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When to return to pain mangement post-op

Lala329LLala329 Posts: 283
edited 06/11/2012 - 7:39 AM in Back Surgery and Neck Surgery
I was wondering at what point post-surgery is it wise to return to pain management following fusion surgery? I mean this as in, when should I have a good idea of the amount of pain that will be left when all is said and done with the surgical recovery? I know recovery can take up to 2 years with the bone graft and everything, but the fusion should be pretty solid before that point...

A brief history: I did the pain management thing pre-surgery for 2 years and was on percocet prior to my surgery. At 2 months post-surgery I came off all my pain meds because my surgeon said his patients tend to do much better off of pain medicine. I am now at 4 months post surgery and the only med I'm on is flexeril as needed because I'm still having muscle spasms. The pain I have now feels like it is all muscular, and my PT assured me that as I continue to strengthen and adjust to the hardware and the loss of motion the muscles should calm down.

This leads to my question. When should I look into the pain management options for the remaining pain? I feel like at 4 months post-surgery muscular pain is to be expected and does not require intervention, but at some point if this continues I feel like I will need additional help. I have in my head that at 6 months I should go back to pain management if I'm still having problems, but I don't know if that timeline is reasonable or unreasonable. I'm hesitant to let it go too long, but at the same time I know surgical recovery is uncomfortable and this is just part of the process.


  • SpineAZSpineAZ WiscPosts: 1,084
    There are some surgeons that push to have all medications tapered off. But in some cases there are other pain issues not taken into consideration.

    I'm about to have lumbar surgery in February and I've recently talked to my PM doc about "what happens if the low back pain eases up but the neck pain continues?". He said that as soon as my surgeon no longer feels he can no longer prescribe meds that is the time to return to him for PM. For me this will likely b 1-2 months after surgery.

    In meeting with my PM he and I discussed a surgeon that my neighbor just used for back surgery. This particular surgeon has a severe aversion to pain medications (before and after surgery). So the PM has had to take those patients immediately after surgery and although the surgeon doesn't like it the surgeon does know that pain management continues. I need to refer my neighbor to my PM doctor as my neighbor has had severe pain with just a week's worth of vicodin upon discharge from the hospital.

    So if you have pain and need help - go seek PM. Let your surgeon know in follow ups and let him/her know how much of the pain meds are for the condition he treated you for and how much are related to any other conditions.

    I hope this helps, let me know if I can help further.
    2 ACDFs, 2 PCDF, 3 LIFs; Rt TKR; Rt thumb fusion ; Lt thumb arthroplasty; Ehlers Danlos 
  • Honestly? In my opinion you should go to a pain management doctor when you are in pain. I called and made an appointment with a PM doctor as soon as I was home from the hospital. To me it was important to try to take care of the pain before it became a huge issue. Unfortunately for me I had a really terribly, rocky recovery at first but not because of my PM doctor.

    If I were you, I'd just call the PM tomorrow and explain your situation. I don't think waiting another 2 months will help you at all, because if you're in pain you won't heal properly. I'm really quick shocked that your surgeon wanted you off pain pills after 2 months. "All his patients" does not necessarily have to include YOU, after all, everyone heals and responds to pain differently.
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  • I never stopped my pain management.
    They took care of my pain meds up until my surgery and even directly after. Well, two weeks after as my pain guy was out of the country right after my surgery but I only had to get one script from my surgeon to tide me over til he got back because my percocet had to be a higher dose.


  • It has been a year (12/12/09) since my fusion. I have had the same bottle of pain pills since February. Out of 30 pills, there are about 20 left. My doctor doesn't think you should need them and I do not. But, they are my buddy and I know that if I need them they are there. So many of us know what the pain was like before surgery and I think we all just want to be prepared in case it comes back. In my case, I did not have pain pills prior to my surgery. I just put up with the pain. Stupid, now that I think about it. I just did not want to ask for them. I would try to stay off them, but then, I am not you and don't know what your pain is like. I too was one of those who thought people with back pain were babies until I hurt my 20 years ago. Never thought that again. Good luck.
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