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SCS or Pain meds?

mellynn36mmellynn36 Posts: 24
edited 06/11/2012 - 8:49 AM in Pain Management
My pain doc informed me he thinks I have failed back surgery syndrome. I had a bi-level spinal fusion (L4-S1) in late June. All signs point to the fusion going great, but I still suffer from searing radiculopathy and lower back pain as a result of my sacroiliac joints. I had injections into the SI eleven days ago. No relief. My pain doc told me that I might need to look into getting a spinal cord stimulator. I am a little squeamish about it, to be honest, and am worried about the practicality. Any input on how the SCS worked for any of you? Would you choose the meds or the SCS? I'm not asking for medical advice as much as personal advice--I need to weigh the pros and cons, and I could use all the real-life experience I could get so as to make the best decision for me (working with my pain doc, of course).



  • Hi Melanie,
    SCS and intrathecal pain medication pumps are supposed to be "last resorts" in the pain management protocals.
    Since you only had surgery in June , it is a bit early for your doctor to be calling what you are experiencing a "failed back surgery syndrome" and suggesting scs as a method to treat your pain.
    There are lots of neuropathic pain medications that you can try, as well as the classic SSRI's which as also very good at treating the neuropathic pain, and then there are the regular opiate pain medications, although some doctors believe that those don't treat neuropathic pain very well.
    You don't say how old you are, or what current and previous treatments other than the surgery you have tried, but my own feeling is that you should exhaust all of the other medical and physical pain treatments you can try before submitting to scs or even the trial.
    You are barely getting started in the journey of treating chronic pain and it seems to me that trying any and almost all other methods of treating the pain should be the route recommended before doing anything more invasive than injections at this point. Did your PM tell you that nerve pain can continue to resolve itself for about 24 months post surgery?
    Physical therapy, stretching excercises, yoga, accupuncture and many other modalities are available for you to give a good try before going the scs route.
    Also , your injections might have failed this time, but my understanding is that even when one fails, or even two, it is recommended to try a series of three because placement may be more accurate with a 2nd or 3rd injection than it was previously.
    Best of luck to you,
  • if i could get by on pain meds instead of an scs, i would in an instant! if you haven't already, you might take a walk through some of the threads in the spinal cord stimulation forum. you should be able to get some good information there.


    "c" owner of a cervical scs since may of 2008
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  • I agree with Sandi. I do have a SCS. But I am also still on meds. And will be the rest of my life.

  • Thanks for your responses. I am almost 37. I had a laminectomy almost nine years ago on my L4/5. The residual pain lasted for about a year. I had no problems other than muscle issues (my back would go "out" maybe once or twice a year). Three months after the birth of my daughter (in '08), I blew out the L5/S1. I saw two doctors (one a spine surgeon) who told me I just had a sore back from carrying an infant seat and a gallon of milk at the same time. Helpful, huh? I asked my then-family doctor to order an MRI (my physical therapist also reinforced my request). I was told that because I was overweight, she would not order an MRI, but was more than happy to set up a gastric bypass. WTF?? I made my own appointment with an ortho/spine surgeon. We did conservative treatments for a year. He sent me to the PM doc, we did three ESIs (none of which worked), did the nerve meds (made me feel like I was in some other world-impossible when teaching 150 high schoolers throughout the day), and went with dicoflenac and Lortab until my June surgery. The surgery was successful in that it allowed me to regain most of the sensation in my left leg. After three months of PT, it became clear that the pain/neuropathy was increasing and it wasn't around the incision, it was the SIs. To sum up, this has been a problem three years in the making, and back pain isn't a new experience to me. Not even close, unfortunately. I have poked around the SCS board, but it doesn't see as much action as this one does, so I posted on this one. Hope that's okay.
  • I agree with Sandi. You are still in the early stages of your recovery. It takes a year or longer to recover from a from a lumbar fusion.

    I have had an SCS but it failed to help my pain and now have a pain pump implant but like "C" would give up my pain pump in an instant if oral pain meds could give me the same pain relief as I now have.

    Are you getting any relief with the meds you are now on?

    Best of luck to you.
    Patsy W

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  • We have a fine group of members that respond to the SCS topic area. We just don't get as many questions as others. I've had my stimulator a little over a year now. I still take prescription drugs on a daily basis. A lot of people who have a stimulator still do. For most it helps us to reduce what we take. I didn't get my implant till almost 2 1/2 years after my fusion surgery and a year and a half after my revision/hardware removal. If you can manage with oral meds, then by all means go that route. A stimulator is such a life altering event that should be contemplated when all other options have been tried.

    What are you currently taking? Are you doing any physical therapy? Tell us a little more about yourself so we can relate our experiences a little better.

  • I have been in physical therapy since August. My most recent session was almost two weeks ago because I'd used up my visits for the year. My next appointment is January 3. The only meds I am currently on are a prescription-strength naproxen, which is WAY undertreating my pain, but I wanted to do the ten days after the ESI to see if it worked. It's important to note that I didn't ask for anything stronger than the anti-inflammatory at my visit prior to the injection b/c I wanted to see how it went. Now that I know, I am calling the pain doc today, seeing as the injection didn't work and I am starting to be miserable.
  • How long have you been on the naproxen? Anti-inflammatories have been found to inhibit bone growth. Don't be to concerned with that statement, cause if memory serves me correct, I was prescribed naproxen at the 4 month mark after my fusion. Your only 6 months out and the fact that you are at least able to withstand a drug holiday speaks volumes. I hope your PM gives you something to make you more comfortable. It sounds like there may be better days in your future, just may have to be patient.

  • My spine surgeon gave his blessing to take ibupfrofen about a month ago b/c I was in a lot of pain. My last x-ray showed my fusion progressing well. How am I surviving? Not very well. I am a teacher and the mother of three children, the oldest of which is almost 12, and the youngest of which is 2 1/2. My husband has been unemployed for almost a year (he's looking, there is just nothing out there), so he's around and has been doing the cleaning, laundry, and lifting of the toddler. There's no way I could do all that. I am sleeping, only because I have sleep meds prescribed for another reason.

    I found out today that I have to stop the NSAIDs today b/c I have to have a colonoscopy (to rule out ulcerative colitis) next Friday. That pretty much leaves narcotics. At this point, I don't even care. I don't harbor any expectations of being pain-free...at this point, I'd just take "in less pain."
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