Back pain with knee pain

Hi Heather...

I was taking a look back at your previous posts as I know I had responded to a few of your threads...

So it seems that you switched off the Fentanyl patch? And just FYI...but the 500mg amount is the amount of Acetaminophen in the Norco pill which is both Hydrocodone and Acetaminophen...

It helps to list the first number, either 5, 7.5, or 10mg as someone may mistake you are actually taking 500mg of the Hydrocodone part which would be deadly at 50 pills a day or more!!!

Anyway...I had asked previously if you have had a MRI last year around Sept. or Oct. and what did that show? Usually a discogram is done when a MRI doesn't show anything seriously wrong. But if you haven't had a MRI in the last 12 months than this needs to be done to determine what is going on.

And unfortunately the discogram is meant to cause some pain as it tells the Dr. which discs are involved and pressing on the nerves.....Did they not give you any medication to help relax you?

Also....are you being seen by an actual Board Certified (and Fellowship trained) Neurosurgeon or Orthopedic surgeon? They are the most highly trained at looking at your lower back to see if there are disc issues.

Other types of medication that can help are actual nerve pain meds like Lyrica, Cymbalta, or Neurontin...As well as muscle relaxers like Flexeril, Robaxin, Skelaxin, Baclofen, or Zanaflex.

This is where opiates/narcotics do not really work well for muscle spasms or nerve pain so that is why you aren't getting much relief even when you were on the 50mcgh Fentanyl patch.

How about treatments like Physical therapy, aqua therapy, injections (steroid or lidocaine), massage, acupuncture, TENS unit??

Sorry for the questions...just trying to assess where you are right now in your treatment plan and what tests have been done so we can suggest things about which to speak to your Dr.

Hello Heather!…and Welcome!

…a discogram is usually done prior to having surgery to pinpoint and make sure that the disk in question is the one causing the problem before trying corrective surgery.

Someone here mentioned that you have not had an MRI?…is that correct? I really think that your Dr would order one, to see what is really going on.

I hope you get to feeling better soon…and sympathize with you suffering so much there.

I'm hoping that you will respond to some of the questions, and fill us in with more information about yourself.

Take care,

SE

I was hoping to get some input. I am going to pain mgt tommorow. I hope he gives ne some news in the next steps he wants to take. My sciatica is so annoying right now. I cant put any pressure on my right side. I get shocks and cramps down my lower back to my calf. Spasms n cramps are more cknstant. Slept with pillow btwn my knees. Helped a little bit. So uncomfortable right now. Sleep is still a fight. Thanks for reading my whiny posts lol

Hi Heather.

My sciatica is awful, both legs and feet, also bad back pain. I've been through all sorts of injections, epidurals, caudals, and they quit working. My pain doctor has been the best for working with this. The orthopod I see only does surgery, which I am not ready for.

I had a couple sets of facet joint injections that blocked the pain nerves. This is not a treatment but a diagnostic procedure to see if nerve ablation will work. The first set only gave relief for a few days, but the second set has helped for a month. My next step is to get the ablation. It's supposed to be just the same as getting the facet block but the nerves will be heated instead of injected so the relief lasts longer.

Heather, I once suffered from the same pain you describe except it was mid thoracic. I tended to favor the left side of my back, where the pain was and that ended up causing my right knee to hurt something fierce. I don't know of a practical remedy but here's how I finally got rid of my pain.
I slipped on some icy steps and broke two ribs opposite the left side thoracic injury. when it all healed up, it took four months, the pain in my right knee was gone . . . that's how I figured that I was stressing that knee by favoring my left side. Like I said, not a practical cure but the pains have been gone for 7 years now. The best of luck and the least of pain . . . Q

Not really sure what the PM was referring to with "cleaning" out the area. It all depends on what nerves are being affected and how badly.

A PM is really not trained at all to diagnose spine issues so as many of us have suggested, you need to seek out a Board Certified, (Fellowship trained as well), Neurosurgeon and they can look at your MRI and results from the discogram. And just to clarify, this MRI was done in the last 6-8 months?

Before ANY type of major surgery is decided upon, it is recommended to get at least 2 opinions from BC Neuros that aren't affiliated with one another. As well as making sure that Neuro is trying all other non surgical means first before going to surgery. (Obviously for those with emergent issues this does not apply)

Then if you receive the same suggestion of a certain type of surgery from both Drs. you can feel more confident that this may be the next step.

Many people who have primarily nerve pain issues really do well with having the nerve released from the pressure. The confusing part though is that you say you have tried all 3 nerve pain meds without even the slightest bit of help? That is truly odd as those are specific to that type of pain. Obviously it's not going to take away all the pain but it's meant to help some. Same thing with injections...they are meant to put a dent in the pain but not make it all disappear.

When did you try Neurontin, Cymbalta, and Lyrica? And did you give each medication at least a month and tirate the dosages? Many times people end up stopping a medication, especially Neurontin, too soon at a low dosage before going up to the therapeutic level.

Same thing with adding a muscle relaxer as I mentioned previously, this helps specifically for spasms. Most opiates do not really target either of these type of pain.

So, if all these meds were tried a year or so ago, I would be trying them again before attempting any surgery...Sometimes it just takes getting the nerves stopped from being inflamed for a period of time and things can improve greatly. Close to 85% of people with spine issue end up not needing surgery.

Because from everything you write, nerve pain issues are your biggest problem. Obviously we aren't Drs. and I am just writing based on my years of having spine issues...

Hopefully you can make an appt. with a BC Neuro soon!!