Very sorry about your pain. Sadly, you might have been able to avoid much of it.
1. Never allow a chiropractor to touch you once you have had spinal trauma, Chiropractors are NOT medical doctors. They do not attend medical school, a residency or fellowship. They are not allowed to prescribe medications and in most cases, have no hospital privileges. Nothing is more important than your health. Why trust it to someone who never went to medical school? If they don't have "MD" after their name, they can damage or paralyze you permanently.
2. Your chiro told you that " x-ray showed the disc above s1 slipped out. " Jbear, soft material like extruded discs do not visualize on an X-ray. That can only be seen with an MRI, myelogram or CAT-scan. Chiros believe that their patients don't know enough to challenge their BS. Do your own research and only trust your health to an MD.
3. Your chiro told you that the disc above S1 slipped out. But you already had that disc removed in your micro discectomy. That was L5-S1. Am I starting to make sense?
4. All recent research on spinal injections reveals that they simply are not efficacious. They don't work. When you filter out placebo effect, injections of simple saline work just as badly as steroids injections.
5.. A rhyzotomy (a.k.a. nerve root ablation) has a track record nearly as dismal as injections mentioned above. But don't take my word for it. Here is the most comprehensive research on all types of spinal interventions that I've ever seen: http://www.painphysicianjournal.com/2009/july/2009;12;699-802.pdf . Read it for yourself. You'll also see that the overall success rate for spine surgery is just over 60%.
6. No two people have exactly the same spinal anatomy or the same ability to tolerate chronic pain. But you should research everything that a medical doctor suggests on your own. You should also ask each physician to explain where they went to medical school, residency and fellowship and how many times they have successfully performed whatever procedure they recommend.
7. Many of us can reclaim our work and family lives with COMBINATIONS of medications, starting with long-acting drugs (Kadian, Oxycontin, Fentanyl Transdermal, etc.) AND short-acting (Hydrocodone, Oxycodone, Tramadol, etc.) medications for breakthrough pain. Add to this combination an anti-depressant, to inhibit the reuptake of Serotonin in the bloodstream. Serotonin is one of the body's own pain-fighting chemicals. Add an anti-inflammatory because almost all of us are plagued by inflammation. Those of us who have (as you do) referent pain, going into a hip, groin, arm or leg, should add an anti-convulsant (Lyrica, Neurontin, etc.).
Be open-minded about options. I can reduce my pain by 15-20% with biofeedback. Others claim efficacy with TENS, acupuncture, hypnosis, PT, kinesiotherapy, decompression, or a host of other options. If none of these help, see if you are a candidate for the spinal cord stimulator or the intrathecal infusion pump. You'll find all of these in a comprehensive pain management program.
First, I have exactly the same situation, except I've had four failed spine surgeries, not six.
I've been to two pain management programs and tried almost everything. The only treatment that helped (very slightly) was biofeedback. I can reduce my pain by about 15-20% with it.
Why don't you try the intrathecal infusion pump? Are you not a candidate for some reason?
Spine surgery today has an over all long-term (12-month) success rate of about 60% (lower if you've had spinal fusion). Surgeons will lie to your face and tell you that, "80% of my patients become pain-free and lead normal lives. Right! And these guys sleep at night?
People like us are called, "failed back surgery syndrome." Doctors want us like a bad case of gout. We're almost untreatable. And surgery has been a large part of the problem, rather than a solution. That's Doc. I love having all of that scar tissue. Thanks for gouging out a piece of my right S1 nerve root, resident. Appreciate that. I always wanted to retire at age 51, unable to sit or stand for more than a few minutes.
Hi Ally. Sorry about your pain. I know how you feel. My severe chronic pain started just after my 17th birthday.
1. Most importantly... NEVER allow a chiropractor to touch your cervical spine. Manipulation can easily transform your stenosis into full-blown disc herniations, requiring fusion. Chiropractors are not medical doctors. Most of them were unable to gain entrance into a medical school. Nothing is more important than your health. Why trust it to someone who is not a medical doctor? I've spent almost 40 years in orthopedic and neurosurgeon waiting rooms. By far, the most common complaint has been severe damage by chiropractors. If they don't have "MD" after their name, flee as fast as you can run.
