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injection for scar tissue?

AnonymousUserAAnonymousUser Posts: 49,671
Has anyone had steroid injections for nerve pain due to scar tissue? I saw an orthopedic surgeon that said "no surgery, but possible injection to relieve inflammation of nerve." I just am wondering if this has helped anyone. My thought is... if the scar tissue that's causing the inflammation isn't removed, how is a steroid injection going to help? Maybe for a week or two, but that's not worth it to me. He also recommended P.T. for me, so I'm giving that a try. He says it's "just" scar tissue and that my discs look good. "Just" scar tissue doesn't exist in my honest opinion. Scarring hurts just as bad as a disc. Any thoughts/suggestions?



  • I had a series of 4 epidurals recently for post micro-D scar tissue. They seemed to help (things are more tolerable now), though now my pain management doc thinks I might other issues too that are causing my pain. He also gave me lyrica and celebrex to try to address the problem. I share the concern about what happens when the shots wear off if my nerve hasn't calmed down and the scar tissue is still there. Some docs have said it would "reaborb," while others have told me that theory was nonsense.

    I hear you about it "just being scar tissue." The surgeon who did my micro-D told me the problem would just go away, but my second and third opinion docs seemed to be more concerned about how much scarring developed and started me off on pain management. I've heard some nonsense from other docs about scars being natural (as if I didn't know that), apparently not grasping what it feels like to have a big one on the sciatic nerve that isn't going to disappear. My scarring pain has gone on longer and in some ways is worse than the pain from the original herniation.

    I've read some stuff online about "lysis of adhesion" and the "racz procedure" for breaking up scar tissue, but it sounds like there's not a lot of medical evidence there in support of the procedure and insurers generally won't cover it. It's just frustrating that there's so few options (and apparently not much research) on how to address scar tissue problems.
  • One more thing... I notice a lot that docs and regular folks attribute excessive scar tissue to lack of P.T. and other movement. I was pretty active after surgery within reason (walking, stationary bike, stretching, etc.), and I got clobbered with pain from scarring 8-9 weeks after surgery. One doc told me that big herniation = big scars, so not sure that a few stretches will deal with it. On the other hand, can't hurt.
  • dcguy,
    How long have you been dealing with your scar tissue? Are you going to have any other surgeries to try and remove it? One of my doctors said that if I still have leg pain in June, that he would "wrap" my nerve to help protect it. I went to a spine orthopedic surgeon yesterday and he had never heard of that - or so he said. My neurosurgeon (who did my surgery) is the one who mentioned the wrap. I'm just afraid to let anyone else back in there. I'm actually going to ask for another MRI or CT scan to be sure it's only scar tissue. It will be my 4th MRI this year if the doc says okay. I'm thinking he'll just think I'm crazy for asking for another one. The last one I had done was 2 months ago, but I've shoveled and lifted kids since then, so I'm paranoid.

    Lyrica and Celebrex? What are they for? And why does your doc think they will help? Zachback (another person on here) said his doctor is going to try Singulair to try and help with scar tissue when he has his next surgery. I'm curious to see how that turns out. I would love to hear that something actually works for us.

  • dcguy,
    I looked up some info about lysis of adhesions. That actually sounds promising. I wonder why doctors don't talk about this. Sounds like it's helped some people.

  • I've been dealing with scar tissue since the end of July. It's been pretty miserable and I felt much better before surgery than I do now.

    The sense I've gotten from the doctors is that removing the scar tissue just risks new scar tissue forming, and no one has figured out a good way to limit the scar tissue that gets formed. I've heard of docs taking out the scar tissue, but not sure what criteria they use.

    I wonder if this is the wrap your surgeon had in mind? http://clinicaltrials.gov/ct2/show/NCT00387829

    I've read about adcon-L gel being used with micro-Ds to limit scarring, but I guess it's fallen out of favor.

    I asked my pain doc if my nerve would ever "learn to live" with the scar tissue next to it, but he didn't want to commit to an answer.

    The celebrex is supposed to help with nerve inflammation and the lyrica to deal with nerve pain. I also take tramadol as a general pain reliever.

    I wonder how much lysis of adhesions would cost.
  • Have you been doing any gliding exercises for the nerve root? Have you had any physical therapy? One of my dilemmas is that I can't tell if I've re-injured my disc or it's just the scarring pulling on the nerve. When I shovel or life something, the pain gets bad. This leads me to believe it's the disc. But, then again, who knows. If the pain is always there, going up and down in severity, how do you ever know what's wrong? (Does that make sense?) I keep asking for more MRI's to make sure it isn't another disc fragment. Doctors are going to begin thinking I'm nuts.

    Not sure if my neurosurgeon was talking about the same stuff as is in that website or not. He didn't give it a name. He just said, "wrap." It scares me on one hand, but has me curious on the other.

    Funny how I asked my orthopedic doctor about wrapping the nerve, and he said he didn't know what that meant. Is that because he doesn't want to try it??? It seems that if he's a "spine specialist" that he know all the new-fangled surgery techniques.

    I've also found sites on Duragen and Neuro Wrap online. There's all kinds of things out there, but the doctors seem uncertain when you talk to them. I'd really like to try vitamin E injections into my scarring. I read this online and that it actually worked. The problem is, again, if the doc has never heard of it, or it's too new, they probably won't try it.

  • My surgeon did give me another MRI (with contrast) when the problems started to see whether it looked like scar tissue or reherniation. I was freaked for a while that I'd reherniated.

    Not sure why, but they never referred me back to PT after the scarring issue erupted. But I'd been doing all the stretching and strengthening stuff at home anyways.

