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Old 10-09-2012, 09:25 AM   #1
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Mild Epidural Fibrosis "ABUT" s1 nerve

Hey guys I had a microdiscectomy in may 2010. I was nerve pain free for over a year. Not even a wince of pain. Before my surgery I was suffering from HORRIBLE NERVE PAIN.

Before my surgery only my nerve hurt. After my surgery only my back hurt. Now it completely switched again and my nerve is aching.

Its been going on since December (9 mos or so). Just an ache about 1/3rd of what it was when the disc was hitting the nerve.

I had an MRI, the only thing I saw that may cause this is "MILD EPIDURAL FIBROSIS ABUT S1 NERVE ROOT" so its not wrapped around I think it is just touching it

I saw about 4 doctors in regards to this, they all said at first they dont think its scar tissue causing this and the pain should reside on its own.

Well its been almost a YEAR and it hasnt. Its very annoying.

what are your opinions on this? I have done PT, stretching, neurontin, lyrica, cymbalta, traction....

 
Old 10-09-2012, 01:58 PM   #2
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Re: Mild Epidural Fibrosis "ABUT" s1 nerve

You are right, abuting does mean touching /in contact with the nerve but not compressing it. Epidural fibrosis means scar tissue. It may be that you need to go back on lyrica or gabapentin again and try a different dose. If it didn't work before, then cymbalta is another option being used with some success at treating nerve pain...and just remember that the doses may need to be titrated up in order to achieve some sort of pain relief so if one of them doesn't work right away, then give it at least one or two dose adjustments before making a decision about whether or not it will work. The side effects usually go away within a week or two of trying these meds. It also takes a bit of time to see if they will be of benefit to you.
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Old 10-09-2012, 02:03 PM   #3
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Re: Mild Epidural Fibrosis "ABUT" s1 nerve

[QUOTE=backhurtz;5069694]You are right, abuting does mean touching /in contact with the nerve but not compressing it. Epidural fibrosis means scar tissue. It may be that you need to go back on lyrica or gabapentin again and try a different dose. If it didn't work before, then cymbalta is another option being used with some success at treating nerve pain...and just remember that the doses may need to be titrated up in order to achieve some sort of pain relief so if one of them doesn't work right away, then give it at least one or two dose adjustments before making a decision about whether or not it will work. The side effects usually go away within a week or two of trying these meds. It also takes a bit of time to see if they will be of benefit to you.
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Backhurtz,

Thanks for your reply. If the scar tissue is not "compressing" it do you think that is what is even causing the pain? My neurosurgeon, primary care doc, and physiatrist all said at first thats not the cause. They brought up things like weak muscles, inflamation etc. Now that it hasnt gone away in 9 mos they are leaning that could possibly be the cause.

One doc said an epidural injection may help break up scar tissue and my body could reabsorb it but he didnt seem sure,

Just trying to figure out what to do???? I have taken, lyrica, cymbalta, and neurontin. I tried them all for only a month, I guess I could try again.

 
Old 10-10-2012, 11:00 PM   #4
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Re: Mild Epidural Fibrosis "ABUT" s1 nerve

I agree, a month is not long enough. I just started Nuerontin, didn't do a thing, actually I hurt worse after some new PT moves, so the Dr started me weekly increasing it. I started at one pill, twice a day of 100 mg pills. Next it was increased to two.pills every morning, and every afternoon and every pm. Now I am.up to three pills three times daily, and It's working for me. Big difference! I can max it out at four pills three times a day he said also. It is so.frustrating I know but hang in there. Maybe you need meds and rest, not PT now? And if it were me, golf would be done for the year to be safe. Don't be afraid of epidurals either. That was a rare issue and They are basically safe, I used to have them and they are amazing, like a miracle when they work too. I used to get up to 6 months relief, felt like a miracle cure.
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Old 10-11-2012, 11:03 AM   #5
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Re: Mild Epidural Fibrosis "ABUT" s1 nerve

Striker,
A month is not long when it comes to trying these nerve type of meds. The usual dosage range for Lyrica for neuropathic issues is around 300 mg but it needs to be titrated up slowly. Cymbalta is somewhere around 60-90 mg I believe and Gabapentin is variable but can go as high as 3600 mg a day, so you can see that it might take some time to find the right dose, but you should start to feel some relief, even if it is not exactly complete before then...whatever you do, do not just stop taking Lyrica or Cymbalta and gabapentin. They are in a class of meds, that needs to be titrated up and down, and tapered off...the good news is that they do help.
As far as whether or not scar tissue can be causing pain, yes, it can. It could be positional too, making it worse in some positions and not so much in others. The reason for this is that your spine moves, which means that the nerve exits also move when you are changing position.....this can cause the abutment to become more of a direct contact in certain positions. Hope that helps.
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Old 10-11-2012, 11:40 AM   #6
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Re: Mild Epidural Fibrosis "ABUT" s1 nerve

Backhurtz & Workinmom,

Do you think the position of the scar tissue could have possibly changed due to golf. I was pain free for over a year and had played golf 20+ times with no issues. Then after one sunday afternoon of golf I woke up the next Monday with a tingly feeling and then pain.

I asked my physiatrist if it was scar tissue why wouldnt it have caused problmes 6 months or sooner after surger and just now hurting? his response was "whose to say it doesnt move around? I dont mind taking cymbalta however, I dont want to be on meds for ever. Im only 25 years old.

Im going to a chiro and having traction done. My physiatrist said it could help.

Do you guys think I will suffer from this forever?

Last edited by Strike554; 10-11-2012 at 11:46 AM.

 
Old 10-11-2012, 02:20 PM   #7
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Re: Mild Epidural Fibrosis "ABUT" s1 nerve

Scar tissue after any surgery is not uncommon, and it could be putting pressure on your nerve. Steroid injections can get rid of scar tissue in many cases. I would probably give that a try if a doctor is recommending it.

