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Radiofrequency-L5/S1 Nerve Roots- FBSS- Questions?

http://www.spine-health.com/forum/pain/sciatica-leg-pain-radiculopathy/ongoing-left-legbutt-pain-after-microdisectomy-going-craz

That is one of my original posts. 5 weeks post op from 2nd back surgery in one year for l5 s1 disc. Butt pain from surgeries. Lower Back through butt. feels like exactly where my disc is and goes half way down my butt. constant ache, weak/numbness feeling, burning on fire.

3/21/12- Microdisectomy L5 S1- unsuccessful, continued leg/back pain in both legs and start of butt pain and increased left leg pain lower half behind the knee and down to foot.

4/23/13- Decompression and Stabilization L5/S1 with 2 titanium rods and 4 titanium screws

Surgeon said he found nerve compression and touched a nerve during surgery, my left leg shot up into the air. He said he freed the nerve on the left side and only went on right side to put the hardware in cause right side looked okay. Both my legs and butt pain for sitting more then 1 minute was unbearable. the sitting part has stayed like that 5 weeks out. Both of my legs are about the same amount of pain i was in before the 2nd surgery but a little bit worse. at times- muchhhhh worse. This is a renowned surgeon in NYC. He really wants to truly help me. most amazing doctor i have ever met or seen. He truly wants to see me get better. He said he is thinking maybe the disc is too far gone and we can only do a fusion at this point. He wont do the artificial disc because im so young and 6% chance it would make me sterile. He says he will not be responsible for that chance of it happening. I'm so scared and i dont know what my options are?

Pain for a month after was worse then ever. went through a break up because of it as well.

Now trying to stay positive but everyday its harder and harder.

Im 25 years old. and have already lost a year and half of my life to this chronic pain. I'm still out of work for 6 weeks now. Got the OKAY from my job to be out 2-3 more months if need be. They are very amazing and understanding with my conditions.

My question is, i spend hours/day researching on this forum and others looking for things I can try to do before getting a fusion as my surgeon is saying is next. Most of my pain that is unbearable is in my entire butt, left leg skips over the thigh, sciatica pain starts behind kneecap down to toes now, right leg skips over the thigh, same pain behind kneecap and down to half of foot, (foot pain in right leg started after this 2nd surgery 6 weeks ago).... I'm wondering about radiofrequency, maybe getting the nerves burned to relieve butt/leg pain.

I'm at the end of my rope here. Hit rock bottom 3 weeks ago. I'm going out of my MIND!!

Please any opinions/input would be greatly appreciated.
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Comments

  • For me, before going through another surgery you are only a short time out from the last one, correct? Two months or a little less than that? Given that the surgeon told you that he touched a nerve, it can take some months before it settles down again.
    I would try the neuropathic medications used to treat nerve pain first, but know that it can take some time to get to the proper doses. Lyrica, gabapentin, topamax, Cymbalta, the traditional tricyclic anti depressants all work wonders in treating neuropathic pain. SSRIs are also used as well.
    If those fail or in addition to using those meds, an RFA might work but that is usually done in the facet joints, to burn the nerve fibers if those in fact are the source of the pain.
    And again, before considering another surgery , I would definately consult with at least two other surgeons and see what their opinions are before contemplating another surgery.
    The problem is that you are so soon out of this last surgery, that it really is too soon to consider undergoing a third surgery, which is going to increase the scar tissue, and in turn could worsen the pain you are having now. I would consider all of the non surgical options before heading down that road if at all possible.
  • YoungL5S188YYoungL5S188 Posts: 81
    edited 06/10/2013 - 11:03 AM
    sandi said:
    For me, before going through another surgery you are only a short time out from the last one, correct? Two months or a little less than that? Given that the surgeon told you that he touched a nerve, it can take some months before it settles down again.
    I would try the neuropathic medications used to treat nerve pain first, but know that it can take some time to get to the proper doses. Lyrica, gabapentin, topamax, Cymbalta, the traditional tricyclic anti depressants all work wonders in treating neuropathic pain. SSRIs are also used as well.
    If those fail or in addition to using those meds, an RFA might work but that is usually done in the facet joints, to burn the nerve fibers if those in fact are the source of the pain.
    And again, before considering another surgery , I would definately consult with at least two other surgeons and see what their opinions are before contemplating another surgery.
    The problem is that you are so soon out of this last surgery, that it really is too soon to consider undergoing a third surgery, which is going to increase the scar tissue, and in turn could worsen the pain you are having now. I would consider all of the non surgical options before heading down that road if at all possible.
    I've tried Cymbalta, Lyrica, Nuerotin(guadpentin) all with no relief at all. Cymbalta was a horror coming off of it. None of them helped. I am on Lexapro right now but for depression because of the chronic pain.
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  • What doses did you get to with the Lyrica or the gabapentin? The reason that I am asking is that both of those particular medications need to reach a dosage level before they work well for the treatment of neuropathic pain. The side effects of both medications tend to lessen as you stay on them , or even disappear as you continue them.
    Some patients do not give themselves enough time to reach the proper dosage levels before stopping them , therefore don't get to the point that the medications can work for them.
    Sandi
  • sandi said:
    What doses did you get to with the Lyrica or the gabapentin? The reason that I am asking is that both of those particular medications need to reach a dosage level before they work well for the treatment of neuropathic pain. The side effects of both medications tend to lessen as you stay on them , or even disappear as you continue them.
    Some patients do not give themselves enough time to reach the proper dosage levels before stopping them , therefore don't get to the point that the medications can work for them.
    Sandi
    I cant remember how much Nuerotin i was on after the first surgery but it was not helping. The lyrica i did not get any side effects from but im on 100mg twice a day as of now.
  • I went to see an internal medicine/arhtiritisi type of doctor because he diagnosed something wrong with my mom that no other doctor she saw was able to. He was happy to see that I did not have the foot drop and i did not have weakeness in my leg when he examined me. he pressed on a few parts where my butt starts under lower back and pressed 3 or so spots on each side and asked if it hurt. he said they felt inflamed and it did hurt when he was pressing on it. he gave me a shot in my arm of something. said for sacrolic joints and i may feel some relief in about 20 minutes and sent me for an xray. i did not get any relief from it at all. everyday is more and more depressed, i've lost 2 years of my young life, 3 or so relationships because of it, i literally have no life.

