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Help with severe nerve pain...?

Hi guys.

I'm exactly two weeks and one day out of L3/4 fusion/lami/decompression. Additionally, they went into the non-fused level above and cleaned out room for my nerves to stave off stenosis and into the fused level below to also clean out room for nerves and clean out scar tissue.

For the last week or so, I've been having unbearable nerve pain in my left leg. It's like someone is stabbing it with a knife. It's always there when I sit, but can go away if I stay stationary for a while - in my recliner, not on a hard chair. When I get up to a standing position from sitting, it hits so hard I can't put weight on my left leg until the pain subsides.

It's worse in the evenings and first thing in the morning. It doesn't seem to hurt while I'm sleeping, only the surgical back pain. That in itself is bad enough, but this nerve pain is killing me and as you know, pain meds do nothing for that.

I know so many of you deal with this, many every day and some constant, so I wonder if you have any suggestions for me? Last Friday my doc said it's to be expected and that it would go away. He said they basically fractured a bone in my back with the Lami and cleaning out space, so my nerves are bound to get upset. I realize I'm still early out from surgery, Friday doc appt wasn't that long ago and remember having this with my last fusion, but is there some secret y'all are keeping that you can share to help make this easier to deal with?

Should I take a few days to mostly sit/lay down, would that help? I'm rather active, even this early in recovery, but I'd do anything for this to even ease up.

Thanks for any suggestions, experiences or help you can provide. It's all-consuming at this point and I'd much rather just battle the surgical pain.


PS Let me know if I've left anything out that you need to know. I don't know who else to turn to other than my fellow spineys. Yes, I could call the doc, but would like to give it time to settle as he suggested, I just am not sure what's the best way other than roughing it out. Sorry this post is so long.


  • dbhamddbham Posts: 42
    edited 01/02/2013 - 10:16 AM
    Sounds like my sciatic pain. Mornings and evenings are worst for me.
    I have not had surgery. Yet........
    I think you probably still have a lot of inflammation from the surgery.
    I'd suggest do what ever to keep the pain away.
    I'm still in bed on my back 24/7 because of the pain.
    I smoke so when I go out in the mornings when I get up I have to give my
    Leg a few moments to adjust. The sciatic pain hits hard getting up from sitting.

    Do what ever to let your back heal. To much up and down might keep up inflamed.

    Hope you feel better soon.

    L4/5 herniation13mm sequestered fragment L5 root compromise.
    L3/4 annular tear.
    L2/3 3mm bulge and annular tear.
    Tens mpo combo system
    Epidural L4 L5 28Nov12 / 12Dec12 / 26Dec12. All no relief :( SO FAR
    MicroD L4 L5 May 23 2013
  • jellyhalljjellyhall Posts: 4,373
    edited 01/02/2013 - 11:00 AM
    to hear that you are suffering with this nerve pain.

    As you know, you are very early on in your recovery journey.
    Some ideas that you could try are to ease back on what you are trying to do. There will be time enough to get more active, but if you are suffering pain, perhaps your body is telling you to ease off. I wouldn't stop moving altogether, as we know that frequent short walks are beneficial, but keep them short and rest inbetween.

    The other thing that may help is icing your lower back. As dbham has said, you probably have lots of inflammation from the surgery and that could be causing compression of nerves. Icing may reduce any inflammation that you have.

    I also found/find that listening to calming music (I made myself a Christian worship music CD) helps me to relax and focus on something else other than the pain.

    I do hope that you will find some of these things will help you, and that everything will settle down soon.

