Dear Dr. Roach: I’m age 68 and have osteoarthritis everywhere over my hips, neck, spine shoulder, knees hands, and they’re all becoming worse. The hip I replaced was two years old as was my right shoulder also replaced in the last four months. About four years ago an X-ray revealed the spine was swollen and I had the lumbar spine was swollen to the point of stenosis (L4-L5). I’m now at a point where I’m not able to walk straight and it’s affecting my hip that is only a few months old.
I’d like to go to an orthopedic surgeon, but I’m not sure whom I should see. A back specialist will try to convince me to undergo surgery but might not offer me with options that are nonsurgical. A chiropractor could cost me a lot of money, but they will not solve any issues. What is best cost and time-efficient option to pursue? I’m suffering terribly.
— S.S.
Dear S.S.: The negative news is that we do not have any treatments that can reverse, stop, or slow the progress of osteoarthritis.
The positive side lies in the fact that there’s procedures that are both nonsurgical and surgical that could help with relief. Before I discuss those treatments, I want to assure you that there are plenty of back surgeons, neurosurgeons and orthopedic surgeons who are slow to operate and only perform surgery after other options have not provided adequate relief or when there’s an obvious need for surgery like weakening that is due to compression of spinal cord or nerve root. This is because these are the surgeons I prefer to recommend my clients to.
I would also like to mention that lower spinal manipulation, a type of treatment that is commonly used by chiropractic practitioners Osteopathic physicians, chiropractors and physical therapists can increase pain levels and the ability to function in comparison with different treatments.
In my private practice, I usually manage lumbar spinal stenosis pain first by combining of therapy and medication. Surgery is recommended when the patient’s pain is not controlled despite treatment or in cases where they are unable to complete the tasks they require to accomplish due to discomfort, or due to the weakness. My patients have often been able to test epidural injections. They usually fail, however certain patients experience a positive response.
If you’re considering surgery for lower back pain caused by arthritis must be aware that the advantages of surgery are likely to diminish over time as arthritis gets worse. Additionally, around 20% of patients will require another operation within 8 years of the initial. There are also no certainties: A small number of patients will experience more discomfort after surgery, and a few accidents can occur. Surgery is only recommended in cases where the health is not good because of the condition.
Hello doctor. Roach: I suffer from claustrophobia and am unable to tolerate the idea of an MRI scan. My doctor has suggested the biplanar imaging of my body (EOS). I saw a photo and am concerned it might feel like it is closed in.
— D.D.
Dear D.D. : The biplanar full-body scanner is a large-sized machine that makes use of very low dose X-rays in order to produce pictures of the whole body while standing, as well as the capability of making three-dimensional and two-dimensional images. It is typically utilized to assess skeletal problems like scoliosis, or the limb length discrepancies.
Although the scanner is massive, it doesn’t fully close, and the majority of people who are claustrophobic do not suffer from this kind of scan. It lasts around 20 minutes.
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