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Ask Dr. D. Love Your Own Question
Dr. D. Love
Dr. D. Love, Doctor
Category: Neurology
Satisfied Customers: 18656
Experience:  Family Physician for 10 years; Hospital Medical Director for 10 years.
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What can I do about pain that is so bad that I can barely

Customer Question

What can I do about pain that is so bad that I can barely walk ? Neck, lower back, pelvis, and knees.
Submitted: 2 years ago.
Category: Neurology
Expert:  Dr. D. Love replied 2 years ago.
Hello from JustAnswer.
It will help if you could provide some further information.
What evaluation has been done to identify the cause of the pain?
Could you list each of the medicines that have been tried?
Expert:  Dr. D. Love replied 2 years ago.
I had asked for additional information about what has already been tried and have not heard back, so I may suggest certain medicines that have already been tried.
The prednisone is a very potent anti-inflammatory medicine, but chronic use s associated with a very long list of common potential side effects, so we typically try very hard to limit the duration of use of prednisone. Instead we would rather try non-steroidal anti-inflammatory medicines. There are many of these on the market, but it would be necessary to know what has been tried to know whether there are any options that have not yet been tried. We typically do not feel the need to try literally every anti-inflammatory drug on the market, but it is reasonable to at least try one drug from each chemical class, but it still would be necessary to know the medicines that have been tried to know whether each chemical class has been tried.
Additional treatment would be oriented towards the underlying cause. The most common conditions to cause chronic musculoskeletal pain are related to wear and tear, also called degenerative disease. In these medicines, it is common to use medicines that suppress the firing of the nerves carrying the pain message, including certain anticonvulsants, such as gabapentin or pregabalin, and certain antidepressants, such as amitriptyline or duloxetine.
There also are certain inflammatory conditions, such as rheumatoid arthritis or psoriatic arthritis, that may respond to certain drugs that work by suppressing or modulating the immune system. There are several of these medicines, including methotrexate, azathioprine, infliximab, and rituximab. These medicines would usually be prescribed by a Rheumatologist.
There are, of course, many other conditions that can cause chronic pain, so if the evaluation indicates a different disease process, different treatment options may be available.
If I can provide any further information, please let me know.
Customer: replied 2 years ago.
MRI shows 2 kinds of arthritis but I didn't have arthritis when I was a teenager and my back hurt so bad I couldn't stand up. I think my knee pain comes from my back. I have taken Lorecet, , many arthritis drugs, and anti inflammatory drugs. Prednisone is the only thing that has ever helped at all.
Expert:  Dr. D. Love replied 2 years ago.
What were the two kinds of arthritis that were shown on the MRI?