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Anthony Bray, MD
Anthony Bray, MD, Doctor
Category: Medical
Satisfied Customers: 6718
Experience:  14 years experience in the field of Family Practice
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Have been plagued with stabbing and ongoing unrelentless chronic

Resolved Question:

Have been plagued with stabbing and ongoing unrelentless chronic low back pain for over 20 years.
Submitted: 1 year ago.
Category: Medical
Expert:  Anthony Bray, MD replied 1 year ago.

Anthony Bray MD : Hello!
Anthony Bray MD : I'm sorry to hear that you have had to deal with this chronic problem....
Anthony Bray MD : Low back pain is of course a common problem and there are several possible causes...
Anthony Bray MD : I would suppose that you have had an MRI of you lower back by this time???
Anthony Bray MD : have you had this and have you been diagnosed with a specific cause to this such as a ruptured disk for example??
Anthony Bray MD : In SOME cases a surgical approach may be your best option but other cases there may not be a surgical solution to the problem.....
Anthony Bray MD : What is the diagnosis for which the Enbrel will be started??
Anthony Bray MD : Have you been in anti- inflammatory treatment for your back?? ( Celebrex would be an option with low risk to your stomach for example)
Anthony Bray MD : There are MEDS that may be helpful for chronic pain that may be used along with a narcotic.... These work by a different mechanism of action and may help to reduce the need for narcotics .... Examples would be Cymbalta, Lyrica and Neurontin. One of these options might have a useful role in which they may be of help to you but I would not expect any of these to be in itself a complete answer. I suspect from your history that it is likely a COMBINATION of therapeutic steps that will probably be the best option to help you....
Anthony Bray MD : Is there any position or action that really produces worsening if symptoms for you???
Anthony Bray MD : This may be helpful to me to better understand possible causes....
Anthony Bray MD : Have you been referred to a pain medicine specialist???
Anthony Bray MD : Have you had or been referred to physical therapy??
Customer:

Yes,Numerous times with everyother test I can imagine.Experts have also told me there is na structural damage to warrant surgery.I was told that I have Djd?ddd of LS-spine with radiculopathy and Pars defect. They also mentioned that I have Something has to which they refered to as osteophtes or otherwise 5 bone spurs.After my latest encounter with a chiropractor on the third visit he tried to do an adjustment on me which was not only unsuccesfull but felt like one of the bone spurs(I surmise) had punctured something leaving me with even more intolerable pain.

Anthony Bray MD : have you tried alternating heat and cold applications to the low back?? Both heat or cold are helpful to DISTRACT a pain signal. If we flood the nervous system with a competing signal of heat or cold then this has effect to diminish the perception of pain. Topical creams such as Aspercream and other similar products use this principle as well....
Anthony Bray MD : OK--- I see--- the added info is helpful. Ddd is degenerative disc disease or the flattening and gradual deterioration of the disk structures that cushion between the vertebrae in the back.
Anthony Bray MD : I would advise that you take the supplement of chondroitin sulfate and glucosamine( 1200/1500mg/ day respectively)
Anthony Bray MD : this supplement helps to give the body support nutritionally to help maintain cartilage in the body... This may have long term benefit but I would NOT expect you to feel immediate effect or benefit from this alone. This is more along the lines of you doing better in all likelihood as time goes forward --- if you are taking this supplement then 6 months from now you may be in a better position than if you did not take it....
Anthony Bray MD : also Vitamin C 500mg/day plays a role in the body' s maintence and repair of connective tissues... ( this includes cartilage, tendons and ligaments)....again this is just a nutritional support to benefit you over the long term....
Anthony Bray MD : the bone spurs are simply calcifications.... It is where tendons or ligaments attach to the bones that these connected structures with chronic inflammation become calcified over time....
Anthony Bray MD : these changes do inhibit the great function and flexibility that we enjoy in our youth...it is a common finding here though....
Customer:

Have used lidoderm patchis with no relief.Went through p.t. 7 times,twice as of late but when they put me in traction the pain got so profuse I had to stop for 2 weeks.I was taking the supplements you mentioned for a long period of time. Now I am extremely perplexed beause the pain became so overwhelming I had to go to an anestigiologist who says it all has to do with nerves so he put me on neurontin along with pain meds which do very little.Now I feel like I'm sitting om the fence as to stick with the anestigeologist or again follow-up with the rheumatologist.Or perhaps pursue both. I'm in quite a quandry.

Anthony Bray MD : DJD stands for degenerative joint disease. This in the back may refer to chronic arthritic changes of the facet joints in the back....
Customer:

Do you concur with staying on with both seeing as I do need Meds to try to atleast keep me comfortable to some extent.

Anthony Bray MD : OK --- I see--- the ridiculopathy is the reference to compression of spinal nerve roots that is probably the main source if the pain....
Anthony Bray MD : I think that you are best off to continue the supplements as I described as these may at least play stole to prevent worsening and support the disks in the back from getting worse over time. It is up to you and would be much a matter of taking these on faith basically as they would NOT be expected to give you immediate relief....
Anthony Bray MD : if you have nerve root compression then you may benefit to at least consult a neurosurgeon to review your MRI. Findings, symptoms and physical exam results. Potentially if a area if compression of a nerve( or pinched nerve) may be relieved then this could offer you the best result..
Anthony Bray MD : Often this may not be the case. Often cases such as yours may not be survival in nature....
Anthony Bray MD : Either or both of the specialists that you are seeing may be of potential help to you.... I can't advise you really to not see either based only on the history that you have given me....
Customer:

I don't quite get the jist of what you mean as to survival in nature.Could you please clarify?

Anthony Bray MD : So-- to your earlier question --- YES, I would advise that you continue to see both specialists. Hopefully their combined efforts will help to give you some improvement and relief!!
Anthony Bray MD : "Survival in nature??" It may have been a typo from the goofy comptur's spellcheck program... Hold on let me find that above.....
Customer:

Thankyou so very much for not only your insightfull input and advice but also your proficient patients.Again thankyou very much.

Anthony Bray MD : I think I meant to say no surgical in nature....
Anthony Bray MD : non surgical
Anthony Bray MD : You are very welcome!!
Customer:

I am most definitely going to follow-up with a neurosugeons opinion.Again many thanks.

Anthony Bray MD : let me know if you have further questions now or in the future and I will be happy to get back with you!!
Customer:

I will most definietly keep that in mind.

Anthony Bray MD : If my answer has been helpful and to your satisfaction then please remember to leave positive feedback. That would be very much appreciated! Thank you and best regards,
Anthony Bray, MD, Doctor
Category: Medical
Satisfied Customers: 6718
Experience: 14 years experience in the field of Family Practice
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