How to treat chronic back pain and avoid surgery?

Hi doctor,

I have spent six to seven hours daily with the computer for many years now, and have developed shoulder or back pain in the last nine years. I have pain in both the shoulders, mid-back, lower back and both the thighs sometimes. The pain has become chronic now and making my daily life difficult. I cannot lift more than three kilograms of weight in my hand otherwise shoulder pain starts. I cannot type on my mobile or write in a pen a few words otherwise shoulder pain starts. I cannot drive my bike since it causes mid or lower-back pain.

I wear shoulder support in both arms and a cervical collar while working on the computer to avoid pain. I use a lumbar-sacral belt and a Taylor brace while working on the computer or while driving to avoid lower back mid-back pain. I use a pillow between my legs while sleeping side-wise to avoid lower back pain and an orthopedic pillow to avoid neck pain. I do exercises like moving my head left and right, moving my hands around, and strengthening my back daily. The exercises give some relief but the pain does not go away due to the nature of my work.

I did an MRI last year, and the report is attached here. It shows the early degenerative change in the L4-5 IV disc, a Mild diffuse disc bulge in the L5-S1 IV disc level causing anterior thecal sac compression, and mild bilateral neural foraminal narrowing. I consulted physiotherapy and have had 20 daily sessions. The pain is relieved while physiotherapy is ongoing, but it comes back after physiotherapy stops.

I have taken the medicine Ultracet three to four times a week when the pain becomes unbearable. If the pain does not go away then I take Pre Gabes MN (Pregabalin Nortriptyline Methylcobalamin) for two to three days to relieve pain. I cannot take Pregabes MN for a long time as it makes me sleepy throughout the day after taking it at night. I also use Instaflex gel and a hot water bag to relieve pain. This process of pain management continues. These are some queries I have in this regard.

1. How serious is my spine problem and can it be cured?
2. Whether the medicines that I am taking are fine?
3. Can you suggest an alternative to Pregabes MN that would not make me sleepy?
4. Which medicine or treatment will you suggest in this case?
5. What can I do to avoid spine surgery for this problem in the future?

Looking forward to your reply. Kindly help. Thank you.

Hi doctor,

Thank you so much for the reply. I have some follow-up queries in this regard.

1. Do I need to take all six medicines simultaneously or some of the vitamins can be taken later?
2. Will any of these medicines make me feel sleepy? (This is because Pregabalin and Nortriptyline medicines earlier made me sleepy throughout the day and I had to discontinue)
3. Whether any of these calcium supplements can cause kidney stones? (I had minor stones (three to four millimeters) detected in one kidney earlier in the ultrasound)