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Southern Ocean County Hospital would like to thank everyone who e-mailed questions for this edition of Ask-The-Expert and would like to especially thank Dr. Michael Yu for taking part in the program.

May : Treatment for Chronic Pain

Dr. Yu's answers are informational only and should not be used as a diagnosis or for treatment. Please talk to your physician about official diagnosis of your condition and treatment.

Question 1
Any treatment for burning pain of neuropathy of both feet right now I'm on pain meds and topamax any new treatments?

Yes, there are some new meds, ie Cymbalta, and there is even more invasive treatments like Neuromodulation.

Question 2
I am a female 64 years old with Osteogenisis Imperfecta. I have had multiple fractures and operations. I have chronic pain all over, especially in my back and ribs. Lately,Tylenol extra strength does not help. I have a lot of trouble sleeping. Any suggestions? Thank you.

Because you have multiple pain generators, it is unlikely that any one discrete nerve block will help you with all of your pain. If you are willing, medical management with opiates maybe the best route.

Question 3
I have had chronic sciatica and lower back pain for 30 years. I have been told I am not a good candidate for back surgery. I have degenerative disc disease and spondylothesis (sp?). I like to swim and walk, but am limited by the pain. Could your therapy relieve this pain?

In this instance I think epidurals and facet injections maybe of some benefit. These are invasive and requires injection near the spine.

Question 4
Can Dr. Yu help pain from bulging discs? I also have a lot of leg problems.

Considering your issues, it maybe of benefit to try epidurals, but you may need surgical intervention, to remove the disc.

Question 5
Will either epidurals or nerve block help me? I have arthritis all through my body but have most pain in the buttocks down the leg to foot and mostly my knees (was told about knee replacement but want to wait. It is bone on bone) would these procedures help the knee pain as well as the spinal stenosis I was told I have?

Epidurals may help some of your pain. But it will not relieve all of your pain. If you have extensive arthrhtis, thru out your body, epidurals will only help with some of your back and leg pain. There maybe other injections that help other issues, but that is difficult to tell without having been able to fully evaluate you.

Question 6
A doctor told me the best treatment for my chronic back pain would be an epidural. Does this always help? How long would it last? What is involved in getting an epidural? thanks

Chronic Low back pain can be treated with both medicines, injections and physical therapy. For the right patinet an epidural can be very benficial. Epidurals can last for upto 1 year, but in my experience they last for about 4-6 months. Thus most patients require 2-3 injections a Year. Epidural is a needle near the spine and is exactly the same procedure that pregnant women have for anesthesia during Labour.

I want to thank everyone for their questions, and I hope that my answers will help you.

Sincerely

Myu, MD