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L3-L4 Am I the only one?

edited 06/11/2012 - 8:46 AM in Back Surgery and Neck Surgery
My first back operation was in 1984, partial Laminectomy L4-L5, same thing in 1987. I have had flare ups since but nothing that time didn't seem to heal. In 2009, I began to have problems again, but this was something differnt. With my L4-L5 problems, I could not stand up straight, walk or sit without severe pain. This time, once I get up and get going I'm ok for the most part. It's when I'm lying down that I have pain. I had an MRI done and it's the L3-L4, the buldge is perfectly cimetrical, however, 95% of my pain in on my right side, buttocks, calf, foot. The worst part of it is that I can't sleep, it's changing me, I can't concentrate, I lash out and I'm depressed. I have had 4 spinal injections, they did help, but quickly wore off. The doctor I'm seeing now says the best way to go is a laminectomy, disc decompression, blah, blah, blah, I'm sorry, he had some other word for it but I don't remember what it was. He said that he would cut away half of the Lami to gain access to the disc. I've been prescribed Tramadol, Gabapentin, Naprosyn and Ambien. None of this really helps, I just feel sick to my stomach most of time.
I have repeatedly asked for opiates from my primary care, pain managment and my orthopedic doctors. None of them will prescribe them for me, maybe it's just as well, but I've gotten hydrocodone's and oxycodone's from friends. It does take the edge off way better than the others. When I asked am I the only one, I mean it two ways. Does anyone else have pain from lying down and does anyone else have problems getting prescribed opiates? Lastly, should I just get this operation done or is there any chance at all that this will go away on it's own, it's been a year and a half now. Thanks and God Bless


  • I'm sorry to hear about your not getting any meds to help with your pain. Keep letting your Dr. know the pain is unbearable and you don't know what to do. I hope you can find a Dr. to help you. I had an L5-S1 herniated disc and annular tear and now have Degenerative disc disease in my whole lumbar spine and understand the pain you're having. Please keep trying to find a Dr. to help you. I hope you're able to get a second opinion for your surgery. I wish I could help somehow. Keep us posted how you're doing. Take care. Charry
    DDD of lumbar spine with sciatica to left hip,leg and foot. L4-L5 posterior disc bulge with prominent facets, L5-S1 prominent facets with a posterior osteocartilaginous bar. Mild bilateral foraminal narrowing c-spine c4-c7 RN
  • Hi E and welcome to Spine-Health.

    The doctors here in Australia are cautious with prescribing opiates. Pre-op, even though I couldn't get enough to cover the pain 24/7, I was lucky that my doctor had experienced severe sciatic pain for quite some time and knew what I was going through. Probably most doctors haven't experienced this pain and they only know that we can become addicted to opiates, hence their reluctance to prescribe them, even when they're really needed.

    Even now, I still get pain/deep aching when lying down, though nothing like it was pre-op. Moving about relieves the pressure on the spine.

    I'd suggest getting another opinion from a fellowship trained orthopedic or neurosurgeon. I'd been to three neurosurgeons before I had my surgery. From the little I know, pain that is still unresolved after 18 months is unlikely to go away on its own.


    XLIF L2-4 20.8.15
    ALIF L4/5 2009
    Laminectomy/discectomy L4/5 2008
  • I wouldn't ever ask for opiates, I would simply tell my doctor that my present medication isn't handling the pain and let him make the suggestion of something that would work better. And, taking someone else's pain medication is a bad idea. You could end up with a reaction, or worse. It's just a bad idea from the get-go.

