Spinal fusion of L1-4 and managing pain. What works for you?

Posted by Nancy @nan57, Mar 25, 2016

I had spinal fusion of L1-4 about 15 months ago. Lately, I’ve had chronic coccyx pain if I stand or sit too long. It becomes unbearable if I don’t use my TENS unit. I’m afraid to exercise since twisting really starts the pain cycle. I wake up every night with pain and use ice packs and Tylenol (and cross my fingers) hoping I can fall back to sleep. My back surgeon isn’t really interested in my aftercare. Where do I go from here?!

@riverqueen1305

Hello, I had very similar surgery 5 years ago due to a work injury. NO MORE TWISTING MOVEMENTS/EXERCISES. Please stop this. With the type surgery we have had that is the absolute WORST thing you can do. You HAVE to be your own advocate for back pain care. Look for and find a GOOD pain specalist, one who will listen to your concerns and does more than just prescribe pain pills. Also, clean up your diet and focus on foods that fight inflammation. Physical therapy will help as well. Most type of water exercises will help with stress relief and keeping you joints moving. Check out the web site, loosethe backpain.com and see which of the strategies work for you. I have found more help from this web site that I stumbled onto quite by accident. Also, what medications are you taking? I take Neurotin, Celebrex, Cymbalta, all for nerve inflammation Nycunta for pain. Subcribe to several feeds/blogs on chronic pain: WebMD, The Mayo Clinic; Neurology Now, a free bi-monthly publication for patients and their care givers. Any time I am in a doctors office I peruse the publications in the waiting room to see what might be relevant to me. If you want to contact me directly by private message. Good luck in your journey to better quality life. Also, NEVER lift anything much over 10 pounds

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Hello,
Thank you for your advice. I tend to lean the way you do – being an advocate for myself and searching out solutions that require me to make changes that can help. I have started aquafit and pool walking and they do help. I had an initial back injury at work and herniated L4, L5 and S1 nerve was compressed resulting in loss of feeling in my right foot and significiant pain. At the acute stage of the injury I was on morphine. Since then (10 years later) I have found out that I have a compression fracture in L2 that was described as acute. This pain is different than the herniation. It is quite severe (at times during the day, not all the time) and wraps around my hip and involves the lower right abdomen. MY dr tried about 3 different pain killers and none worked. The next “tier” of drugs were opiates or narcotics and I opted to avoid them. I asked for something to help me sleep instead since the pain kept me up at night. This is working and I am much more able to deal with the pain during the day when I’ve had a good night’s sleep. Not being able to lift anything over 20 pounds was what I was told. And my beautiful grandsons are 25 pounds and 35 pounds! I get the one year old to crawl to me and shimmy up as I lift from a seated position. The older one (3) follows me to a chair and gets into my lap. I cannot give that up! I will look at the website you recommended. Thank you for your advice! Martishka

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@martishka

Hello, I am wondering if there is anyone who is dealing with an “acute” compression fracture of a vertebrae. I have recently been diagnosed with this and have been struggling with intense pain (at times) for over 5 months. The pain centre here has recommended a vertebroplasty. Has anyone gone down this path, or another? Thanks, Martishka

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Yes, I have definitely had this experience. I ruptured a disk at L5-S1 in
2012 as well as a fracture of the L-5 vertebra. I underwent a
vertebraplasty for the fracture and couldn’t be happier. The procedure
takes about 30 minutes performed by an Interventional Radiologist. I was
lucky in that I actually worked as a RN in this area and knew the doctors
well. He did a great job and I have experienced no pain since. I would
highly recommend going ahead with it.

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@martishka

Hello, I am wondering if there is anyone who is dealing with an “acute” compression fracture of a vertebrae. I have recently been diagnosed with this and have been struggling with intense pain (at times) for over 5 months. The pain centre here has recommended a vertebroplasty. Has anyone gone down this path, or another? Thanks, Martishka

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HI Sasaka,
Thank you for your response. I would like to do something that could help restore a better quality of life. I have two grandchildren (1 and 3) and I care for them 1 day a week and it is proving to be very difficult. I had heard some negative feedback about the procedure and was a bit nervous about the possibility of leakage. I was also told that the vertebrae above and below the one being treated had a greater chance of fracture after the procedure. But it is good to hear that you had a positive result.
Thanks,
martishka

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Hi Martiska,

I can’t even imagine how you’re caring for a 1 and 3 y.o. with that
vertebral fracture. It must be excruciating. I’m glad my response helped
you somewhat. Truthfully, having practiced in this field as a RN, I must
tell you I never saw any of our patients return with a leak or another
fracture. Good luck with whatever you decide.

