Wednesday, February 15, 2012

Friday, July 04, 2008 biddolf asks

Q: Thoracic Disc Protrusions

I suffer severe chronic pain due to several thoracic disc protrusions/extrusions with the worst one compressing my spinal cord 7mm at the T6-7 level. Fortunately I only suffer from pain and occasional nuerological issues. I am on SSD because of the pain and medications used to treat the pain. Since information is so hard to find on thoracic disc herniations and types of treatment, I would like to ask the following:

 

1. What is the probability of recovering from this situation without surgery?
My doctor is hesitant to perform surgery and those that have surgery seem to get only a few years of slight improvment before experiencing problems.

 

2. What are some of the newest pain medicaitons available to control breakthrough pain? I currently take 20 mg oxycodone 3 times per day for breakthrough pain. Duragesic (200 microgram) patches, opana (60mg), nuerontin (3600 mg) are used for baseline pain.

3. How successful are the implantable pain pumps?

Thanks in advance,

Brian

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Answers (1)
7/ 7/08 10:59pm

Anytime, someone is considering surgery or implants the question should be: Are you willing to risk your situation getting worse? The thoracic spine is a difficult, high risk area because of the vital organs nearby (lungs, heart, arteries..). So not many surgeons are willing to tackle thoracic spine disc herniations. Only the best surgeons should be consulted like those found at Mayo Clinic or Texas Back Institute and even with the best the risks are high. Pumps also have substantial complications which makes them a last resort.

 

None of the newer medications are magic bullets and some of the older medications are very useful yet overlooked (like methadone). If oxycodone pills are just not enough for activity related breakthrough pain, OxyFast (liquid oxycodone concentrate) is a useful alternative with the strength to handle the toughest pain and keep you as active as possible.

 

Most importantly chronic pain patients benefit from reducing the suffering associated with chronic pain. Suffering comes from worrying about the future. Suffering comes from comparing yourself to the past. Live in the moment, do something you enjoy everyday, and remove the suffering from your life. That is the best way to live with pain.

Dr. Christina Lasich, MD

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