arthritis of the back

Spinal arthritis typically occurs when cartilage breakdown causes inflammation and irritation of the surrounding nerves. Depending on which type of arthritis you have your physician may recommend different treatments. Ankylosing spondylitis, often referred to as spinal arthritis, is a rheumatic condition that causes inflammation in the spine and elsewhere.

Neurontin is used to treat neuropathic pain - pain caused by irritation or inflammation of the nerves. Physicians can also recommend anti-inflammatory drugs such as Tylenol and other NSAIDS to treat inflammation if it is present. A 2005 study suggested that taking NSAID'S regularly rather than just when you're in pain may work better if you have ankylosing spondylitis. They may also suggest Remicade or Embrel; two more powerful anti-inflammatory drugs.

Because pain often causes reduced flexibility which impairs blood flows and inhibits repair agents from reaching the injured site some physicians often recommend doing non weight bearing stretching in pools. The buoyancy of the water relieves the friction on the  joints - allowing arthritis patients a degree of flexibility not found out of the water; pool therapy is sometimes referred to as ‘floating traction'.  Pain and stiffness can also be relieved by heat and massage. 

Cort

Neurontin is a common treatment for people with neuropathic pain, which tends to respond poorly to traditional pain medications. Arthritis can cause nociceptive pain (the more common form of pain) through joint inflammation, but it can also cause neuropathic pain when degenerative changes in the spine compress or irritate nerve roots exiting the spine.

You should inform your doctor if neurontin hasn't provided any pain relief. He or she may recommend you try it a little longer (depending on how long it has been) because sometimes the full effect isn't achieved for weeks. Your doctor may also want to add another agent because neuropathic pain often responds better to a combination of pain medications rather than just one drug.

Medications used to treat neuropathic pain include neurontin and the following:

Antidepressants  

Tricyclic antidepressants (TCAs- nortriptyline, desipramine, Amitriptyline), SSNRI antidepressants (selective serotonin-norepinephrine reuptake inhibitors- duloxetine and venlafaxine)

Anticonvulsants (neurontin, lamotrigine)

Topical anesthetics (lidocaine patches)

Antiarrhythmics (mexiletine)

Opioid analgesics (tramadol, morphine, fentanyl)

*Tramadol actually combines the effects of TCAs with opioid analgesia and tends to be well received by patients.

I have arthritis, or degenerative disc disease, of my lower back also.  Degenerative disc disease is considered a type of arthritis, and I believe that is probably what you have.  I've had 3 back sugeries, two for a herniated disc at level L4-L5 (the disc between the lumbar disc #4 and #5), and after the nerve pain came back, in my legs, back and arms, my doctors came up with other diagnoses.  A few doctors told me my pain is nerve damage from chronic exposure (over 16 years) to chemical solvents on my job (I was an industrial lab tech).  Basically, I am in chronic pain with sharp pains shooting down my legs and arms, with burning, and "pins and needles" type pain also.  My third surgery was an implantation of a spinal neurostimulator to help ease the pain in my back and legs.  This was in 2002; it worked well for about 6 months, now it is worthless.  In my opinion, don't let any doctor talk you into having this device implanted in your spine.  Like you, I am on Neurontin (gabapentin), 900 mg. three times a day.  You have to get the 600 mg. tablets and take 1 and a half (they break apart very easily).  This does help ease my pain, decreasing the "shooting" and "stabbing" type pain.  I had been taking Lyrica (something new like Neurontin), but I had a very bad reaction from it due to taking an antidepressant with it (Pamelor).  I now take Cymbalta, an antidepressant.  This drug is also prescribed for neuropathic pain.  This medicine also helps.  With mild opioid pain medications also, taken strictly according to my doctor's directions, I am able to function very well.  It takes many months, sometimes years, to come up with a plan with a good pain management doctor that is effective.  Yours pain profile may not be as complicated as mine (I hope it is not), so maybe just one or two of the meds I take may help you considerably (or maybe different meds may be more helpful).  It is important to note that I had XRays, CAT scans, MRIs, myelograms, and nerve conduction studies to diagnose and properly treat my chronic pain.  I suggest you find a good Pain Management Doctor, have all the necessary tests, and receive the proper, effective medications.  Physical therapy is very, very helpful. But do not see a chiropractor.  In my opinion, the most serious problem they can handle is maybe a pulled muscle.  Remember, chiropractors call themselves "doctors", but they did not go to medical school!  I saw one, and he really messed up my back so bad, I had to have the second surgery I mentioned before.  All the diagnostic tests you will receive will help zero in on the cause of your pain, and then, with hope, successful treatment will result.