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Recurring L5/S1 - MRI inconclusive -no options left?!?!

I had a microdiscectomy in September 2013 for a herniation at L5/S1 with full compression on the S1 nerve root. Surgery was a success and I was completely pain free for 5.5 glorious weeks. Since then, pain has returned and same issues have developed. I had an MRI done in March and report showed that there was another herniation at same level with some nerve compression.
Saw the surgeon this week. He feels that the report is somewhat inconclusive. Could it be a small fragment from a herniation..... Maybe. Could it be the cause of pain..... Maybe. But not entirely convinced. My options are bleak.....
Facet blocks don't really work. Had rhizotomy last summer with some improvement (so we will repeat this next week and be a bit more agressive with it). Another microdiscectomy? Comes with more risk. He could go in and remove said fragment, but existing scar tissue means he has to peel away at the layers which brings higher risk. And another cut means more development of scar tissue. Discogram? He doesn't like them and doesn't feel they are a good diagnostic tool as there are too many false positives and false negatives. And he would have to send me away for that. Same with a disc replacement. Has its own set of problems. Fusion? Well, that is an option, but if the pain I have isn't coming from the disk itself, then I out myself through a major surgery and wake up to have the pain still there.
There doesn't seem to be any way to the,not diagnose exactly where my pain is coming from (disc, nerve, joint, muscle)???? So they don't really know what to do to help me or how to move forward.
I have had to drastically reduce my hours at work (standing for 10hours 4 days in a row) does not help, physical activity is great, but I pay for it afterwords.
Pain meds kinda sort of help on days where I am sedentary. But in order to be active, I can't seem to achieve enough pain relief to do the things I need to do (hiking/competitive horseback riding).
I am currently on 50mg Nucynta (tapentadol) twice a day (only one I can take without awful side effects) and 300mg gabapentin twice daily. Anyone in a similar boat (with no apparant oars)?


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