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Old 03-16-2012, 10:01 PM   #1
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Unhappy Neurontin post micro-discectomy?

Hi, all- I just joined and I would like to thank you in advance for your input. I am a healthy 39-year-old female. My story starts back in September of 2011. I went in to see my primary physician due to lower back pain which also radiated around my hip and down my left buttock and leg. I also had spasms in my left buttock. She requested I get an x-ray which showed I had narrowing between the L5/S1 disc. I was referred to P/T and did that for almost three months. The pain become unbearable to where I couldn't drive or sit and so I was referred to a neurosurgeon who immediately requested an MRI. The MRI revealed I had a herniated disc. I had my first discectomy on 12/21/11. I was still in quite a bit of pain post-surgery and I went in for another MRI on 1/6/12. It revealed there was either fluid or blood at the site and so I went in for an aspiration on 1/12/12. The MRI also revealed there was some disc protrusion but not enough to classify as a reherniated disc. The gentleman who performed the procedure was not able to aspirate any fluid so he decided to administer an ESI. I followed up with my nerosurgeon the following week because the pain was steadily increasing. He recommended I have another discectomy which was scheduled for Monday, 1/30/12. The Friday prior to surgery #2 I went into the ER because the pain was excruciating. I could not sit, lay, stand, anything. They admitted me to keep the pain under control throughout the weekend. The PA came to the hospital to see me on Saturday and requested another MRI. It revealed a massive reherniation and they rushed me into surgery the next day. The neuro doc said it was the largest herniated disc he had ever seen. Since then I have been on two rounds of methylprednisolone and I am still in pain. I still have spasms and nerve pain. Worth noting, I have a desk job where I sit all day and I've been working from home on my laptop most of this last week so I can lay down. I had MRI #3 last week and the doctor said there was nothing he could do surgically to help. The pain is getting worse, I'm still on narcotics, and he prescribed Neurontin, which I'm hesitant to take. Having said that, I have an ESI scheduled for next Wednesday. Should I wait and see how that goes before starting this new drug? The doctor said he would probably keep me on it for 3 months. I have read it has some unfavorable side effects and I really don't want to add another pill to my arsenal. Will this nerve pain ever go away?!?!! Does anyone have feedback on Neurontin? I feel like I'm locked in on this for life even though it's only been a few months. Help!

 
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Old 03-16-2012, 10:47 PM   #2
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Re: Neurontin post micro-discectomy?

I have been learning that nerves heal very, very slowly. They can be aggravated by prolonged stretching, but can also be stretched in short bursts through nerve glides. If you are not in PT, you might want to request a couple of sessions to at least get some effective stretches which won't aggravate your back.

I have not taken any nerve-specific medications, but I think Lyrica is a newer generation drug that might be better at avoiding side effects. I use Lidoderm patches, which you stick wherever it hurts. There is some dermal absorption, but certainly less drugs in your system than ingesting a pill.

I hope the epidural gives you some relief. teteri66 had some interesting comments in another thread about a doctor who insisted on resting for 72 hours post injection to ensure that the injected drugs stay in the affected area.

 
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Old 03-16-2012, 10:56 PM   #3
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Re: Neurontin post micro-discectomy?

Thank you, SweetPea. I just read his post. That might be something to consider. I had every intention of going back to work the next day but I think I just may lay low for a couple of days.

 
Old 03-16-2012, 11:26 PM   #4
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Re: Neurontin post micro-discectomy?

Welcome to the board. I'm sorry you are having such a hard time trying to recover from the discectomies.

I can understand why you would be reluctant to add another drug to your body, but you must also take into consideration the effects of so much steroid usage, orally and in the ESIs. Ultimately, the side effects of one of the so-called nerve pain drugs like neurontin or Lyrica are probably less harmful than the more permanent issues caused by steroids.

I've taken neurontin and Lyrica at different points in my journey, and I feel it is worth trying. Some people do get fairly good relief from one of them. I was never that lucky. But if you happen to be one who is helped by it, then it will be worth it. Options are somewhat limited when it comes to nerve pain.

