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Hello,


My 95 year old Mom has been having lower back pain for some time (decades). It seems to be causing her more issues recently. I know she hesitates to take medicine (Advil) to relieve her symptoms until it's so painful there's no other option.


My cousin, trying to be helpful, told Mom last week that she should visit an oncologist to rule out a more sinister reason for her back pain. Mom told me this information tonight, and I am both annoyed by my cousin and anxious on Mom's behalf.


Mom doesn't have any other symptoms. She hasn't lost weight. She's not coughing. She has been falling asleep in her chair more often, but that's only because she's 95 and not sleeping well at night.


I feel like it's osteoarthritis and her symptoms might improve with more regular use of meds like Advil. Heat on the joint when she's resting would also help.


Does anyone have other recommendations? Wouldn't something suspicious come up in her regular blood work if it was a more serious condition?

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Has she had X-rays done for compression fractures? As we age osteoporosis can become a very real danger. My mom (89) recently had a bone density test and the results were frightening. She also suffers from PMR and is on prednisone which is a double whammy. As of now the only thing that helps with her back pain is tramadol. We are trying to wean her down on both drugs, but it’s been a challenge. She is stubborn and insists on doing things when she feels well that has a negative impact on her back. It’s a vicious cycle.
Good luck ...... once they reach this time in their lives, one complication often leads to several others.
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If NSAIDS are used be sure to watch the stools for blood. I can't take any of them because I started passing blood in my stools. The other prescription pain killers did nothing for the pain but did cause some other brain issues.
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When my mom was suffering from back pain the neurosurgeon ordered a battery of tests, including a nuclear radiation test to look for cancer. She had several bad discs and pretty bad stenosis and it was affecting her ability to walk. (Which resulted in more falls, more spine damage.) She would just sit & cry and my mom’s a very tough lady! Tylenol nor Advil did anything for the pain, she also used a heating pad. Mom needed prescription pain meds. Even if it’s not cancer, back pain can still be excruciating.
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My neurosurgeon suggested I use Biofreeze and sleep with a pillow between knees. A recliner is the worst for a bad back. Have her sleep in bed.
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MargaretMcKen Dec 11, 2018
Sometimes a recliner can work OK, it's trial and error. In bed, it often helps to lie flat without a head pillow but with two or three pillows under the knees. That keeps the spine completely flat to the bed.
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Voltaren is also available (and effective, I can vouch for it) as a topical gel. I think they've even recently introduced applicators as part of the packaging to reduce how much gets absorbed by the caregiver!

Annoyed by your cousin... well I should think you are. Is "annoyed" putting it quite mildly? A roll of duct tape might be best for this source of anxiety.

I'm not sure if you'd have the same kind of access to them that we were lucky to enjoy, but if you know of a friendly and encouraging Physical Therapist it's never a bad idea to ask for gentle exercise suggestions.

Sorry - just had an afterthought. If possible, have a very good look at the uncomfortable area and make sure there aren't any skin integrity issues. If your mother isn't changing her position as often pressure sores could become a problem.
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MargaretMcKen Dec 11, 2018
Yup, check the skin. I gave myself a bad case of heat rash through lying on hot water bottles - not the usual issue with back pain! And yes, Voltaren and the other ibuprofens are really good, the first option, so long as you don't have the stomach problems. Advil, Voltaren and Neurofen are all ibuprofen, a NSAID ie non-steroidal-anti-inflammatory.
I think I might carry duct tape to deal with the many many people who tell me I should try their wonderful little chiropractor grr grr. It's a great idea!
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I’m the Back Pain Queen, so here is some basic stuff. You need to maintain a base level of pain control all the time, then top it up when the pain is particularly bad. Waiting to take something when the pain becomes unbearable is like scaling a mountain from sea level – it takes very strong drugs and far too long to kick in. Warmth is consoling, and may help you go to sleep, but it doesn’t reduce the pain in the long term. A cold pack is better to reduce the inflammation and the actual pain, but lying on it is not comfortable in the short term so it doesn’t help you go to sleep.

For drugs, anti-inflammatories like ibuprofen and voltaren are the first thing to try, but about 10% of people cannot tolerate them because they irritate the stomach. The stomach pain can be just as bad as the back pain and can permanently damage the stomach lining. Half of the 10% can tolerate the ibuprofen if they take a stomach drug with it, but the other half (including me) cannot tolerate it at all. Taking the drug as a suppository is just as bad, because it is absorbed and still gets to the stomach. Turmeric acts as a natural anti-inflammatory and doesn’t irritate the bowel. The turmeric powder needs to be mixed with ground black pepper and ground ginger in a 7: 2: 1 proportion. A therapeutic dose is 1 full teaspoon, and it is easiest mixed into plain yoghurt (it tastes pretty vile). Smaller amounts like in cooking are a waste of time. I make up a large jar of the powder mixture, then take a teaspoon full in yoghurt twice a day. It takes about 45 minutes to kick in. A few people find that it causes diarrhoea, but at least for me that is trivial compared with the back pain. There is a lot of research going on currently about turmeric, this is not snake oil.

Paracetamol aka tylenol rarely has any impact on back pain. The best pain killer is codeine. There are stronger opioid drugs like endone, but they are highly addictive and best avoided. I turn down offers of prescriptions for them. Codeine is the least addictive opioid, and though there is a witch hunt about it at present I would be lost without it. Where I am, codeine is always mixed with another drug, paracetamol or ibuprofen. Because I can’t tolerate ibuprofen, I have to have the paracetamol option even though it’s an extra drug that does nothing for me and I would prefer to avoid. The toxic dose of paracetamol or ibuprofen is reached with fewer tablets than the toxic dose for codeine. Virtually all hospitalisations for overdoses are because of the paracetamol or ibuprofen, not the codeine. Codeine has the advantage of sending me to sleep, or to put it the other way the disadvantage of making me groggy in the day time. I cannot understand why anyone would want to abuse it, and I have no trouble in stopping taking it as soon as a bad pain bout finishes.

I know that my back pain is caused by scoliosis (double curve, 54 degree top cob angle). Yes it is a good idea for you to try to work out the cause, as well as how to treat it.

The very best of wishes in dealing with this, Margaret
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