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My elderly mom has spinal stenosis and is in constant pain lower back. They seem to have tried it all except ibuprofen. Doctors and online sites suggest ibuprofen is bad for kidneys in elderly. Her brother who is 97 was also told his by his doctor but slips one in now and then (he asks at this point, what is he saving his kidneys for?) He also accepts pain is in a way comes with territory now.



I wanted to know what people here whose opinion I trust have to say about this? Tired of daily rants about how much she hurts. I feel sorry for her, but at some point not much I can do?

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As an old retired RN with old nurse's back Ibuprofen was ALWAYS my go to, my drug of choice. And given that or opioids it is a GOOD choice.

However, nothing is benign. I read the side effects and I was well aware the chances of a bleed from it, or the other common symptoms. What I DIDN'T know was the connection between the gut mucosa and NSAIDS and that's what took me down. A nasty bout, 10 years ago, of diverticulitis.

What happens is that it blocks an enzyme called cyclo-oxygenase or COX enzyme. This enzyme is needed to keep the mucosa that lines the gut healthy and thriving. Ibuprofen inhibits it. BOOM. Down for the count.

I will say this, I still occ. take it for bad headache. But truth is that once weaned from all pain meds and everything else I don't feel much different. Yeah, at 81 things hurt. I am honestly at this point quite used to it. I live with it.

Our spines compress. My 83 year old partner just got back from PT exercise training to help his.
There's nothing we can take without side effects. Just read up on them best you can and do blood tests and watch for symptoms. Best you can do at some point. Follow the directions. And really ask yourself how much it is helping. They can sometimes cause more pain by "rebound".

Good luck.
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What is the "all" they have tried? Has anyone suggested kyphoplasty? Lidocaine injections?
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Karsten Jun 17, 2024
They did the lidocaine. Have not heard of the kyphoplasty.

Now they did this but not working

Medial Branch Blocks (MBB): MBB is a diagnostic procedure used to determine if the facet joints are the source of a patient's pain. It involves injecting a local anesthetic near the medial branch nerves, which supply the facet joints. If the patient experiences significant pain relief after the injection, it can confirm that the facet joints are the pain source.

Radiofrequency Ablation (RFA): After confirming that facet joints are the pain source using MBB, RFA can be used as a therapeutic procedure. During RFA, a specialized needle delivers radiofrequency energy to the medial branch nerves. This energy "ablates" or "burns" the nerve, disrupting its ability to send pain signals.
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When my mom hurt her back bad this winter mom wouldnt take any prescription pain meds. The doctor told her to take ibuprofen (Motrin) and 3 hours later Tylenol, but that was to get her through the pain and getting her diagnosed.

My feeling is id probably rather see mom on motrin if it helped than scripts because of side effects, of a possible fall, dizziness, constipation.

Also you could try CBD , Im Leary of telling people that too because of risk of falls. So if my mother ever said she wanted to try CBD ( which I'm sure she won't) I would want to be there the first few times, to see her reaction.

Honestly I think ibuprofen risk out weighs the pain at some point in a persons life
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Karsten Jun 17, 2024
yea, considered CBS. My cousins did it for my aforementioned uncle and it helped pain but they were worried he might fall

And like I said, he does not used ibuprofen regularly as he does Tylenol, but takes it now and then if in even more intense pain or he has to go somewhere, and figures why is he worried about saving kidneys at age 97

Part of the problem in a sense is people just live too long now
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It is always my fallback when I find that an NSAID prescription had GI side effects.. have you asked for a pain specialist? She needs balance between quality vs quantity of life
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Karsten Jun 17, 2024
yea, we have been to pain specialist and he has tried everything. Those cortisone shots, now some special injections that would need insurance OK, but the test one didnt work anyway. She does have OCD so is paranoid about taking extra strength Tylenol, even up to recommended limit

Asked pain doctor about Relief Factor, that thing you see on TV and I thought he would dis it but said he has had patients for whom it worked and those who did not
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Bad idea, its very hard on the stomach, you have to eat something whenever you take it to protect the lining of the stomach. Use extra strength or arthritis strength Tylenol but not 24/7. Relieves the pain without the chance of bleeding internally.
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Anxietynacy Jun 17, 2024
Good to know
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If mom is so OCD and won't even take Tylenol up to the recommended limit, why would she take ibuprofen or ANYTHING for that matter? Some folks just want to complain to be heard. Like my late mother, for instance.

I have spinal stenosis myself, and such a bad spine the orthopedic surgeon was shocked I could walk. I use ibuprofen, Tylenol and 1 Tramadol a day. The heating pad helps most, and moving around to stay a bit more lubricated I guess. I had kyphoplasty last May for part of my thoracic spine that was fractured. The pain now is worse than it was before the surgery.

I'd let mom use whatever meds she wants to use, who really cares about kidneys at this stage of the game? 90% of all elders have kidney disease of SOME kind, after being alive too long and using too many drugs in general. My mother lived to 95 with stage 3 kidney disease. It did not kill her. CHF and advanced dementia did.

Pain is something many of us live with on a daily basis because there is no fix. My mother took tramadol regularly and had no issues with it at all. Whether it cured her pain or not I don't know. It does help me, that I know. If I was very old and in pain, I'd bring in the big guns and laxatives too because why not?

