that physical problem and the pain was so intense NO NSAID was going to touch it.
However for these little facets, I've found it pretty darn effective - so much so that I have canceled any more invasive work on the facets for now.
I must also mention that I used the Zone Diet to lose 25 pounds and do the core exercises as often as I can and that has contributed to the overall relief.
Perhaps one day these facets will be so bad that an NSAID won't do the trick. But for now I hope this experience helps others.
IDENTIFYING facet pain is not easy without injections or blocks, and trying multiple modalities of both PT and medicines is what it takes. All that takes time.
BTW: hopefully this is also helpful to others... I experience depression literally up and down directly correlated with the pain. Also YOU have to study and DIRECT your care as I had several doctors head the wrong way on this case. I am a firm believer in Internet Research and being in charge of your own care / direction and not being afraid to say no, or suggest other directions of both diagnostics or treatments.
This will be extremely important in the future (God help us) when health care becomes a lumbering tedious gigantic bureaucracy. WE have to learn to search, understand and direct our care!! Power to the Patients!!
I've been reading your comments and have found it all very informative...thank you.
I also suffer from DDD and osteoarthritis of the lower spine with the nerve impingement.
I too have seen a physiatrist who wanted to do the facet injections.
I agree this procedure is for diagnostic purposes...After doing alot of reading and research and weighing the pros and cons I decided not to go ahead with.
Many have spoken of an increase in pain following this procedure also it can take many injections to identify the offending facet joint before going ahead with the nerve block, which also isn't always successful.
It wasn't possible for me to make multiple trips to the city and find someone to drive me, also the costs of such trips were a huge issue in my decision to decline.
I've been doing the core exercises and 'trying' to loose some weight.
The low back pain/ache is similar to what you describe however for me the worst of the pain is neuropathic, down the hips and legs. I have been given Opiates and anti epileptic medications to help with this.
I HAD been using Celebrex for many years.
The doctors at this clinic told me to discontinue this drug because of risks and gave me Opiates in place of.
However after reading your comments I'm going to try it once again. The Opiates are only moderately controlling the back discomfort, I don't think they are anymore effective than the Celebrex was.(if I can recall correctly).
I've been struggling with this thought for awhile now and after reading your post it makes alot of sense because Opiates will not be effective for inflammatory pain and this is no doubt why I have only experienced 'moderate' relief.
I totally agree that we as patients need to read,search, understand and be the directors of our own care.
Actually Facet joint injections can help some people for many months. Most injectionists use them for diagnostics. And you are right, even to the point of burning the nerve (at multiple levels) the pain relieve is from 2 months to 2 years depending on the person and how good the burn was and how fast that nerve grows back.
I am a veterinarian and not an MD, however, my thought on your case is that - as you state - spinal nerve (those major nerves that exit your spine) pain is neuropathic. That type of pain - in my personal experience - is usually not helped a great deal with NSAIDS. When you have disc bulge or other types of pressure or impingement on spinal nerves - that level of pain really needs the opioid-narcotics (and other modalities of relief) as it can be so severe and sometimes debilitating. When my Spondy was at it's worst, no NSAID in the world would help it. And also, narcs only helped DULL the pain they don't remove it completely. And of course those drugs have many other issues (increasing need for higher dose, GI slowing, dulling mental alertness etc.).
IF you have facet arthritis and pain opiod-narcotics will certainly help, but this is where I found the NSAID Celebrex to be of value. Some days I take no narcotic, and others I do need to take one or two small doses. An MRI can look closely at the secondary boney changes of osteoarthritis of the facet joints.
AND you may very well have BOTH conditions - in fact I believe most back patients have multiple causes of pain. But remember the serious spinal nerve pain probably will only be helped a little with NSAIDs.
It is your facet component may be helped with the NSAID.
So if you try Celebrex try to differentiate over a period of a few days, how much relief and Where that relief is. That will help you decide how much of your overall pain is Facet. You may find the "Low Back Ache" and "diffuse" type pain will improve a little to a lot. However, I would guess the radiating pain down your leg will still be very bothersome.
