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Doctor Hive: DH in severe pain: Degenerative Disc Disease


Garga
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My husband has degenerative disc disease in his neck. In the past, he'll get growing pain and then get some PT or muscle relaxers and it would subside. He could always still work and do what needed to be done. The pain never completely went away as far as I could tell, but it didn't stop him from living life.

 

For the past 2 days he's been in very severe pain. I had to get him from work and drive him home because he can barely move his neck. My adhd (heavy on the H) husband has had to sit still for 2 days. If he doesn't I've heard him whimper and moan if he moves the wrong way. My dh is not a wimp. He is not the sort of man to get a "man cold." (When a man gets a little cold and acts like a big baby.) My husband pushes him self too far. He's the guy who has a fever, yet is out mowing the lawn. Hearing him whimper and moan is making me pretty scared.

 

He's being treated with pain killers and muscle relaxers and the like. They aren't doing anything apparently. Or, if they are, it doesn't feel like it to dh. He has an orthopaedic guy that knows about his case so it's not like we need to go to the doctor or ER. We've already gone to the doctor and gotten the meds and a traction device for over the door. (Holds a person's neck up to relieve the pain--so far it isn't touching this pain.)

 

My question is this: when will this severe pain subside? I don't know who to ask about what to expect. The doctors say, "Yes, it can be painful." Websites just mention, "There can be episodes of severe pain." But for how long?

 

If anyone of you had a severe flair up of pain, how long did it last? Were you terrified it would never go away? Was there anything that helped? Did your pain meds not have any effect? (That's really demoralizing DH. He's taking these powerful meds and still hurting just as much.) And...I don't even know what else to ask. I'm scared for him and I guess I want some reassurance that others have lived through this and come through ok.

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I get DDD flares.  

 

For me the are caused by two things:

An unexpected jarring motion ( like when I tripped over a power cord and took a very hard couple of steps as I tried to keep my self from falling)

Dietary inflammation.

 

 

I have L4/L5 issues and DDD.  When I want to be good and take a pill every day to prevent pain, I take Zyflamend which is supplement with natural anti inflammatory properties.  

If I eat nightshades, my pain is Phenomenally worse but it is often over the next 2 days that I feel the pain, not the same day as eating the offending food. 

 

 

Ice always works much, much better than heat, but heat feels better in the moment. Heat, almost seems to make me worse in the long run.

Posture and not clenching my neck is vitally important to my pain levels.  I also have to change positions often.  I am on my lap top on the couch right now, after 20 min, I will switch to another piece of furniture.  I try to move the position of my computer so that I move between looking left, right and center. I do best if I am laying flat or walking when I hurt the most.  Sitting is one of the worst for me. 

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You'll need someone to go with him to an ER, and it should be to a private hospital (they tend to have better guidelines that patients have a right to have pain properly treated than public hospitals, who are often more concerned about drug seeking behavior).

 

They'll need to rule out further and/or more dangerous injury, and when they do so they'll likely give him a shot of some very strong painkillers (and if they are strong enough they might make him sign a paper that he won't drive for a certain amount of time).  They may also be able to draw some fluid off of swollen joints and/or give him a steroid shot into the joints to relieve inflammation.

 

Whenever you suddenly have a significant increase in pain, or have a different pain than you had previously, you should be reevaluated by a doctor.

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Hmmm. He was at the ortho guy's office this week and was sent home with a boatload of meds. I mean, I'll listen to you guys about going to an ER to get relief, but it's not like he hasn't already seen someone when this started. I am 100% positive my dh will not go to the ER tonight. He'll take the valium and sleep until morning.

 

I guess we'll see in the morning about the ER. Thanks guys, for responding.

 

And Tap, we're just now (I mean just today for the first time ever) starting to look into dietary causes. Really, my dh is one of those guys who will run himself into the ground without a peep and I wasn't aware of how bad this was getting. I'm going to start making changes to our diet as soon as I can, but it'll take a few weeks before I'll be able to change everything over to a proper anti-inflammatory diet and implement it.

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I just talked to him and said, "Dh, if this hasn't changed by morning, I'm taking you to the ER." He said, "I agree." This is a huge step for him. I can't imagine the pain he's in. He gets migraines and just keeps trucking. He doesn't ever let pain stop him. :( For him to agree without a peep means he's miserable. I'm going back to ask him if he wants me to take him now...

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I would look at pretty much any alternative or allopathic treatment except non-acute use of narcotics. Chronic/recurring pain isn't helped much by narcotics and leads down the road to addiction. I would look for a pain clinic that uses multiple specialties and approaches.

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He's had cortisone shots in his arm (for a different condition) but not yet in the neck. I don't think he's done a TENS unit. Really, this all seems new to me. He downplays everything so much that I haven't really been up on what's going on. In the past when he's gone to the PT he's gone on his lunchbreak and never mentions it to me.

 

Once we can control this out of control pain, I'll be researching and doing everything I can think of to prevent this in the future.