  • Cathie - do they have you on any lyrica or gabapentin? Shortly after I got home from the hospital, my legs started going nuts. It was like a bad case of restless leg syndrome. They felt like they were on fire and I couldn't do anything to stop it. I spent most of my time on the couch, just writhing from the pain. The doc called in some gabapentin for me, but it didn't help. Then we tried Lyrica. My insurance didn't want to pay for it, but it worked, so the doc wrote a justification, and I ended up getting a prescription. It can cause some side effects, one of which is weight gain, so I eventually weaned off it. Two other times during my recovery (period of about 18 months), I had bad leg pain flares and ended up taking the Lyrica again. It was the only thing that helped me. I think after about three doses, I felt a lot better.
    Hope that helps!
    3 level spinal fusion, L3/4, L4/5, L5/S1, November 2008. Stiff, but I can walk.
  • Thanks Dave, Jelly and Linda.

    I haven't iced my back at all, so will try that. I thought that I may be moving too much. When I do get up and can finally walk, it goes away slowly the more I walk, but then hurts even more once I sit again. So sometimes I just walk around my house for 30 minutes or so. I also have a numb patch on my left leg that doc says is also normal, considering. My incision is pretty swollen, but looks fantastic - just the normal swelling that happens when someone slices 7" inches into your back. LOL

    Linda, no I don't take nor have any nerve medications like gabapentin or lyrica and am going to try and stay away from them for now. This pain can't keep on like this unless there's something seriously wrong in there. In that case, back to the doc I go next week. I just took a shower, which felt fantastic, and am in my recliner resting. I think that's the best thing. Like my doc said, "If it hurts, don't do it."

    I don't know how some of you live with this kind of pain on a daily basis. It's driving me crazy!

    Thanks again. I'll keep you posted.
  • Cath111CCath111 Posts: 3,702
    edited 01/02/2013 - 11:31 AM
    I really think when we're in recovery (as well as other times, but I'm just talking recovery right not), we really need to listen to our bodies.

    I just realized that I get very sleepy around 2-3 in the afternoon. When my hubby was working inbetween holidays, I'd lay on the couch in the afternoon, turn on a movie and either watch it but most likely fell asleep during it. Obviously my body is telling me to rest.I just remembered this when my eyes started to close a minute ago.

    According to my doc, this surgery was in the "critical" category with all the possible complications and he told me at my pre-op that my recovery would be more difficult and painful than the last one, so to be prepared. So I think that's the key - rest, rest, and more rest. If my body wants a nap, give it a nap. If it wants to sit, then I'll sit. I need to take it more easy and do more resting. Not an easy thing to do, but my future back is at stake here and I will not compromise its recovery.

    Just had to throw that in.

  • That sounds like a good idea Cathie!
    Just what the doctor ordered!

  • thepretendertthepretender Posts: 36
    edited 01/02/2013 - 2:25 PM
    I suffer from chronic and possibly permanent nerve pain. I'm very experienced in trying everything and do have a pain specialist to help me. Some ideas:

    - TENS unit. I'd be lost without it. I actually have 3 but love this one from Zynex that has two other settings. IFC and NMES. the NMES setting is most effective on me because I have severe numbness and it really cuts down deep But any TENS unit will be helpful for you. If you don't know how to get one from your doctor you can also order them online. I've used Amazon.

    - Keep a pain log to track when the pain starts to spike. Once nerve pain starts for me it just spreads like fire so it's best to get really ahead of it. If you have access, I use both slow release and short life pain meds. My pain spikes around 2 so to get ahead of it I take my slow release oxymorphone around noon with lunch and then two 5 mgs of oxycodone at 2. I find that if I d that I control the pain and don't need to take really anything else after that. It nicks it in the but pretty well.

    - ice. Depending where the source of your pain is, mine's in my right butt which I call my rump roast because it burns so much. Putting ice directly on the source doesn't necessarily do anything for long term but in the short term provides relief.

    - nortriptyline. This is an anti-depressant based drug that puts your nerve to sleep. It's what I'm most fond of because I am pretty sensitive to opiates. The drug acts to put your nerve to sleep. It does take a few weeks to build up before it works and is more a long term type med than short term so depending on what they think this looks like for you it may be effective

    - walking! Last but not least is walking. This is my ultimate friend. When you start to walk it is hard, sometimes I am literally tearing up walking down my street but once I hit a stride, be it endorphins or just the action, my nerve pain starts to feel better. Walking is also great for your spine recovery so walk as much as you can, multiple times a day even. It really helps.

