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Dr. Mark
Dr. Mark, Neurologist (MD)
Category: Neurology
Satisfied Customers: 1985
Experience:  Neurosurgeon - Brain, spine, and peripheral nerve surgery
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I've been in pain for 15 years it's my s1 l4.and l5 scioti,

Customer Question

I've been in pain for 15 years it's my s1 l4.and l5 scioti
JA: How long have you had the pain? What seems to make the pain better or worse?
Customer: Nothing. I.had surgery on l4 n l5 in 1994
JA: Anything else in your medical history you think the doctor should know?
Customer: I had a bad fall which course the pain
Submitted: 8 months ago.
Category: Neurology
Expert:  Dr. Captain replied 8 months ago.


Welcome to the question/answer interface.

I am a Family Medicine doctor, board certified with active licenses and certification in Internal Medicine, Pediatrics, Obstetrics and Gynecology, as well as Integrative Medicine & Naturopathy, with advanced training in Neurology, Cardiovascular Medicine, Gastroenterology, Endocrinology, and Psychiatry. I am also well-trained in Functional Medicine. Perhaps most importantly, I consider myself a patient listener. So far, 98% of the justanswer community of patients has found my answers helpful. I will do my best to win over your approval as well.

For your review, here is my direct link with my current ratings from patients like you:

I have read your post and observations. Is there a specific question you have for us to tackle? We can proceed with either a back and forth dialog, or I can provide a specific answer to any specific question that you may have.

Either way, I’ll do my best to take the appropriate time to help you.

Customer: replied 8 months ago.
An answer to the problem
Expert:  Dr. Captain replied 8 months ago.

These pains you describe are not unusual for muscle strains, excessive muscle tension.

With usual back pain, I think it's wise to start off with some less intense therapies, before you consider more intense options. If you find relief with the simpler options, you'll save yourself substantial cost and effort!

Here are some concrete options for you:

1- I would recommend that you consider keeping a written journal of what you're experiencing. It doesn't have to be long or wordy, but it will be helpful (to you for purposes of keeping track of your feelings and the treatments you try and like or dislike - which in and of itself can often be therapeutic, believe it or not!, and for a healthcare provider that could review the journal later and collect useful information about your experience) Examples of useful information would be the timing of the pain, what makes it better or worse, if anything you're doing (or medications you're taking) effect the pain for better or worse, and what else is going on in your life at the same time (for instance, it's worse at the end of a work day, or after lifting groceries or spending long hours on your feet, etc) The more you get to know what is painful, the easier it is to correct it!

2- consider increasing the amount of gentle body stretching and back exercise that you include in your regular routine. Muscles that are worked too hard without appropriate stretching and exercise can cause significant pain. Especially for us humans. Our backs are stuck with the burden of carrying our body weight, and the muscles are rarely strengthened appropriately. This is the treatment that I've found to be most helpful for my patients. We don't stretch and exercise anywhere near what our bodies are built for, and if you can withstand the discomfort of stretching for 7-8 minutes, up to 3 times a day, I've found that most of my patients get better within a week.

3- consider trying out some insoles in your shoes. In-soles can sometimes help improve the support the distribution of weight on your foot, and this can improve the alignment of your legs and hip bones, and may offer some relief. There are expensive options out there, but I have found that some of the common brands (from Target, for example) are just as helpful to my patients.

4- some people choose medications to help alleviate pain. Although I tend to view pain as important signal that your body is giving you that something is wrong or needs improvement (and therefore not something that you necessarily want to stop or turn off), some medications such as Tylenol and Ibuprofen are (generally) safe medications you can try at home, provided you are following the general guidelines of use, and there are no contraindications to you taking the medications. More, most people who are taking these medications are not taking them in the best way they could be taking them.

5- Perhaps above all else, the basics of sleep and water can be the most needed, and most neglected, solutions. Almost irrespective of your daytime demands, and without regard to individual differences, we all need at LEAST 8 hours a night. This has been proven time and time again, in fact - especially - for the people who think they can do with less. if we are not getting that much, we are not only poorly arming ourselves to fight illnesses naturally, but we setting ourselves up for not only more prolonged, sometimes worse illness. Water is also a vital part of staying healthy. Someone who is having yellow urine during the day (except for the first of the day, that one can be yellowish), is most likely dehydrated, and also an easy set up for prolonged illness. Urine, after the first of the day, should be clear, like water. One should be drinking more and more water, until urine is clear. That’s a simple way to measure enough water intake.

Very few people are taking care of the basics. Do you feel like, in your case, you are taking care of those?

Customer: replied 8 months ago.
i am
Expert:  Dr. Captain replied 8 months ago.

Excellent! Once the basics are covered, the next step would be some combination of imaging, to make sure anatomic abnormalities are known evaluated, and addressed where need be. What sorts of therapies have you trialed? A variety of medications, i presume? injections? Alternative treatments? Have you had surgeries?

Customer: replied 8 months ago.
No therapy I can not stand upright the nerve is radiating my pcp diagnosis my chronic conditions as lumber radiation
Expert:  Dr. Captain replied 8 months ago.

I'm so sorry - that sounds very frustrating and undoubtedly painful. The standard of care these days with such conditions is to at least incorporate, if not centralize, physical therapy. Has that been discussed with you yet?