You are still fairly early in your recovery from the last surgery. Every time the disc herniated, you are starting all over again, plus this last time there was probably more damage than the previous time, so you are possibly looking at more nerve irritation and/or damage.

Did you try to go back to work fairly soon after the last surgery? As you know, sitting is just about the worst thing one can do after lumbar spine surgery.

Did the surgeon indicate why he thinks you are in increasing pain? What did he suggest you do about it other than have an ESI to try to settle things down and take neurontin?

 
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Old 03-17-2012, 07:41 AM   #5
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Re: Neurontin post micro-discectomy?

Thank you, teteri66. Can you elaborate a little on your comment about the more permanent effects of steroid use? I'm not aware of what those effects could be. Do you know the difference between Lyrica & Neurontin? I went back to work about 2-3 weeks post-surgery. My neurologist told me I should sit for 10 minutes, stand for 10 minutes, rinse & repeat. Unfortunately that is not possible in my work environment so I have been sitting more than I should (even though they provided me with a really nice chair). There have been days when I've had so much pain that I've opted to stay at home and lay flat, which is the only position comfortable. As far as a future prognosis, my doctor didn't mention any options other than the injection and the Neurontin. He said that my nerve would be "angry" for quite a while, considering the size of the herniation. He also said he would prescribe P/T for me after things calmed down a little and the pain subsides a bit. I've tried doing some of the exercises I did last year in P/T but it hurts and I don't know if I'm helping or hurting it. One thing I wanted to mention was that, in my last check-up, I am the one who inquired about taking a drug like Neurontin. His response was, "Yes, we could certainly try that". I found it odd that he didn't present it to me first. He told me the injections are basically just buying me time, he cannot change the anatomy of my back, and that I would probably have problems in the future. As far as medication, I take Valium for spasms and Percocet for pain. I requested Percocet last week since the Norco they most recently gave me was not working very well and it just makes me feel weird. I broke down last night and took some of the Dilaudid I had leftover from right after surgery. I slept through the night well but I think the pain in and below my left buttock this morning is the worst it's been since before surgery #2. Is it possible the nerve is just aggravated? I've been home the last 2-1/2 days and can't imagine I've done anything to cause a flare-up. Is this a waiting game? It just takes time? Thank you, again. It's so nice to know I'm not alone and that there are people who can relate. It validates me and makes me feel like I'm not making more out of this than I should be.

 
Old 03-17-2012, 10:33 AM   #6
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Re: Neurontin post micro-discectomy?

You are not making too much out of it. Unfortunately, it is a very real problem that lingers well after surgery. Some people are lucky and emerge from surgery without nerve pain...but it seems like they are in the minority.

In your case where you had a dramatic disc rupture, and one of a large size, it would stand to reason that you have more trauma to the nerve. Nerves heal very slowly and are easily ticked off by the least little thing once they have been assaulted. Simple tissue swelling will increase nerve pain.

I ruined a simple surgery to decompress a nerve by sitting too much in the early days post surgery. I was pain-free for the first time in years the day after surgery, but a couple days later there was a family emergency that required me traveling 45 minutes from my house and hanging around an emergency room and then hospital for the better part of a week, traveling back and forth every day. Timewise, this was before my surgeon had even cleared me to ride in a car...but I had no choice. As the week progressed, I could feel nerve twinges start up and then grow in intensity. I could feel the swelling increasing and I felt helpless to do anything about it. And by the end of the two week emergency, all my symptoms were back, just like I'd never had the surgery. The surgeon put me on steroids...I may have had an ESI --can't remember now...but the damage was done and I continued to have the nerve pain.