    Hope some or all of these hell you out. Good luck, nerve pain is the worst!
  • If worse comes to worse doctors often call in. Prev pack which is roids for 10 days to take away severe inflammation !
    If you feel its realy out of control and rest aint enough to help call the doctors nurse , The 10 day roids always helped after surgery during recovery,
    Flexicore ADR 2004 resulting nerve damage l4l5 Fusion 2006 same level, 2009 hardware removal with lami !
    2012 scs implant ,
  • I'm glad you can hold out. When I had the pains in my legs, they would not subside and I needed the medication. If I were to have a recurrence at this point, I'd do it again. I don't know how you could stand to do without it. I could not tolerate the pain, it was so bad.
    3 level spinal fusion, L3/4, L4/5, L5/S1, November 2008. Stiff, but I can walk.
  • Cath, shame this is happening.

    Do you pain generating nerve is from L4 decompression or the L5 clean out based on the Dermatome map?

    Sounds like the nerve does not like sitting but is ok walking. So have you considered alternating lying on bed and walking? Thereby allowing nerve to settle.

    Good advise given by other members.

    Take care.
  • Cath,

    I actually disagree that pain meds don't help nerve pain. So if your feeling the pain that bad, I would try them. As you know I live with lots of permanent nerve damage, and most certainly those pain meds help with the nerve pain. How they work on it or what it does, I don't really care, I just need the relief. I will also tell you the number one way I always have to stop it is lie down with some meds and ice. However we know that is not always possible. But you are in recovery, so you need to take it easy. Remember the whole regime on walking, maybe you should try just that and leave the rest of the things alone for awhile. I know it is hard and boring, but hopefully it will be well worth it in the long run.
  • Hi Dave. On the dermatome map, my nerve pain is from the L3/4 level and the numbness is at L5 level. That to me men's that where they cleaned up the mess during surgery above my fusion is irritated, which makes sense as they probably irritated the nerves at that level. The numbness might come from cleaning out the scar tissue.

    So with all that talk of rest and how some or most of us believe that's key right now, I took my first walk outside yesterday with a rolling walker and two friends spotting me on either side. I made it a block and back. I think it helped, though, but today my recliner is going to get very tired of seeing my butt. The nerve pain is not shooting dramatically like it was, ok it is but not as bad as before, but the pain is constant. Oh, I also tried some ice on my back while in the recliner and believe it helped a little.

    Alex, if this is still happening next week, I may try the road pack - its helped me a lot in the past so it may come down to that. Time will tell, so thanks for the suggestion.

    Tam, like you and Dave said, walking is the best thing we can do, even if its the only thing we can do. I'm going to start a walking regimen this weekend and will add my little Wally on Monday. Dad will take him with us this weekend. That's our best exercise, even if you have to walk one day and rest the next for a while.

    I also believe that pain meds can help nerve pain, but not a whole lot mostly. I suppose it depends on the severity. For me, it probably helps the ongoing, nagging pain, but nothing for the stabbing pain. The only thing that helps would be to rip my leg off. I tried, but it's on there pretty solid. Too bad I haven't had a hip replacement where they install little release clips so I can remove it when I want to. Lol. I could just set it in the corner and stick my tongue out at it. :-)

    Time, time, time, rest, rest, rest, walk, walk, walk. That's the key to recovery in the first few weeks - and meds, thank goodness for them.

    Hope y'all are having a good, pain-less day. I'm going to nap today. Ahhhhhhhh.

  • sunny1966ssunny1966 VIRGINIAPosts: 1,385
    edited 01/04/2013 - 5:04 AM
    Well, I see you're getting stir crazy already. I understand that all to well! Lol.

