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post-discectomy numbness

I went through microdisectomy for L4-L5 six months ago and had very good pace of recovery till first one and a half month after surgery, with only less than ten percent numbness around ankle and anterior portion of foot and very mild on shin( the original place of trouble). My surgeon advised me to take it easy for some time and prescribed gabapentin. I am now above 67 and had six or sixteen years old history so I accepted and diligently followed advice. CT scan revealed bulging evidence of L4-L5, more marked on left side with no evidence of frank disc herniation in mid 1997 and I suffered from intermittent spells of per acute, acute and chronic backache for about twenty months and thereafter I had spine-traction of varying periods for about ten days. I had an almost comfortable life style with short spells of backache for about ten years and I again had a major upset in May, 2007. MRI revealed disc dessication in lumbar spine with protrusion of disc at L4/L5 and L5/S1, more on right side and diffuse bulge at L2/L3 & compression in b/l L4 and L5 nerve roots and degenerative disease in lumbar spine. I experienced numbness on back of right foot around last three digits for the first time along with acute backache and I have realized ignoring the numbness factor had a certain effect on my having acute sciatica in early 2010. I was virtually confined to bed for about 70 days in early 2010 on account of acute sciatica when I adapted myself to living with it. I would perhaps fail to describe the extreme sciatica pain I had for almost two hours in late August, last year. MRI revealed spondylo degenerative changes with disc dessications, marginal osteophytes, schmories nodules at multiple levels; right posterior disc extrusions at L4-5 level, indenting thecal sac encroaching upon right lateral canal with compression on rt. traversing L5 nerve root; diffuse posterior disc bulge at L5-S1 level.
A long story with no ending, the initial 45-days post surgery had infused a hope that I am on way to leading almost sciatica free life. The onset of mild distress continued for another sixty days and then it got aggravated with occasional spells of very mild pain around ankle and shin with shifting numbness gripping and tingling sensation which becomes acute on my exceeding walking limit of around 250 to 300 meters. I am still diligent with gabapentin and mecobalmin though the feeling of uncomfort has been compounded with a woody feeling in leg and it is been post-190 days surgery.


  • sandisandi Posts: 6,269
    edited 04/20/2014 - 7:58 AM
  • Has anyone else been notified by their pain management clinic that the FDA has announced new guidelines for the total medication limits set for non-cancer patients? I received a letter setting out the guidelines my clinic would be following, which would result in my medications being reduces by more than 1/2. I have been on 100 mg MSContin 3 times daily, 30mg oxycodone 4 times daily for breakthrough pain, 6mg zanaflex 4 times daily, 300 mg Neurontin 3 times daily for or almost 10 years. I have had fusions at C5/C6 and C6/C7, a discectomy at T1/T2 and most recently, this past August a microdiskectomy at L5/S1. I have DDD, facet joint disease, multiple bulging disks, severe lumbar stenosis and osteophytes an almost every level of my spine. Until last summer all of my problems were basically cervical until the severe sciatic pain started with the L6/S1 disk herniation. Since that surgery, I still have severe sciatic pain and lower back pain. According to the myleogram done to see why I will still in so much pain, it is due to more bulging at the L5/S1 and L4/L5 and the severe stenosis. I have C3-C8 medial branch RFL performed approximately every 6-7 months, which has helped somewhat with the cervical pain. To date they have done a caudil epidural and a SI joint injection with no success for the sciatic pain. Believe it or not, I am still working. I don't know how I will be able to continue to do so for another 7 years in order to receive a pension (I am a widow) if they make these cuts in my medication. I am usually in tears by the end of the work day and it's all I can do to keep up my house. No one else seems to have heard of these new guidelines. My pain management clinic is reported to be one of the best in the state and say they just wanted to give there patients a "heads up" on what is coming. Although they assure that the cut will be done slowly so as patients will not suffer withdrawal symptoms, my concern is the amount of pain I will be in and how I will be able to continue to work. There is no way I could live on what I would receive from social security without any type of supplemental pension. I just don't understand how the government can decide what medications your condition requires instead of your doctors. Has anyone else heard of new guidelines?
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  • Whenever I've searched for 'Guidelines' for non-cancer pain management I've read this statement or similar,

    "These guidelines are based on the best available scientific evidence and do not constitute in- flexible treatment recommendations."

    It's my understanding that 'guidelines' are just that & not 'rules' or 'laws'. I'm still learning & I hope someone more knowledgable than me will answer this. If your clinic is changing their rules regarding patient care I'm really sorry. I don't think that a doctor should be restricted in giving the best possible care they feel is appropriate. I'm actually taking lower doses of narcotics than I was in the past & have found that it hasn't really changed my pain levels. More doesn't always equal more pain relief long term. You may be pleasantly surprised but if the reduction is going to limit your ability to function I believe your doctor should have the option to increase your meds again.
    Osteoarthritis & DDD.
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