Pain meds for lower back pain

Patient

Q: My chiropractor said the spongy part is completely gone I believe between my L5. I have chronic lower back pain. Is it reasonable to ask my regular MD for pain meds?

Doctor

A:   I recommend you to get evaluated by a orthopedic surgeon specialized in Spine problems, this evaluation should include: physical examination, X-rays and MRI to confirm the actual status of your lumbar spine: vertebrae and discs. In the case that your back pain is caused by a herniated disk or decreased intervertebral space producing a nerve compression that affect local nerve roots (neuritis), if you are symptomatic and having a lot of pain, the treatment strategy would be as follows:  try to keep a proper posture, avoiding repetitive cervical and lumbosacral stress (example weight lifting), adhering to a healthy lifestyle and proper nutrition, physical activity, losing excess of weight, smoking cessation, seeking medical advice in a timely manner when indicated. During the pain crisis a physical therapy program should be followed and aimed to reduce pain and inflammation, and you also can take anti inflammatory medication (“Aleve”, “Advil”) , if they do not work ,you might ask for other kind of analgesics that are given by prescription. If after all these you still show poor response to treatment, then the surgical option may be considered.

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