My WebMD Sign In

Please enter email address

Enter your password

Keep me signed in on this computer

Show more Information

If you select "Keep me signed in on this computer", every time you visit WebMD.com you won't have to type your email address and password. This means that a cookie will stay on your computer even when you exit or close your browser which may reduce your levels of privacy and security. You should never select this option if you're using a publicly accessible computer, or if you're sharing a computer with others. Even if you select this option there are some features of our site that still require you to log in for privacy reasons.

Forget your password? Having trouble signing in?

Why should I
sign up for WebMD?

With a WebMD Account you can:

Track your way to weight loss success
Manage your family's vaccinations
Join the conversation

See more benefits Sign Up

Why WebMD?

My WebMD

Show Menu

Facebook Twitter Pinterest

WebMD Home

Back and Neck Pain Exchange

What are the best treatments for back and neck pain? Who are the best doctors? ... more

Reply: Sciatic Pain after spinal fusion L2-S1 with instru...

Ironically, Neurontin is much, much more safe than a radio-frequency ablation (a.k.a....

Posted by cweinbl

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 csw2@bex.net .View Thread

Posted bycweinbl

157 Replies | Reply | Watch This DiscussionReport This| Share this:Sciatic Pain after spinal fusion L2-S1 with instrumentation Ironically, Neurontin is much, much more safe than a radio-frequency ablation (a.k.a....

Reply: Charles - "Research and the search for a Gold Star...

Contact me at csw2@bex.net , with questions or concerns.

Posted by cweinbl

5 Replies | Reply | Watch This DiscussionReport This| Share this:Charles - "Research and the search for a Gold Star" Contact me at csw2@bex.net , with questions or concerns.

Reply: Charles - "Research and the search for a Gold Star...

Hi Bren. It's called "hyperalgesia," and it refrers to an exceedingly rare condition in...

Posted by cweinbl

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

Posted bycweinbl

5 Replies | Reply | Watch This DiscussionReport This| Share this:Charles - "Research and the search for a Gold Star" Hi Bren. It's called "hyperalgesia," and it refrers to an exceedingly rare condition in...

Reply: Sciatic Pain after spinal fusion L2-S1 with instru...

Spine surgery is only 50% successful for pain. If it means anything, there are countless...

Posted by cweinbl

157 Replies | Reply | Watch This DiscussionReport This| Share this:Sciatic Pain after spinal fusion L2-S1 with instrumentation Spine surgery is only 50% successful for pain. If it means anything, there are countless...

Reply: Sciatic Pain after spinal fusion L2-S1 with instru...

Same thing happened to me after my 4th spine surgery (with multilevel fusion). I'm left...

Posted by cweinbl

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

Posted bycweinbl

157 Replies | Reply | Watch This DiscussionReport This| Share this:Sciatic Pain after spinal fusion L2-S1 with instrumentation Same thing happened to me after my 4th spine surgery (with multilevel fusion). I'm left...

Welcome

Welcome to the back and neck pain exchange. Let's add some perspective to the...

Posted by cweinbl

Take the Poll

Where can a spine surgeon be located?

0 Replies | Reply | Watch This DiscussionReport This| Share this:Welcome Welcome to the back and neck pain exchange. Let's add some perspective to the...

See Related Pain Management Communities

See All Communities

Women's Health Newsletter

Find out what women really need.

Other Member Communities

Dieting Club: 10 - 25 Lbs Member Community Share Your Tips and Support!
Caregiving Member Community The Support and Understanding You Need!
Parenting Friends Talking Member Community Get Support from Members Like You!

The opinions expressed in WebMD User-generated content areas like communities, reviews, ratings, or blogs are solely those of the User, who may or may not have medical or scientific training. These opinions do not represent the opinions of WebMD. User-generated content areas are not reviewed by a WebMD physician or any member of the WebMD editorial staff for accuracy, balance, objectivity, or any other reason except for compliance with our Terms and Conditions. Some of these opinions may contain information about treatments or uses of drug products that have not been approved by the U.S. Food and Drug Administration. WebMD does not endorse any specific product, service, or treatment.

Do not consider WebMD User-generated content as medical advice. Never delay or disregard seeking professional medical advice from your doctor or other qualified healthcare provider because of something you have read on WebMD. You should always speak with your doctor before you start, stop, or change any prescribed part of your care plan or treatment. WebMD understands that reading individual, real-life experiences can be a helpful resource, but it is never a substitute for professional medical advice, diagnosis, or treatment from a qualified health care provider. If you think you may have a medical emergency, call your doctor or dial 911 immediately.

Health Solutions From Our Sponsors

In-depth coverage:

Find us on:

URAC: Accredited Health Web Site

HonCode: Health on the Net Foundation AdChoices

About WebMD Advertise With Us Terms of Use Privacy Policy Sponsor Policy Site Map Careers Contact Us

Medscape Reference eMedicineHealth RxList Medscape MedicineNet BootsWebMD WebMD Corporate

First Aid WebMD Magazine WebMD Health Record WebMD Mobile Newsletters Dictionary Physician Directory

WebMD does not provide medical advice, diagnosis or treatment. See additional information.

Back and Neck Pain Exchange

See All

Preferences

My Communities

My Discussions

My Email Digests

cweinbl