Severe back pain, diabetic. Done MRI, disc herniation. Have had radio frequency ablations. Given tramadol, zanaflax. Further?
Patient: Severe back pain since 2007 which is worsening every day. Today I am a 8/10 on pain scale with meds. 43 year old female, type 1 Diabetic. My most recent MRi was done 3/15/13 on a 3.0 Tesla Ultra High Filed Skyra Wide Bone MRI. I have had many epdurals in these areas as well as many Radiofrequency AblationsNo narcotic pain medication helps. I have been given dilaudid, morphine, oxycontin, oxycodone, Opana IR, Tramadol, Nortriptyline, Pamelor, Cymbalta, Elevil, Zanaflaz, Flexoril, Amrix, Ibruprphen 800, Lidoderm patches, Flector patches, Trigger point injections, and finally Fentanyl patches which I change every 48 hrs on 100mcg. They work but for constant pain they don't and no medications work for breathrough pain.Considering North American Spine Institute Accurascope all the way in dallas.Disc desiccation at L2-L3, L3-L4 and L4-L5At L-23 level there is a disc space narowing and circumferential disc bulging without central canal or neural foraminal compromise.At the L-3-L4 level there is a circumferential disc bulging with a left forminal disc herniation resulting in narrowing of the left neural formenAt the L4-L5 level there is circumferential disc bulging with a small superimposed central and left sided disc herniation. There is a mass effect upon the descending left L5 nerve rootImpression: Developing disc bulging at L2-L3Stabble L3-L4 left formaminal and L4-5 central and left sided disc herniation Doctor: Your spine surgeon should think now for performing disc removal/laminectomy etc or spinal fusion to very bad areas to relieve your pains and all radiations . this is the only solution as all modalities have been tried on you alreadyjust trust the treating doctor who might  be already planning to give you surgeryas ultimate remedy