As these things take time to "trial and error" our way through what works, this would be a good thing for you to try and keep track so your doctor knows what helped.
thanks so much for answering my post, I realize you are only another suffering of pain similar to my own and not a medical doctor...that said I have often referred to my Vet as our family doctor...ha, ha.
I have had an MRI and it did confirm both conditions.
The second being osteoarthritis of the facet joint.
I know from the past that NSAID's do nothing for the neuopathic pain.
Its my wish that the CELEBREX will DULL the ' lower back' pain enough that I maybe able to decrease the Opiates, I do believe I will need to combine the 2 (3rd being Gabapentin) medications.....like you said this is trial and error and needs to be used for a few days/weeks to note any change.
The discontinuation of the Celebrex when I began Opiates may well be the reason why the back pain is not thoroughly controlled as well as it should be!!
Interesting why my PMP would discontinue CELEBREX
while yours recommends it????
Difference of opinion I assume....this is not uncommon.
I believe a person should not be on Celebrex very long term due to the side effects. SAMe may be something you want to look into. Some studies show that patients showed similar to greater pain relief after 60 days of SAMe when compared to Celebrex. I'm starting that transition now.
Also take Omega3's (in pretty high doses) and trying to really get after the CORE work as most physicians will tell you that has a tremendous effect on all types of low back pain.
Had a consul with a specialist in "natural" remedies today. Now I'm skeptical about SAMe. I'm also more concerned about Celebrex and its current and long term effects. I'm ready to get off it. My BP has really shot up.
A patient REALLY needs to research, read, learn and question and take control of "our" treatments. Nothing in medicine is simple! Well maybe wart removal.
Yes all the pros and cons never end do they!!
Why the skepticism abt SAMe?...side effects or just doesn't work?
You know I fully understand the risks of Celebrex...but what doesn't carry a risk?
Sometimes a heart attack is preferable over the pain don't you think?....although strokes are a different matter unless fatal.
Prior to oxycontin I had been on Celebrex for years my BP went up over time so you add another med..If able to keep the dose low at 100mg OAD than for those than can tolerate don't you think this is still a good option? Let us know if you can find a safer option for inflammation ok.
Wart removal and perhaps a mole? lol
MD thinks SAMe can be more effective than Celebrex after 60 days. However he is young and that tells me this comes from reading and not experience. I did ask him to send me the study so I can read for myself. One has to know WHO paid for the study!!!
I've heard from some natural experts that SAMe has very mixed results. But it is natural and I am very willing to try it. (On my third day today). I want it to work. Also taking high dose of Omega 3's (Nordic Naturals), and Tumeric, bromelain, as part of this "cocktail" to increase the body's natural anti-inflammatory properties. Heck even Ginger is in the mix!!
I think my main point is that NSAIDs are thought by many to be pretty innocuous but they actually mess with some pretty important bio-chemistry. Some are effective and others are not. But these new "powerful" COX 2 specific NSAIDs like Celebrex can have some serious side effects and therefore I'm thinking should be used to calm a problem, then wean over to other things with less side effects.
Hi, I just wanted to add that I too became a victim of celebrex several yrs ago. First I started having congestion in my chest and didn't make a connection. I don't have asthma or any other respiratory issues. Then a few months later I caught a bad cold and the congestion I then had was something like I had never experienced. I really felt like it was from the celebrex. Anyway, I stopped it and I never that those problems again. I just recently tried the new "Elations" drink. I comes in 2 flavors and basically is liquid glucosomine and chondroitin. It tastes good, I usually mix it with a little water or carbonated water. It comes in a 6-pack for $6.95 or at Sam's an 18 pack that's a little cheaper. But the good thing is it seems to really lessen my joint pain. You're supposed to drink one bottle a day for good results. I noticed the difference in the first week.
I had facet injections almost a month ago, and they've been very successful. I'm probably going to go ahead with the RF ablation when it wears off. (that's the next procedure scheduled). I've had 3 ESI's this year, too.
Side effects I've had from Voltaren and other NSAIDs make them not a desirable choice for me, personally.
Good luck, and I'm glad something is working for you!
Would you kindly look at my Posts on Back& Neck ... Dec 14 I think?
I would really appreciate your comment as you seem to be well read in areas that are relevant to my injury with many years of chronic neuropathic ... and DDD cervical and lumbar pain with radiated inflammation.
