Lumbar Spine Osteoarthritis

They did an X-Ray, blood pressure and blood tests. They also did strength and coordination tests. She also wore a heart monitor for a weekend. Her heart and blood pressure were fine. It was a consultant in general medicine at the hospital who gave her the diagnosis. She has also suffered with fibromyalgia on and off for 10 or 15 years before this issue. My mother feels that she should see a rheumatologist and should have an MRI. The hospital and her doctor have offered neither.

I was told I was suffering from degenerative disease of the lower spine and would have to live with the pain and difficulty walking - that was by an orthopaedic specialist. However, when I finally was unable to move and ended up at the local A&E because of the excruciating low back pain, the pain clinic there identified that my entire back muscles were as hard as boards - due, they decided, to myofascial pain syndrome.. They worked on them with steroid shots, a technique called needling and manual mobilisation of the trigger points that had formed in major muscle groups. I've had 3 years almost entirely pain free - so much for the specialist orthopod!

I wouldn't be satisfied with a decision from a general medicine specialist either and I would want to see a rheumatologist - though even they are less than perfect! (I speak from experience!). If it is OA of the spine I don't know there is a lot to be done. However - are they sure it was fibromyalgia? Does she have any other symptoms - stiffness, fatigue, anything other than what you have mentioned?

But I would also seek the advice of a really good sports physio or sports massage therapist to see if there is anything similar to my problem going on with her back muscles. I'd also consider looking for a good Bowen therapist to discuss what they think and try a few sessions - it is a gentle complementary therapy which is effectively chiropractic for soft tissue, i.e. muscles, ligaments and tendons. I know it sounds daft but several of my friends have had a lot of relief for similar problems. If it is going to help your mother you will see some change in 3 sessions at most - many struggle in to the room and walk out an hour later with a lot less pain but it isn't a cure-all remedy and most good practitioners will tell you 3 sessions will show if it works for you and not to waste your money on more. Though, saying that, several people I know who use it say it is such a good relaxation therapy they keep going anyway! The best thing is you don't have to go on bended knees to your GP for a referral!

Thanks for your reply, Eileen. I don't believe the problem is pain but rather her not feeling steady on her feet. My mother initially thought the problem must be with her feet, she has fallen arches and wears insteps and she was falling over a lot. She was surprised the problem was her lower back, though I think she now accepts it makes sense - the signals are not always getting through. After initially using a stick, she has gone quite quickly to the stage where she walks with a wheeled frame. She is getting quite depressed by this early loss of mobility (she's only in her 60s), paricularly as she spent some years nursing her own mother.

... the other thing to mention is she moves slowly, generally now. Not just on her feet. Holding things or reaching for things, she moves her arms, hands, everything slowly and deliberately. Through her slower movements she gives the impression of someone thirty years older than she is.

I was asking because some of what you say is reminiscent of the arthritis I have - polymyalgia rheumatica - in its early stages. I tripped over my feet for no reason and we all tend to comment about how we move slowly - everything is stiff, never mind pain. 

My suggestions are also not directed entirely at pain - but the possibility that the muscles are simply "not right" and that can cause problems even long before you get to the pain stage. It is important she tries to keep as mobile as possible and I also think she should see not only a physio but also an occupational therapist. I fully appreciste how she feels - she's much the same age as me probably! Has she tried using walking poles rather than a walking stick? Because you are using 2 your balance is helped and it isn't as "old lady" as a rollator so  you gain confidence and don't feel so "different". It is very common to see very elderly people with them here where I live - just walking poles from any outdoor shop will do but nordic poles have velcro hand bits so you don't drop them.

Is going private an option? Just for one consultation at least. A good rheumy will then transfer you to their NHS list if they feel it is going be necessary. Though private rheumies are mostly in the NHS too - and can be hopeless even though you've paid!

There's some great advice here, Eileen. I'll certainly pass it all on to my mother.

A couple of questions, Eileen. First though, yes private is an option. She has done that before through a scheme she's in. She was already considering doing that. Which leads me to...

How can she tell if she's seeing a good rheumatologist? Are you saying that the NHS ones who also do private are not very good?

Does a rheumatologist cover Fibromialgia, Osteoarthritis and related problems or are there other types of specialist consultants she should be asking to see? Thanks

No, what I'm saying is that private doesn't ALWAYS equate to better than NHS. Where does she live? Maybe I can point you in a reliable direction (no promises though). Would she travel? A  few days away to go to a really good rheumy is probably worth it.

Yes, rheumies can do fibromyalgia and a load of other things - though with fibro you won't get much change I doubt. It's now recognised as "real" but not all are convinced. However, they are fairly reliable in sorting out what something can be done about and what can't. Orthopods tend to do bones - and any soft tissue problems go by the board.

I don't know about the NHS but in Australia private is ALAWYS better than the public hospital system just my opinion and every story I've ever heard about the public system. Good luck

Thanks for your reply, Eileen. She's going to ask her NHS doctor if she can see a rheumatologist, hopefully demand it. She saw a rheumatologist about 10 or 15 years ago privately and he diagnosed the fibromialgia. Incidentally, she thinks that was triggered by a virus when she was in China. I suspect all these things are related and she should go back for a re-diagnosis of all the new symptoms.

Thanks, Jane.

It depends on the system and it depends on the doctor - in the UK the vast majority of doctors who do private work also work in the NHS (still). If they are poor in the NHS they will also be poor as private (whatever sort of poor, rude, not fully aware of certain illnesses and so on) and the only difference will be it will cost you a lot. It is also a question of how much you let yourself in for: once you see aprivate doctor in the UK, everything has to be paid for unless they transfer you to their NHS list, all tests, all care and so on. Unless you have private medical cover it can be a matter of thousands just to get scans done. 

Where I live in mainland Europe a private doctor appointment costs about a third of what it costs in the UK - and even in the UK the charges vary dramatically. YOu do need to do some homework.

I have paid exorbitant private health fund fees since 1976, my choice. I have paid that and forgone other things so that I would have the choice. and even though I am in a private fund there are still many many extra fees to be paid.Private Dr;s also work in public hospitals but successive governments has removed incentives for them to do so as they used to. I don't really need to do homework on our health system I unfortunately am quite familiar with it. re NHS i've only heard stories and a lot of them not very good. it is one's own choice to go public or private sacrifices must of course be made for private but that is my choice

I didn't mean YOU had you do your homework, I meant in general.

I don't think it is entirely "one's own choice" - it all depends on your income. There are many people on this forum for example who are living on a state pension plus a bit of private pension. I'm reasonably well off but I have never had the sort of income that would have covered private health care. Especially for the last 22 years since my husband had cancer.

You have only heard stories about the NHS - and yes, there are bad ones. But the good ones far outweigh the bad. And one certain thing is that if you have a serious illness - as my husband did - you won't end up bankrupt at the end. In such cases the NHS is outstanding - and private health care would almost certainly send you to them as they couldn't offer the same standard of care.