    Sorry you're having so much pain and hope it soon subsides. Time, rest, and walk....yep. Don't you love it? This too shall pass...right? Soon you'll forget all about this and be better than normal! That's the plan anyway right?

    Thinking of you my friend and hoping you're much better soon.
  • dilaurodilauro ConnecticutPosts: 9,846
    I also agree with Tam. I have a lot of nerve pain and take about 2600mg of Neurontin daily. Sometime, I feel a bit better, but at night, the only that takes care of my nerve pain is my Oxycodone IR. So, I would not hesitate about take your narcotic (as long as it falls into your daily dosage prescribed)

    I would take it much easier the next couple of days and use ice. Then after a few days if you see any type of improvement.
    Ron DiLauro Spine-Health System Administrator
    I am not a medical professional. I comment on personal experiences
    You can email me at: rdilauro@veritashealth.com
  • Long time no talk, Debbie. Yes, you know about restlessness and overdoing it. I haven't seen a reply to my email from you...are you afraid to tell me what you've been doing? I'm sure it's not what you're SUPPOSED to be doing. Let me know how you are, my friend.

    Ron, my doc actually told me to take more oxycodone than I have been. He knows about the nerve pain and said "you've got them, take them! There's no need for you to be in this kind of pain!" So I take it before I go to bed and in the middle of the night. I also take it during the day if I feel like I'm dying, but not very much or often. I rested all day today, got a nap in and will rest thi weekend, too. I just have to go to church and that's it. I'll see about the walking...I need to watch this leg and make sure it's temporary. I'll never know unless I rest and luckily hubby understands and has taken great pride in taking care of me including cooking every meal with veggies, carbs and protein since I got home. I think we had one frozen pizza one day, but otherwise he does everything and works all day too. I'm very lucky.

    So we'll see how it goes. Thanks for the reply and suggestions. I'm off to get some ice and plant myself back in the recliner now.

  • Cath, yes you are lucky with your husband. He sounds like a kind man.

    I laughed at you taking your leg off and poking your tongue out at it. I can relate to it.

    Non the less, We hope that this will get better. Fingers are crossed.

    Yeah, there's no point in suffering unduly. The meds are there for pain relief.

    Take care.
  • Why is it that you won't take a nerve pain medication like Lyrica or gabapentin? I have a fairly high pain threshold, but I could not bear that leg pain when it was really bad. If relief is available, why would you refuse it?
    3 level spinal fusion, L3/4, L4/5, L5/S1, November 2008. Stiff, but I can walk.
  • You survived surgery and you now risk eating husbands cooking ? You are brave !
    Flexicore ADR 2004 resulting nerve damage l4l5 Fusion 2006 same level, 2009 hardware removal with lami !
    2012 scs implant ,
  • First, lol Alex. I haven't thrown up yet so I think he's doing alright. But then, maybe he's sneaking in a neighbor to do the cooking and passing it off as his own. Lol

    Linda, it's not that I refuse to take nerve meds, it's just that this particular nerve pain is temporary (as it was with my first surgery) and since I can't drive to my surgeon's office for the script, and I believe it will go away before the nerve meds have a chance to kick in, I haven't pursued it. It seems to be getting better over the last two days, but believe me, if it was to hang around for another couple of days, I'd put a call in to the doc. I just truly believe its temporary and will go away on its own. It's already better today and I'm taking my first real walk, so we'll see what happens. I may end up on them yet. Thanks for your concern!

  • Just over a year ago I had L3/4 fusion/lami/decompression... I'm still have cronic nerve pain in my legs and feet. I'm on gabapentin 800mg 3 times a day, and pain meds 3 times a day.. None of this has helped. I still suffer from chronic pain the worst pain i have ever had.. I see a pain mgt doctor but nothing seems to help. The pain med only helps for an hour or so...Its hard to focus on work with the pain so bad.. it's hard to sleep..
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