2. Having "nerves burned" is a procedure called a rhyzotomy (a.k.a. "radio-frequency ablation"). This rather medieval procedure calls for large-diameter needles inserted deep into your spinal nerve roots, where electricity is employed to destroy the nerve root in the blind hope that a damaged or destroyed nerve root will stop sending pain signals to the brain. In many cases, like mine, the rhyzotomy increases pain permanently. Some people have urine and/or feces incontinence or partial paralysis after a rhyzotomy. The long-term success rate is about 60%, which considering the risks, seems far too low. But, that's up to you. Please ask your surgeon how many times she or he has performed this rhyzotomy before agreeing to have it done. Here is a link to the latest, greatest, most comprehensive research on ALL SPINAL INTERVENTIONS: http://www.painphysicianjournal.com/2009/july/2009;12;699-802.pdf . It's pretty technical. But it covers the viability of each intervention.
Headaches, including migraines, do not respond well to conventional pain medications. Be aware that they must be treated differently.
Finally, the best advice I can give you is to see a spine surgeon. A spine surgeon is an orthopedic surgeon or neurosurgeon who has completed a FELLOWSHIP in spine surgery. That's typically 3-4 years AFTER a residency. Please ask your specialist if she or he completed a fellowship in spine surgery; if not, find one who has. No one on the planet is as talented, experienced or able to implement the most advanced treatments as a spine surgeon. These extremely advanced physicians can often be located at or near teaching hospitals (universities). After nearly 40 years of chronic back and leg pain, 4 failed spine surgeries and two comprehensive pain management programs, I cannot more strongly emphasize the value of seeing a spine surgeon. They operate on celebrities and millionaires. If you don't need surgery, they'll tell you. They don't need more money.
Finally, obtain a referral to a comprehensive pain management program. I can reduce my pain by about 20% with BIOFEEDBACK alone. Note that recent research proves that injections of steroids and anesthetics have NO LONG TERM BENEFIT. Thus repeated iterations of injections will also fail, not to mention put you into danger of nerve root impingement. Most pain management options will fail. But some might offer benefit. If they offer a dozen or more treatment options, give it a try.
Suboxone and Nalaxone are medications that significantly reduce the ill effects caused by withdrawal from long-term opioid use. As long as you use either one as directed, you should have no trouble.View Thread
Forgive me, but it sounds like you are using opioid medications and you would rather not stop using them. Is that right?
As long as you are not using opioid medications to get high, rather than for chronic pain, it won't matter. If you have a medical condition that requires opioid medications, employers understand. You cannot be fired for using pain mediation, unless the job requires you to be a driver, pilot or machine operator. But you have been prescribed Suboxone, which is designed for the addicted patient requiring assistance with withdrawal. So, please rest assured that you have the best medication for withdrawal symptoms. Or, do you prefer not to use Suboxone and to remain on your opioid? Perhaps if you have that much chronic pain, this job is not the best option for you?View Thread
In this case, they're not sharing it with your insurance company or the local newspaper. If you can't trust your physicians and pharmacists, then I guess you can try to slug it out on your own. I have no problem with those two professions knowing my diagnosis. I trust their integrity.View Thread
Sorry about your issues. I've had the same since age 17 due to central canal stenosis.
I've been researching these problems for the past 30 years. I've intensively researched the SCS for the past ten years. Please provide your double blind, control group algorithmic research that suggest such a connection between electricity and cancer. As far as I've seen it cannot and does not cause cancer. Please no anecdotal data.
The SCS is ONLY for neuropathic pain. Millions of us have nociceptive, not neuropathic pain. The SCS is useless for that. I have collapsed vertebra. All the SCS in the world would not help. Nor did wearing a TENS at full power for six months.
