Laser surgery for degenerative disc disease (a.k.a. spinal stenosis, herniated disc, etc.) is completely unfounded and lacks any serious credential. I urge you to obtain second opinions by at least two SPINE surgeons. A spine surgeon is an orthopedic surgeon or a neurosurgeon who has completed a fellowship in spine surgery (at least 2-4 years AFTER an internship or residency).
After four failed spine surgeries, I've learned a great deal about fraud in spine surgery. Be careful and never fall for doctors who describe "non-invasive surgery" and "fast recovery." Take my word for it. Spine surgery is at best 50% successful for pain (it's about 80% successful for improved function). Most people fall into surgery for pain relief. In reality, it's at best a crap shoot. Questions? Contact me at email@example.com .
Want some research for spine interventions? Here it is:http://www.painphysicianjournal.com/2009/july/2009;12;699-802.pdf. Beware of anyone promising "laser treatment" or "laser surgery" for spinal stenosis. It is not what they claim it to be.View Thread
Two things. First, start a new post of your own to deal with your issues. Your comment does not address the issues of the person who posted this thread. Second, any physician who tells you that you should "be off pain meds because god will help you" should be reported to the state board of medical licensing. That is outrageous. Find a new physician who will treat you like a human being and provide the medication that you require for chronic pain. I wish you the very best of luck in managing your pain with a more compassionate, ethical and well-trained physician.View Thread
Ironically, Neurontin is much, much more safe than a radio-frequency ablation (a.k.a. rhyzotomy). A radio-frequency ablation destroyed one of my spinal nerve roots, resulting in continuous severe back and leg pain. I've learned a great deal about the RF Ablation since that destruction of my spinal nerve root.
Worse yet is the "Laser Spine Institute," a process that has never been vetted or adequately studied for effect. I conduct a great deal of spine research and I can tell you that any of us with spinal nerve root impingement are far better off working with a fellowship-trailed spine surgeon than the so-called Laser Spine Institute (we really don't know anything about their effectiveness). In fact, as far as I'm aware, they have NO fellowship-trained spine surgeons on board.
I find it amazing that someone who recommends "non-invasive" treatments would tout the INVASIVE destruction of nerve roots (the "Radio Frequency Ablation") over the NON-INVASIVE medication, Neurontin. If you prefer non-invasive options, then you SHOULD prefer Neurontin over the invasive destruction of your nerve roots (RF Ablation). Neurontin (Gabapentin) is a proven workhorse drug for referrant pain (nerve-related pain). Even better is Lyrica. They are both good drugs, not injections that are designed to damage your spinal nerve roots.
Search for the Laser Spine Institute at your own peril. Know that this solution is unproven, risky and without properly-vetted research. Until we know more about this alleged "institute," it should remain risky and without valid merit as a solution for back and leg pain.
One might be much better served by using the world's more potent and effective pain medication - Fentanyl. Fentanyl is available as a liquid (for IV and IM injections). It is also available as a Transdermal patch ("Fentanyl Transdermal"). NO MEDICATION IS AS EFFECTIVE FOR CHRONIC PAIN AS FENTANYL TRANSDERMAL. And, because it is non-invasive, there are no unusual risk factors, as exist with the Radio Frequency Ablation. Instead of a needle puncturing your spinal nerve roots, this is a powerful medication that cannot damage your spine.
For more information or details of the research that supports this information, contact me here, or at firstname.lastname@example.org .View Thread
Hi Bren. It's called "hyperalgesia," and it refrers to an exceedingly rare condition in which people either fail to obtain relief from narcotics, or the drugs make the pain worse. Most physicians will practice 40 years and never see a case of hyperalgesia. If you had it, you would have experienced no relief at all from your narcotic pain medications, or an increase in pain associated with them. So, is that true in your case? Do narcotics make your pain worse?
Doctors today are highly motivated to avoid appearing on a DEA list for prescribing large numbers of narcotics. Sadly, the patient suffers so that the doctor can feel safe from federal investigators. In reality, the only doctors investigated by the DEA are those that prescribe massive amounts of certain narcotics. The average physician will never draw that much attention. And, most physicians in general practice wil have two or three dozen patients using powerful narcotics, for very good reasons. That's not enough to make the DEA sniff in their direction (no pun intended).
Some doctors also fear patient litigation related to narcotic accidents, overdose cases or bad reactions. Again, only a tiny percentage of these accidents occur. But the other patients suffer needlessly when doctors fear prescribing appropriate medications.
I functioned so well on powerful narcotics over 20 years that I was able to manage a university division and still have time for my family. Opiates are natural substances in the body. They damage no organs and can be safely used in large amounts over a lifetime, if necessary. If narcotics help you, if they work well, you should not be stopping them unless you have a better replacement. Do you?
