I will appreciate any thoughts and experiences. Trying to keep it short. In 2003, herniated L4/L5, DDD stenosis at L3/L4, L5/S1, slight ddd at L2/L3. Recommended for fusion or pain management/therapy. Tried everything for three years(therapy, chiroprator, message therapy, numerous epidurals, aqua-therapy and so on) In 2005 started tramadol at 50mg 2x day and cymbalta. Worked part-time 2006/2007 (white collar, sit and drive a lot). Received partial disability. Coflex operation Jan. 2008 (two levels), overall good and worked part-time for one more year and went off prescription meds and used over the counter. In 2009, back full time, but severe spasms, fatique, more pain, more injections, back on tramadol and clonzepam for sleep. I have had sleep problems since 03 and tried everything for that also (I can fall asleep but I do not stay asleep). My most recent visit with my physiatrist (been seeing since 03)suggested that I may consider seeing a psychiatrist based on the long term chronic pain and problems such as fatique and insonmia. This statement hit me hard as I always felt that I have mental stability. I will appreciate any input.