I have recently had Celebrex 200mg andthe newer Meloxicam (Mobic) to trial and compare. Mobic "seemed" to give more relief in quelling some of the mind invading
searring burning in arms, legs, back of skull and face .... along with redness and swelling as inflammation grows ....especially once vertical and walking or typing like this.
Do you know anything about the long term risks of daily bd 7.5mg Meloxicam ... or can find out and send me ... I can only stay on here for short periods ... typing in punishing.
Lately even talking [that was my profession for 30+ yr as a therapist] is painful as my saliva dries out and mouth is like parchment .... even with sipping water... right down my gullet dries and burns ... as well as in through mucus membranes of my ear canals with burning round back of my ears and base of my skull.
Once I get vertical I have too watch any elevation of pain/burning etc ... If I dont lie down and elevate legs when it gets much worse...it will be there all day and can take days to subside.
From being VERY active as therapist, lecturer, wife and mother I now am housebound with my darling husband ( who trained in medicine then went into neurophysiology & academic life) is my full time carer. I have been searching and trying things for years.
My hair is falling out by the brushful each day lately (on thyroxin).
I really want to find a better existence.
I take EPAs, feverfew for inflammation... two different bone support formulas (for DDD & stave off knee replacement), valerian for spasms (helps), a great herbal formula for sleep (she basically altered the formula to aid my case), etc. Plus chinese herb tea from my acupuncturist [formula from Beijing hospital where he goes back to chat with colleagues each year)
Please make contact and THANKS for sharing your journey to relief. Best wishes. J
Not being a medical doctor it would be inappropriate for me to do this. However as a fellow pain patient I can discuss experiences. If you'd like to PM me a question or two I'll give you some personal patient experience.
I am grateful for you to share any personal experience, info you have or what you have read, or where to find appropriate help to get more relief ..... I respect that this you cannot give "expert advice". Anything that comes to you ... what/where/who etc
I had tried to post this on the Expert Forums ... but they are always full for the day.
Other than that which of the Experts would you send a personal paid request to if you were me? I am very grateful you have even replied. I wondered too why you are considering ceasing Celebrex?
... also what do you see as the problem with SAMe? ...what dose is used for chronic pain?
.. or is it more to lift one's mood? [which inevitably gets affected by unrelenting pain and the uncertainty of knowing how to get relief or when?
... Also How much EPA do you use/find useful [I see this as an antiinflammatory]?
Basically please share anything you can ... I will accept it as a fellow "pain traveller' .
My personal and not professional opinions are these; Celebrex is an NSAID and this category of drug can have some bad side effects taken either short term or long term. Even though it is ridiculously expensive, I would stay on it for the pain relief if I could. But NSAIDs can be dangerous.
Using it short term to reduce inflammation, to solve an acute pain issue, or even to help diagnose a pain generator (like my facets) it is fine. However to take the drug long term you run the risk of liver, kidney, GI effects, High Blood Pressure and stroke etc. Therefore I and my prescribing physician want to get my dose down (after a month trial) and then completely off the drug.
Consequently the "weaning" onto SAMe, Tumeric, and several other natural remedies supplemented with the use of a narcotic analgesic strictly on an as needed basis.
SAMe has had good effect in some. My physician quoted one study (and I've asked for a copy) where after 2 months patients report even better pain relief with SAMe than Celebrex. SAMe does not have deleterious side effects. The other natural meds have been reported to have some anti-inflammatory effects - and are pretty risk free - so I'll be taking them in combination. SAMe+Tumeric+Ginger and Norco as needed (hydrocodone).
If, after a good trial of these naturals + narcotics do not adequately control the pain (I would say for 3-4 months) I will then continue to pursue facet injections and or RF Rhizotomy (electronic neurectomy of the media branch – the nerve that carries the pain signal from the facets). This is an invasive technique that only sometimes gives pain relief. The nerve regrows and pain can return anywhere from 2 weeks to a year. Peekawho above is going to be having this done and I’ve asked her to let us know how that procedure was and what kind of pain relief she received. Will be interesting to know.
So, we all have to balance our level of pain, with medications that do the least harm. PT (basic Core strengthening) is also so important and I’m trying to find time 5 times a week to do those time consuming exercises. However THEY DO HELP!!
