Severe spinal stenosis

Has anyone tried fentanyl patches for severe spinal stenosis?

Hello @gotoandrea, I combined your discussion on fentanyl patches for severe spinal stenosis with your previous discussion titled, "Severe spinal stenosis" - https://connect.mayoclinic.org/discussion/severe-spinal-stenosis-1/.

I did this so the members you connected with like @loyal, @doriskay79, @gently, and @dlydailyhope would see your question about trying fentanyl patches.

@gotoandrea
Is the stenosis in the cervical spine or lumbar spine and at what level(s)?

Physical therapy and gentle stretching and strengthening have helped my lumbar stenosis/sciatica some. Lidocaine pain patches like Salonpas have also helped (haven’t tried fentanyl patches). When I had lumbar spine surgery in August 2024, they used fentanyl in my IV for pain but it didn’t help me. They needed to switch to dilaudid/morphine and that worked much better.

Depending on the cause of the stenosis (disc bulge/herniation, shifting of vertebrae or osteoarthritis/bone spurs), surgery may be the only real relief since the degeneration continues over time.

I had tried the Buprenorphine 10 MCG 7-day patch but ended up going back to Hydrocodone 7.5 - 325. I may need to change to Oxycodone 10 Mg soon though. I have what a Radiologist just reported on Cervical MRI on October 10, 2024, as "extremely severe foraminal narrowing (spinal stenosis) on right and left C5-6. I am currently waiting to hear from an Orthopedic Surgeon for a consultation after my Cervical MRI is reviewed. I had previously seen this Orthopedic Surgeon in August 2023, but he did not think surgery was required at that time. I am a 67-year-old male that has been dealing with symptoms that have increased in duration and intensity for the past 18 months

I have had three neurosurgeons view my cervical mri. All three recommended surgery. My medicare plan disagreed with the three neurosurgeons. As a result , I am on pain management for my cervical. Currently, I take morphine 30mg er two times daily and hydrocodone 10/325 up to five times a day. The meds do not eliminate the pain, but make it tolerable. I just had a reverse total shoulder replacement and that took my mind off the back pain. I am 67 too. I'm just looking for some relief. I've tried injections nerve blocks and two different spine stimulator. Im at a loss on what to do next.

@koneil, you may have a very good medicare advantage plan. Then again, you might want to effect a change during the next three months. Original Medicare is so much better at paying for surgery . You probably could challenge your plan.
Opioids are sometimes necessary but they don't make a good long term plan and you are only 67.
If you do switch or challenge be sure and consider artificial disc replacement https://spinehealth.org/cervical-disc-replacement-procedure/

I get about 6 weeks from my epidural injections. I am worried if that will make my Osteoporosis worse. I am currently going to PT and a chiropractor. I also get acupuncture in my SI area.

maryandnans, does the chiropractor help with the SI. It's the best for me. Do you get thrust adjustments.
https://journals.lww.com/md-journal/fulltext/2019/06280/effect_of_medications_and_epidural_steroid.30.aspx.
Small study so who knows.

This is not uncommon unfortunately. I’m guessing you’re on an advantage plan or a PPO unfortunately. Contact the physicians and ask them to write a letter and you too need to write a letter to your insurance explaining how bad your situation is. Your insurance is weighing the cost of your medication monthly vs. the much higher cost of surgery and rehab. Don’t take it lying down. Your insurance may have an ombudsman you can speak with also to state your case. And also call your insurance company too and complain.

No but I did try and currently use buprenorphine 20mcg patch every 7 days.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4675640/