Spine surgery patients w/ ongoing radiculopathy

[CrankySailor]

Ok, non-scientific, I know. But I'm wondering what people do to control pain who fit the following:
Patients must have long-term nerve pain (radiculopathy)
Must be a spine (stenosis, disk, lami, spongie, etc) or main branching nerve root related (ok if lumbar, cervical, radiating)
Must have had at least one surgical intervention.
Must have continued pain 3-months post surgery.
Pain must limit functionality.
Pain must be perceived as under treated.
and you must be currently under treatment of an MD.
no recreational users please (in fact a separate query would be interesting for this group).For pain questions, please answer the one type of pain med that treats to functionality - do not click more than one.

[Suboxstitute]

I don't know if I did it right - but I marked that I do not have legal access to what treats my remaining radiculapthy from two disc surgeries (most rec Feb 2007)... it would be Sched II the oxy IR - the real little white pills. It worked GREAT and I could add tylenol or ibuprofen as needed. But it was not to be - 2 months after surgery I should not be needing those anymore. I guess the doctor had a mind/meld into my pain.

But one thing let to another and now I am on bupe. It is supposed to help with pain some, if you take SMALLER doses and divide them up. That is somewhat true, but not cutting it.

If it gets real bad, I'll have to abandon the bupe plan and see about better pain management. Right now, it is bothersome and affects my life but I am living with it, just w/the bupe as some sort of pain mgmt.

[Princess]

I don't know if I help this at all. I have not had any corrective surgery for my numerous back problems, but I have had radio frequency & nerve blocks (put under for both and had both twice). I have been told by every orthopedic surgeon I've been sent to that they want to do a multi-level fusion and some disc repair... but I'm trying to wait as long as possible.

I'm supposed to be getting epidural injections still, but haven't in a few years. I have been refusing the epidurals because my scoliosis is so bad that the epidurals seem to screw my back up more.

Currently, I use Fentanyl & percocet 10/325 and sometimes MSIR 30mg. I also occasionally get trigger point injections.

[CrankySailor]

I don't know if I help this at all. I have not had any corrective surgery for my numerous back problems, but I have had radio frequency & nerve blocks (put under for both and had both twice). I have been told by every orthopedic surgeon I've been sent to that they want to do a multi-level fusion and some disc repair... but I'm trying to wait as long as possible.

I'm supposed to be getting epidural injections still, but haven't in a few years. I have been refusing the epidurals because my scoliosis is so bad that the epidurals seem to screw my back up more.

Currently, I use Fentanyl & percocet 10/325 and sometimes MSIR 30mg. I also occasionally get trigger point injections.

Since the epis are steroidal, and steroids worsen osteoporosis, I would think someone with severe scoliolis should stay away from them. might help short-term, but long-term would be bad. my godmother has scoliosis due to steroid use, and she's been in agony for twenty years.

Good luck

[Princess]

I didn't know that! But its ok, as I said, I won't get epidural injections anymore. The first round gave no relief and just caused more pain.

[Suboxstitute]

Prior to surgery for a herniated disk that was pressing JUST RIGHT on that great big nerve that goes down your hip and leg... I had two epidurals (pretty much required before surgery here as protocol).

They did NOTHING second one made things MUCH worse.

So I had the surgery. I will have to say that altho I have other things on my MRI that are worrisome, the surgery for the herniated disk really did deal well with the radicular pain in my leg, and I hung with the physical therapists and did exactly what they said, and I'd have to say my back is pretty good, except for a dull ache if I've been active a lot, and then i can usually relieve that with stretching exercises.

I need to lose some weight and get in really good shape and STOP SMOKING (cigarettes) since my surgeon told me that smoking really cuts into the blood supply to the bones - probably true, or it was just freaking me out into quitting. I don't smoke a lot, or he would not have even done the surgery.

If I do those two things, I don't think I'll need another back surgery. The doc said if I DON'T do them I'll be "a burden to society, in a wheelchair at 60, and on welfare". "Your choice". Doesn't beat around the bush I guess.

it's been tough, since I found out recently that I have VERY LOW thyroid levels (never knew it, it is not something my primary care routinely tests for) and that's been likely preventing me from losing weight even though I eat next to nothing and go to the gym - now that I'm on meds for that should start to see some weight loss.

