I am a 47-year old male with mild scoliosis that has led to bulging discs around t4-t6. There is a noticable lack of space at one of the foramens causing often severe pain at that point, as well as on the left side of my back and ribs.

I cannot take nsaids because I have a cerebral vascular malformation, and am extremely sensitive to meds: I take codeine in liquid form, and - believe it or not - it only takes 3 or 4 mg to quash the pain. The problem is that even at that amount, I feel hungover the next day (if I take it in the evening). The vascular malformation, in my brainstem, may contribute to the back pain, according to my neurologist, since it is causing extra activity that might be setting off something in my spinal cord. It also may be the cause of my extreme sensitivity to meds, but that's pretty hard to prove.

I was taking neurontin (an anti-epileptic) for a few months, and it eliminated most of the pain, but made me too dopey, so I stopped taking that. (i may try another similar med soon.) but i'm pretty much at a loss, since there don't seem to be a lot of pain meds that allow me to take doses small enough that they don't knock me out.

Can anyone suggest any options that might be available in such a situation? My gp is willing to try anything, but his experience is more with the usual pain meds. I am going to see a new rheumatologist soon to discuss this (the one I was seeing is no longer available, and i'm in a rural area).

The gp said that cortisone injections are out, because it's too risky; I don't want to have to start thinking about surgery, though it seems that a foramenectomy might be what I need.

Thanks for any advice.

Kirk