Back pain and ADT

[spencoid2]

I have been on ADT for a year and my PSA seems to be under control. I had two known distant mets in mediasteinal lymph nodes as well as a couple of bone mets. The bone mets are no longer painful but I have recently started having rather severe pain in my lower back. My MRI indicates severe degenerative disc disease as well as lateral stenosis. However I have had just minimal pain for nearly a year after starting ADT. Now it is pretty severe and I need to take pain meds to be able to sleep and function during the day. I am concerned that this may be due to bone deterioration together with an otherwise messed up spine. I guess I need to have a bone scan, more radiation Any thoughts?

[Hidden]

I’ve got the sample issues. I have been told that it could be arthritis and possible fatty liver. I believe arthritis because taking anti inflammatory otc meds helps. I believe losing weight is helping as well.

[tango65]

Consult about getting a MRI of the lumbar spine and see if the degenerative process is getting worse and nerves are being affected or if there is a problem with the PC. If the degenerative problems are progressing and surgery is not required, a epidural injection of steroids may help to control the pain. Consult with orthopedics specialists.

[spencoid2 in reply to tango65]

i have an appointment with a neurosurgeon soon for now it will be ocycodone

[cesces]

Try exercise to keep your back muscles toned.

Consider the essentrics videos.

[spencoid2 in reply to cesces]

When my neurosurgeon saw my MRI he was surprised that I was walking. He did not recommend surgery unless it got worse. I have been biking virtually every day and this has kept me in decent condition. If I miss more than a couple of days of biking and do not take a long walk as a substitute I have severe pain. So some how I have strengthened my back and stomach muscles enough to compensate for the disc disease. However this is no longer working. I can try anti-inflammatroy drugs after my surgery tomorrow but I was also warned that they can interfere with urination which is just barely acceptable. At least I can now get a catheter in (after my miracle castor oil treatment) so I don't have to worry about not being able to pee far from medical help. I am also not getting UTIs since I started on prophylactic antibiotics. So I am managing OK but do not like the idea of taking opioids regularly.

[33Ford]

I've had back issues my whole life and they only get worse with age! Makes it difficult to distinguish between cancer issues and just more of the degeneration. It fact, it was the other way around that lead to my PCa dx. I was having sever back and hip pain and during all of the testing the cancer was detected. I was sure it had metastasized into the bones because of all the bone pain, but bone scan came up clean, to my surprise. Guessing the bone scan was correct as an epidural to the lower spine seems to have stopped the bone/nerve pain. I would suggest seeing a pain management specialist.

[Exrunner]

ADT will cause bone loss over a period of time and possibly bone factures. You should ask your Dr. about a DEXA scan to determine if you have thinning of your bones. Low Estradiol caused my low testosterone will cause bone loss, hot flashes and other unpleasant side effects. You should discuss this with your Dr. as there are many ways these side effects can be dealt with.Good luck.

[Don_1213]

The take-away message here - is sometimes it IS just back/hip problems. It's way easy to suspect that something involving PCa is causing the increased pain - but I think everyone has to also consider a factor we have no control over - age.

I've had back issues for over 40 years. They've gotten worse. I have left/right spondylitis (my back looks like an "S" when x-rayed from the rear). I also have the lumbar bones curving toward the front of my body. All of these combined put pressure on the sacroiliac joints causing inflammation and problems walking. Extensive X-rays and MRIs of the area have shown nothing concerning PCa and my issues are basically wear and tear caused by abuse of my back when younger and age catching up with me. I've been through 6 months of PT - where I felt better for about an hour after treatment, but then the pain was back again.

Dunno if there is a "fix" yet. I tried cortisone shots to the sacroiliac joints - they made things feel better for a few days and then the pain returned. The pain MD next pitched PRP (Platelet Rich Plasma - Google it.. ) shots which are sort of in the witch-doctor area - it's not a proven or approved treatment for anything - but it's quite popular with some sports participants for ortho issues. I'm on the fence about it. It's also not covered by any form of insurance - it's an out-of-pocket treatment.

A friend (motorcycle friend - often the best kind of friend) is a semi-retired chiropractor. He offered to help me (free!) and we had one session of stretches and directed exercises at my gym. I actually felt noticeably better after, and better for several days. So we're going to do some more. He's not talking about neck stretching or cracking or "adjusting" things - just basic very directed movement-based stretches aimed at the problem. I was always a bit dubious about chiropractors.. but in this case - I think I trust him more than the pain MD and the PRP shots.

Anyway - sometimes it is just age catching up with us..

[spencoid2 in reply to Don_1213]

I agree with all that but I am starting to have pain in other places where I never had problems. Could be just aging but I suspect that PC has some effect. I am having random aches (nothing severe just noticeable)in joints and mid bone where I never felt anything before. Together with muscle weakness it is making it a little difficult to get around and do the things I always did with ease. Discussing this I think I have it figured out. I have been able to manage the back pain with exercise, if I bike regularly I have almost no pain. My theory is that the muscles can keep things in alignment and minimize bone to bone contact. Now that my muscles are generally weaker they can not do that as well? It is very obvious that I have lost a lot of strength. Just a few minutes ago I moved the meat grinder for making dog food to the house and I had to stop three times. Used to do it without thinking. I am going to have to reorganize my shop and put all the heavy stuff on bottom shelves because I can't lift it anymore. People tell me I should get rid of all the junk but many times in the past I have found a use for something I had for 40 year and saved thousands of dollars not having to buy it new. Still I need to do some major dejunking if I can find anything truly useless. I build machines for my work and almost anything can be useful at one point. I live in California so there is always a threat of fire in the summer. I have a lot of custom machines that would be difficult to replace so I need to get them out when fire threatens. The last time we evacuated it took me a week to recover. Now everything is on wheeled carts and we bought a toy hauler trailer with a ramp which can be rolled up to the shop door. The idea is that we can winch everything in and have to do not lifting. I also use my backhoe tractor to lift anything heavy. I also have a lift stacker dolly that I am using for more and more things that never seemed heavy before.

[Don_1213 in reply to spencoid2]

Certainly, ADT is known to cause sarcopenia (muscle turns to gut fat..) and as far as I know, it doesn't just pick some muscles to do that to, so increased back pain and weakness might just come along with it. I wouldn't be overly concerned.

[Hidden]

I’m sorry to hear of this pain spencoid2…. .. For me the first year on adt stripped my muscle and then my bones now after six years my joints and teeth are challenged . I pray that you can find relief to the pain . That’s brutal... I had three rough years with a jacked up urology causing me hell . I escaped somehow to a better place . The Fact is that adt stops t and with no T the muscles go . I think everything negative in us is amplified with treatments . I ve aged 20 yrs in 6 . Take care . Scott

[Fanger1]

Hi Spencoid2,Sorry to hear of your back pain. I like the advice you have received from above members. I have degenerative disk disease and osteoporosis. My pain LBP started after my RP in 2019 and luckily after multiple scans and doctor consults it was ruled to be not from PC. I too am in CA and have had some success in getting spine microsurgery to repair disk tears in Southern CA by Dr. Tony Mork. I'm also getting care for the lateral facet pain at the pain clinic Stanford. The dexamethasone/lidocaine injections seemed to help and the end goal is to undergo radiofrequency ablation to select areas. My excercise of choice is walking and swimming. I also use gel ice packs when I drive and have my own TENS unit to "shock the monkey". Best wishes for better roads ahead🤙