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Has anyone had pain block 4-5months post fusion

sleeprgirlssleeprgirl Posts: 695
edited 06/11/2012 - 8:43 AM in Back Surgery and Neck Surgery
Good morning spineys,

I will be 5 months post op PLIF L4-5 on Apr 23rd, and have had quite a bit of pain, especially in the evenings. I have to just go to bed and take my meds. It takes about 4 hours to break that pain cycle, then I'm able to finally rest. It is excruciating; I would cry but breathing makes it hurt worse.

My question is there is one area about 4 cm from midline probably S1 or S2 about the size of a golf ball, that is the main area of pain. I have tried just about every drug on the market, and was thinking that maybe a pain block would help. I had 2 blocks about a year ago, but none since surgery.

Has anyone had a pain block in their early post op period, and what were your results from the block?

Thanks so much!! Everyone have a wonderful Sunday!!



  • I had my 2 level ALIF at the time of your surgery. I am still having pain, but the meds help. I have never had any of the shots, hopefully someone will be able to help you.

    One question: the bad pain comes every evening? Could you be doing too much throughout the day and not realizing it? I know for me it is soooo easy to do "too much" without realizing it. At almost 5 months post-op I still have all of my restricions of no BLT for another 2 months. Its killing me with spring here.

    I have been through a 2 level PLIF and it is a very tough and long recovery. Hang in there and I hope you get some answers from other spineys, and get some pain relief soon.

    Take care,
  • I want to write more but I am having trouble with my keyboard. There is one letter that will not print...so I'll see if I am able to word this in a way that I avoid that letter...so far, so good. I would like more information as I am not understanding the 4m area...is it sore when you press on it? Does pain radiate from the area? I wonder why you have pain right in that area when your fusion was higher up. Do you think it might be more in the soft tissue? I'm going to send this and reboot -- hope this makes sense.
  • Lisa,

    I'm sure there are times that I do too much, but sometimes it can be from things very simple. Example...taking shower, makeup, drying hair, clothes, going to lunch, sitting for 1.5 hr. Coming home and then the pain is fairly intense. Take pain meds. Within 2 hours, I'm in terrible pain. It takes another 2 hours to break the pain, then I'm able to sleep.

    Gwennie...It maybe L5 or S1, slightly left of midline (1-2 inches). Both sides are slightly tender, but this pain goes deep around the buttock and hip into my left groin. It radiates down the back and lateral side of my leg to my heel, bottom of my foot, to my great toe, and the next 3 toes. My heel, bottom of my feet and toes are numb all of the time, but when the pain in my back is intense, the numbness and burning is excruciating.
  • On my initial MRI one year ago, the radiologist said that I had facet changes at L5-S1. When I had my first visit with my surgeon concerning surgery where he said that I needed a fusion at L4-5, I questioned the MRI radiology report, and his answer to my question was " I don't care what the radiologist said, you need a fusion at L4-5". I have always had an uneasy feeling about this situation, but I did have pain blocks and the anesthesiologist trained in blocks said my problem was L4-5 also.

    I have my postop Xray, and L5-S1, looks OK from a lay persons view point. Of course, I did anesthesia in an orthopedic MECA for 3 years, so I've seen quite a few Xrays in my day.

  • Ok, after several attempts to fix my letter C, I made a trip to the basement and located an old keyboard, so I am back in business! By now I have forgotten what I was going to say....oh, I remember...it may or may not be relevant....when I had my fusion two years ago, several doctors recommended doing three levels, and would not consider doing fewer. Several felt one was sufficient and would solve my problems. What ended up happening as far as I have figured out, is that when the surgeon fused L4-5, due to the spondylolisthesis, it ended up creating more structural issues at L5-S1 that are not seen easily on a supine MRI.

    If your surgeon did anything along the lines of realigning the segment that had slipped in your spine, it may now be putting more pressure on the segment beneath it. This is not a medical interpretation of events -- just what I know happened with me. When L4-5 fused together, it created a wider angle at l5-S1--when I am standing, the anterior load of the abdomen causes the fused segment to slide forward which leads to a functional foraminal stenosis at L5-S1.

    Maybe something similar is going on with you, if the doctor manipulated the segment in an attempt to get things to line up better. It definitely sounds from your description of your pain, that you are having compression at L5 and possibly S1.

    The more you are on your feet, the more the situation is aggravated. You can start out fresh in the morning, but as the day goes on and you're on your feet more, the effects of the loading eventually reaches the point where the pain sets in and then just continues to increase.

