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Epidural Fibrosis/Help requested

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Old 12-19-2004, 06:53 PM   #1
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Epidural Fibrosis/Help requested

I have been visiting here for some time and have received a good education on chronic pain and pain managment. Thanks to all. I had discectomy on L5-S1 Jan 03'. Also have bulging L4-L5, L3-L4. Virtually pain free 4 wks post-op. At 6 wks I started having leg pain. 16 wks MRI showed scar tissue wrapped around nerve root. Started Lortab 7.5/500, 3/day. Had 2 ESI's with no effect. PM upped Lortab to 4/day. Pain continued to get worse. PM tried me on Nerontin, Trileptal and Cymbalta with no reduction in pain. PM upped to Lorcet 10/650, 4/day starting end of month when current Lortab script expires and is releasing me to my primary. She says the only thing left to try is Spinal Cord Stimulator. I feel that is a last resort. The pain is intense. Tops out around 8, down to 6 with meds and 5 if I lay in bed. I wonde if I would benefit from long acting meds with sa for bt? PM is opiod phobic I think and I might get better advice from my primary. I am doing PT, Pilates and start swimming in Jan. Walking and cycling are too painful.
Does anyone know of any treatments, therapies etc for epidural fibrosis that I might have missed?
Thanks to the folks here. Nice to know we are not alone.

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Old 12-21-2004, 05:42 AM   #2
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Re: Epidural Fibrosis/Help requested

Hi K, I haven't heard the DX epidural fibrosis but I'm very familat with arachnoiditis, same basic thing, scar tissue squeezes and raps around the arachnoid layer of the cord. It's difficult to treat as with any scarrig problem, often removed scar tisssue just comes right back. Some of scarr heavier than others and are more prone to the problem but it doesn't mean the only treatment is lortab, PT and an SCS.

Sounds like your doc has one or two tricks up his sleeve before he throws them up in failure and tells the patient thay must learn to live with it because if he couldn't fix the problem or relieve your pain nobody can.

With a doc that uses such a wide a variety of modalities it's just hard to imagine anything else he might try, Perhaps Accupuncture, TENS unit, TINS, spinal manipilation like chripractice, there are many techniques and methods used for back pain from the Mckenzie method, myofacial release, scar management, work hradenng, all the feel good modailities but if this one therapist can't fix you I guess there is no hope.

Sorry, that's my sarcasm slipping in. You also have the whole mind body connection thing you can ignore and go straight to invasive surgery, why learn bio feedback, self hypnosis, Guided imagry, yoga, or try any of a dozen anti seizure meds used to treat nerve pain, Nemanda, any of a dozen or more anti depressants used to supress substance P, Baclofin, clonidine, Lidocaine infusions, robaxin infusions, Trigger point injections, Just to name a few, without even mentioning all the long acting pain meds available for intractable pain that doesn't respond to other modalities.

It took me 8 years and a dozen PM docs, 3 surgerries and being bed ridden before I found relief with long acting meds, but when nothing else is beig offered and the SCS is the only option put before you it sounds like the next step, but it's not everyones next step.

That's the thing, each and every PM doc will have a few different modalities to try, if you get in with a clinic composed of several docs with several specialties you can try every modality with one of many specialist in a clinic setting.

But it is a huge leap from lortab to an SCS and no reason not to try anything else before throwing in the towel and saying this is all there is to offer. It may be all he has to offer and not looking elswhere may be something you have to live with, if you let this one guy convince you nothing else could posssibly work.

Obviously there are many other methods to try, whether you want to spend the time learning them or consulting with other PM docs and surgeons is entirely up to you. But your doc doesn't have much to offer. It makes me wonder if every patient gets the same treatment and the same SCS when his treatment doesn't work. You can't slam evey peg through the same hole and square pegs just don't fit in round holes regardless of what your present doc thinks.

Time to look for a different aproach and other modalities and at least try something before you have to live with a decision that you made while in pain when no other option was presented. Bad way to make a decision.
Good luck, Dave

Old 12-23-2004, 06:56 PM   #3
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Re: Epidural Fibrosis/Help requested

Thanks Shore,

Of course I realize that this PM doc only has so many tricks in her bag. She has released me to my primary and I will discuss other options with him. My Physical therapist is doing mobilizations and I know there are many other avenues to explore. I consider the SCS a last resort and I'm not there yet.
I appreicate the sarcasm.
I was hoping to get others experience with this condition. Yes, it's a variation on a theme of Arachnoditis.
Of course THAT is often caused by or agravated by <gasp> ESI, so I probably will not get that diagnosis from the doc that actually DID the ESI.

Thanks again, soldiering on,

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