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Surgery options???

I have recently moved from a regular orthopedic to a pain management center now. My old place said they would continue to do steroid injections and if it didn't work i thought he said maybe surgery? My new pain management doctor and me talked about this and he said i am young and he doesn't want me on narcotics forever. I asked him about back surgery. I have a herniated disc at L5-S1 and it pushing out on my sciatica nerve. My PM said usually if it's an easy fix or the doctors think it can be fixed they would refer me out to a spine surgeon. He said in my case he gets the impression they don't believe it's an easy fix. Has anyone ever heard of this??? Or maybe he thinks it's the wrong idea for me with being only 29 years old with 2 young kids 7 & 9 i don't know. Right now i am just being treated with percocet 10/325 2x day and flexeril as needed. I also have an ulcer and have already had 2 injections since June so i have to wait on a 3rd injection. Any opinions on this??
Herniated disc diagnosis 6/2013
Bulg disc pushing on nerve at L5-S1
Steroid injection #1 was 6/2013
Steroid injection #2 was 10/1/2013


  • Pain management is not there to recommend surgery or not, they are there to offer treatment alternatives to surgery. To find out if surgery is an option, I usually tell people to visit at least one ortho and one neuro spine surgeon for a consult to see what they think. The surgeons will tell you if surgery is an option and if so, what type of surgery might be done.
    They will also tell you if surgery is not an option. And if you find that the surgeons don't agree, then you always can visit another. I visited 5 different surgeons prior to my second operation to figure out what if anything could be done.
  • Yes my 1st doctor with at a neurospine center he was a psychiast though sorry if that is spelt wrong. Anyway i don't ever remember him recommeding surgery as an option for me i but he may have and i forgot maybe if he did it was something along the lines if physical therapy and the injections don't work. I hear conflicting info... people telling me it's the best thing they have ever done and other's telling me i am too young and i will make things much worse.. it's this or the continued meds/injections at this point. The first injection i had definitely helped knocked the sciatica out a whole lot but the second injection didn't work. My job requires me to be on my feet all day and life stuff and i am in a whole lot of pain by the time i am there 2 hours IF THAT. I still have to sleep with a pillow under my back too because i always feel like something is bulging out.... it's not fun that's for sure. The neurospine center however told me it's one or the other... either PM or the neurospine center and they already made me aware no nacotic pain meds would be given and i definitely need something stronger than flexeril which makes me sleep or tylenol after being on the go all day.
    Herniated disc diagnosis 6/2013
    Bulg disc pushing on nerve at L5-S1
    Steroid injection #1 was 6/2013
    Steroid injection #2 was 10/1/2013
  • http://www.spine-health.com/forum/pain/chronic-pain/chronic-pain-treatment-step-step

    There is a step by step process that doctors use when it comes to treating back pain, starting with the least invasive treatments and therapies and then progressing if things don't improve or resolve. Thankfully , sciatica is usually in most cases self limiting- meaning that it resolves itself over a few weeks to even a couple of months and then disappears just as quickly as it came.
    The only times that it doesn't do that is when there is something compressing the sciatic nerve that needs to be relieved.
    Insurance companies don't want to have patients heading into surgery when surgery isn't medically necessary or warranted in most situations.
    You saw a physiatrist, right? I understood what type of doctor you meant, I saw one too, at my consult with the surgeon before I ever saw the surgeon......in fact, he managed my care right before, and for several years after....
    I adored mine and he was really good about ordering whatever tests and studies I needed and referring me to doctors that I needed to see.
  • laura, i also go to pain management for herniated l5,s1, and at my last appointment, almost 3 months ago, the nurse practioner came in and said the doctor was not going to treat me anymore, because there was a solution to my problem, which was surgery. i was in shock, as how good i was feeling, and just like that, he was going to stop helping me. but the nurse called me later, and said i spoke with the doctor, i believe you are a good honest person, always at your appointments on time, and never fail the drug test, so he will keep seeing you. i was totally relieved, but i have my next appointment in 2 weeks, kind of concerned what will happen this time. the nurse told me a while back that he would not have any problem, giving me meds, as long as something was working, and not needing something stronger all the time, which i have not. good luck to you, hope you get the help you need.
  • i don't understand the it is either the pm or the surgeon statement they gave you. i see both and they both work in conjunction with the other. it is not either or but both and it should be that. i also had to go through several steps and procedures before they gave me meds. disectomy, mri, x=rays,, cat scan, nerve conduction tests, injections, lasar disetomy, and then weak meds, narcotics before they gave me stronger ones. i had methadone first, then weak oxy, then 40 mg with breakthrough meds, fenatyl lollipops. then finally a fusion which kept me in the hospital for 10 days i have had 3 other fusions since and i see my pain dr every two months. one does not go to a pain ddr and expect narcotics off the bat. i never had have a urine test or a count either. just signed a pain contract when i first saw him. i have seen 2 pain drs in my life and the first retired. i never had had issues with anyone.
    I have 4 fusions from L5-3, the latest last May '12 where they fixed my disc that broke.They went through my side this time. I take 40 mg of oxycontin 4x a day and 4 fenatyl lollipops 300 micro gms 4x a day.
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