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10 months post op L4-S1 360 fusion & pain still super high

Wondering if maybe I am stuck this way. Pre-surgery I was on morphine for pain, but main reason for surgery was losing feeling in feet. I've followed all doctors orders. I've had PT. I no longer have foot numbness and leg pain, but back pain is excruciating. EMG and myelogram/CT scan show no nerve compression, yay! Still ridiculous debilitating pain. Cannot tolerate pain without meds. Quit meds and just suffered for eight weeks, hoping it was from narcotics changing pain signals, receptors. I am climbing walls with pain, unable to function. Will be meeting with pain management doc to discuss options. Has anyone experienced this? I am a 44 year old female and have small children. Lost job, too. Advice? I now think back pain is real (not from desensitivity of narcotics). Believe I may have waited too long for surgery (six years of conservative treatments). Ideas of what to take for my chronic pain. Will discuss with doc, but want info from people with my same problem.


  • http://www.spine-health.com/forum/announcements/spine-health-announcements/welcome-spine-health-how-get-started

    10 months out is still early in whole fusion surgery recovery process. It can take up to two years and even a bit more before you really start to see where you are going to wind up. Are you in physical therapy or aqua therapy to help ease and stretch the muscles since your fusion was a 360? If you aren't you probably should be........the issues with cut muscles and ligaments can contribute to ongoing pain, unless you really work hard at recovery and restrengthening those muscles and stretching them out again.
    There is probably always going to be some residual pain, since the fusion creates one longer bony segment instead of the flexibility of having multiple smaller bony sections that move , bend and flex with is....
    I would strongly encourage you to talk to your doctor about getting into some rehabilitative physical therapy, and possibly some aqua therapy as well to help strengthen and stretch out some of the muscles again.....and maybe a muscle relaxer might help as well
  • Big Daddy JimBBig Daddy Jim Posts: 10
    edited 04/08/2014 - 8:11 AM
    LelaOliviaM....that is so so sad. I am sorry to hear about your continuing pain. I realize everyone is different and we heal in different stages. I am 2 weeks post-op and no pain remaining and off of the meds totally, like I said everyone is different. I just wanted to stop in and share my "good vibes" with you. I just hope that your pain management appointment only produces GREAT results. Take care of yourself.
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  • dfhughes57ddfhughes57 Posts: 32
    edited 04/15/2014 - 1:47 PM
    Hi LelaOliviaM
    I had a L5-S1 fusion last July my pain is still worse than before the surgery although I am able to work I have difficulty sleeping at night. I realised how much pain I had when I started to reduce my pain meds which had been doing a great job of managing my pain. I have heard you can continue to improve for a year or more so hoping this will be the case with me, I still have panic attacks just thinking about having to live with this pain for the rest of my life but handle it better when I stop focusing on the future and take things day by day. When I see a post like Sandi's above this really helps and gives me hope that things can and will continue to improve over the next year or so, helps give me a more upbeat and positive attitude.
  • it has been 13 years since my first fusion, have had 4,and i still have chronic pain and still take meds and see a pain doctor.
    I have 4 fusions from L5-3, the latest last May '12 where they fixed my disc that broke.They went through my side this time. I take 40 mg of oxycontin 4x a day and 4 fenatyl lollipops 300 micro gms 4x a day.
  • I had a checkup yesterday. My neurosurgeon told me that at ten months, I shouldn't have anymore back pain at all! I told him I did, and asked what could be the cause. I was sure to tell him the surgery was a success in that I can feel my feet and walk without falling down. Bit, I still have horrible pain if I sit in a chair too long, I can go about 45 in a good chair, and I can stand for about 10 minutes. As the day progresses I just get worse and worse. He said it is one of three things1) permanent nerve damage since I suffered for six years before succumbing to surgery, 2) X-rays this week showed fusing, but he ordered a CT just in case the fusion is fully formed, he will be able to tell, and 3) it could be strain on level above (L3-4). He ordered a Facet Injection for that level. He said if I get any relief, then it is most likely that. :-(. All options seemed bad. Hoping I am just a slow recoverer like some of you above. I appreciate all your responses. Thank you Sandi, our neighborhood pool opens 5/1 so I plan on getting in and doing some strengthening exercises. My PT hasn't helped a bit. I am walking or using elliptical every day. I am moving around house trying to manage my family, but I am just super limited and need a lot of help. Thanks for all the warm wishes.
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  • Hi, I had L4S1 discectomy on April 1, 2014. At 3.5 weeks post surgery, suddenly began feeling new symptoms of sciatic nerve pain (pulling, stretching like a rubber band) and my NS basically is doing same as yours: he has a theory and is taking steps to figure out what he truth is. First I'm starting with prednisone type meds to fix swelling, in case that's the cause. From there, an MRI to see if there is a new stressor or a re herniation....Lela let us know what the surgeon says. Good luck.
  • youngatheartyyoungatheart Posts: 42
    edited 04/25/2014 - 7:20 PM
    I am also 10months post op and have been pain free until a few days ago when I began having what feels like a pulling type of pain with a strange sensation on my right leg. It mostly bothers me when I get up from sitting or laying down. I actually posted this topic earlier but no responses yet.
    I don't know what symptoms I would have if there is a screw that came loose or maybe its a new issue since I have degenerative disc disease.

    I'm. Considering calling my surgeon Monday

    As for your issues did you have PT? I hope you get some relief soon
  • I had my l4-s1 360 in July of last year. I was pain free until I went back to work after 3 months.
    My therapist and I discovered my back pain was scar tissue and SI joint pain.
    I had SI problems for years before the surgery but they got worse.
    I wear and SI belt but I rarely take pain med's.
    The scar tissue pain went away the more I excercised.

    Is you pain muscle pain, is it where your surgery was?
    I would suggest trying a different PT, a good one can help you discover what is causing your pain.

    99/00 L4/5 & L5/S1 herniation
    2001 L5/S1 microdisectomy age 25
    severe DDD at surgery level
    2011 pars
    2012 RFA L/3/4/5
    7-02-13 L4/5 l5/S1 360 fusion ALIF PLIF
    DX spondylitis , DDD, scoliosis, and slight kyphosis
  • I am 9 months post TLIF and I go to a pain management center for care.
    L5/S1 TLIF July 18, 2013
    4 Screws 2 Rods and BMP
    Post surgery L4 Dermatones
  • Regarding the narcotics, did you stop suddenly or wean off slowly under direction from your doctor? I haven't had a fusion and can't really comment on that but I think many of us have wanted to go off meds to see what our baseline pain is. To get an accurate picture of your baseline pain, the drug must be weaned slowly and it may be some time after you are off it completely that you can really say, "this is my natural level of pain". The reason is that going off the meds can cause rebound pain for a while. Kind of like if you take sleeping pills every night for a long time and then stop, you'll sleep poorly for a while, perhaps worse than before you began taking them.

    It also sounds to me like your neurosurgeon has given you high expectations and that is problem. He told you you'd be pain free at 10 months, that time has come and you are not so you feel that something is wrong. What I have read here is that recovery from this surgery can be very slow, up to two years even. Don't give up hope that you'll get better just yet. Results from surgery vary a lot. All the you can do is follow your surgeon's orders on how to help your recovery. PT, pacing, avoiding certain activities, staying positive as best you can and continuing to manage the pain that you have now. You have been playing this game a lot longer than I have so I'm sure you have an idea of things that help you and things that don't. Good luck. Six years in pain is such a long time and I really feel for you. I hope you feel some improvement soon.
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