OT Degenerative disc disease

[Matthew]

My wife suffers from degenerative disc disease. She has had her C5,6,and 7 fused. It has caused her to give up most exercise and her beloved beach volleyball. She currently is on a muscle relaxer called Zanaflex. The problem we are having is this med makes her goofy. To the point where I sometimes fear for her safety. She also unfortunately is very depressed and takes meds for that too. She has at times even hallucinated and this seems to be more frequent as of late. She is unable to work and has lots of idle time. She is also on ambien to help her sleep. I am looking for help in finding another medication that may help her pain but not make her so "out of it." This is really putting a strain on our marriage because she refuses to stop the zanaflex or ambien because she claims it is the only relief she gets. But this stuff or the combination of things is putting herself and others (her driving) at risk for injury. I am at my wits end. Please offer any suggestions in dealing with this disease. She has tried vicodin and oxycodon and they were not good and terribly addictive. Thanks, Matt.

[bargainguy]

Sorry to hear about this, Matt. Sounds like a tough situation.

I used to work in the medical field and agree on the goofiness of muscle relaxants. My wife was given Valium once after an injury and it made her goofy too. She recognized this immediately and stopped it.

While other muscle relaxants might produce various degrees of goofiness, they all still have the same underlying action, so goofiness is pretty much unavoidable with them.

I'd highly recommend going off ambien if she can manage it - and substitute something like Benadryl 50 mg. at bedtime. You can get it super cheap from the wholesale clubs - I think costco has a 600 count bottle of 25 mg. generic for around $4.

I'd also maximize whatever alternative therapies work best for her. If she has DDD, chances are her soft tissue is all wound up in knots. Myofascial release would be of immense benefit here as long as it isn't contraindicated by her primary physician.

[Matthew]

Thanks for the reply. This is a nightmare that is not getting better. All she wants to do is sleep. I honestly think her depression is worse than the back pain. It is slowly killing her and our relationship. She has tried flexorall and hated it. She also takes wellbutrin and occasionally atavan for panic attacks. She is actually seeing a substance abuse counselor but this is not really working either as it is just once a week at most. I am beginning to think my only option is calling 911 when she is really out of it as she refuses to check herself into rehab. I don't know what to do anymore.

[Matthew]

She has tried physical therapy and was seeing a pain management doctor that was getting some results but he kicked her out of his practice because she cancelled too many appointments with less than 24hrs. notice. She has looked into accupuncture but has not tried it. Not sure if that would help.

[JWDR]

I only have a bulging disc and a permanently broken piece of bone in my back, so it's not as bad as your wife's condition. I have had decent results with Robaxin and lidocaine patches. I did not care for flexeril due to making me feel out of it. I also go to pain management yoga and acupuncture since the chiropractor won't touch my back due to the broken piece in there and the fear of doing greater damage.

[R2D2]

Have you talked to the prescribing physician?

[rnhood]

I also think pain management should be considered - via a real orthopedic doctor and perhaps with a DO degree. I have some degen in my back and nothing really helps the acute back pain with regards to the meds I've taken (Oxy, Aleve, etc). They can take the edge off but not much else. I do think the exercises prescribed and administered in physical therapy helps to a degree. I still do them at home now. But my back is not anywhere as serious as your wife's so what works for one may not work so well for another.

I don't think there is anything wrong with ambient as its a pretty weak sleeping aid with a relatively fast half life. But since I'm not a doctor, that's a call for your doctor to make.

[buddybikes]

Discuss Lyrica with her doctor. It is for pain and works for anxiety also. A larger dose at night helps sleep. Minimal side effects except maybe minor dizziness that can go away, and may need colace or metimucil to keep GI track moving.

Also, consider going to a pain management doctor. Perhaps a guided steroid shot in that part of the spine would help.

[Ralph]

I have been diagnosed with degenerative spine disease by my Orthopedic Doctor. Have/had constant pain in the neck and coccyx area. 2 disks fused themselves, and another one almost. Makes it difficult for me to look over my shoulder. My issues are probably age related....I'm 72.

Doc sent me to a pain clinic for a shot to my neck....they put me under for that....buying some time. Then he sent me to a physical therapist who specializes in back issues. She taught me how to stand and sit. And worked on posture. After therapy was over, the therapist gave me the exercises to do at my local Planet Fitness gym. Weight lifting designed to strengthen my back, plus work on core strength. Been doing this for couple years now.

It seems to work. I'm a lot stronger in all the core muscle groups than I was a few years ago. I'm mosly pain free, on no medication for this at all. Still have pain if I slump in a chair or car seat. Have to make sure I sit on sit bones and not lower back (most people sit on their lower back). Proper posture very important for me. None of this keeps me off my bike almost every day. Good luck to your wife.

