Dear Doctor: What can a pain management expert do about my lumbar spondylosis, or low back pain?

Greetings, Dr. Roach I am a 75-year-old man who has experienced soreness in my outside thigh muscles and buttocks. My health care physician recommended that I see an orthopedic specialist who specializes in back problems and ordered a lower back MRI.

Due to disc compression affecting the nerves, the doctor determined that I had lumbar spondylosis. Physical treatment was initially recommended by the doctor, but it was ineffective. Despite my reluctance to have surgery, the doctor did not recommend it.

He then directed me to a pain management specialist, and I now know that the course of therapy will probably involve an epidural injection in the area close to the spine in the lower back. I’m worried about the procedure’s efficacy and hazards, as well as whether there are any alternatives, like acupuncture or medical marijuana. — C.B.

ANSWER: Degenerative arthritis of the spine is known as spondylosis. This may cause the spinal cord itself or the nerves that emerge from it to be compressed by hard structures like bone, bone spurs, and ligaments. Although discomfort is typically the initial symptom, this might result in any combination of weakness, numbness, and agony. The cornerstone of conservative management is physical therapy.

Surgery should be the last remedy because the issue is anatomical, but it has drawbacks and isn’t always more beneficial than physical therapy. There are some exceptions, such as when someone has growing weakening, in which case an immediate surgical procedure is necessary.

In my view, a pain management specialist is the best consultant when surgery is not recommended. They can think about injections, medicine (such as painkillers and anti-inflammatory drugs), and other therapies.

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Acupuncture has inconsistent facts, yet it is certain that some people experience alleviation. It’s unclear if it’s superior to sham acupuncture, which involves not inserting or placing needles in the same places as traditional acupuncture for low back pain.

Although there is little information on cannabis’s long-term use or how it stacks up against other treatments, it has been demonstrated to reduce pain in the short term when compared to no treatment.

Other options, such as facet joint injections, other injections, radiofrequency and electrothermal treatments, Botox, and spinal cord stimulators, might also be discussed by a pain management specialist. Among their instruments are epidural injections.

More advice

Greetings, Dr. Roach Recently, my girlfriend visited the neighborhood drugstore where she usually receives her immunizations. She asked for the senior high-dose flu shot. According to the documentation, she received the Fluad vaccination. According to my investigation, this was not the high-dose flu vaccine that is currently on the market. Does she still need to receive the greater dose of the flu shot? — L.I.

ANSWER: Two varieties of flu shots designed especially for elderly people over 65 are available. As you may have anticipated, high-dose flu vaccines such as Flublok and Fluzone High-Dose contain more of the purified flu antigens than a standard-dose vaccine.

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An adjuvant is a chemical added to the Fluad vaccine to increase its effectiveness in older people, whose immune systems are frequently not as strong as they once were. For elders, any of these is deemed excellent. Your partner doesn’t require any additional vaccinations.

A standard flu shot is still a viable choice if these senior-specific vaccinations are not available. Getting one immediately is more crucial than waiting.

Although he regrets not being able to respond to each letter individually, Dr. Roach will try to include them in the column. Questions can be sent by mail to 628 Virginia Dr., Orlando, FL 32803 or by email to [email protected].

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