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Karen asked...

I have been diagnosed with degenerative disc disease

I have been diagnosed with degenerative disc disease affecting 4-5 discs in the lumbar region, I also have a slightly twisted spine. My consultant has me trialling Buprenorphine pain patches 20 micrograms per hour, but aren't really helping.I have also had a lumbar epidural. Can i try anything else?

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The answer

I really sympathise with your predicament. Degenerative disease of the spine – one of the most common parts of the body affected by osteoarthritis – can have a huge impact on your life. The spine is made up of many small bones called vertebrae. These are linked by squashy intervertebral discs which act as ‘shock absorbers’. The spinal cord, which carries nerves connecting the brain with the rest of the body, runs through the spinal cord. Sometimes the soft material in the middle of an intervertebral disc can bulge out through the tough outer covering, and can press on the nerves, causing severe pain and other symptoms. Sometimes pain comes from wear and tear on one or more of the many joints that make up the spine. With so many possible causes for pain, it’s not surprising that there are many treatments. The patches you are using contain similar medication to morphine, but some patients find they cause fewer side-effects, like sickness, which you have had with other strong painkillers. There are several options you could discuss with your doctor. It may be possible to change the dose of the patches you are using to provide better pain relief or to change to another ‘opioid’ painkiller with a medication to combat the sickness and other side-effects like constipation. Acupuncture, TENS machines or hydrotherapy (a form of physiotherapy done in water) may help. Speak to your GP about referral to one of the many specialist pain management clinics which have a whole team of healthcare professionals who use a range of different treatments, including group work with other patients, to look at strategies for managing your pain.

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