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pm - what to expect

portholepporthole Posts: 2
edited 02/25/2013 - 5:29 PM in Pain Management
This is my first post. I have had two herniated discs. I had a discectomy in 2011. A laminotomyin December 2012. My back pain has changed but not lessened.

I still have major back pain and my leg pain comes and goes. My tail bone hurts most of the time. The last my neuro surgeon told me the only thing he would do next is a double fusion of l4-l5 and l5-s1.

To my question:
I don't want to do a fusion. I'm always in pain, from mild to major. I saw my first pm doc almost a month ago. He went think about prescribing anything until after a month. He gave me a urine test (I will be clean). Then he is making me do therapy. I'm doing it and it isn't helping.

What is typically done? What do I expect? He told me he doesn't like to prescribe meds. He said my options would be meds, fusion, or an electric stimulator. What does a doc start with first? Is the stimulator invasive? I guess I'm worried I'll come out of there with something prescribed that won't fit my needs.

I've been on pain killers before and they worked fine. I wasn't addicted(nor do I want to be), but it just seems the easiest. Am I wrong?

What can expect from a pm? .I'm just concerned I won't get what I need. Am I worrying for nothing? Should this even be my next step?


  • Your surgeries were fairly recent, especially the laminotomy which was only two months ago so you are still in the healing stages post op for the last one. It can take time for the nerves and muscles to heal again after surgery, so you may find that you are left with some pain even once you are completely healed.
    As far as what to expect with a PM doctor goes, it depends on his examination and what he feels is the most appropriate option for you, and for your pain findings . Physical therapy can help alot in regards to helping to make sure that you are moving and lifting , bending correctly, especially given the lumbar issues and it does help to strengthen your core muscles around the stomach and back areas...so be open to that, and giving it some time to see how it works.
    As far as meds go, if he feels they are appropriate, then I'm sure that he will prescribe what he feels is best for you, once he completes his exams, goes over your previous surgical reports and findings, and any tests or MRI's and CTs you have had...
    As to whether or not he will give you pain medications, there is no way to know. If your pain is mostly nerve related, there are other medications which are far better suited than opiates to treat neuropathic pain, so traditional "pain" meds might not be the option that he chooses.
    Spinal cord stimulators work to lessen your perception of pain by interrupting the pain signals as they travel up and down the spinal cord tracts...there is a trial period where temporary leads are used to see if the pain levels you experience are lowered enough to justify the implanting of the device and leads..but I'm sure that he will discuss that option with you if he feels that you might benefit from it....
    Mostly, have your records complete when you see him, and let him discuss his findings a nd treatment plan. Give it some time and go from there. Most PM doctors do not prescribe any type of meds right away, they want to see how you manage your pain currently, make sure that you aren't abusing any meds that you are currently taking and need time to come up with a plan to manage your pain...
  • I think I'm a bit anxious. I'm so sick of being in pain. I am approaching 3 months post surgery. I had my surgery the first week in December. My back has progressively gotten worse rather than slightly better each week.

    Anyway, thanks for taking the time to respond. Hopefully meeting with him Thursday will put my mind at ease.
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