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Old 04-28-2010, 04:29 PM   #1
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Unhappy Support for chronic pain

I have moderate bulging disks C5 and C6-7. The spinal cord is being touched in two places, but the signal is presvered. A year ago it was only mild stenosis from my head hitting a tree in a bicycle crash. I've been on pain meds for over a year and a few muscle relaxers, Amrix, Skelaxin, Zanaflex. I have bad side effects with the MRs, and the Norco is no longer working. The pain doc is pushing a little for me to get the injections into the neck since the neck pain is radiating down through the arms and now into the legs. It's a 24/7 thing and I'm desparately seeking support. I don't want to have surgery, but I don't want the nerves that are being pinched to cause permanent damage. Even worse than the pain, the facial muscles around my mouth wrap back around the base of the skull and there is something being pinched there and when I try and smile, my muscles flatten out and cause this horrible line around my mouth, sometimes making it difficult to talk, and it getting worse. I can even feel the muscles pulling down behind my eyeballs and it hurts to try and focus on anything. Plus I look like a freak with the muscles around my mouth not working properly. I can't smile. It even hurts my neck to smile. Is there anyone who has a simiar story about neck pain or chronic pain that can offer a lttle hope and maybe some support? Please

 
Old 04-28-2010, 08:56 PM   #2
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Re: Support for chronic pain

I'm concerned with your level of pain and symptoms. Not sure if you are afraid of the surgery but you should seriously consider surgery if your doctor has recommended it as waiting too long can cause symptoms to become more severe and/or permanent. I waited a bit too long and still have one part of my left index finger that is numb. The nerve was never able to recovery all the way (when I went into surgery I had searing nerve pain down the left arm and into the index and middle finger with numbness and tingling in my index finger and middle finger). I have had a ton of surgery and I will tell you my ACDF (anterior cervical discectomy and fusion) was one of the easiest in terms of recovery. I had to wear a pesky Apsen brace for 6 weeks, but as soon as that was off I was able to significantly reduce my pain level. I had one Epidural Injection in my neck after surgery as there was one nerve that just wouldn't "calm down". And, the injection worked.

I hope this helps, let me know if you have any questinos.
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Old 04-29-2010, 06:04 AM   #3
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Unhappy Re: Support for chronic neck pain C5, C6-7

Thank you for making me see a very good point instead of just being afraid of surgery. Isn't there a way to just fix the bulging disc? Isn't is possible to reduce the swelling so that it's not touching the spinal cord?

 
Old 04-29-2010, 10:26 AM   #4
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Re: Support for chronic pain

I'm not aware of any, have you had a discussion or consultation with a Neurosurgeon and/or Orthopedic Spine Surgeon? They often strive to work on non surgical methods first. I saw my OSS in July and it took 6 months for him to determine that only surgery would help (after injections, ablations, and PT)
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Old 05-01-2010, 06:10 AM   #5
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Re: Support for chronic pain

I saw a neuro surgeon last year, but then it was only a matter of a couple of herniated discs and was nowhere near needing surgery. What does an orthopedic spine surgeon do versus a neuro surgeon/ Is that simply a matter of location on the spine? You have me thinking now that pain management would only be masking symptoms and if I actually considered surgery I may have a normal life back again. How were the injections for you? What were your side effects? At what point did you get to that helped you decide surgery was your best option? One thing that seems so stick in my mind is the fact that people who have had surgery say that it always leads to more down the road, but with the searing pain down both my arms is unbearable. Did an injury from an accident cause your conidtion?

 
Old 05-01-2010, 09:17 AM   #6
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Re: Support for chronic pain

Both Orthopedic Spine Surgeons and Neurosurgeons who are board certified in Spine Surgery can work on the entire spine. I have seen both but have always had better rapport and better luck (and better gut feelings) when using an OSS.

I have used OSS for all of my spine surgeries (cervical and lumbar). My lumbar problems stem from spondylolisthesis. This is a condition where one vertebrae slips forward (or backward) over the vertebrae above or below it. Slippage forward is the most common. The only cure is to surgicall fuse the moving vertebrae to the one above or below it.

My neck problems are partially from loose ligaments and tendons which allow my vertebrae to move a little too much and I also link it to a minor accident I had 20 years ago. I fell hard onto my elbow on the street. I had a very sore elbow, shoulder, and neck for over a month. But I got better. However, I believe (and the doctor agrees) it's likely that the accident caused a bit of disc damage and over time the disc became more and more degenerated and finally one morning herniated without cause. I woke up one morning, stretched just a bit and that was it. I had horrible nerve pain and eventually ended up with a cervical fusion.

You are correct that very often pain management is used to mask symptoms. If there are MRI/CT/x-ray findings that show a condition that is most likely best helped by surgery, then going to pain management for repeated injections only reduces the pain temporarily. There are however people who have ongoing nerve pain in the spine for no visible reason. It can be scar tissue, or just some part of the body that is irritating a nerve repeatedly. So these type of people may use Epidural Steroid Injections (ESI) repeatedly over many years to control the pain. There is also a nerve ablation procedure that an interventional pain management doctor can do. This is where they "burn" the affected nerve using radio-frequency ablation to prevent the nerve from transmitting pain signals. I had an L5 ablation and SI joint ablation last year, done in my pain management physicians treatment suite they have in their office. It was done under conscious sedation (versed to make you loopy and demerol for pain). This helped my SI joint and I think, now 9 months later, I may need to do it again. But if it works I'll do it as often as needed.