Anyway, I digress. After my last surgery, the PT and I calculated that given my height and the location of the numbness, if I followed the standard time for healing, we wouldn't know if the nerve damage was permanent for about 1050 days -- over 3 years! Now most surgeons will tell you that if you haven't recovered within 12 months, you probably won't...but I know in my case at least, that is not true. I am almost 2 years post surgery and I am still regaining feeling in my feet. My point is that nerves take a long time to recover. But you should see baby steps-worth of progress.

I would suggest you have the injection -- it may be just enough to calm down the inflation and get you over the worst of it. If not, I would try neurontin. Usually insurance carriers now make you try neurontin and having it fail before they will OK paying for Lyrica. Lyrica is more expensive -- it is the new sister to neurontin. Advantages are that it is formulated in such a way that you can take less of it, and therefore there are fewer side effects for most people. Some people have very good luck with one or the other. Neither one did much for me. But it may be because I didn't have a therapeutic dosage. When the dosage went above a certain point, I would develop swelling and then would discontinue it, so I may just never had enough to do any good.

If the doctor doesn't think you are ready for PT, if I were you I would lay off the exercises and stick to walking. You should take a number of short walks every day as walking is the best way to stretch out the spinal nerves and to help to prevent scar tissue from attaching to the nerves. You don't have to go far; even several laps around the house or just pacing through the house will help to stretch the nerves. If walking hurts, shorten your stride; slow down the pace...experiment with mixing things up.

Regarding the steroid injections and Medrol packs: too much steroid affects healthy tissue. Some docs say 3 injections every six months; others say 3 within a year. Mine said the amount of steroid was so small that it wouldn't be harmful...and I ended up having more than that because we were trying to figure out some issues that weren't being confirmed by MRI, so I had quite a few nerve blocks, etc within an 8 month period. I discovered that there is a type of cataract that forms due to steroid use. Aha -- no one mentioned that to me. So, I'll be dealing with that in the future.

 
Old 03-17-2012, 10:43 AM   #7
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Re: Neurontin post micro-discectomy?

I don't know if you might be able to give your back a break from sitting by lying on the floor. Maybe you can close the door to an office or go to a break room or something? If so...and you can do this at home, too. I've been know to go into a dressing room in a dept. store when I felt I just couldn't walk any further....

Lie flat on the floor, knees bent, feet flat on floor. Place arms close to your sides, palms facing up toward the ceiling. Be sure you are lying "straight" so you are in alignment and the pelvis is in a neutral position. Breathe so the belly rises up and down and just relax.

This position is a natural form of traction that allows the discs to unload. Since the muscles aren't being signaled to hold up the spine, they will be able to relax and stop "guarding" which can lead to the spasms. If you can, stay in this position for 5 minutes.

I usually stay in this position for at least several minutes; then I allow myself to move my arms to hold something to read...and I stay as long as time permits...as long as it is still comfortable. Even though my surgery was almost 2 years ago, I still do this twice per day, more often if I have been doing something that I know stresses my back (trying to pick up the house).

It is also recommended for athletes who need to relax the spine -- like runners and cyclists. It may not feel comfortable in the beginning, although it always has for me.

 
Old 03-17-2012, 01:08 PM   #8
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Re: Neurontin post micro-discectomy?

I had surgery on 12/19/11 and at first things were.great then the pain came back. My surgeon said it was nerve.pain and it would take up to a year to heal, especially the sciatic nerve. He put me on neurontin and it has been a miracle drug cobra me....they move your dosage up in increments till it works,,,for me it was 1200 Mg a day. Now I am only on this and no pain mess. I also walk 2 times a day for 30 min.....walking is very important for healing. Good luck.to you!

 
Old 03-17-2012, 03:02 PM   #9
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Re: Neurontin post micro-discectomy?

I have been on Neurontin for about 5 years and probably will be taking it the rest of my life. It is a wonderful drug for nerve pain but it is something you must take every day not like a narcotic that you take when you have pain. I also tried Lyrica (made me eat like a horse) and Topamax (or Dopamax). Neurontin was the best for me.

