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medication change & increase or Stimulator?

Good evening! I have a tough decision to make. I am having pain control issues and asked my PM office for other suggestions. I have been having this flare since 02/2010 and I am really, really discouraged. Since 02/2010 I have had: physical therapy x 3 (3 month) rounds, 9 epidural steroid injections, I use a Tens unit daily, massage therapy regularily, accupuncture, hydrocodone, oral steroids x 7 rounds of Medrol Dose Packs at various times, muscle relaxers, gabapentin trials, antidepressants, nabumetone, etc, etc. My PM office has suggested I research and decide if I want to switch meds to either a Fentanyl patch or oxycodone or do a Spinal Cord Stimulator trial. I have an appointment with both the pain med doctor and nurse educator on 9/30/13 to discuss both options and see which way is the best to try next. I am torn because if I start down the slippery slope of increasing pain medications I will limit my future options. The spinal cord stimulator is frightening but I am past the point of letting fear control my decisions. Any suggestions, experiences, questions I should ask at the appointment? Thanks in advance for your time, thoughts, and perspectives.
DDD & spinal stenosis L4-S1 since 2001
30+ injections, PT, massage therapy, accupuncture, TENS unit, meds, etc but no surgical intervention
I am not a surgical candidate


  • If surgery is an option, before going for either option, I would seriously consider having the surgery done to repair the nerve compression/stenosis issues. While scs (spinal cord stimulation) is a good option, it is meant to be one of second to last resort..it is not meant to mask mechanical or compression issues that could be fixed with surgery.......in fact, inserting another device into an area ( if it is the canal itself that is stenotic) could worsen those issues......even though the leads are thin, and so are the paddles, stenosis can worsen over time, so if the area is already compromised, it would be a bit unwise to take up more space...
    As far as the fentanyl goes, there are many other options available in pain medications before making the jump to fentanyl....
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