If you have nociceptive pain and you cannot benefit from powerful pain medications (and I emphasize the plural), consider the intrathecal infusion pump. It has a better chance than the SCS.View Thread
Still talk. However, in some states it is more difficult for chronic pain patients to obtain the medication that they require to live each day and more physicians are refusing to prescribe powerful opioids at all. Many pain clinics have Draconian rules about medication. You can flunk a drug test from eating bread with poppy seeds and be booted out of the program permanently. If you become tolerant (which happens to all patients using opioids, or if your pain becomes worse and you require more medication than prescribed and you run out too soon, you may find yourself out of luck with physicians who suspect you of selling your medication or giving it to someone else. I'm guessing that most chronic pain patients today can still obtain the medications and dosages that they require. However, the tide of opinion with the FDA, DEA and physicians is going against chronic pain patients. I suspect that we'll soon see an increase in states that disallow a 90-day supply of opioids, making it more difficult (but not impossible) to obtain medications. At the same time, we see a continual increase in states that allow medical marijuana. This is beneficial for many chronic pain patients, as THC, the active ingredient in cannabis, binds with opiate receptors in the brain. But many chronic pain patients fear trying marijuana. Others find the temporary euphoria is uncomfortable. There are two ways to use cannabis pharmacologically. The drugs are Sativex and Marinol. They were designed to treat the nausea and weight loss of chemotherapy patients. However, they can also help chronic pain patients in the same way that opioids work. Chronic pain patients should complete a comprehensive pain management program. Some treatments work quite well. I can decrease my pain by up to 20% with biofeedback alone. There are many other potentially viable treatments, including Yoga, meditation, biofeedback, systematic relaxation, acupuncture, physical therapy, kinesiotherapy, TENS, counseling, combinations of long and short-acting opioids, off-label drugs (anti-depressants and anti-convulsants), spinal decompression, spinal cord stimulator, intrathecal infusion pump and much more. But when those treatments all fail, patients are left only with opioids. If they are not allowed to access the medications and dosages that they require, I'm afraid that suicides will increase substantially. The bottom line on facts is this: Among all chronic pain patients, less than 3% become addicted to pain medications. If you remove from that group patients who already had an addiction disorder before requiring opioids, the addiction rate is less than 1%. Research articles that prove those facts are here: http://www.ncbi.nlm.nih.gov/pubmed/20091598?itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum&ordinalpos=1,http://updates.pain-topics.org/2011/01/study-finds-low-risk-of-rx-opioid-use.html and http://updates.pain-topics.org/2013/08/remarkably-low-opioid-abuse-in-pain.html .
The research on addiction in chronic pain patients is very obvious. These studies involve large test and control groups and they are algorithmic in nature. In other words, the vast preponderance of research on addiction among chronic pain patients all along on the same facts - the rate of addiction among patients with no prior history of addiction disorder is less than 1%. So, please tell me... where is this "massive addiction rate" that we hear about from politicians and people who stand to gain financially from addiction treatments? The truth is, it doesn't exist. We've been lied to by the medical, addiction and state lawmaker populations. In order to punish those few people who steal or illegally purchase and sell opioids, everyone will suffer from Draconian new laws. Those who will suffer the most (and who might commit suicide) are chronic pain patients with legitimate reasons for using these drugs. When they have no more medications, how will they survive? This is what we should consider.View Thread
Why no narcotics? Do/did you have an addiction disorder? You should know that just one medication reduced my pain by 80% and added 9 wonderful years to my university career. And my pain is not "incapacitating 2-3 days per month," it's been like that every day for the past 25 years! Without medication, I would have stopped living years ago. With it, my pain is managed successfully.
You should also request a referral to a comprehensive pain management program. Comprehensive means that they offer a wide range of treatments, including biofeedback, systematic relaxation, meditation, Yoga, TENS, acupuncture, etc. Mind-body treatments can help. Just one, biofeedback, reduces my pain by up to 20% at any given time.
As an axiom, all chronic pain patients should be using an anti-depressant. These drugs inhibit the reuptake of serum serotonin, one of the body's natural pain-fighting chemicals. Cymbalta is a fairly new anti-depressant that was off-label for pain until recently, as the drug characteristically reduces pain. But many other anti-depressants also work well for chronic pain.
Finally, our goal is not to eliminate chronic pain. That is impossible. However, we can learn to manage our pain so that it will not adversely effect the important parts of our lives, including work, family and enjoyment. By accessing the many valid tools of pain management, we can return to a meaningful and rewarding existence. Good luck.View Thread