Running out of ideas and could use advice

Posted by sfmcfar @sfmcfar, 12 hours ago

I'll try to be brief. I have had nerve pain in the bottom of my left foot since injuring my back many years ago. My back pain was much improved after an artificial disc replacement at L5-S1 but the nerve pain has remained. It's not constant - it only flares up once or twice a month on my current dose of gabapentin and lasts twenty to thirty minutes - but the pain is horrible. The flareups tend to occur after sitting for long periods of time or if I get pressure around my pubic bone (e.g. during sex). My MRI is inconclusive partly because the artificial disc throws off artifacts at the L5-S1 level. The spine surgeon to whom I was referred says he can't help me. The physiatrist at the same practice is recommending a spinal cord stimulator which I think is crazy for occasional pain that seems to be exacerbated with certain positions.

What should I do?

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Welcome @sfmcfar, I don't think you are the first person whose ever asked that question - what should I do know? It's a great question and I'm pretty sure that's the question that came to my mind back in 2016 when I was first diagnosed with idiopathic small fiber peripheral neuropathy but only had numbness so no drugs were available that helped numbness and tingling. That's really what brought me to Mayo Clinic Connect to learn what other members have shared helps. I know it's not much comfort but I think it's good that the pain you are having is not constant. That would give me great hope that I could find something to provide some relief when the pain does occur.

One thing that comes to mind when I read your description and symptoms was another discussion started by @jenniferhunter - Myofascial Release Therapy (MFR) for treating compression and pain: https://connect.mayoclinic.org/discussion/myofascial-release-therapy-mfr-for-treating-compression-and-pain/. Do the doctors think you may have some nerve compression in your spine possibly causing the pain flareup?

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Honestly, I don't know what they're thinking. The surgeon just told me there was nothing he could do and the physiatrist said that anti-inflammatory injections wouldn't help because there was no evidence of inflammation.

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