    I'm afraid if i have another surgery since the first two did not, that this fusion wont work either. i dont know what to do anymore.
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  • Lyrica can go up to a maximum of 600 mg a day total dose, so there is a good amount of wiggle room if it is not helping you enough at the 200 mg you are currently taking. If the current dose is not giving you enough pain relief, talk to your doctor about increasing the dose, at least on a temporary basis, to see if you get more relief from it.
    The problem with going ahead with another surgery this soon, is you haven't given your body enough time to heal completely and to recover from the last surgery, so you could just wind up further traumatizing your body further.
    I had my first surgery in 2006, and my second in 2007 and I can tell you that it is only this past year that I have finally found some relief from the constant pain that I suffered. It was constant, severe and never ending, but with a combination of medications , and treatments, the pain levels have changed enough right now, that I am better now than I was all that time.
    We all know the desperation for relief but hang in there, try whatever you can before going ahead with another surgery unless there is something compressing the nerves somewhere , because it can make it worse and believe me, it can be alot worse.
  • I'm on Neurotin 600mg/3 times a day. it is not helping at all.

    I am off the Lyrica

    I saw the surgeon this past week. He said the only thing left at this point is for me to get the fusion. TLIF I believe he said. He feels that the disc is just too far gone and either way if i dont get fusion now or later, i'll need it soon. He think it may help the leg pain by removing the disc and giving all the nerves room. He said because i have a flat back. I cannot do PT due to the amount of pain I am in. It is almost impossible. Yes i realize that after microdisectomy the burning, inability to sit or stand should be better. In my case they are worse. I love my surgeon because I know he is not giving up on me like the first surgeon and he truly cares deeply and wants to see me get better. He is straight up honest with me with everything and told me that theres no chances of this to work, i am an out of the box case, more difficult hes ever dealt with.

    I am giving myself one more day to decide. I am still out of work. 2 months as of today. If i'm going to get the fusion i need to decide and get it done because I can't be out of work longer then I need to be.

    Should i do it?!?!?!?!?!
  • No one here can make that decision for you. You , in partnership with your surgeon and other medical team need to decide that .
    I have told you what my concerns would be, having yet another surgery, this soon, might in fact, make the problems you are experiencing worse , and if you can not tolerate the pain you are in now, how are you going to get through the recovery from surgery if it does not relieve the pain ? There are no guarantees in back surgery, and pain relief is not the goal of it, because if it was, than many of us were given the wrong information, prior to our surgery.
    Only you really know if the pain that you are in currently is worth the risks of further surgery. It could turn out that having the surgery does relieve the majority of the pain you are having, and if it does, I will be the first to cheer you on during your recovery, but I also think that you really need to do some more research into this, before making a decision one way or another and you need to be prepared for either outcome and have a game plan in place to deal with whatever outcome you wind up with.
    Does your recent MRI ( sorry I can't recall right off the top of my head) show nerve compression?
    The whole issue with not going ahead with a disc replacement in the L5-S1 level of the spine has to do with the multiple negative outcomes because at that level of the spine, the adr (disc replacement ) allows far too much motion which is not the normal happenstance for that level of the spine, and ultimately, many patients who have had adr at that level wind up with more problems down the road, and eventually need to have that level fused anyway.
  • After dealing with extreme ciatic pain for 20 years I finally had back surgery by a dr highly recommended to my husband and I. Since the surgery my pain which is different is worse than ever. They've put me on every drug seemingly possible I walk through life In a fog when I am able to sleep its because of the high dose of valuim . (Ps I hate taking meds) I cant eat without being near a restroom. My toes dont lay flat and I feel like I'm walking on a golf ball with serious numbness throughout my leg. Dr gives me no answers. Been to neurologist, and pain management clinic. I just want to know why. It's getting extremely hard to make it through a day any and all advice welcomed . Desparate it's been 10 months.
  • Orry, like I said this is a first for me and I realize Ithis comment didnt go to the peoper place I'll figure it out
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