Fusion Surgery Pain Management

Had back fusion surgery. Only 6 weeks of low dose norco. Ended up with nerve pain in my foot (zapping shocks that will take the strongest person down). Ortho doc said It would go away possibly in 6 weeks, maybe longer. Ortho surgeon they will never give anyone any opioids past 6 weeks no matter what. He tells me to go to pain management but he does not recommend or refer for any one of his patients to a pain management clinic. Says he does not want the responsibility of that. Truth is he doesn't want docs asking why he give very little pain meds or have his patients being referred back to him. He said to go to my regular doc.

So I did see my regular doc and they said I have to go back to my surgeon as it's his responsibility. One time the pain was so bad I went to ER, they said my ortho must work on the pain meds. I can only go to them so many times. My PT guy is shaking his head over all of this. We are working on the mental part of pain with a book called Explain Pain. However we are only able to get the pain and use of pain meds only so low because the shocks I get from the nerves.

I cannot take Tramadol. Does not mix with Zoloft and had a seizure on half a pill. Cannot take NSAIDs or Ibuprofen because it hurts my stomach and ulcer. No matter what I try and because it stops the growth of fusion in back. I am on such a high dose of Gabapentin that my glands are swollen. I am concerned with going to any pain management, I don't want to waste time and money just to be told NO. Anyone can help with advice in central IL??

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Hello,

I’m a 44yo female that had 4 major surgeries on my back in March. 1st one was a spinal fusion from L2 to S2. A week after the initial surgery I fell and broke 2 bones and dislocated all my hardware. Had 3 more surgeries in one week to fix it.

I’m 8 months out and have an amazing pain management doctor. She is conservative and smart yet understands pain. I’m so sorry you’re going through this. I know what it’s like. Everyone treats you like you are drug seeking and it’s not fair. I’m supposed to move in 5 months and am scared to because of my med situation. What do you do if a new doctor disagrees with your current meds?

I’m 8 months out and still hurt even with Morphine. Hope you find a doctor that can help you.

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It’s your PCP’s responsibility to refer you to pain management. It sounds like they thought you wanted your pcp to give you pain meds.
If your insurance doesn’t require a referral you may be able to find pain management that lets you self refer if you send them records.

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Re: Optimistic (# 2)

Every pain management I checked in town said they will not dispense pain meds either because because I as not referred by surgeon or they want to give me injections 6wks after surgery even though over time this will heal. I'm blown away how the patient is trapped in the middle. I don't need but them to not feel the majority of the shock in my foot. I'm learning how to deal with the pain but I need something higher than IBU and no more than 5/325.Norco. This has gotten out of hand. I would love to take something electrical on whoever foot that made this one size fits all rule.

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Go to a pain management doctor. Gabapentin is usually dosed at 1800-3600 mgs. That is likely to work better for you than opioids.

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If You had a lumbar fusion done then most likely prior to surgery you had something called epidural steroids injections done? How many epidural steroids injections did you have done?

Have you ever heard of a condition called Arachnoiditis????

I bet there is a 90% chance you have Arachnoiditis and your doctors caused it And that's why you are getting the run around from one doctor to another doctor to another doctor to the hospital then to another doctor.

If I were you because I've been there, I would definitely be looking at the am arrive for evidence of arachnoid adhesions or even lipomas in the epidural space.

There is a reason that the drug manufacturers add steroids have said not to use the drugs by epidural route. There is also a reason why the Food and Drug Administration has never ever approved steroids to be injected into your spine.

Why? Because they cause lipomas or lipomatosis and Arachnoiditis. The thing about that is, If you're still having significant pain following all of this then there was most likely caused by your doctors.

If I were you I would be writing everything down who you talk to, what they said, when you talk to them, what reasons they refuse treatment.

If a doctor causes a failure of back surgery it is his fault !!!

Don't let them push you around. Be demanding. Take a pen and paper and show then you are taking notes of everything.