The major side effect of Neurontin (Gabapentin) is dizziness and tiredness. Also you may gain some weight. The side effects tend to fade over time. I am on a heavy dose 2100 to 2700 mg per day but you will never be put on that much to begin with. It is an easy drug for most people to take. It is not addictive like a narcotic and it is easy on you liver and kidneys.

I will always have some nerve pain but Neurontin has helped a great deal. Also nerves do take a very long time to heal (up to 2 years) so don't be discouraged.
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Old 03-17-2012, 04:06 PM   #10
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Re: Neurontin post micro-discectomy?

If the PT exercises are causing you pain, don't do them! After surgery, my PT exercises were significantly modified from what I had been taught pre-surgery. I would hardily recommend not doing the same exercises you were doing before. If you and your doctor feel like you are ready to start, you should be re-evaluated and given modified exercises. Of course, walk, walk, walk. As often as possible.

There are a couple of PT stretches that really helped me in the beginning of my recovery: hamstring, piriformis, calf, and nerve glides. If you were taught any of these before, you may want to see if they help. It's important to note that nerves can be aggravated by prolonged stretching, so the nerve glides are a good way to tug on the nerves.

If you can't do the full 10 minutes standing or get away to lie down, standing up for a minute, marching in place, then sitting back down, has worked out well for me. I started working part-time and have gradually increased my hours to almost full time. I find it is easier to ease back in and build my stamina.

 
Old 03-18-2012, 06:59 AM   #11
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Re: Neurontin post micro-discectomy?

The neurontin may be worth a try. I had been put on it at one point early in my journey with back pain. It did nothing for me, but the true source of my pain hadn't been located at that point, so it was just a band-aid effort by the docs who didn't seem to interested in finding the true source of my pain. I have since replaced those docs and have docs that are actually figuring out what is wrong.

Take your time and let your body heal! If something increases your pain level, stop doing it or find another way to do it. Your body has been through a lot from what you described, and it is going to take some time to heal. Each person is different in their healing time too.

I will make one suggestion for working on your laptop even from home. Get one of the adjustable height hospital type tables. You can order them online. The weight of the laptop on your lap may help increase your pain by adding stress and strain to your back. I recently ordered one, and it is a real bonus to have it. I paid just under $70 for mine including the shipping, and it's been well worth every penny.

 
Old 03-18-2012, 04:41 PM   #12
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Re: Neurontin post micro-discectomy?

Neurontin (gabapentin) will not help with back pain. It is only effective for nerve pain specifically. Sciatica yes it can help.
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Old 03-19-2012, 09:01 AM   #13
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Re: Neurontin post micro-discectomy?

I'm so sorry, I can truly relate. Mine put me in a wheelchair for 8 months. I had a hemi laminectomy( 1 step more than discectomy) in 1/07 disc blew completely out in 8/06. Been there with ESI's, Medrol packs, Pain Mgmt, Neurontin just prescribed(not started yet either) steroids took me from 120lbs to 210lbs. I was athletic n healthy, did PT everything unrelenting no sit stand toilet pain stopped after surgery, but was left with heavy ache, dull nagging pain in hips n leg( my back never hurt). I have burning n tingles in both feet, have a walking on marbles sensation since(no barefoot for me) weakness in legs, edema, broken veins , cannot move toes, or spread them open, have not jumped, ran, been on knees, bent forward, laid on right side, sat on floor, danced since surgery. Shower is a two hour deal, can't feel feet unless it's the burn or tingles. If someone brushes my skin on legs, bumps toe I hit the roof with a startled jump, became diabetic, high triglycerides after.. They told be ESI, Surgery nothing will help and where I was in 5 yrs is where I will stay because you have all the regeneration you will get by then, I truly understand where you are, I wish I could snap fingers and change this for you but if your not 5 years in, wait a bit and all the steroids will just aid in damage to the rest of your body so be careful with them. I take Lortab, Flexeril and going to try Neurontin but Leary. I wish you well and I pray you heal much more
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