Sasaka

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@sasaka

Hi Martiska,

I can’t even imagine how you’re caring for a 1 and 3 y.o. with that
vertebral fracture. It must be excruciating. I’m glad my response helped
you somewhat. Truthfully, having practiced in this field as a RN, I must
tell you I never saw any of our patients return with a leak or another
fracture. Good luck with whatever you decide.

Sasaka

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Thank you Sasaka,
The day after I have the kids (with the support of my husband, we do it together) I pay for it. The alternative of not having the children just isn’t an option for me. I am going to have to stop picking up Tavio, (one) from the ground. But he is hard to resist with his arms up asking to be lifted! Your experience is very encouraging to me. I do hesitate though since I seem to have poor luck with my health in terms of a track record. I was born with some heart rhythm problems including SVT (a type of tachycardia) and I had 4 unsuccessful ablations and the fifth worked. I have two friends who needed ablations on their heart, they both went in, and came out cured! I feel that with my back I have fewer chances- going into the spine does make me nervous. I am googling studies about the procedure and still haven’t found any reliable ones. The study that an endocrinologist told me about was not encouraging. IT reported that the two groups (one group had the procedure, and the other group had a placebo) were about equal in rating their pain or lack of it 6 months post “procedure”. Those results don’t seem like good odds. Any thoughts?
martishka

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@martishka I agree with PT and I wish you the best. Gabapentin can cause memory loss and make you unsteady on your feet. I would ask about Lyrica. Both are meds that you must titrate on and off.

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@sasaka

Hi Martiska,

I can’t even imagine how you’re caring for a 1 and 3 y.o. with that
vertebral fracture. It must be excruciating. I’m glad my response helped
you somewhat. Truthfully, having practiced in this field as a RN, I must
tell you I never saw any of our patients return with a leak or another
fracture. Good luck with whatever you decide.

Sasaka

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Martishka,
I really can only describe the actual procedure to you. The physician
inserts a needle into your back at the level of the fracture, feeds a small
catheter through it until he can visualize (uses fluoroscopy) the actual
fracture, then injects a small amount of adhesive directly into it.
Afterwards you lay flat for about one hour before going home. I remember
having considerable discomfort on the 1-1/2 hour ride home in the car, but
as soon as I was laying down again it was gone. The next day I was fine.
The fracture has caused me no more pain. However, I do suffer from
spondolethesis which is a narrowing of the foramens where the nerves feed
through, and arthritis in the facet joints. These cause me considerable
pain when I stand or walk for any long period of time. It is not the same
pain that I had from the fracture. It can be relieved by resting and pain
meds. I certainly understand not wanting to give up the grandchildren time.
Mine are about the same ages and the last time I visited them (4 hours
away), it was difficult to pick up and walk with the youngest who weighs
about 22 pounds. He’s quite the wiggle worm and is a challenge for me. Good
luck with whatever you decide.

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Hello Sasaka,
Thank you for the information about the procedure. One of my questions regarding it has to do with the diagnosis which is not conclusive. It states that there is either a “compression fracture and/or a prominent Schmorl’s node.” I was thinking that if it wasn’t a fracture, but in fact , was the node, putting cement into my vertebra would be a bad idea! Knowing that they can clearly see the vertebra during the procedure would be very helpful. THe reason I don;t have a conclusive diagnosis is because my MRI was for the pelvic and abdominal area. I have had significant pain in the lower right quadrant of my belly in addition to the back pain. So the dr asked for an MRI of the pelvic area. The MRI found no worrisome masses and the radiologist happened to see 3 vertebra in it and one of them had an “acute injury within the past year”. He said that the vertebra had nerves leaving there that wrapped around the hips and came over to the belly which could explain the stomach pain. He said that a dedicated MRI of the lumbar region would give more info. I am waiting to see if this will be the recommendation. It has been a long time dealing with this (over 5 months). Perhaps a simple xray could be conclusive.
It doesn’t seem like rocket science to me and I am hoping that someone will make the right referral!
martishka

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