### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
Hi I m a 68 yr old female patient of Steven Hashiguchi, MD in Lake Oswego, Oregon. I was about to write a note to him tonight as I continue to have chronic back pain following 3 back surgeries over the past approx 10 years. I have been to pain management clinics and do all I can at home with exercises, stretching, etc but have been fairly successfully treated with Oxycodone 20 mg, 2 tabs, tid (by Dr. H) for the past several years. We have a pretty good relationship regarding this, however I know he is very watchful and must be careful regarding the prescribing of opioids. The difficult part for me is that some months the prescription is enough to control the pain and other months, depending on activity - it is not enough. I honestly don t feel I have side effects after being on the meds as long as I have and infact, if the pain is controlled I am so fortunate to be able to do the things I love, i. e garden and travel and hold my grand children!! Its a bit depressing not to be able to live a full life when the pain is not controlled, especially because I am lucky to be healthy in every other way. I m always embarrassed if I have to tell my physician I ve run low on the medication and it puts him in a tough spot prescribing meds sooner than scheduled. I do not above the meds. I m careful with the timing of them and am quite aware of the risks involved. Basically, some months are just much easier than others. I d appreciate any advice you can give me and I d also be fine if you felt like contacting my physician with your ideas. At my age I m honestly not interested in starting something totally new as this has worked for me for quite some time,, Thanks, Suzanne Schrinsky

### output:

Hello, Thanks for your query on Chat Doctor"As"per your clinical history is concerned please follow like this -1)Do a clinical examination by your treating Doctor[Neurologist]and to know current exact status do an MRI scan.2)Discuss with your Doctor about [gabapentin], [Cortisone injections] and discuss with your physiotherapist for specific exercise plan with heat and ice therapy]Do follow lifestyle modifications like this -1)Do exercise. Strengthening the trunk muscles helps stabilize and support the spine.2)Try to maintain good posture. Good posture reduces the pressure on your spine and disks. Keep your back straight and aligned, particularly when sitting for long periods. Lift heavy objects properly, making your legs not your back.3)Try to maintain a healthy weight. Hope that helps