Good luck to you.
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Karsten Jun 17, 2024
good to hear insights from someone who has spinal stenosis. Thanks
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Ibuprufen was always my go-to, as I find tylenol really doesn't help me for much of anything. I didn't take it daily, just sporadic, and never had any side effects, But, once I developed mild high blood pressure and starting taking medication for that the Dr. said no to ibuprufen because it can exacerbate high BP. How's your mom's BP? Does she have any GI problems? My layperson's viewpoint is that it can't hurt to try ibuprufen. If it doesn't work, discontinue and no harm done. If it does work and mom would have to take it daily, then have a Dr. consult on the pros and cons and ideal dosing to balance pain relief and possible side effects.

FWIW, I've used OTC topical pain relief for my back (SI joint) problems and it's worked pretty well--voltaren gel once in a while and also a stick on "icy hot" electrical stimulation patch.

Once of my grandmothers had extremely severe arthritis in her hips, knees, back, and hands for many years and took several doses of aspirin daily for quite a few years--lived to be almost 98 and was one of those lucky people who had no side effects so far as I know. this was before the days of the newer nsaids.
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At some point, with chronic pain, you have to make the most judicious choice for yourself.

I have chronic back pain, Shots were worthless and finally 2 surgeries made the daily pain bearable. I was on Norco for years and was able to wean down to Tylenol #3, which my PCP prescribes for me, but I can't take anything stronger. It keeps me mobile (a must) and as much out of pain as I can be. I do take Ibuprofen, I KNOW it's hard on my kidneys, but, wanting and needing some quality of life--I have made the choice to 'piggyback' ibuprofen with Tylenol #3.

Without it, I am worthless to anyone. The pain is so debilitating and I live my life around it. At 68, I am not as concerned as I would be if I were in this place at, say, 40. I've been through several back surgeries, cancer & chemo and I know I will not have a long life.

Choosing to be as active as I can be, exercising, trying heat or cold packs, not overdoing the lifting--I do what I can to be out of pain.

I'm hearing good things about CBD gummies and may try them. But at this point? I'm managing the pain and learning to live with it.

I DO have frequent blood tests and my kidneys are 'mildly angry' but I was given the go-ahead to continue with ibuprofen and Tylenol #3.
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ElizabethAR37 Jun 17, 2024
Agree. I piggyback the same meds, also as an attempt to "manage" back pain. They do NOT eliminate the pain but do make it bearable so that I can function (more or less). I also know that ibuprofen is hard on my GI tract and kidneys, but for me it does reduce pain much more than plain Tylenol (which is basically useless). I try not to take it on a daily basis. So far, my kidneys are O.K., but at 87 I'll take what pain relief I can get. It's absolutely about functionality and quality of life over quantity.
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Ibuprofen hurts the kidneys, acetaminophen hurts the liver, opiates are addictive and may increase the risk of falls - at some point we are all going to die and the reality is that people with advanced dementia and nonagenarians are close enough to the end that a focus on a healthy lifestyle is moot. Give her as much pain medication as maximum daily guidelines allow, my mother used tylenol alternating with ibuprofen when that wasn't enough, we also used topical pain relief creams.
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AlvaDeer Jun 17, 2024
Hmmmmmmmmmmmmmmm. You are saying I should just have taken advantage of that diverticulitis so I didn't have to face down another bout of cancer as I am.
It's a thought, cwillie. At some point it gets kind of ridiculous and I was just saying to another OP this a.m. who worried about getting elder who didn't want care into care for her CHF. Used to be we stayed home and the CHF got us. And I mean, is it so much better this one or more decade in care and losing our minds quite literally?
Teasing you here. But you make a great point.
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Ibuprofen is brilliant for most people, but causes real gut problems for a 10% minority. My doctor said half of those can manage with gut medication as well, the remaining 5% can’t tolerate ibuprofen at all. It’s easy to pick – the stomach pain is quite severe. I’m one of the unlucky 5%, which is very unfortunate because it would be the drug of choice for my back pain.

I’m pretty sure that years ago I read that problems are more likely as you age, but also that no stomach pain means no problems. Ask a good doctor, I can’t remember the details. My last experience was when a locum said I could tolerate it as a suppository. My doctor was keeping his anger under control, when I found after 3 days I was back to severe pain – it enters the blood stream, no matter how you get it inside you.

Because of this, I have unlimited access to Codeine, which is the oldest (100 year +), least addictive and least ‘high’ producing of all the opioids. I don’t take it regularly, just when I am in pain (which admittedly is often). I would refuse any of the newer nastier opioids. Don’t reject codeine just because it has the ‘opioid’ label.
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I think ibuprofen alleviates pain better than Tylenol.

My mother’s doctor said that she couldn’t have ibuprofen.

It is hard to see someone suffering, knowing that we are powerless in resolving their issues.

I am sorry, Karsten. I know that it’s frustrating for you to be going through this situation.
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I have cervical spondylosis, stenosis, etc. I also have a horrid IBS and most oral pain meds are horrible.
-In the olden days, before it was taken off the market, Vioxx was a lifesaver for me. The only Cox 2 inhibitor left on the market today is Celecoxib - a class of NSAIDs called COX-2 inhibitors. It works by stopping the body's production of a substance that causes pain and inflammation. It doesn't help me but perhaps it could help her.
-Has she tried lidocaine patches? They can help to a certain degree.
-With 100% CBD, there should not be a "high" but it also may not work.
-When things get really bad for me, I can tolerate Voltaren for a couple of days
-how about a electrical stimulation, from a PT or an at home TENS unit? They are less than $100 on Amazon. Has that been tried? If not, talk to her pain meds specialist about it.

My to your mom and all the other posters suffering from chronic pain. For so many of us, it's a way of life. I have figured out ways to tolerate it but man when I have something temporary but that causes acute pain--ight now it's a dental abscess--I go from cranky to kill mode!!!-:)
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