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

### input:
My husband is 27 years old and has been sick for the past 4 years. First he went to his doctor as he lost alot of weight (around 2 stone) in a short space of time, and would fall asleep alot. Suddenly he was admitted to hospital with abdominal pain to his right side (which he still has today). They took it as his apendix, and removed it, but they told us that it was not enflamed enough to cause the pain he was experiencing. Since this he has been to a G.I. consultant and she diagnosed him with crohns disease, which was two years ago and has now said he dose not have crohns disease and will confirm this with a sample from his bowel this may. Also he has haemochromatosis, and oesteoperosis in his hips and lower spine, at a density of -6.5. He is in contant pain in his lower right side and this pain has travelled into his lower back and shoots down his right leg to the front and into his bum on the back. We got him an mri in 2008 and they said he had a trapped nerve between two discs, and put him on medication for it. We got him another mri in july 2010 and they have said this is not the case anymore and his mri is clear, he just has a minor curveture in his spine. His osteo doctor said there is nothing surgically he can do to help him. He attend pain clinics to manage the pain but we dont understand why no one can tell us what is wrong. He is on 100mg of Lyrica twice daily, 10mg amitriptyline once daily, 100mg of tramadol hydrochloride every four hours, 60mg of codeine phosphate hemihydrate with 100mg of paracetamol every four hours, 20mg omeprazole twice a day, and sleeping tablets at night. He can hardly walk up and down our stairs in our home. He is like an old man trapped in a young mans body and we are desperate as we feel we have no where else to turn, we have literally tried everything, ie. physio which the physio therapist said he can not work with my husband ubtil his pain is managed, he has tried reki, acupuncture, meditation and all of the above medication which he is still on. Please can you give us something to go with as we are at our wits end. Thanks, kind regards Miriam

### output:

Hi miriamNothing to despair as MRI is clear. All he should do is wear a lumbosacral brace during daytime, avoid bending, lifting,physical therapy, massage with muscle relaxant gels and reduction of either tramadol or Conan, increase of dose of amitriptyline to 25 mg instead of 10 mg and use gabapentin 300 mg twice instead of lyrics. Addition of methycobalamin 1000mcg if your doctor agrees. Too many opioids make a patient lethargic, and if pain can be relieved by local measure, gels,brace, massage would be safer best wishes, regards