    By the way, welcome to Spine-Health. :)

    2009 Foraminotomy C6-72010 PLIF L4-S1Multi RFA's, cervical inj, lumbar injLaminectomy L3-4 and fusion w/internal fixation T10-L4 July 17Fusion C2-C5 yet to be scheduled
  • Thank you for the responses. I guess as far as the opiates thing goes, the doctors are under some pressure from the DEA and their own sense of not wanting to start a problem or add to one. I'm sure that many people go into a doctor’s office just to dupe them into prescribing medication. However, when the MRI is staring them in the face, I really don't understand why they would deny it. From what I've read, as bad as a rap that Oxycontin gets from the media; its benefits are totally lost on the people who do abuse it. In my primary care physician’s office, there is a sign that says they do not prescribe medication for pain management. In my pain management doctor’s office, they have a sign that says that all opiate prescriptions will require a signed contract, whatever that means. I will just have to learn to deal with it in other ways. Last night was bad; I took 10mg of ambien and 1000mg of Tylenol about a half hour before I went to bed. An hour and a half later I took a tramadol and finally got to sleep. I woke up this morning sore and feeling like I had a hangover. I think I'm ready to go ahead with the procedure, I just wish there was another way. My doctor said he thought that for my age 47, overall, my spine looks pretty good considering the l4-l5 problems I've had in the past.
    They did a test where they took x-rays of me on my side curled in a fetal position and they another with my back arched while on my side. He said this indicated that I was a good candidate for the laminectomy as opposed to a fusion. I think my trepidation has to do with the stories I read about people getting worse off then they were before. Any insight would be appreciated.
  • SpineAZSpineAZ WiscPosts: 1,084
    Doctors are under a lot of pressure here in the US and the DEA has become more vigilant.

    I have a GREAT Pain Management doctor. Two weeks after my discharge from the hospital, after my L3-S1 fusion, my PM agreed to take over pain management from the surgeon. My surgeon looked SO relieved.

    At my last PM appointment this week we decided I might try to switch my Long Acting med back to Opana ER from MS Contin. But, in the past Opana ER was too expensive. So the PM doctor gave me a prescription for each but said I MUST return the one I don't fill and he must have it next week when I see him for a cervical epidural injection. Turns out that even with the co-pay assist card from the manufacturer Opana ER will still be over $75 for me which right now is too much. So I remain on MS Contin for LA and Norco for break through pain (along with Soma 350 and Neurontin). Under my prescription plan each generic is $10 so I can get those 4 for $40. I just can't see turning down $10 MS Contin for $75 Opana ER.

    I recommend consiering surgery, if the pain has lasted this long I don't see that it's going to go away on it's own.