So if you have a defined problem that has a surgical option, it makes sense to explore the options and get opinions from a few OSS and or/ NS. There are surgeries that deal in partial disc removal, but your surgeon has to determine you are a candidate for that type of surgery versus something like a fusion. If all or most of the disc is out of it's normal placement it can't be put back in. Often on an X-ray you can see the spacing between vertebrae where discs are. In cases with severe disc herniations or degeneration it's very visible on x-ray that the space between vertebrae is far less than it should be. Often those are cases for surgery.

The injections were quite easy as my pain management doctor does them under that conscious sedation. I had a little bit of pain at the site on the day of the shot and then the next day the pain in the nerve can increase. But for my neck I was able to do a series of 3 injections (each 2 weeks apart) and do this twice a year. I was able to postpone surgery around 2 years but once I had continual numbness and tingling in my fingers I should have forged ahead with surgery. I still have numbness in one finger that will be permanent. Not a big deal but bothersome.

For me I always move toward surgery if it can fix the problem AND to prevent permanent nerve damage. My orthopedic spine surgeon told me that if I did not have the surgery, the cervical nerve damage would likely become permanent . And for my lumbar problem there is no cure beyond fusing the vertebrae that is moving around. So I was eager to have surgery so I could feel better. I'm not really afraid of surgery. While I do get a bit nervous as the date approaches, especially for spine surgery, I go in knowing I made the decision myself to try the surgery as a possible treatment for my problem. I don't know that anyone with back or neck problems is ever 100% again, but for me it's about regaining as much as I can.

And yes, sometimes additional surgeries down the road are needed. But I totally understand the cervical nerve pain down the arms. I call it "searing pain" and for me I would do anything to get even partial relief. When I awoke from my cervical (ACDF) surgery much of the nerve pain was gone when I was in the recovery room.
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Rt&Lt thumb arthroplasty 2012 ; RT TKR & Bilat CTS 2011
Fusions: L5-S1 (87), L4-S1 (93), C5-C7 ('06), L3-S1 ('10)
C5-C7 foraminotomy 08

 
Old 05-03-2010, 03:01 AM   #7
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Re: Support for chronic pain

Quote:
Originally Posted by Dirtangel View Post
I have moderate bulging disks C5 and C6-7. smile. It even hurts my neck to smile. Is there anyone who has a simiar story about neck pain or chronic pain that can offer a lttle hope and maybe some support? Please
hello Dirtangel. It breaks my heart just to read your posting. I suffer from severe chronic neck pain 24/7. It doesnt' get to my mouth and I can smile(but I dont' smile a lot - guess why...). Anyways, I also have 2 bulging disks in my neck caused by a whiplash, how were you injured by the way?? doctors said I'm not for surgery. and anyway, nobody can promise you when you go through neck surgery situation will improve. Nobody can promise you the pain will go away. There is no guarantee in any surgery.

It's been like that for the last 5 years. Did you ask your doctor to prescribe you oxycontin, that definatelly takes the pain away. My doctor has me now on Clonazepam and it DOES helps a bit the neck pain. Valium(diazepam)didn't help. I'm also taking xanax for sleep cause I cannot fall a sleep at all time cause of this neck pain. so looks like xanax 1mg helps. I was sleeping yesterday. some say it's addictive but my doctor said that also oxycontin is addictive so it doesn't matter anyway. There is also gabapentin(neurontin) it helps a bit for neck pain. But oxycontin helps the most.

Again, I'm really really sory you had to go through this neck pain. I know how you feel.

P.S did they check for TMJ. I have TMJ also, it hurts a lot.

Last edited by nochange; 05-03-2010 at 03:12 AM.

 
Old 05-04-2010, 11:33 AM   #8
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Re: Support for chronic pain

Thank you! You seem to be the most rational, sane person that has ever shared their experience with me. I wish doctors could explain things to me the way you posted your msg. And thank you for being so timely. My left arm has begun feeling numb and I know I will move from denial to acting on finding the right person to help me. Was your nerve ablation in your lumbar or your neck? Is this a relatively new procedure/ I live in a military town in NC so finding a doc with the latest technology & current on their knowledge of procedures in a concern of mine. The military is all too often a testing ground for doctor wanna-be's who are fresh out of school and want to practice in the civilian world one day. Like our nurses, they go through school and then get their on-the-job training on us. But, I will be looking to a teaching school maybe for a good doctor. Ortho is 1st on my list now. I'm excited to learn from you that they take care of more than just the lower back. What is your average pain level? What kind of PT did you/do you have done? Any manual traction on your neck laying down with a towel? I'm not so confident about my PT either. Please share more!

 
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