Post spine surgery pain, scoliosis and depression

Dear Ask The Doctor: Hello! My mom had a lumbar disc herniation surgery a few years ago. The herniation was pressing upon a spinal nerv. The good part is that she didn't get paralyzed but she still has major back pain.She also has scoliosis and her brain doesn't get enough oxigen, and sometimes she faints. And she also suffers from depression. She tried acupuncture, physiotherapy,and she takes medicine for the depression and sleeping pills. What should we do about the spine problems? She is 44 years old. I'm sure if she doesn't have any more back pain she would recover from the depression. Please help us find a way to get rid of her pain. Thank you! Sincerely, a very concerned daughter.

Dear Timea: Very difficult indeed your mother’s situation in the view of the multiple health issues present at the same time. The scoliosis and the damage produced for the previous nerve compression are causing the Chronic low back pain (CLBP) , which is considered  the most expensive condition in industrialized countries and the most common cause of activity limitation in persons younger than 45 years. It is defined as pain that persists longer than 12 weeks and is often attributed to degenerative or traumatic conditions of the spine. Your mother case may be managed as chronic low back pain (CLBP), she tried already Physical Therapy and acupuncture, you do not said if she is taking anti-inflammatory medication (“Aleve”, “Motrin”). Some antidepressants are useful in chronic LBP to alleviate insomnia, and pain. In addition, these medications may improve the patient's ability to cope, and they may reduce depression, anxiety, or fatigue associated with chronic LBP. Local anesthetics, corticosteroids, or other substances may be directly injected into painful soft tissues, facet joints, nerve roots, or epidural spaces. I suggest an evaluation by a specialist in pain management to explore other treatment possibilities for your mother.