    At the same time try to find a good PM doctor. They can be hard to find but it's worth it to reach out to try and find one that will comfortably prescribe you meds. When you do use a PM doctor you will sign a contract that says you ONLY get pain meds from them. So if you go to the dentist and get a tooth extracted, and your PM doc is giving you Percocet you can't fill a Vicodin prescription from the dentist. In an emergency (for example, shattering a bone on the weekend and having surgery and discharged with stronger drugs) you can usually fill it BUT must call the PM doc immediately to let them know. PM (and other docs) have access to run a report of what you are filling where, so this also avoids someone filling Percocet at two pharmacies, etc I know this sounds stringent BUT if you get pain relief it's all worth it. When I had surgery I talked to the PM and he agreed upon discharge the surgeon could prescribe meds (which was good since I was having some severe pain upon discharge) and we also agreed I'd revert back to the PM doc as soon as I could. I recently had my first random urinalysis test by the PM. They do this to make sure you are using what is prescribed and that it's at the right levels in your system. If the test came back and said I had no meds in my system, yet they have been prescribing them for over a year, they'd likely suspend treatment as they'd think I was not using the meds for my own use.
    2 ACDFs, 2 PCDF, 3 LIFs; Rt TKR; Rt thumb fusion ; Lt thumb arthroplasty; Ehlers Danlos 
  • My surgery was nearly a year ago and I too experience horrible pain after lying down and attempting to rise. Even just resting my head, if I am reclined even a little the pain is extreme. I have gained 50 pounds from my inability to exercise. I go for walks and use my exercycle but then I started having heart palpitations so I am not supposed to do any cardio until I see the cardiologist Sept. 3.
    I have seen the spinal surgeon whose biggest concern was releasing me from his care. After seeing that it had healed nicely from an xray, he said I didn't need to see him again! That I need to see my primary Dr. for any other attendant issues.
    Getting medication is a real issue with Kaiser also. It is without a doubt that I am in real pain and need real relief or I can barely walk. I am also having terrible hip pains, all the way through my legs at times and my knee has decided to join the chorus!
    I was able to get my Dr. to prescribe percocets but I absolutely have to keep that to a minimum. I remember after the surgery I had the worst pain I had ever had and I was taking so many drugs that cutting back was so hard. It was like being addicted, with the shakes and physical illness.
    So I hear you loud and clear. It's awful. I may never work again because of all this and I had a GOOD job and in this economy that is a concern. I have another torn rotator cuff from having to use my arms so much when my back was so weak. My fourth.
    I had been considering medical marijuana as an alternative and finally had to break down and get my medical card. I live in CA so that part is easy. I was likely one of the few people there specifically for pain control! But the funny thing is, it WORKS. I can't take too much I hate feeling high and out of control. But if I take a percocet and just a little marijuana the pain is SO much better. I'm not advocating everyone run out and start smoking pot, but I felt it was worth mentioning and nothing else has provided too much relief except percocets and after awhile they lose their ability to kill pain and you have to take more and more and then you can't get your Dr. to prescribe them. There needs to be a better alternative and I find it almost impossible to believe that there isn't!
  • PM docs have you sign a pain management contract to protect you the patient and them the provider. The contract usually has you agree to only fill and one pharmacy, take the meds as directed, take meds that are yours not others, be honest about everything(I probably missed something). At first I was like "what" but now being in around it I understand. People will do just about anything to get meds. They can be pretty darn tricky. The only way I can get an appointment is if the PA writes an order and it goes to the receptionist and they call me. I have to take all my prescriptions in with me when I go in for new meds or a med changes. They count them and give me my new script. I can tell the PA is relaxing around me a little bit she is trusting me as much as she can. I would be upfront with your PM clinic explain that whatever meds their giving you do not cover your pain. Tell them that you would like to sign a pain management contract and get your pain managed. I would personally be careful mixing the drugs your mixing unless you've been told by the doc that you can take them all together. Ambien can do crazy things to people especially when you start adding other things I would be careful. Like someone else said taking meds from friends is a bad idea. I know you probably feel a little desparate but it could cause doctors to not trust you at all if something were to go wrong and you ended up in the hospital. Try keeping a pain journal for a few day to show them. Track your pain on a scale of 1-10, 10 being you want to go to the emergency room. What activities make it worse? How much sleep do you get? Let them know you are taking this seriously and that your miserable. You shouldn't have to live in so much pain and a person should get some sleep(lack of sleep for me elevates my pain). I was running a good 7-8 before the PM doc now I'm 6-7 on a daily basis. It's still a fair amount of pain but it is to where I can do what I need to do on a daily basis. I use THC under my doctors care to help sleep at night. I hope that you can get things figured out!!
  • I don't have this presentation of symptoms, but the last time my dad had a disc herniation he did. He could not lay down, sit or stand still for more than 5 minutes even with pain meds. He constantly had to pace around. He didn't sleep at all. The pain was unrelieved until he had a laminectomy. However, now (about 2 yrs. later)he is having some milder back pain that they said is being caused by spinal stenosis and scar tissue. The pain is not enough at this time to make him want to have surgery though.
  • I also have a herniation at the L3-L4. It causes severe pain in my lower back, butt, and shin on my left side. I cannot lay down on a couch or bed, and cannot sit for longer than a minute or two without severe pain. It is very hard for me to walk. I can only lay down on the floor to get somewhat comfortable. I did not take the Doctors recommendation on 07/15/10 to have surgery, and tried to tuff it out. This was not a wise choice. Finally, I could not take the pain anymore and decided to have a laminectomy, discectomy, decompression L3-L4 on 08/30/10. I cannot wait.

    My Dr. has always given pain meds to help with my pain and if he did not, then I would have found a different Dr. The Dr is suppose to help you. That is why you or your insurance pay him. The DEA should let the DRs do there job.
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