OA in back, pain relief & physio

Fionabee

Hi all
Since having my new knee and starting to do a bit more my longstanding back pain is back with a vengeance.
Am stiff and creaky when I get up, usually improves for an hour or two and then the longer I am upright the worse it gets and my leg is now involved too. If I sit down this usually relieves it partly.
Have had a fusion and decompression 9yrs ago, MRI'd a few yrs ago, showed advanced OA taking age into account.
Have been to physio & Pilates with no real benefit, taking gabapentin 600 am & pm with Tramulief 200 at night 100 in morning.
Have seen physio privately this week who is concerned about the amount of analgesia I am taking. He is recommening core strengthening: tummy in pelvic floor up, tightening of buttocks & thighs on back, on side & standing. This is just like the Pilates of a yr or two ago, I'm going to give it my best but there is only so much time in a day you can devote to this!
I have reduced the Tramulief a bit and boy don't I know it, even my new knee is hurting.
I just don't know where I go with this long term, is it possible to manage a chronic back with pilates and no pain killers? What sort of doseage will I need in a few yrs time and there has to be a maximum dose??
If any of this rings a bell, how do you manage the situation?
I am 53, working P/T but have applied for VR with council and waitimg to hear outcome.
Thanks
Fionabee.

dreamdaisy

The trouble with taking the stronger pain relief is that it leaves you nowhere to go when things worsen (which can happen from time to time) and the ageing process doesn't help either. The body builds a tolerance so you may find yourself needing to take more than recommended to get a similar level of relief: it's a slippery slope. It's interesting that your back has worsened since you have become more active - I take it it was easier when you were resting more? Your knee will still be painful, there is some very deep healing to be done, the older we are (although 53 is not old) the longer it takes to rebound from surgery or illness.

Your physio is right, it is better to learn to live with the pain and to reduce the dullers but that is very hard to achieve. We all have different takes on pain, one man's dull ache is another's screaming agony. I take four 30/500 cocodamol per day, that leaves me room to increase to six or eight if necessary. I guess I'm one of those who has a pretty high tolerance to pain, and for that I am grateful, but it took a few years to adjust to constant pain. I find it astonishing that my friends sit there totally unaware that they have toes, ankles, knees, sacro iliacs, hips etc - how does that happen?

OA is a beggar but at least it is honest in how it presents. It cannot be fully-eased or stemmed through exercise and pain relief but both help. The exercise keeps the muscles stronger and the pain relief makes life a little more tolerable but it is a case of finding what works for you and that will take a little time and experimentation. There are a number of options open to you - seated exercise, maybe the Alexander Technique, your 'adapted' version of Pilates, who knows? Each of us is unique and we have to find our own ways of helping ourselves. It's not easy and I hope you find a solution that works for you. DD

barbara12

Hello Fiona
I have chronic back pain on top of other things and I agree with DD taking all the meds leaves you nowhere to go if things gets worse .
Strengthening the core really helps if you walk and hold in your tummy and bum you will feel a difference so this needs working on so it becomes second nature..I wish I could get down low to do palate's it really is good for you.
good luck with it and let us know how you get on

19smp59

I take Tramadol and Amitriptyline for my back pain. I have learnt over the years that just taking the pain killers when my pain is at it's worst just doesn't work. I now take 100mg of Tramadol three times a day, regularly and at pretty much the same time every day. That still leaves me another 100mg to take if I have a really bad day. I find this works for me, as it keeps things on an 'even keel', I'm not totally pain free (but who is) but it's manageable. I also work full-time, which I find difficult, but if it wasn't for the pain killers I would have lost my job a long time ago!

knuckleduster

Hello Fiona

I agree with Barbara that exercise is good for your back and I've recently done an NHS 6 week course of easy yoga which involved sitting and standing and I shall definitely continue at home. I've had back problems for many years and when I found getting up and down from the floor was too difficult (also had a THR in 2010) I managed to buy locally from an auction site a massage table for £15 and I wouldn't be without it now as I do the majority of my exercises laying on it.

Listen to our physio and good luck with the exercises.

Janet

hileena111

Hi
Like everyone else I agree with the exercise......I do seated zumba.....sometimes standing for a little while but mostly sitting. This is with our arthritis care branch.
Next month someone is coming to show us seated yoga???? that will be in interesting.
The fact that we all have arthritis helps.....we aren't looking at the next person and thinking "Oh look how well she can do that move"
10 weeks ago I had a THR {have spinal problems as well} 4 weeks post op I had a fracture in that hip.....6 weeks sonce the fracture so haven't been at zumba since.....Saw the orthopaedic surgeon on Friday and he sways get yourself back to it......do what your body tells you to. Stop if it hurts but do it if it doesn't.
So Monday week I'll be back there
Love]Hileena

Fionabee

Oh rats, why does this happen? Composed a reply on my iPhone, went off to do something, returned, carried on, when I submitted the screen went blank, eventually thought I'd refresh pg, and yes it all disappeared into Internet ether. My son heard me cussing and said "very first world problem Mum"!
Thanks for replying.
Yes, just after the TKR I was doing less, so the back was less trouble. Pain depends on the amount of time I am upright whether standing or walking
Am working on reducing the Tramadol first, cutting tabs in half, shall leave the Gaba for now, I can see how my system has become used to it, it felt so much more effective to start with. I have taken it continuously to try and avoid the peaks and even things out, without it I don't think I could work, it is exhausting tho (Tram/gab/both?) I never wake up feeling refreshed although it hurts every time I turn, so that wakes me up anyway.
I don't find the pelvic floor bit of the exercises as easy as instructors make out, I'm supposed to do them anywhere!! I have such a look of concentration on my face when doing it, and then I panic because it is afternoon and I haven't done them since lying in bed that morning!
I wish I had some of your stoicism DD! I have not come to terms with this and I know deep down I'm still seeking a magic pill and not taking responsibility of this, I'm wanting someone else to manage it for me :0(
I may not be at work much longer, there's a lot I'd like to do more of when I've more time, swimming, aquafit & Zumba looks good, but I think thats a bit optimistic just now! I'm going to apply myself rigorously to the exercises and give it my best.
How do you manage your back Barbara12?
You have probably gathered I am a glass half empty person, many apologies for going on. Others here have said this, I have a lovely family who are kind and supportive, I feel for them being lumbered with me. Hey ho.
Have just seen Hilena's post about seated Zumba, that sounds terrific! I must look into what happens in the West Midlands (B'ham).
Fiona

barbara12

Hello Fiona
At the moment my back is managed with gabapentin I have had many injections into the facet joints but sadly nothing worked...but the gabs help, I also know when the back pain is coming on and what makes it worse..believe me you are not on your own with a glass half full..well sometimes... I do hope you can get some relief soon ..x