The success rates for the intrathecal pump and the spinal cord stimulator (at 12 months) are about 50%. For patients with prior spine surgery it is more like 40% and for those who have never had surgery, it is more like 60%. But, frankly, a 50% or 60% surgery success rate is TERRIBLE! Would you have knee replacement surgery if you had a 50% chance of failure? Would you have LASIK with a 50% success rate? Would you have ANY elective surgery with that high failure rate? And, each time a stimulator or IT pump fails, more surgery is required to remove the ineffective device.
Bren, I'm not sure I would stop the medication as long as it helps. Cognitive therapy is terrific. Physical therapy is great, as long as it helps. Continue to keep an open mind.
The reason that most people on long-term opioid therapy experience an increase in pain is tolerance, not hyperalgesia. Tolerance is easily dealt with by increasing the medication dosage. When a maximum safe dosage is achieved, you rotate to a different opiate. After a couple of months, you rrturn to the original drug and it's more effective again. Frankly, this hyperalgesia nonsense is pure BS from someone who wants his patients off of narcotics for his own reasons, not for the benefit of the patient.
If you want to try going off narcotics, that's up to you. As long as going back to narcotics (if it doesn't help) remains your decision, you have nothing to lose. But, I would want that in writing. Good luck!View Thread
Spine surgery is only 50% successful for pain. If it means anything, there are countless thousands of us with chronic severe pain following spine surgery (myself included, after four failed surgeries).
Comprehensive pain management programs offer dozens of non-invsive and minimally-invasive treatments for chronic pain. For example, a person with your condition can try a corset, brace, TENS, traction, acupuncture, biofeedback, physical therapy, kinesiotherapy, injection of steroids and anesthetics, non-steroidal anti-inflammatories, cortisone, rhyzotomy (radio frequency denervation), spinal cord stimulator, intrathecal infusion pump, off-label medications (anti-depressants, anti-convulsants), combination of long-acting pain medication with breakthrough meds, counseling, hypnosis and meditation.
Unfortunately, your surgeon has given you bad advice regarding pain medication. The best results are obtained by using a long-acting narcotic (Oxycontin, Kadian, Fentanyl Transdermal, etc.), plus a short-acting narcotic (Oxycodone, Hydrocodone, etc.) for breakthrough pain, plus an anti-depressant, to inhibit the reuptake of Seratonin) and an anti-convulsant (for neuropathic pain resulting from nerve damage). All of these used together will far outperform any of them used alone. Trouble is, most doctors are reluctant to prescribe that much narcotic. Research revelas that it is the only way to consistently manage chronic severe pain (http://www.painphysicianjournal.com/2009/july/2009;12;699-802.pdf ).
Some pain management programs are nothing but injection factories. But, research reveals that if injections do not help initially, then future injections will also fail. Be careful to use a pain management program that offers all of the treatments mentioned above, not only injections.
Same thing happened to me after my 4th spine surgery (with multilevel fusion). I'm left with nerve damage, massive scarring and collapsed vertebra.
Why didn't your surgeon remove the bone spur? Did you have a microdiscectomy, rather than a laminectomy? Something doesn't make sense here.
You should know that most chronic pain patients respond much better to a long-acting pain medication (your Vicoden is short-acting). Then, you can save your short-acting drug for breakthrough pain.
Chronic pain also responds well to an anti-depressant, to inhibit the reuptake of Seratonin. Celebrex is a good one. I use Trazadone. The dosage is lower than a psychiatric dose, yet it will still maintain plasma Seratonin quite well.
You should ask about a referral to the pain clinic. There are dozens of non-invasive and minimally-invasive treatments. I can reduce my pain by up to 20% with biofeedback alone. some people respond well to accupuncture or TENS. It's worth a try. Just be certain that you go to a COMPREHENSIVE pain management program. There are some in which doctors only push injections. This despite research revealing that if injections don't help originally, future iterations are also likley to fail.
You may or may not go back to work. I'm wondering why a doctor would tell you that it won't happen. Just one medication gave my career nine extra (wonderful) years. Just when I thought that nothing would help and I would need to retire, along came Fentanyl Transdermal. Fentanyl wiped out 80% of my pain, when I started it. Of course, 15 years later, one is bound to become tolerant to it. But, at 80 times more powerful than morphine, Fentanyl is a very potent pain medication.
I understand that you are tired of "living on drugs." Yet, the right COMBINATION of long and short-acting narcotics, along with your pain management treatments may get you back to work. It happened to me and I believe that my damage is more severe than yours.
If all else fails, there is the spinal cord stimulator (SCS) and the intrathecal infusion pump (IT Pump). They require surgical implantation and they have less than desired success rates, especially for post spine surgery patients.
Finally, damaged nerves take a very long time to heal - up to a year. So, you still could see some improvement. Good luck!View Thread