If you have not had a recent MRI then you need to get 1. And you need to have someone with the expertise that is capable of interpreting the imaging to see if the doctors messed up.

Good luck. It isn't normal to still have significant pain after

surgery. Isn't that the whole reason why you had it done in the 1st place?

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Re: DrTim (# 4)

I am already at that level of Gabapentin. At the point where my glands are swollen from it but so keep taking it. Contacted men PMC and they said they would give me a shot in my just repaired back before meds. My surgeon said no yet my foot keeps zapping Lennon stop. Very painful. I've soaked my foot in epsom salt, you name it I've tried it. Thx for your recommendation but already take the GABA and already contacted PMC.

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This is crazy. When are we chronic pain patients going to stand up together and say WE NEED OUR LONG TERM OPIOIDS. WE ARE NOT DRUG ADDICTS!!!

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An option may be to get a spinal cord stimulator ... this is an implant ant that has leads resting on your spinal cord inside your vertebra that go to a control unit .... you do a trial of a few days to see if it helps .. they put leads in spine and you have a belt to carry the control unit ...you do this for 3-7 days then it is removed .... (I suggest keeping a log of events starting a couple weeks before trial period thru a week or so after trial.... this will give you a guide of the usefulness of the unit) I got my unit in sept of 2020 my 30 day follow up is coming up soon.... my trial went great improved my situation 300% at least but I did not remember it is a band-aid (like pharmaceuticals) it does not fix the problem thus after the fact it took a week or two for my increased pain (from over straining the areas of pain because I pushed myself to get a good understanding of how well it worked) then a couple months (end sept) I received the implanted unit (out patient surgery) the unit is helping but I am on restrictive activity till I heal ... (this is to lower risk of moving leads & opening the pocket in my back made to hold the control unit ... I researched almost 2 years b4 I decided to go with a boston scientific unit ... there are several you tube videos on you tube videos about spinal cord stimulators ... the channel djporkchop73 is a scs patient that had his procedure about 3 years ago if you want input from a long term user ... there are also other videos both by stimulator companies and other users of stimulators both by boston scientific & other stimulator companies... I will need to learn how far I can push myself (as do all users imo) with out making it hurt later .. it does stop a lot of pain but the pressure is still there (kinda like the novocaine effect @ the dentist) .... just wanted to share another option with you hope you find relief with something .... (ps the lack of opioid fog is good thing)

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Why wouldn’t you want to go to pain management if you need your pain managed? It’s what they do. Did your regular doc refuse to give you a referral or were you asking for meds? They should give you a referral.

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Re: DrTim (# 4)

Gabapentin is trash. If patients want to be depressed and fatigued all day it’s probably ok but most people want to live life.

Gabapentin withdraws are worse than opiate withdrawals. Opiate withdrawals are over in a week (if you’re not on suboxone or methadone) But Gabapentin took weeks even after tapering down to 100 mg a day

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Re: IN2B8U (# 5)

Hi -Sorry you’re having such a rough time. First - welcome to the endless loop between docs when you’re trying to find relief. I would suggest making an appointment with either a neurosurgeon or a different ortho. You’re describing neuropathic pain. You’re on gabapentin, which is specific for neuropathic pain. You’re in PT. You’re doing what you’re supposed to do to get better, and you’re not. It’s time to rule in or out if your surgeon screwed up. When you talk to a new surgeon, make it clear that you’re not doctor shopping, or medication seeking. You’re looking for answers as to why you’re experiencing so much pain. Get your PT to back you up on this. I would suggest a neurosurgeon for the re-exam. Sorry your ortho is such a dick.

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Re: Beth (# 11)

Hello Beth,

I had an appointment with an amazing new ortho spine surgeon in early December. He pointed out things on my old MRI's and CT scans that were never brought to my attention before. He ordered new MRI's and CT's of my lumbar and thoracic spine. The radiology report showed a .6 nerve sheath tumor between T12-L1 butting up against the Caudia Equina along with some other things. I have an appointment on Jan 14th to review my case with him.

