Have you had any recent trauma?
Any prior musculoskeletal problems?
Not to my knowlege. I work in "catering" and lift heavy items.
In a primary care setting the work up of new-onset of back pain in the "average patient" should start with antiinflammatories, physical therapy and an x-ray. If these have been sufficiently tried then a further workup is warranted.
Did all of the above. Pain seems to be getting worse. Especially when I sit down.
I had an MRI on Thursday but it won't be read until Monday.
The next step in a workup would include an MRI of your lumbar spine. This would show if 1) there are any bony defect such as a misalignment (anterolisthesis, retrolisthesis or pars defect, 2) if there are any problems with the intervertebral discs such a s a bulge, protrusion, or sequestration into the spinal canal or one of the neural foramamina (where the spinal nerve roots exit) any variety of the intervertebral disc problems can cause impingement or displacement of the many nervous system components throughought the spine.
The results of that MRI are going to guide treatment further. If it simply is a low-grade (1-4 out of 4) listhesis (antero or retro otherwise described as vertebrae that have slid forward or backward on another) then the recommendation would be to continue physical therapy and symptomatic management.
low grade would be like a 1 possibly 2 out of 4
We are moving so I've been packing up boxes all day. I have to work tomorrow - big job. How much motrin can I take?
any sort of instability or severe disc protrusion would warrant consideration of a surgical option. Considering this is a relatively new (yes 2 months does feel like quite a while though) problem most orthopedic surgeons would want to wait and see how you do before turning the page and considering a relatively invasive back surgery.
The recommended dose of motrin over the counter is 200mg. You would have to see a physician 1-on-1 to be prescribed or directed to any other pain medication at a different dose.
Really don't want surgery. I will try anything before that. I'll say my prayers and hope that it can be fixed with P.T.
It is not advisable to take more than the recommended dose on any medication. Motrin specifically is excreted by your kidneys and overdoing it can hurt your kidneys
Physical therapy is not a quick fix, but rather takes a bit of time
Especially when there is inflammation in an area it takes time for that inflammation to go down before the true healing can occur
Your MRI will show in great detail what your next step should be.
Alignment of your vertebrae, any slipped/malpositioned disks and/or nerve/spinal cord impingement or abutting (having a disk touch or deform a portion of a nerve)
There are orthopedic surgeons who subspecialize in spine just like some focus on knees or ankles
It seems to help when I contract my stomach muscles. Or,maybe it is just taking my mind off of it.
Are you going to see one who personally focuses on spine or is generalized
There are back braces you can use to help stabilize your core
I don't know of anyone in the Seattle area.
A call to a university hospital is usually the best bet for finding such an orthopedic surgeon who focuses on a specific region of the body
It is quite common in the area where I live for orthopedic surgeons in a larger practice (multiple surgeons) to each have a focus. So literally a large practice has a foot guy, a knee guy, a hip guy etc.
Actually, I had a brain tumor removed 10 years ago (benign). I could see if that neurosurgeon is still in practice.
would you recommend ice or heat at this point?
That may be good for continuity of care, however I would wait until the orthopedic surgeon sees you because if this will be a medically managed issue for the time being you could do well under an orthopedic surgeon's care and if it escalates into a spinal surgery you could opt to go to the neurosurgeon if they do that type of surgery.
It is good you got an MRI given your neurologic history.
MRI is the ideal imaging modality for the central nervous system
Either one literally. Decide based upon which makes you feel the best.
Aleve is usally a better antiinflammatory as it doesn't need to be dosed as frequently
thus you won't have peaks and valleys to your pain control
Aleve does nothing for me. Actually, when I took high doses of Motrin, it worked the best. I also drink over 64oz. of water a day.
I can not recommend high doses of Motrin as I haven't physically examined you or taken a physical
I can only tell you the recommended dose and risks of taking excess
I hope you understand that
Thank you for your advise. I realize that. My GP actually said I could take the higher dose for a short period of time.
I can not speak to whether or not you should follow or change your GP's prescribing advice.
But if a physician did prescribe you something you have every right to follow their recommendation as they fully examined you and know of your other medical problems and history
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Thank you. Yes, it was helpful to know that I should really see a back specialist.