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Ask Dr. Gott 8/23
Back pain eludes diagnosis
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    DEAR DR. GOTT: My sister has been suffering with back pain for a very long time, and her doctors haven't been able to find out what the problem is. She's had all kinds of testing, and they've put her on many different pain medications that haven't done her any good. Now they are giving her morphine. Would a vibrating, reclining chair be the answer? Should I be concerned?
    DEAR READER: It might help if I knew how old your sister is and what other medical conditions, if any, she might have. Without that information, I have to start from square one. And yes, you should be concerned.
    If your sister suffered any trauma, such as an automobile accident or major fall, she could have discogenic disease. A slipped or compressed disc can be extremely painful. Confirmation is made with an MRI. There are numerous methods, including balloon kyphoplasty, for pain relief.
    Osteoporosis is a condition characterized by pain, loss of height and nontraumatic compression fractures of the spine. Ordinary lifting and routine activity can cause lower-back pain when a fracture occurs in the front portion of a weakened bone. Diagnosis is best made through dual-energy X-ray absorptiometry (DEXA).
    Fibromyalgia is characterized by widespread muscle pain of the tendons and ligaments. Diagnosis ordinarily includes a history of at least three months of widespread muscle pain that is accompanied by tenderness in at least 11 of 18 possible points on the body.
    Osteoarthritis is a degenerative joint condition that causes spinal disc deterioration. Without the normal cushioning the discs provide, areas between the vertebrae press against each other, causing stiffness and pain.
    Strain is simple injury to a muscle. A sprain is injury to a ligament. Lifting, poor posture, obesity or sleeping at an awkward angle will cause muscles and ligaments to act up, resulting in pain.
    Unexplained underlying problems can include kidney disease, cancer, infection or diabetes.
    If your sister is on morphine and a reclining chair that vibrates provides some pain relief, by all means, she should make the investment. A recliner will allow her to shift her weight to ease pressure on her back. Quality of life comes into play here. Have her do what feels best in terms of relieving pain, providing, of course, her doctor is in agreement.
     I recommend you have your sister return to her physician so he or she can put a name to her pain. If all the appropriate testing has been done, her doctor should have a pretty good idea of the source of the problem. Your sister should then request a referral to an appropriate specialist. Morphine is pretty heavy stuff. She should know why she's taking such a strong pain reliever.
    To give you related information, I am sending you a copy of my Health Report "Managing Chronic Pain." Other readers who would like a copy should send a self-addressed, stamped, No. 10 envelope and $2 to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.

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