This entire experience is very frustrating. Fortunately, my pain management doctor is at the same hospital system as this surgeon so he has access to all my records. I actually put off a move out of state because I was so worried about switching pain management doctors. Happy holidays!

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carla (# 12) -I’m glad you’re seeing someone competent. It sounds like you may have a way out of this mess. I’m sorry you’ll have to probably wait for pain relief, though. Happy Holidays! Hang in there!

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I had the same exact thing after fusion surgery of my entire lumbar 4 months ago. It really came on in the second month as I switched from walker to cane. If I miss-stepped with my left leg or lost a little balance and had to quickly correct myself with the left leg, it felt like lightning shooting through my entire left leg and my ankle would feel numb and weak for a day or two. After thinking about it, I finally isolated the movement that caused the problem and carefully avoided that movement for a while. My surgeon had no answer. I actually went to the ER twice, thinking I screwed something up, but X-rays and CT scans showed all ok. So, I began working on that movement in a slow and controlled manner. Lots of stretching and PT. After a few weeks, it began to get better and I continued to avoid that guilty movement. As I continued the "therapy" that I came up with for a few more weeks, it got better and better. Now, after 4 months I'm walking without a cane and in the gym everyday strength training. I am almost ready to get back on the tennis court and hit some balls (I was a tennis pro). I know full recovery from my surgery will take at least a year, so I'm not gonna be stupid about it.

My point is that by identifying the action that caused that electric shock of pain, and working on it with controlled, slow movement, it will get better and eventually go away. Oh yeah, I was taking Peracet and Tramadol to help along the way. Be patient my friend and don't be alarmed, you can make it go away on your own. Hope this helps.

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Hi I know it has been a while since your last post on your condition, I hope and pray by now you have received some kind of help. I have had 3 back surgeries and ended up with a incurable disease in my left leg from my surgeries ( something no doctor will tell any patient it can happen) and I have been dealing with these health problems for over 39 years. I have been through it all from doctors telling me my leg issues are in my head to injections in my spine ankle and toes for year and I have been in pain management for over 39 years, and they want to operate on my spine and do a fusion from the top of my neck to the bottom of my spine and I will not have it , so now I am so hunchback and I can’t stand up straight at all but I deal with it. I truly understand how you feel the first think you did wrong is you had a orthopedic doctor touch you NEVER have them operate on your spine always go to a neurosurgeon. Also if your PCP won’t help you get into a pain management program fire him and get a new PCP that will help you. Now as far as the leg pain goes I would look into a medication that is called amitriptyline I have been on it for years for the same pain you have and it’s the only medication that has helped me, also if this doesn’t work for you they have hundreds more medications for the nerves that you can try. I hope I have helped you or someone else with these health problems cause I know what it’s like.

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Re: Groundhog (# 15)

Check my earlier post #8 it has an option that has helped Me

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Re: IN2B8U (# 5)

I have arachnoiditis from a "cerebrospinal dural tear during my first of (2) lumbar. (multi-level fusions). I have drop foot in the left foot, EXTREME bee-sting senations on my side incision, which is arachnoiditis. I also have EXTEME tingling down both legs that drops me to the floor. Connecticut passed medical mj for Workers compensation claimants. I have found the magic bullet to my arachnoiditis via THERAPLANT 360X HYBRIDOL syringe oil. One rain drop "dose" in an empty capsule and the nerve agony is gone! I still take 10mgs Oxycodone BID for thoracolumbar scoliosis and my left ankle is blown out, because they were too cheap to buy an AFO for my foot drop CAUSED by the surgeons.

If your state has medical mj, get a referral for the oil. I have everything in writing with "reasonable and necessary" just like they asked.
I understand the pain you remain in. Mine fusions were in 2016 and 2017, then my right ankle in 2019.

