I have been battling lower back pain for almost 8 years. I have had a disc herniate which was successfully repaired. Then after many injections and rhizotomies I had a two level lumbar fusion (L4-L5 and L5 S1) with hardware. The hardware was hitting me in the spine so it was removed. The pain continued so I tried a spinal cord stimulator which didn't work either so I had it removed. A broad assortment of narcotics helped take some of the pain away but much still remained and things gradually got worse.
After a severe bout of pain which went down my left leg (very unusual, the pain is usually confined to my lower back) I had another MRI. My neurosurgeon said that he didn't see anything that would cause this pain or the continuing pain I have had. He said that there is new information that says that the SI joints can be a pain generator in the lower back. The diagnostic injections were great-my pain was completely gone. So I had both side fused with the SI-Bone system. The surgery seemed to go well but now my right foot is very painful and the skin feels like it has been put into boiling water. There is also some tingling and an occasional spike of pain up my calf.
My Dr. said it might be neurogenic pain which narcotics don't help much. I do get some relief from the oxycodone so we decided to add gabapentin which is prescribed for neurogenic pain. It gave only a very slight improvement so I'm left with a very painful foot. There is no pain going down the leg which seems very confusing. Has anyone encountered anything like this?
One possibility might be the development of a pain syndrome called Complex Regional Pain Syndrome. Following is a link to information on the sister site to Healthboards that we are allowed to link to:
This may be what your surgeon was referring to. The NIH website has some good information on CRPS as well. It can come about as a result of several surgeries or it can flare up for no particular reason. A feeling of being sunburned is one common symptom and the skin is usually very sensitive.
Read up on it and let me know if this is the type of thing you are describing.
There seem to be many similarities between this and what I have. I have another appt. with my surgeon and I will bring this up. I am hoping that the people at SI-Bone have some kind of support for doctors that have used their product and run into problems. Thanks for this information. I'm really bummed out that my back problem might be fixed and along comes this other very strange problem that might not be fixable.
There is a lot of good information on the internet pertaining to CRPS. I hope you don't have it but whenever I see someone describe pain where the skin is so sensitive, I think about the possibility of CRPS.
Every time we have any procedure on the spine, injection or surgery, we run the risk of nerve damage. Any time the space around the spinal column or cauda equina is invaded, there is a risk. Problems that can arise include these generalized pain syndromes such as arachnoiditis and complex regional pain syndrome.
As far as I am aware, these complex nerve pain syndromes are handled with pain management. If your surgeon doesn't know much about them, you should be able to find an interventional pain management doctor who will be able to help.
But, it may turn out to be another issue...so don't worry at this point.
Thanks for the info. So far the drugs haven't helped at all. I'm going to try and get a CT scan to make sure there isn't something screwed up with the implant. I had a fusion done on my lumbar spine and was in agony after the surgery. It turns out the hardware was banging me in the spine which we found with a CT scan. I assume that the people at SI-Bone have some kind of tech support line for their Drs. I'm going to try and get mine to call them and see what they say.