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Doctor says no NSAIDS, so WHAT then?

TessGTTessG Posts: 23
edited 06/11/2012 - 8:19 AM in Back Surgery and Neck Surgery
If NSAIDS interfere with the fusion process, what drugs can be taken for arthritic pain? My 77 year old mom has developed arthritis so bad in her hands lately that it's hard for her to grasp things. It's in her arms/shoulders as well, and she also has rotator cuff issues. These things prevent her from being able to push herself up in bed effectively to get out and walk as much as she should. The pain keeps her from even wanting to try.

It's really dampening her progress and she's depressed. What do the rest of you with arthritis take after fusion surgery that doesn't interfere with the fusion process? I have a call in to her doctor, but it's not been returned yet.




  • When was her fusion surgery? Mu understanding is that once the person is fused it is OK to take NSAIDs, although I am not 100% sure. But since my own fusion was less 2 1/2 months ago, the only things I can take for arthritic pain are Tylenol and Vicoden. But you are wise to check with her doctor, there may some more effective NSAIDs.

    Hope she find releif,

  • She's 5 weeks post-surgery. Not sure how long a typical fusion takes, especially in a 77 year old. She's sees the surgeon again in 2 weeks for another followup, so I guess that's a question we have to ask. I hear Tylenol makes a product especially for arthritis so I'll go to Walgreens and look for it. Thanks for the reply! This group is a Godsend...
  • At 5 weeks, it is still too early to go back to NSAIDs. Now as far as the fusion, it varies greatly, some people report that they are fused at 6 weeks, some at 9 months or later. Officially fusion can continue up to two years after surgery. At my 6-weeks check-up I was disappointed when the xray did not show fusion yet, but my OS it was way too early, he did not expect anything until at least 3 months. Then there is the question of whether someone is fused completely or just beginning to show signs of new bone growth. So I guess we just have to be patient.

    Kin :) :) :)
  • I started the same subject about a month and half ago and replied to one just a few weeks ago.
    I called the surgeon who performed the operation and he said that it is OK to take nsaids. I was confused about why he would say that it is ok but other drs disagree so I called my regular dr and she too said that it is OK to take them after surgery and she too was confused on why any dr said that it is not ok to take.
    I guess it just depends on the dr
  • In fact he prescribed them at my 6 week check up after my cervical fusion.
  • i think it has something to do with bleeding after surgery not 100% sure.
  • My surgeon allowed me to go back on Celebrex one month after my last lumbar fusion. After the 1st surgery it was 6 months. Really needed it for arthritis in my hands and knees.
    He said new research shows NSAIDS are ok after fusion surgery.
  • NSAIDS and fusion is a highly debatable subject among surgeons. Some say that even with the new research, proof is still there that NSAIDS interfere with bone growth.

    This is the way it has been explained to me: For the ossification process to occur, there has to be inflammation. The inflammatory response automatically increases cell activity around the area that needs to "fuse" together. This is important especially in the early stages up to the first 3 months. By taking an anti-inflammatory, you are stopping the production of increased bone cells. Without that increased cell activity, some say that the bone graft could shrink rather than grow with your own bone, and eventually it could just shrivel up and die resulting in a non-union.

    Now, I am not a medical person, so please don't take this for fact. I'm just relaying what I have been told. I am in a different situation where my new surgeon prescribes ibuprofen, so everything I just described is voided out by his opinion. but having gone through one failed fusion already, I am not going to take NSAIDS, because why risk it?

    Please just consult with your doctors and do what they say is best for your own individual situation. In a situation such as the original poster on this thread has, with arthritic problems, maybe the benefits outweigh the risks in her situation.

    And now that we are all thoroughly confused on the subject, I'm signing off. ;)
    Surviving chronic pain one day at a time, praying for a reprieve because living another 40 years like this doesn't sound too fun!
  • My surgeon is also on the no NSAIDS band-wagon. There are steroidal anti-inflammatories like prednisone, but of course they have their own issues (decrease healing, upset stomach, cause water retention, etc). The tylenol arthritis formula may help, but remember to check if she is on pain-meds containing tylenol(acetaminophen). The max daily dose is 4000mg do to the risk of liver damage. Good luck, Sue
  • I suggest that your mom talks directly with her doctor about this issue. Arthritic pain is debilitating and her doctor may deem the benefits of an NSAID may outweigh the risk, or he/she may prescribe some suitable alternative.

    The medical profession seems to have mixed feelings regarding the effect that NSAIDs have on bone fusion. Apparently the evidence that it inhibits bone growth is somewhat anecdotal or at least has not been 100% conclusively proven. So, the majority of doctors err on the side of caution and will not prescribe NSAIDs so soon after fusion surgery.

    My surgeon, however, prescribed me a COX-II NSAID for my first 4 weeks post fusion (as this was when inflammatory pain was worst and therefore NSAIDs were most appropriate) and I still fused as quickly as anyone else. DON'T however, use my case as evidence that NSAIDs don't affected bone fusion - please always follow your own doctors advice.

    Keep positive!


    ...an old timer here and ex-moderator

  • Chris' OS has him on Celebrex, a cox-2 med but no other NSAIDs. When we questioned him about the Celebrex, he said studies had shown that it did not inhibit bone growth as other NSAID compounds did. Terri
  • Finally, I found a blog that touches on the dilemma of people with severe arthritis in their feet who have to stop taking non steroidal anti inflammatories to allow a spinal fusion to take. It's horrible pain in my feet that prevents me even from walking and I'm normally perfectly capable of walking and getting around just fine - even exercising and running in the gym so the problem is so what am I going to do for the next 6 months while my Fusion takes?  So far, my fusion at C-1  C-2 is taking well.  I'm our of the halo but my feet hurt so bad, I can hardly get out of bed, where I used to do a step aerobics class three times a week.  Can anybody assure me that the pain will go away completely from my arthritis as soon as I resume my non-steroidal anti-inflammatory?
    David Band
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