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4 Weeks post- L4/L5 Fusion- Pain Med Options?

ArubaBabyAArubaBaby Posts: 1
edited 06/11/2012 - 8:59 AM in Back Surgery and Neck Surgery
Happy Holidays.... even with my LSO back brace they have been enjoyable :)

I'm 4 weeks post op and imo and my Dr's opinion I'm doing very well. Walking everyday. I'm still dealing with tingling and some leg cramps in my right leg, overall I'd say that my pain is not horrible. I was Rx'ed the following for pain meds when discharged:
Oxycodone (aka) Percacet 5mg - 2 every 4-6 hours
Diazepam - (aka) Valium 5mg - 1 every 8 hours

The first 7-10 days I was watching the clock for pain meds, at the above dosages but now I've been weaning myself to the following:

1 Oxycodone in the AM
1 Oxycodone + 1/2 Diazepam at bedtime

If needed:
Midday- if I have pain I will take 1/2 Oxycodone- My problem is I can't tell if its nerve pain or muscle pain (leg pain) which is SOOOO frustrating b/c I don't know what to take...pain pill or muscle relaxer. Can anyone shed some light on telling the difference?

At my 4 week checkup my Dr said that I should start on something besides oxycodone for the pain, which is fine, but she recommended VICODEN which I've been on before (11+ years ago post surgery) and didn't have the best reactions with it. I asked Dr if I could just try Tylenol vs and Rx and she said to try 1/2 Oxycodon with 1 Extra Strength Tylenol. So I did.... I thought I was just having random stomach cramps, but then after a few days I put together that it was after the Tylenol- even tried just taking 2 Ext St Tylenol (no Oxy) and it was really terrible stomach ache.....so this brings me to my main question...

Any suggestions for what to ask my Dr to let me try?

I really, really want to get off these meds, but I don't want to feel miserable in the process. Of course the Oxy works great for masking the pain even just 1 pill stops it 99% of the time, but I feel like I need to get off of it- am I over reacting about this 4 weeks post op?

The Diazepam I think I could do without, and only take it if my muscles feel tight at night so I can rest.

My other concern with the Oxy is my nighttime sleep quality. I usually only sleep about 5 hours max - I read that the Oxy is probably causing this. Any pain meds that don't cause this?

Thanks to anyone who may have some suggestions for weaning off the pain meds....ready to get back to my life and I feel like without pain meds it will be better!!!

Wishing you all well in preparation for surgery or recovery from surgery- happy to find this forum!



  • If the pain is in the back and sharp - more likely to still be nerve-related, since you aren't on a nerve-pain med (like lyrica, neurontin, elavil), I would probably try using the oxy for break through..
    I too am not a big fan of the use of valium post-op, its mediocre at best as a nerve relaxer compared to other agents out there...If your needing sleep maybe ask for Elavil? It is non-addictive, helps nerve pain and deepens sleep.
  • Welcome to Spine-Health :))) Sounds like you're coming along nicely for only a month out.

    I, too have a problem with stomach pain when taking meds which include codeine and Oxycodone, as well as some other drugs.

    In the hospital they gave me Phenergan 25 mg (Promethazine hydrochloride BP)for nausea and said it was a good idea to take it with Oxycontin, and it helps me.

    Another drug which helps too is Nexium (Esomeprazole).

    Perhaps your doctor can prescribe Oxycontin rather than Oxycodone because it goes into the system at a slower continuous rate.

    I was sent home with Oxycodone for breakthrough pain, Oxycontin for continuous pain relief and Neurontin (Gabapentin) for nerve pain. I was on these pain meds for a couple of months.

    When I take Oxycontin, I can't go into a deep sleep. I have degenerative issues with the levels either side of my fusion, but they were there prior to surgery. My surgeon didn't want to operate on those levels at that time. He fixed the main pain generator, and so I'm able to do most things.

    I had some nerve pain for a few months post-op but nothing like it was before surgery. Also got pains in my hips and other parts of my body once I started becoming more active, but that can be normal as the body adjusts to it's new position.

    As you become more active, try not to push ahead too quickly and keep to the bending-lifting-twisting restrictions. Don't sit for too long in a normal chair - say 15 minutes at a time if that's comfortable for you. In the beginning, I couldn't get comfortable in my recliner, but after a few weeks, it became the most comfortable place to be. I put a pillow behind my back and under my knees.

    Recovery will take a long time. It was 6-7 months before I started feeling "normal" again and several more months before my fusion felt strong. It was the never ending backache that was the worst, but I knew it would eventually go. I was driving at about the 6 week mark, and 4 weeks when I started walking outside the house. I used a walker then for a couple of weeks - it was good to be able to sit on it when I felt tired. Of course I overdid things in my desire to get well quickly, but paid for it with increased pain and fatigue. I then learned to pace myself.

    Keep going along steadily and I hope you get a good result like me.


    XLIF L2-4 20.8.15
    ALIF L4/5 2009
    Laminectomy/discectomy L4/5 2008
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