    That's my art-major guess of what could be happening to you, too!!
  • I took a walk with an Anesthiologist friend of mine today who works with a Pain Mgt Anesthiologist. She thinks the same way you do, Gwennie. It makes so much sense physiologically for Traci and I might be experiencing L5-S1 issues. My friend said that maybe the facets at L5-S1 may now have alignment issues. I may seek out help from this pain mgt doctor, when I figure out the proper way to handle it thru my surgeon. This Pain Dr does radio-frequency..so that should be interesting consulting with him. I know him professionally, as I have given anesthesia for his spinal cord stimulators and pain pumps, so I think we will have a good repoire.

    It truly saddens me that we make such a huge commitment having the fusion to potentially have other alignment problems.

    I do, however, feel so blessed to be able to share my situation, and have people care enough to help me trouble-shoot these issues.

    Oh, Btw...Lisa B...I'm sure that I do too much...I want so much to be well, and it is incredibly beautiful here in the South. Also, I miss the intellectual stimulation from my colleagues.....I remain hopeful.



  • You often make me laugh!!

    And we all have fusions at L4-5. I think that is a tricky area. I still think it is very easy for problems to develop in the soft tissue -- either piriformis or psoas as you start going to PT and start using muscles that haven't been used in a long time.

    What has been used is probably not in balance from being stressed prior to surgery...if there was nerve pain prior to surgery, it seems often to be just as bad after surgery, until things get all sorted out.

    I started physical therapy and stopped for awhile because it was just too much. I took a month off and then went back. It was better the second time. Sometimes I think they push too hard too soon...if you end up having such a flare that all you can do is go home, climb into bed with a heating pad and take some pain meds, it is hard to consider this progress.

    Well, take care everyone....

  • Lisa,

    I too am having many of the same symptoms and our surgeries were very close. My pain is also just south of midline but to the right, rt hip, groin, thigh. Mine fortunately, is not extending to lower leg or foot. The burning pain is really beyond belief. It has been worse than ever this weekend. And this is after a whole boatload of PT.

    I hope you can visit a PM Specialist, maybe one that is a certified Physiatrist. Did I spell that right? LOL Blonde roots. Keep us posted and pm me anytime if you like.

    Best Wishes,
  • I'm nearly 6 months out and not in as much pain as you, but still have an issue with L5/S1 lower back pain and left groin and thigh pain, especially with sitting and when I've pushed things too hard. I'm glad I had my fusion because I can walk without leg pain.

    When I've overdone things, it's from simple things too, and I thought it was old age!! What I've had to learn to do is break up jobs such as washing and cleaning the floor and lie down in my recliner in between and watch some TV. It's a bit frustrating, but .....

    Gwennie, you explain things so well. I've had to cut back on the physical therapy too and go at my own pace. I've felt that my physio has pushed me too hard at times. I've had to modify some of the exercises and because the floor (and exercise mat) is too hard, I lay on the bed.

    Lisa, would be a good idea to talk with your doctor about a pain block.


    XLIF L2-4 20.8.15
    ALIF L4/5 2009
    Laminectomy/discectomy L4/5 2008
  • I also changed my meds when I went for my 4 month visit with my surgeon. I went from Percocet/Soma to Darvocet/Skelakin. I'm sure that is starting to catch up with me. We changed the Darvocet to Lortab last Thurs., but I had to take 4.5 Lortab over the course of 9 hours to get relief...and only 3 hours of sleep, plus, now I'm nauseated. Never had any problem on Percocet. I'm calling my surgeon again today to hopefully make some changes back. I have to leave a message with the "medical assistant". Always love trying to discuss dermatome levels and pain management with this person.

    Another beautiful day...I am going to rest!!

    Everyone take care,

  • My new surgeon always wants to give me ultram. I swear, I could take a whole bottle and it wouldn't have any effect on me. Some drugs just don't work for some people. I hope your surgeon will put you back on something that works for you. I hate being nauseated more than just about anything.

    How do you feel today after your big hike of yesterday??
  • I called my surgeon, and just got a call back that they will put me back on my prior meds...Thank God. I am in bed now in severe pain. I am unable to get in the car to drive into town to pick up the RX, since that would mean being in the car about 1.5 hrs during rush hour traffic. That will just have to wait till the AM. At least he did hear my plea for help. He must be reading my posts....LOL

    All I can say is thank goodness for 4 lb laptops and satellite TV!!!

    Thanks for checking on me. I'm going to lounge for the next few days...I know better than to not over do things...this is what happens!!!

  • Lisa,

    I see from your posts your meds aren't keeping up. I wish I had your surgeon. At least he listens to you. A change back to your previous meds can only be a good thing if they were helpful. I am with gwennie, being nasueous on top of pain is bad bad.

    Are you doing any PT at this time? Please continue to post your progress. We have so many of the same symptoms. Isn't it strange that this surgery effects so many of us in the same way, but we really don't get any heads up of things that may come up so long after the surgery. My surgeon told me about adjacent levels, of course. I just didn't expect the problems so soon.

    I hope you were able to get some rest!

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