[CrankySailor]

NOT ONE spine electrode implant. that I think means something, like, pain meds work better, are safer, cheaper, and have a successfull track record over stimulators.

[samsong]

MY PM doc brought up the stimulator for my ongoing chronic neck pain that a 2 level fusion did not alleviate--I was actually in way more pain after my ACDF than before it, but have gotten the pain under control with fentanyl and opana IR and quarterly selective nerve root injections. Nothing helps the numbness though, and I have tried Lyrica for it but my whole hand has been numb for 3 years now.

Just had L4-L5 fusion done back in January and healing pretty well--pain is getting better every week so am hoping no permanent nerve damage there like I seem to have in the cervical area. Still some hope the cervical will get better some day, but I am 2 years post op and even an MRI done 6 weeks ago indicates no new herniations or problems with the hardware, so it is nerve damage. have to wait and see how permanent it is going to be. I figure if it goes another year, it will never get better, but that's just my non-medical opinion. At least I have a compassionate doc that is willing to keep treating me and rx'ing me with opiates, and I thank God daily that I have him.

[CrankySailor]

MY PM doc brought up the stimulator for my ongoing chronic neck pain that a 2 level fusion did not alleviate--I was actually in way more pain after my ACDF than before it, but have gotten the pain under control with fentanyl and opana IR and quarterly selective nerve root injections. Nothing helps the numbness though, and I have tried Lyrica for it but my whole hand has been numb for 3 years now.

Just had L4-L5 fusion done back in January and healing pretty well--pain is getting better every week so am hoping no permanent nerve damage there like I seem to have in the cervical area. Still some hope the cervical will get better some day, but I am 2 years post op and even an MRI done 6 weeks ago indicates no new herniations or problems with the hardware, so it is nerve damage. have to wait and see how permanent it is going to be. I figure if it goes another year, it will never get better, but that's just my non-medical opinion. At least I have a compassionate doc that is willing to keep treating me and rx'ing me with opiates, and I thank God daily that I have him.


Sorry about the numbness, Samsong; That's what I'm facing in my leg, one year out. Numbness and pain, which is kind of funny since people thin numbness is considered no feling. Unfortunately, I've got bad drop foot, and the Lyrica scares me a bit. I'm a cancer survivor and I've see some mouse studies that seem to correlate Lyrica use with increased hard tumor growth. This of course scares me to no end

be good and best of luck!

Cranky

[reddragon3668]

I had two lateral herniations on lumbar levels L4-L5 and L5-S1. The herniations went in opposite directions, both pressing on the root nerves. This caused pain in both legs and ended up causing nerve damage because they waited too long to do the surgery. Its was an on the job injury and Worker's Compensation did everything they could do to prevent giving me the surgery.

During the treatment period, I had a series of selective nerve root injections. They actually were very successful. I was able to return to work for a while on limited duty, doing physical therapy everyday for four hours. Unfortunately, the therapist put me on a traction bed, and I guess she let the tension off too quick and ended up squeezing the rest of the jelly out of L5-S1, making surgery unavoidable.

They ended up doing a two-level fusion, adding rods and screws for stability. It was a complete success. I worked very hard in physical therapy, passing the functional capacity exam with flying colors.

My neurosurgeon advised me to never return to pipe-fitting. However, he couldn't prevent it because I passed the test. I returned to work about 9 weeks post op, and was relatively pain free. It was the worst decision I've ever made. I made it 15 months and by time I quit, I was in so much pain. I've not worked since.

I recently had a MRI done to check to the condition of the fusions and hardware. They found that I have a bulging disc right above the surgery site, at the L3-L4 level. I figure its the result of the work I did before the doctors shut me down.

Today, I manage my pain with a variety of pain meds and stretches, etc. Right now, I take 120mg of Opana (40mg 3x's a day) and 120mg of Roxicodone (30mg 4x's a day) a day. I also take Cymbalta (90mg) to help treat the nerve damage. Surprisingly, it works fairly well. While my pain is constant, the medicines do well to keep me relatively comfortable.