[Louis]

Discuss Lyrica with her doctor.

A good buddy of mine at work is on this (maybe for the rest of his life) and so far it's been great.

[Matthew]

Thanks for all of the responses. No matter the topic it seems the good folks here always have valuable suggestions. I appreciate it greatly. I will definately look into Lyrica as that sounds promising and there is a good physical therapy place in our area she has used in the past. Biggest hurdle is getting her to commit to it long term. I talked to her prescribing doctor today and he is very concerned too and has told me he will do a full review of her medication she is currently taking. Again, thanks for the help and support! Matthew.

[2LeftCleats]

Cymbalta or Neurontin (gabapentin) may also offer something. Try to avoid the narcs as much as possible. They create other issues including the tendency to be labeled. Yoga, PT, etc can be helpful for some.

[67-59]

I've had back issues in the past, and a good physical therapist made FAR more long-term difference than any meds. Naproxen and limited use of Flexeril helped in the acute phase, but once I got into the exercises recommended by the therapist, I didn't need them anymore. The Flexeril made me loopy and lethargic, so I got off it as soon as I could manage he pain without it.

As for sleep, I'd echo the comment that Ambien is really a pretty mild sleep aid...and is probably causing far less of your wife's problems than the muscle relaxants.

I'd talk to the doc about a good PT for the back issues, and maybe focusing more of your wife's medication therapy on depression - perhaps even seeking the help of a psychiatrist or psychologist. I have had issues with depression for a couple of years now, and a good therapist probably saved my life...or at least turned it in a much better direction.

Hope it works out...

[jensenn]

Cymbalta or Neurontin (gabapentin) may also offer something. Try to avoid the narcs as much as possible. They create other issues including the tendency to be labeled. Yoga, PT, etc can be helpful for some.


this is good advice.

but as for you calling 911, you may have to think twice about doing that. all depends if they will admit her to a hospital unit or straight to rehab. in your wife's case since she seems to be dependent on her meds, once in the hospital she can have the option of IV medications which are way more addictive. although it is a very good pain killer, try to avoid dilaudid (hydromorphone) at all cost. i work in the medical field and i have seen people change cause of this stuff to the point where they are counting the seconds till the next time they can get the medication.

[malcolm]

I also think pain management should be considered - via a real orthopedic doctor and perhaps with a DO degree. I have some degen in my back and nothing really helps the acute back pain with regards to the meds I've taken (Oxy, Aleve, etc). They can take the edge off but not much else. I do think the exercises prescribed and administered in physical therapy helps to a degree. I still do them at home now. But my back is not anywhere as serious as your wife's so what works for one may not work so well for another.

I don't think there is anything wrong with ambient as its a pretty weak sleeping aid with a relatively fast half life. But since I'm not a doctor, that's a call for your doctor to make.

There is very little difference now days between a DO and an MD except regular med school is probably a bit harder to get in (from and MD, so I'm biased), but I have DO friends and they are as good as anyone else. I think the joint manipulation, chiropractic aspect has been considerably reduced in DO school over the years. My understanding, maybe a DO will chime in.

Degenerative disc disease is a very broad diagnostic category and has almost become a waste basket diagnosis. Doesn't mean it can't cause real pain, but has been so broadly used as a term I'm not sure anyone really knows what it means any more.

There is an epidemic of people with prescription drug problems in our country. Many were produced by physicians inappropriately using short acting narcotics and the patients misusing them as well.

If your wife is having chronic pain problems as in she will need long term management she should see a pain mgt specialist. These are not orthopedists but usually anesthesiologists maybe in conjunction with an orthopedist or neurosurgeon. In my experience orthopedists, no offense to orthopedists are not good managers of chronic pain.

Now not to offend pain mgt guys or gals but but they come in a couple broad groups. 1) the ones that want to sell you pain meds and 2) the ones that want to effectively manage your pain with as little narcotic especially short acting as possible. You obviously want #2 and this is where your orthopedist or primary care doc can help.

This is a very difficult problem and can have long term repercussions that you can't even imagine. Your wife should find docs she likes and trusts that are well known and trusted in the community and most of all be patient as it may take some tinkering to find what works.

This is all my opinion and worth exactly what you paid. I do wish you and your wife luck and relief from pain.

[TomP]

I also have degenerative disc disease. Radio frequency ablation has given me my life back. If it is an option for her, the procedure entails burning the pain sensing nerve with high frequency radio waves.