    I saw the pain management doc today and he wasn't surprised about my pain levels going up and down or different things feeling painful or tingling on different days. He thought that the scar tissue might be affecting lower level nerves besides L4, so that why my legs feel like crap in general. The pain doc said that spinal cord stimulation was a potential option down the treatment path.
  • Did your doc tell you how long before this scar tissue is completely formed? Will it keep forming forever, or changing forever? Will your pain level off or keep changing? (Just curious)

  • I have had 3 spine surgeries and all the evidence now suggests I am dealing with scar tissue around the nerve.
    My problem is that as soon as I do anything, it irritaes the nerve, spasms my back and my pain flares.
    I am having PT to glide the nerve but that also flares the nerves.
    I know it is nerve, it switches on in a milisecond, vibartes auff, it is horrid, floors me for up to 10 days.

    Regards the steriods, I have been given some to help reduce the inflammation. I think it helps a bit but as you say, this is short term. Mine are wearing off now and it is not good. Nor do I really want to have another injection.
    There has been a post about the fat wrapping, Zachback I think posted it.

    Take care
  • I got the impression that the scar would stop growing at some point, but my symptoms have sort of varied. Things have gotten a little more bearable for me (though still awful), but that could be from the epidural.

    I have a friend who had a pretty bad experience with scarring after his L4-L5-S1 microdiscectomy. He's got some pain on a daily basis still, but he said the nerve calmed down some but it took months.
  • this subject is interesting to me because I also had a radical microD 1 year ago. I am wondering if a rhizotomy would help this? Burning the actual nerve that is being effected by the scar tissue? I get them done yearly for my facet arthritis and it works pretty well. At least it lasts a full year and even longer for some. I do not have a clue if this procedure would even be considered for scar tissue problems but it would last much longer than a steroid injection. Just wondering.
  • Thank you everyone for so much input. I appreciate the advice. It especially encourages me when I hear that the scar tissue pain calms down after awhile. I will read up more on the fat wrapping thing. Anyone else hear more about this?

    The nerve gliding exercises also irritate my nerve when doing them. So it's good (well, not GOOD for us, but...) to know that someone else has the same feelings.

    It is, however, discouraging to hear from my doctor (yesterday) that another MRI is not necessary at this point. I would like to know that I definitely only have scarring - not scarring WITH a disc fragment. Why do doctors have to take their time with everything? Don't they realize this costs us money? I guess that's why they do it. They benefit from our pain. (Sad to say).

    Has anyone gone in specifically to have scar tissue removed? Just wondering what the outcome was.

  • What is a rhizotomy anyway??

  • I don't know. It sounds like a laser type thing to me. I will look into it more.

  • I'm in the same boat. I had my surgery in April. Had another MRI in June because I was so afraid I had re-herniated or herniated the 'other side.' Nope...just a lot of scar tissure. I just posted asking about steriod shots post surgery. My family doctor (who's an osteopath) thinks I should get an ESI. I've had 2 (before surgery) and they didn't work then. But my herniation was HUGE. I'm definately doing a lot better now, but still a lot of nerve stuff going on. I'm on neurontin (like Lyrica, etc.) for the nerve pain. I could up the dose of that, too, my dr. says. I'm just curious if I should go through with the ESI ( want to do it soon so it's done this year for insurance reasons and while my husband is home to help out with the kids so I can 'heal') If anyone has any advice on whether it will help....great!
  • I had 7 epidurals before getting my microdiscectomy, and I didn't think they were effective at all back then.

    So I was really skeptical about more epidurals after the surgery, but as it turns out, they seemed to have helped reduce the pain from the scar tissue.
  • dc,
    That's odd - that the epidurals would work after your surgery but not before. Well, if it works, that's great! I hope the pain stays away permanently for you.

    I'm getting a myelogram done Christmas eve day (CT myelo.). I'm excited to be getting this done, since I know different things can show up from an MRI. The more info., the better. Now I just have to get the billing/etc. straightened out.

  • I thought it was weird, but I reckon things around my disc after microdiscectomy looked different (lots of scar tissue) than they did before surgery (floating disc fragments).

    I had 2 two different docs doing the injections, one before surgery, and one after. With hindsight, I wonder how much experience the first doc had based on the injections (it took him forever to find the spot) and some of his medical advice in general. The second one has been doing this stuff forever so I wonder if his technique or wealth of experience made a difference.

    Let us know how the myelogram goes and what you learn from it - I'm curious to hear your experience. I haven't had that done.
  • dc,
    I will let everyone know on the myelogram. I'm sure the results won't be in for at least a week, since Christmas and N.Y.'s take up half the work days. I just hope the interpreter knows what he's looking for.

  • What did you end up doing about your scar tissue issues?
  • Noticed comments from itsalongwalk...can so relate to your condition..14 months ago had L5/S1 microdiscctomy, rhizolysis and foraminotomy..wish now I had have put up with the pain of the Sciatica.

    Rested for 6 weeks as told with PT, came OK for a few weeks and did heaps of walking. THEN I wondered why I had the op..vowed I would never be "cut" but pain was terrible with burning etc down right leg and into foot I felt I did not have a choice.

    14 months later after 3 x MRIs, nerve pain and feelings of "electrical shots" up the right side of my back and into my neck, not to mention 25hrs a day spasms!!! my Neuro is going to try Cortisone injection as he believes it could be referred pain up my back from SCAR TISSUE!!

    Neuro stated he would go in and remove Scar Tissue as last resort but prefers NOT TO DO that treatment. (Thought I would add that info if anyone is contemplating this action.)

    Will definitely post and advise how I feel afterwards.

    I feel for everybody going thru the pain which is not fully explained to us before we have these ops.

    Stay strong
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