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He's had cortisone shots in his arm (for a different condition) but not yet in the neck. I don't think he's done a TENS unit. Really, this all seems new to me. He downplays everything so much that I haven't really been up on what's going on. In the past when he's gone to the PT he's gone on his lunchbreak and never mentions it to me.

 

Once we can control this out of control pain, I'll be researching and doing everything I can think of to prevent this in the future.

 

They might try something for nerve pain like neurontin. 

 

I have a TENS unit and have had cortisone shots in my back. He can't have that done by himself someone else will have to drive and he may need help out, I could not walk afterwards but that was because I could not lift up my knees afterwards. It was weird!

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I use a pemf device for the times when my lower back pain -- or any pain -- bothers me. For neck pain, something like the Sota device would probably work. It's not an instantaneous fix and would probably take several weeks of consistent use. The NIH is starting to study them a bit more, but they've been used elsewhere in the world for decades.

 

http://drpawluk.com/marketplace/sota-magnetic-pulser-mp5/

 

Personally, I would also consider prolozone therapy.

 

The other thing that might help is to cut out/back on sugar and simple flours. Eat the right amount of protein. Lots of good veggies. More prebiotics and probiotics. Some believe arthritis is caused by problems in gut flora.

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Thank you all for the replies! The answer to questions like, "Has your husband tried..." will all be "no." He hasn't done a single thing to help this other than stretch his neck every now and then. I'm torn between compassion for his pain and exasperation that he hasn't taken this seriously and now he's in all this pain.

 

Please, keep giving suggestions though, as I'm going to have to spend a bunch of time figuring out how to help him take care of himself from now on. I know absolutely nothing about DDD. I'm at the starting line on this one.

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 I think the most important thing at this point, when someone has hit rock bottom in how they feel is that they can actually sleep.

 

If I cannot sleep at all my whole frame of mind is wrecked. I was a complete mess but once they gave something to help me sleep I actually was able to start working on solutions rather than just lay on the floor in the fetal position. It didn't make my pain go away but it did help me be more interested in working towards solutions.

 

 

Physical therapy can be helpful as can some yoga. Chiropractic care can help some people. 

 

 

There are a lot of things he can try, I hope something helps.

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Dh had sciatic nerve pain this summer and he was miserable. I can't help with solutions for acute pain, but long term he thought what helped him most were the stretching exercises in this book:

 

http://www.amazon.com/Treat-Your-Own-Back-802-9/dp/0987650408/ref=sr_1_2?ie=UTF8&qid=1415944796&sr=8-2&keywords=back+pain+book

 

At first he could only do the first exercise and it was very painful for him, but gradually he was able to do more and more. His whole episode was maybe 6 weeks duration--a setback early on but mostly each day a little better than the one before. I realize your husband's pain is in a different location, but when I went to find the book at Amazon I noticed it does say for neck pain too. I hope your dh finds relief soon.

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Has the doctor suggested surgery? My family member has had vertebrae fused twice. It works. It's actually easier and safer in the neck than in the back. In addition to the pain and tingling symptoms, the doc said there was a risk of a major injury if she fell or was in even a minor car crash. The surgeries were 20 years apart.

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I would look at pretty much any alternative or allopathic treatment except non-acute use of narcotics. Chronic/recurring pain isn't helped much by narcotics and leads down the road to addiction. I would look for a pain clinic that uses multiple specialties and approaches.

 

With all due respect, and I do mean a great deal of respect, DO NOT take this option until you are certain the pain is chronic, not acute.

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Has the doctor suggested surgery? My family member has had vertebrae fused twice. It works. It's actually easier and safer in the neck than in the back. In addition to the pain and tingling symptoms, the doc said there was a risk of a major injury if she fell or was in even a minor car crash. The surgeries were 20 years apart.

Yes, but for the future. Right now they've been at the "let's see if we can control the pain with other methods" stage. This is the first time DH has been in such pain that he can't move.

 

I just really want to know if the pain will go away long enough for us to try the other options. He slept through the night on the couch, where he's been for 2 days. This is the beginning of day 3 of the debilitating pain. He cannot move. He's seconds away from calling the ortho guy right now.

 

But again, thanks to everyone for replying. Once we get past this episode, we'll be able to start other options.

 

After he calls the ortho guy, we'll see what happens next. Go to the ER, go to the ortho, etc.

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My DH is also that guy so I understand. He has DDD in his neck as well as failed back surgery for a ruptured disc. He frequently has had bouts of pain like you are describing. Finding the right pain med for him was a terrible process. Several years ago when the neck pain started he did have some PT and it helped tremendously. He does. Do a fair amount of sitting at his desk working on the computer so learning the correct height of his monitor, getting a pair of glasses just for the computer, etc . all of it helped some. . Ultimately he was crashing every weekend with a migraine and sleeping on the couch. He/we are seeing a chiropractor weekly. DH started out three times a week. He is a young chiropractor with a relatively new kind of adjustment . He does use a clicker but itis the next generation of tools and he can work on very specific areas. It has been nothing short of a miracle for my DH. Yes, he did have some chiropractic care in the past but no one has helped him as much as this guy does. It is not the Manipulation, bone crunching kind of care.