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Re: Rootsgal (# 17)

Thank you. I cant take MJ- anxiety believe it or not. CBD hurts my stomach

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Re: Optimistic (# 10)

So true I had c-1- to C-6 fused 18 inch rods 14 2 half inch screws , lasered from c-1to C-6 inside vertebrae to open up, cadaver tissued all the way up , and THEN HERE COMES GABERPITEN, yes Dr.Tim after 3 years of this s*** and all kinds thing happening to my head and body , but did help with nerves, GABERPITEN JUST DECIDED NOT TO LIKE ME, I ENDED UP GOING TO A PSYCHIATRIST AND HE EVENTUALLY GOT ME OFF AND THE LAST PILL WAS A MONTH AGO . Still fill the pill in me and other adverse effects for a little bit but psycay said no issues with my mind r crazy, it had to go to him just to get off this dangerous pill, ow I feel everything and my next step is pain management it I live in Fairbanks Alaska and doctors r not so giving here even though they see my back because from c-1to C-6 all my vertebrae r sticking out like a skeleton because 6 weeks later they took stitches out and whole surgery site opened up and had to rush back to Seattle for another 9 half hr surgery so they cut 1inch and half away because of infection so all I have covering my spine is a membrane of skin and messed up muscles not attached because they couldn’t and nerve damage BEYOUND,I hurt so very much every day because of these two surgeries and to try to get help is impossible these days, well Dr.Tim thanks for listening,

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Re: Hard place (# 18)

The oil does not have CBD in it.

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Please tell me what state you live in. I don’t know if you need a referral for pain management. If you do not I would just go looking for one that takes your insurance in your area. That pain is not normal at all & Gabapentin is horrible for you especially in a high dose! I would see a Neurologist or rheumatologist also. If your family doctor says it’s his responsibility then you should tell him you need a referral you might not need one it depends on insurance.

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Re: Carla (# 38)

Sounds like you might be one of the luckier people. He is in Washington state.

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Re: Carla (# 38)

I live in central ILLINOIS. Glad you are getting relief. I am still not

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Re: Carla (# 38)

I'm in Central Illinois.

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Re: colle (# 37)

Are you in Southern California? I am in Orange County, Southern California. I truly am so thankful for having a wonderful team of doctors. Not only pain management but neurology, orthopedics and urology. They all work together to provide coordinate care. My pain level after 4 spine surgeries still isn’t great but I am at least functional. I’m only 45 and this was all unexpected.

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Re: carla (# 12)

Is it possible to say your location and a great doctors name? Im trying to help my brother, retired dentist, who has had 4 back & neck surgeries. He spends 2/3 of his awake time in bed, due to intolerable pain. He had a good doc who retired. It's so hard to watch him spend his retirement this way.

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Re: vi (# 35)

Seeking a doctor who performs the MIST (disc snip) is clearly to avoid a pharmaceutical alternative.

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Re: Woundman (# 31)

I live in Az. So, you have to be careful about Dr. shopping they think your looking for drugs when all your looking for is relief. I enjoyed reading about how people who became addicts have caused this problem with people who actually need the pain medication to get through life, and even then not pain free but dealing.

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Re: lee (# 33)

I have had multiple back surgeries including fusions. Find a good orthopedic dr. that will give you steroid/cortisone shots. It's a temporary fix to a life long pain problem. There really isn't anything more then can do. I feel your pain. I have been dealing with it since 1987. I wish i could give you more to help you.

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Sounds like a victim of the drug war.. the usa allowed over prescription for so long.. and used our military to help grow the largest poppy fields in the world in Afghanistan. Then when people started noticing it they had to crackdown hard and point the finger at the people taking the meds. An people with debilitating pain suffered for it. You may try lidocaine but long term use isn't good for the nerves and muscles the serve. An with you being on ssri that reduces options for milder opoids because many have snri or tricyclic actions. May try Marijuana but that really messes with some people functionality an also probably not powerful enough for a back surgery ive never seen one in person that didn't end with lifelong pain... I've heard about them from people who probably had enough money to go to the best in the country but never seen em myself.

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