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*I am not a medical doctor, nor can I render professional medical advice, though my work has dealt with individuals with low back issues*
While ESI's (Epidural Steroid Injections) and other physical therapy modalities can be helpful in many cases, for many people they do not offer significant or long term relief. An evaluation by a physiatrist (Physical Medicine and Rehabilitation) might be beneficial for a targeted physical therapy plan (with a qualified physical therapist) if you do not have one already. I think what was said above about building up leg/lower back musculature as much as possible is probably right on. Chiropractic can have good short term results but generally has not been shown to have as much success for long term neuropathic (nerve-related) pain, as much as they would tell you otherwise. I've seen some interesting studies about accupuncture for chronic pain, but these will not change the underlying pathology (nerve root impingement, if this is what it really is).
Sometimes surgery can be the most beneficial option if all conservative treatment has failed. The problem is that surgery is not a cure-all, and can sometimes offer little or no relief - it can be a gamble, but is worth considering getting an evaluation if your quality of life has significantly decreased. While I do not know what the medical system in Scotland is like, if you were in the US, I would say find the most qualified orthopedic spine or neurosurgeon that mostly performs low back surgeries, at your area's largest teaching and research hospital. Get two or more opinions before proceeding with surgery - sometimes surgery is not appropriate but there is always a surgeon willing to cut ($$). Sometimes the latest and greatest procedures in this field (some of the newer artificial disc replacements) do not have long term studies to prove their efficacy and can be less successful than procedures that have a track record. Chronic pain docs that do surgery (i.e. percutaneous disc nucleoplasty, laser this and that, etc.) are not worth your time.
Edited by ChrisMorgan on 06/20/2009 12:14:29 MDT.
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