Have you tried ice packs?

 

You have my sympathies, I do understand .

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Has the doctor suggested surgery? My family member has had vertebrae fused twice. It works. It's actually easier and safer in the neck than in the back. In addition to the pain and tingling symptoms, the doc said there was a risk of a major injury if she fell or was in even a minor car crash. The surgeries were 20 years apart.

 

FWIW -- Surgery doesn't always work, and fusion surgery has it's own risks.  I won't tell the whole story here, but I have a family member who almost died from complications of fusion surgery and is permanently disabled.  We went to nationally-ranked doctors at a nationally-ranked medical center, and were the 1/10,000 exception to the rule.  Another friend had two fusions and did well but has no relief at all.

 

Pain is horrible, but you need to be diligent about running down every possible option before going for surgery.  If a doctor suggests surgery without having you try chiropractic, physical therapy, traction, a pain clinic, etc. etc., you need to run the other way.

 

Sorry to be so sober about this, but the consequences can be life-changing!

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I would do spinal fusion as a LAST RESORT. 

 

If y'all can find something that works for awhile then I would not get surgery. My Dr did recommend surgery to me but he did say that there was only 50% chance that it would work.

 

There is a LOT of amazing research being done in this field at the moment. If you are close to a hospital doing this research then try and get in a clinical trial where they are using stem cells or wait until it is more widely available. I am holding off on surgery until they have something better to offer.

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FWIW -- Surgery doesn't always work, and fusion surgery has it's own risks.  I won't tell the whole story here, but I have a family member who almost died from complications of fusion surgery and is permanently disabled.  We went to nationally-ranked doctors at a nationally-ranked medical center, and were the 1/10,000 exception to the rule.  Another friend had two fusions and did well but has no relief at all.

 

Pain is horrible, but you need to be diligent about running down every possible option before going for surgery.  If a doctor suggests surgery without having you try chiropractic, physical therapy, traction, a pain clinic, etc. etc., you need to run the other way.

 

Sorry to be so sober about this, but the consequences can be life-changing!

 

 

I agree.

 

I don't know anyone with bad experiences with the surgery but if they are recommending surgery and haven't mentioned *any* of the dozens of things one can try before surgery then I would be wary. 

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I had successful spinal fusion surgery-- but it was after more than 5 years of pain pills, physical therapy, exercises and dealing with chronic pain EVERY DAY.

 

In my case when the pain increased (right before my surgery) it was due to a bone spur poking into my spinal cord!  I would be in a wheelchair or worse if I had not gone through with the surgery...  The bone spur did NOT show up on the MRI.

 

DDD does not heal.  The disks are degenerating--most likely due to past injury-- and eventually it will be bone on bone.  Strengthening the muscles can help delay the wear and tear-- other than that they (Drs) just give you pain meds and say "I'm sorry" and awful lot.

 

 

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He definitely needs to get new images of his neck taken.  A disk may have ruptured, there could be bone spurs, etc.  Dh had spinal fusion done a few years ago of three vertebrae in his neck.  It did relieve some of the numbness in his hands, but did not relieve the pain.  However, he, like Jann above, had a bone spur poking into his spinal cord which is a very dangerous situation to be in.  So, although the pain is still there, the risk of paralysis or worse is not.  Dh also has fibromyalgia and other problems that we can't seem to nail down, so we are unsure if all of his pain is from degenerating disks.  

Some things that do help him are taking Celebrex regularly and taking muscle relaxers regularly during a flare up.  (he will take them at night, every night, during the bad weeks).  

He actually has a neuro appointment on the 2nd because he is getting worse, so we don't have answers either.  :(  

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Been in the ER or at the orthopaedic guy's office all day today. They gave him lots of pain killers and it did nothing for the pain. So....he has a bunch of meds to continue to take at home.

 

His ortho guy is going to call the pain clinic on Monday to see how fast they can get him in for a cortisone shot. At this point, all the other suggestions you guys have made are awesome, but they'll be for the future. Right now, we're still waiting for this level of pain to be controlled. He says it's the same level as the kidney stones he had years ago which we all know is equivalent to labor pain. Basically, he's been in labor pain for 3 full days now with no end in sight until the cort shot on Monday or Tuesday or whenever they can take him.

 

I'm hoping that the continued round the clock doses of all these meds starts to kick in.

 

And after that, it's hours and hours of research to figure out all the options we have to control this in the future. Everyone agrees that surgery is the very last resort. We are no where near that option yet.

 

Thank you all for your answers and suggestions. I am certainly writing them all down to research them all further. And even though the ER didn't really help with the pain, at least he's been looked at by the ER guys and his ortho and we know it's just a matter of waiting for the pain to subside so we can start the next step.(PT, tens, etc.)

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