 
Old 10-11-2012, 02:36 PM   #8
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Re: Mild Epidural Fibrosis "ABUT" s1 nerve

It strikes me that your physiatrist has some "interesting" ideas. I don't believe that any tissue just kind of randomly floats around inside the body. Particularly when you have micro surgery, very little other tissue is disturbed. If you had an open surgery, I'd be willing to acknowledge that the fascia was disturbed and other muscle and tissue was cut through in order to access the disc...but that didn't happen.

I think it is more likely that you have a small annular tear in the disc that is not visible on MRI or something similar. Perhaps there is a bit of instability...but the MRI revealed that you have not reherniated, right?

 
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Old 10-11-2012, 03:04 PM   #9
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Re: Mild Epidural Fibrosis "ABUT" s1 nerve

The neurosurgeon did say its possible I have a small tear in the disc thats not showing up on the MRI. However, I have absolutely 0 back pain. My back has never bothered me much while I had a herniated disc or now. The only time it did hurt was for about 5 months after surgery. It that was just soreness.

I brought up the annular tear theory to my physiatrist. He said thats not whats causing my pain since I dont have back pain. He said if there was a tear my back would hurt.

Its annoying bc every doc has a different theory.

DO ANNULAR TEARS HEAL? ITS BEEN GOING ON SINCE DECEMBER OF THIS YEAR???

Also I was about 4 days out from having an epidural injection but I backed out last minute bc of people dying due to meningitis.

Thanks for everybodys replies and input. This whole thing is starting to cause anxiety /depression. The pain isnt horrible but It mixed with anxiety constantly gets me down. very hard to get it out of my head.

 
Old 10-11-2012, 03:06 PM   #10
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Re: Mild Epidural Fibrosis "ABUT" s1 nerve

AND no i dont not have a herniation. I do have a very small bulge that neurosurgeon said was more than likely there before my surgery. Every doc has said the bulge is too small to cause a problem

 
Old 10-23-2012, 03:55 PM   #11
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Re: Mild Epidural Fibrosis "ABUT" s1 nerve

Everybody,

A part of me does want to think it is scar tissue. Certain movements like bending over and a few other things cause a split second jolting nerve pain. Otherwise it is just an achy feeling prob like a 2 on a scale of 1-10 but constant.

What do you guys suggest. Try the cymbalta or nuerontin again but give it longer and higher dose,

Or skip straight to the epidural injection which may break up the hurtful tissue?

Any input is definately appreciated

Thank you everyone!

 
Old 10-23-2012, 04:39 PM   #12
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Re: Mild Epidural Fibrosis "ABUT" s1 nerve

Strike, if it were me I would skip the drugs and go for the steroid injection. The drugs won't heal you, while steroids are used post op after many different surgeries to prevent overhealing - my Lasik surgery was one example. Steroids can work wonders on scar tissue.

I remember reading that once you pass the one-year mark, scar tissue is considered "old" and may or may not respond as well to attempts to eradicate it. The body has a great natural healing process, but sometimes it overheals, and this could have happened in your case and caused the fibrosis.

 
Old 10-23-2012, 04:53 PM   #13
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Re: Mild Epidural Fibrosis "ABUT" s1 nerve

I played golf several times before and never had problems. And if golf that "time" would have caused my pain wouldnt it have happened right after me playing golf and not the morning after?

Do you guys think maybe my scar tissue got aggrevated or moved somehow.

What does everyone think?

 
Old 11-07-2012, 01:55 PM   #14
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Re: Mild Epidural Fibrosis "ABUT" s1 nerve

[QUOTE=CT06405;5077409]Strike, if it were me I would skip the drugs and go for the steroid injection. The drugs won't heal you, while steroids are used post op after many different surgeries to prevent overhealing - my Lasik surgery was one example. Steroids can work wonders on scar tissue.

I remember reading that once you pass the one-year mark, scar tissue is considered "old" and may or may not respond as well to attempts to eradicate it. The body has a great natural healing process, but sometimes it overheals, and this could have happened in your case and caused the fibrosis.[/QUOTE]

CT06405

Have you had an epidural steroid injection for scar tissue? Did it work for you? The weird thing is my physiatrist gave me 2 seperate options. Traction or Epidurals.

Im guessing he suggested traction to try to break up the scar tissue? Im not sure but I was suprised. My brother in law is a chiropractor and is allowing me to use his decompression machine. I have done probably 8 treatments with no noticeable decrease in pain yet.

When you have a Micro D is the scar tissue attatched to the disc? If so then I could see why traction would work. As far as the epidural he said that is a quicker route.

He said hopefully it will break up some of the scar tissue and allow my body to re-absorb it.



I have bad anxiety so I am also taking venaflaxine, I just started it.

 
Old 11-07-2012, 02:28 PM   #15
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Re: Mild Epidural Fibrosis "ABUT" s1 nerve

Hi Striker, I just today got an epidural steroid injection. My problem is not a disc and I've never had back surgery; my injection was into a synovial cyst on a facet joint between the L4 and L5 levels (basically an arthritis symptom). I'll let you know if it works; it will probably take at least a week to know. I'm trying to shrink the cyst both for diagnostic purposes so that I know what is causing me pain, and also in an attempt to get rid of it totally.

I think in your case, wherever they cut during surgery could cause some scarring down of tissue as it heals and the fibrosis. This could contract or pull on the nerve roots in the area. It takes very little to irritate sciatic nerve roots, as we all know on these boards. The steroid should at least relax that, assuming they inject it into the right place, and may totally get rid of it. I have heard of many people having great results with steroid injections, assuming they inject it into the right area.

 
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