Age Related Degeneration · Chronic Pain · Pinched Nerves

Chronic Pain & Age-related Degeneration

My body has been aging too fast, degenerating and on the decline. Scientists have claimed that difference in aging rates are 80% due to environmental factors and only 20% due to genes.

I’ve had to have a laparoscopic myomectomy to remove uterine fibroids, followed by a hysterectomy to remove my uterus and cervix when new fibroids developed. I’ve had to have my gall bladder removed. I’ve had to have carpal tunnel release surgeries on both hands. Treating one medical condition after another as they developed has felt like a game of whack-a-mole.

Right after I recovered from severe meningitis, I suffered from chronic pain in the form of headaches. The neurologist treated my excruciatingly painful headaches with one anti-depressant after another. Each anti-depressant had unpleasant side effects. It took years, but I finally managed to wean myself off the last anti-depressant prescribed.

In the recent years, what started as a crick in my neck and tensed shoulder muscles has magnified into chronic pain that interferes with regular activities like house work and office work. X-rays and MRIs showed deterioration in parts of the fifth and sixth levels of my cervical spine (in my neck). The orthopaedic specialist explained that degeneration of the spinal column is caused by wear and tear, a natural aging process and largely unavoidable. The spine is made up of bones called vertebrae. A disc between each vertebrae allows movement, provides stability, and acts as a shock absorber. The opening in the centre of each vertebrae forms the spinal canal. The spinal cord is located within the protective spinal canal

My C5 and C6 spinal discs (in my neck) had dehydrated and become thinner, and bone spurs had also developed in my spinal column. These degenerative conditions caused nerve compression diagnosed as “C5 to C6 spondylosis”.

I feel the most pain in the trapezius, the large band of muscle that fans out from the base of the skull, down the neck, to the spine and shoulder blades. The trapezius helps the neck support the head, which weighs about 10 pounds. Leaning forward while working at a desk puts a particular strain on the trapezius, as well as on the sternomastoid muscles that run down the nape and along the sides of the neck. Add to that C5/C6 degeneration and bone spurs pinching on spinal nerves, and I have had to rely on painkillers and anti-inflammatory drugs.

After undergoing physical therapy for a year that temporarily relieved some of the pain caused by pressure on my spinal nerves, I consulted a spine specialist to find a treatment that could stop the recurring chronic pain. He told me that I needed to have a disc replacement surgery to replace my degenerated disc with a titanium disc. He said that the more conservative treatment options could only provide temporary pain reduction. The highly invasive open spine surgery is not a risk I wish to take. I asked him for the progressive treatment steps available in-between pain meds & physical therapy, and spine surgery. He referred me to a pain management specialist.

The pain management specialist recommended having cervical epidural steroid injections performed using fluoroscopy (live X-ray) for guidance to properly target and place the needle (and to help avoid nerve injury or other injury). In the operating theatre, I was instructed to lie face down. Intravenous sedation was administered and a local anaesthetic was given to the area around the base of my neck. Using fluoroscopy for guidance, a needle was inserted into my skin and directed toward the epidural space. The epidural space is the outermost region of the spinal canal through which spinal nerves travel. When the correct needle position was confirmed by x-ray imaging of injected contrast solution, a combination of local anaesthetic and steroid was injected into the anterior epidural space and the exiting spinal nerve sheath.

I expected to be pain free for at least 6 months to year, but after the sedation and local anaesthesia wore out, I felt no significant reduction in pain.
Complete pain relief from cervical epidural injections in patients who suffered with the symptoms for over a year is about 50%. In addition, the FDA warned on April 23, 2014 that injecting corticosteroids into the epidural space of the spine may result in rare, but serious adverse events. This has led to controversy and discussions regarding the effectiveness of cervical epidural injections [1,2].

  1. U.S. Food and Drug Administration. Drug Safety Communications. FDA Drug Safety Communication: FDA requires label changes to warn of rare but serious neurologic problems after epidural corticosteroid injections for pain.
  2. Manchikanti L, Candido KD, Singh V, Gharibo CG, Boswell MV, et al. (2014) Epidural steroid warning controversy still dogging FDA. Pain Physician 17: E451-474. 

 

 

 

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