As for the Essential Fatty Acids, I use Nordic Naturals (nordicnaturals.com) ProOmega and that has 35% EPA to 25% DHA. (650 mg EPA and 450 mg DHA) and I take two per day. I also use Nordic Naturals Cod Liver Oil for my dogs who have inhaled allergies for its anti-inflammatory properties.
More and more documentation on the anti-inflammatory properties of Omega 3 FA’s is emerging. A paper has even been written on Omega 3’s and Spine Pain. (sorry I don’t have a link for that).
NSAIDs are good on the one hand, and dangerous on the other. Recently after an eye surgery in my horse we used NSAID eye drops for only 4 days and it removed his entire cornea!! They are not drugs without consequences! I use them very sparingly and in the case of my back pain, which will need to be controlled for the rest of my life, I will not use NSAIDs long term.
Hope that was helpful. As for use of SAMe and these other natural anti-inflammatory compounds, Google has tons of information. Research, read and learn, then try under supervision of your doctor.
Dang, your story sounds so much like mine! I have nerve impingement at L3 that is pretty much constant - it used to respond to chiropractic adjustment but only for a few days at a time. We tried the nerve block thing but like you it only lasted a short while, like a few weeks, before it came back, and after that the doctor dropped me like a hot potato. Also, other than the pain center at L3, I have things going on at the S1 joint and the right hip, so it wasn't "the answer" to my problems, though I don't understand why they didn't consider injecting me at other points.
It is criminal, how expensive that Celebrex is! This doctor I'm seeing has me on an extremely short leash - actually too little - but because I blew out my stomach on massive doses of ibuprofen about 6 years ago I can't take that any more, and what else is there? I take 15 milligrams of Mobic and I have the pain pills and that is it.
I didn't know that the Celebrex was so hard on the belly - but don't you take less of it than something like the ibuprofen? My therapeutic dose was 2,300 milligram, which I could never take; the most I could do in one day was about 1,600, and that not days in a row. Aye, what a nightmare this is!
OMG! Thank u so much! You have described exactly the kind of pain I have along with OA in my shoulders, spine, and hips. I had an MRI and the diagnosis was DDD in T11 & T12 but was not a candidate for surgery. I have been taking percocet 10/650 3 times a day but it doesn't help with all the pain I have. Like u said it is very difficult to explain the different kinds of pain. I wake up with pain from the OA & I take a pill in the A.M at noon and 1 in the evening. I clean houses for a living and that involves A LOT of moving, bending, and twisting and by the time I get home the pain is unbearable most days and the percocet doesn't even touch it! It feels almost like a kidney infection, I don't know how else to describe it but you described it to a T! So thank you! I am on day 2 of Celebrex after doing some research about othe options besides percocet I came across celebrex and decided to talk to my doctor. I am tired of being treated like a drug addict for a pill that doesn't work for all my pain. He gave me a perscription for celebrex and cut me down to 2 percocets a day and I'm hoping the celebrex works well enough that I can eventually quit the percocet all together. My doctor is not vey helpful at all and I think because I am only 38yrs old he doesn't seem to think my pain is all that bad. I have had to ask him to put me on anything I have taken so far when it should be him going down the list and trying different things untill we find one that works! I mean HE is the doctor, not me! I am hopeful that celebrex will be the one that works for most of my pain. I am so glad I found this forum as it feels good to know that I am not alone! Thanks again for sharing your experience, it is greatly appreciated!
That is quite an impressive story! Back pain and surgeries are just so painful to recover from. I'm not speaking from experience from back surgery, but I've had 2 hips and 1 knee replaced and shoulder surgery. The knee is doing well just with occasional pain. At first, of course, they give you the heavy hitters and then they weaned me off and put me on Celebrex. I still have chronic OA in the other joints in my body. My left knee is going to need to be replaced but I'm holding off as long as possible. Back to the Celebrex, it really isn't working for me at all. Can't figure it out with all the great reviews it receives. I'm in bed all day with pain some days worse than others. I will be seeing a rheumatologist to see what the next step is. Do you or does anyone else know of a med other than an NSAID that would relieve the pain?
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