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Inadequate Pain Relief?

A short history: I injured my back at work in January of last year. Doctor put me through physical therapy and I returned. It still hurt, but I continued to work. I reinjured 6 months later. After another round of physical therapy and it still wasn't getting better my primary finally send me for an MRI. It took until November to finally get the MRI. When the results came, it showed a massive disc herniation and I was in the neurosurgeon's office then on the operating table within a matter of weeks. Last December, I had a spinal fusion on L5-S1 which was where the main disc herniation was. My neurosurgeon said it was impressive and that he was surprised I could still walk. Last year's MRI showed that I also had mutlilevel DDD, multiple disc bulges (though none as severe as L5-S1), mild scoliosis, multilevel foraminal and central canal stenosis. My back is a mess.

The pain never went away. In fact, it seems to get increasingly worse. I saw my neurosurgeon four weeks ago because the pain is not going away. He ordered a new MRI. I showed him where the pain is coming from and he said it's a little bit above my surgical scars. After looking at my last MRI, he said it's most likely another level failing so he ordered the MRI to see what kind of damage there is and said based on that we may start epidural steroid injections. I started physical therapy three weeks ago (yes, I was late starting it because of all the pain I've had.) After starting it, the pain was crippling. I had a hard enough time getting around before hand. I mean, I am unable to do most housework, I can't walk very far, my life has changed, life as I knew it was over. But, after I started physical therapy it got even worse. I wasn't sure that could even happen. I have had a hard time standing from a seated position and needed assistance. I cannot walk up stairs without taking them one at a time, holding on to something and resting between each steps. I have a very hard time walking and have used a cane.

This pain is unreal! Let me back up and mention that I am only 35. I am the mom of three kids, so this kind of downtime is just not doable. I have to take care of these kids and have dinner on the table when my husband gets home from work. I am not carrying my weight around here and I feel horrible for that. I have not worked in almost a year and don't see myself going back if things do not drastically change. Anyway, my neurosurgeon has left my pain medication needs up to my primary doctor, and here's where things are falling flat. I also want to mention that I've had several surgeries and have never had this difficult of a recovery. I was flipping pancakes in my own kitchen two days after a c-section - twins!!

Currently, I take Percocet 10mg 3 x Day, Neurontin 400mg 2 x Day, Flexeril 10 mg 2 x Day. I also use arthritis rub, heating pad and this cool Polar Cube that I brought home from the hospital after my fusion that circulates ice water. I also use biofreeze from time to time but find that the arthritis rub works better. I also have some epson salts to soak in. I cannot take NSAIDS like Aleve, Aspirin or Ibuprofen because I've had a partial gastrectomy and it puts me at increased risk for ulcers - but lately I've been desperate and have taken it on occasion.

Anyway, I called my primary last week to tell him that since starting physical therapy I was in so much pain that I couldn't move. He wanted to see me ASAP so I went in. He said I couldn't take percocet more than I was already taking it, even though I told him it works at first but wears off after about 4 hours. So he put me on Tylenol 3. He said that codeine was just as good as percocet. I had huge doubts about this but I thought, he's the doctor I'll give it a shot. OMG. I got no relief from it. I am so scared that we are never going to find adequate pain relief. The best dose I've found is the Percocet 10mg but it will not last the 8 hours that is prescribed. He insists that there is no benefit of taking it 4 or more times a day. I don't know what to do. My quality of life is so low right now. I feel hopeless. I'm to the point that if I didn't have kids, I might consider doing something drastic just so I didn't have to endure the pain anymore. I don't know what else to do? I have the pain meds, muscle relaxer, nerve meds, heat, ice, rub, oh and my TENS unit, too. The Percocet and ice help the most, but I can't keep ice on it all day long and I can't take the Percocet more than every 8 hours. I'm at a loss. Help?
Large L5-S1 Disc Herniation
Spinal Fusion scheduled for 12/17
Multi-level disc degeneration and protrusions


  • wdufrenewwdufrene Posts: 9
    edited 09/23/2013 - 4:32 AM
    sorry to hear about your PAIN and lack of releif.. Not sure what you have as far as harware but i was told I can no longer use a TENS unit because of the Titanium in my back. Now if you was using it say in the Thorasic or cervical area ( I am not a doc but i would assume it would be ok) but the Lumbar should be a NO NO you will send electrical pulses into the pedical screws/rods? Somone please correct me if i am wrong but that might cause more Pain as well? I know we have nerves in the actual disc so sending electrical Freq into the harware might be part of the increased pain! what type of pain are you having? is it still shooting pain or is it localized lumbar pain. if its shooting pain you might have perm nerve damage or inflamation and scar tissue causing same issues you had pre op. have you had an EMG? if it is nerve pain maybe the doc could up the nurotin i was on almsot 1300 mg of gabapentin a day. i asked the doc to take me off to see if it made a dif. so far 2 months without it and YES it sucks for me right now. I just got the OK to get back on it but i have to build up to the dose that is theraputic. best of luck!
  • First of all , I'm sorry for the pain that you are..........but you are seeing your GP for pain management? You need to see a pain management doctor instead when it comes to long term management of pain. If there is indeed stenosis of the nerve roots and canal, that might be the cause of the ongoing pain and difficulty walking, which could be corrected by surgery to open up the spaces for the nerves to pass through. When it comes to the nerves in the spine, the longer you wait, the more chance that the damage can become permanent if it is not corrected. Surgery is offered in two circumstances in spine treatment- one is mechanical or structural damage, and the other is when the nerves /canal are compromised if it is severe enough to be damaging the nerves. Stenosis is classified as mild , moderate and severe....usually surgery is considered when it is moderate and severe.
    As far as the ddd goes, we all have that, and it is considered a normal finding on anyone's MRI unless there is contact with the nerve roots or the thecal sac( canal nerves covering).It is is a normal part of the aging process. People read the word disease and think that it is a horrific illness and means that the spine is deteriorating. It simply means that as we age, the discs loose some of their water content, it is a very slow process in the majority of people . DDD Resources



    Here is a link to a thread about getting treatment for chronic spine pain. It might help you to know what the standards are when it comes to treating back pain, but the first thing you need to do is find a proper pain management office and have them take care of the pain needs.
  • Oh and TENS is not dangerous to be used on the lumbar spine or anywhere else after surgery. Transcutaneous electrical stimulation is simply a 'massage' unit of sorts used to help treat pain and muscle stiffness. Many people find it extremely helpful for treating pain. It can be worn all day, every day and used regularly helps to mask the pain.
    There are also not nerves in the discs. The nerve roots in the spine exit the spinal vertebre at each level. The nerves in the canal travel through the spinal cord covering down through the spine.
  • well thats good to know.. therapist told me somthing different so i got rid of my TENS!
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