One of the biggest complaints that I hear from my patients with chronic pain is that they don't sleep well. Getting more restful sleep is important and a huge challenge for many. I did want to add to this discussion by raising caution around the use of sleeping pills, in general. Some of the more recent research done on sleeping pills has raised concerns that they can be associated with negative health effects. In fact, even periodic use of sleeping pills correlates with an increased risk, including lower life expectancy.
It sounds like you are continuing to have nerve pain from the original injury. Nerve pain, also known as neuropathic pain, is usually triggered by some type of injury to the nervous system, and it sounds like you had significant peripheral nerve damage at the time of the injury. Common descriptions of nerve pain include burning, stinging, shooting, or electrical pain symptoms.
The coldness is not unusual in this type of situation, and it suggests some dysfunction in the autonomous nervous system which regulates blood flow to the skin. Sensitivity to touch is also not uncommon, and it reflects nerve conduction channeling linking pain to light touch receptors, which can happen with certain nerve pain problems.
Surgery is often not the answer, but some simple things that you can try at home include contrast baths with warm and cold water and moving your foot around in a bowl of uncooked rice to desensitize the skin. There are other treatments like this that a physical therapist could help you with. There are also medications that can be considered for nerve pain that you could talk to your doctors about.View Thread
Deciding on a spinal fusion surgery is a big decision to make. While you and your doctors need to decide what is right for you, I would like to give you some food for thought to help with your decision making.
When the purpose of the surgery is to alleviate back pain, as opposed to correcting an instability problem, it is worth pointing out that evidence-based research has generally found extensive rehabilitation treatment as well as interdisciplinary pain programs to be just as effective. Another issue that is often not discussed in the decision making process has to do with the long-term ramifications of spinal surgery. At your age, there is a strong possibility that you may need more back surgery in the future if you have one now. Things just seem to degenerate quicker after surgery has been done and sometimes the levels above or below the fusion wear down.
Try to avoid choosing any medical treatment out of feeling desperate. If you do decide to have the surgery, be clear about your reasons and talk to your doctor about your expectations to make sure everyone is on the same page.
With skin sensitivity from nerve pain, there may be other ways of treating this beyond medications. As mentioned above by cweinbl, this is sometimes called allodynia, which means something is painful from a non-painful stimulus. We see a lot of this at my center, and we often employ what are called desensitization techniques to try to diminish the sensitivity. Some examples of this would include contrast baths, using parafin wax, clay, or making contact with textures like uncooked rice or lentils. Desensitization techniques can be found from a physical therapist or occupational therapist who can help guide you. You can ask your physician for a referral if it applies to your particular situation.View Thread
Spinal cord stimulation is a treatment sometimes considered for patients who are still struggling with pain after undergoing back surgery, like the fusion that you mentioned. It is generally considered to be more effective in reducing pain that radiates down the legs than the pain in the back itself. If the stimulation that you are feeling during your trial is uncomfortable, then it is possible that the trial leads, or wires, are not in the proper place and this should be evaluated promptly. If indeed they are in proper alignment, then it is possible that your condition is not receptive to this type of therapy.
If the leads were placed percutaneously, meaning through the skin without an incision, then they can usually be removed quite easily by your doctor in his/her office. If they were placed with a surgical exposure, then you likely need to have the incision re-opened in a surgical setting to remove them.View Thread
We have an acupuncturist at my center as part of my clinical team, and acupuncture is something that I often consider for some of my patients. As you probably know, acupuncture has been around for centuries and is based on Chinese medicine practices. In theory, it helps by promoting energy flow to areas of injury or illness that may be out of balance.
Acupuncture can be tried safely for a whole variety of pain problems including back pain, sciatica, arthritis, and neuropathy. I avoid recommending acupuncture to patients who have skin sensitivity to light touch or pressure as it may be irritating. I would suggest you check with your physician first before starting treatment, and if you decide to try it, ask around to see who others recommend.View Thread
Hi Anjile, As you likely know better than anyone, treating symptoms related to Crohn's disease, including pain, can be a real challenge. As some others have already pointed out, Demerol is no longer recommended for more chronic or daily use largely because of the risk of having seizures.
I think it is worth pointing out that the long-term use of opioids, or narcotic pain killers, in general may be questionable for Crohn's disease. Some of the reasons for this may include the fact that opioids slow down the movement of the intestines and can result in hormonal changes that can impact gut function. Also of note, some studies have been published finding relief in Crohn's symptoms from the use of a low dose of naltrexone. Naltrexone is actually a blocker of the opioid receptors in the body, which means it causes the reverse effect of the Demerol, as an example.
There also may be many other treatment options that could help that would be worth discussing with your doctors.View Thread
My impression from this information is that your consulting neurosurgeon felt you were neurologically stable but needed help with pain management? Does that sound correct?
If so, then I think it is important to think about pain management as something much more than treating MRI findings. A whole person approach is what I think works best. For example, if you have been struggling with back pain in your thoracic region, it is quite possible there have been numerous effects of this including problems with posture and movement, trouble reaching and bending, mood changes, and sleep disturbances, just to name a few. A more integrated and comprehensive team can help you with multiple issues related to your pain, and that could include pain specialists or physiatrists, physical therapists (who understand chronic pain), and psychologists or other types of counselors, as examples.
I am so sorry to hear that you had these bad experiences while trying to get help for your chronic pain condition. I thought it might help to give you some perspective from a pain doctor on this.
There has been a lot of mounting pressure on us to do more and more drug testing and screening. This can come from the insurance companies as well as state medical boards. Unfortunately, this all seems to really deflate the compassion and healing aspects of being a doctor. I don't think doctors want to act like policemen with their patients, and I know this is not how I would like to spend my time with my patients. I want my time devoted to transforming lives and getting people healthy and well, not being a drug tester.
I think your frustrating experience probably resonates with a lot of other folks out there, and it speaks to the need for improvements to be made in not only how we manage medications, but the greater need to offer much more than just medication management to those suffering with chronic pain. We need a better system all the way round because we should all be on the same team with this.View Thread
As unsettling as this may sound, doctors often don't know the true causes of many of their patients' pain problems. This can be a source of real anxiety for patients and their caring spouses like yourself. In fact, it has been estimated that for low back pain, that as much as 90% of the time the causes are really unknown. Moving ahead with the recommended neurology consultation certainly sounds reasonable, but I thought it might help to know that your wife is certainly not alone in dealing with pain of uncertain causes.