Sciatica nerve pain due to scar tissue following back surgery - Cymbalta and sleeping problems

Hi, I'm new to this site and this is my first post. I had back surgery for a ruptured L5 S1 last June. The surgery was successful, but according to the surgeon I developed scar tissue that is now pressing on my sciatic nerve causing chronic pain in my right rump, hip, and leg. It's not as bad as pre-surgery but still very debilitating. I tried Gabapentin, but at 300mg three times a day I developed terrible mouth sores. I also tried Lyrica, but had severe mouth/gum pain. It was so severe I couldn't eat solid food. My PM doc started me on Cymbalta 30mg for a week and then increased it to 60mg. It was like a wonder drug for the pain. I was dizzy for a while when I increased the dosage to 60mg, but that went away after a few days. My mood was also much better. However, after starting the 60mg, I've had a terrible time sleeping. It started like restless leg syndrome. I have an uncontrollable urge to move/kick my leg. Would go to bed at 10:30pm and would toss and turn until 2:30 - 3:00am. This would cause leg pain and I'd usually take a 5-325mg of hydrocodone-acetaminophin. Would finally fall asleep, but had trouble waking up to go to work after only 3-4 hours of sleep. PM doc had me start taking 300mg Gabapentin at bedtime. So far no mouth sores, and it helped a little with the restless leg, but didn't help me fall asleep. I tried Ambien. It made me very drowsy and I was excited about getting a good night sleep. Went to bed at 9pm, but could not fall asleep. I was still tossing and turning at 3am. I could not go to work the next day because I felt exhausted. I've not taken Ambien since. Once I've fallen asleep, after being in bed for hours, if I have to get up to go to the bathroom I am able to fall right back asleep. I don't know why I don't have restless problems then. My PM Doc had me reduce my Cymbalta to 30mg (take it in morning) and still take 300mg Gabapentin at bedtime. The Cymbalta still helps my mobility (less stiff) and pain during the day, but not as well as it worked at 60mg. With the increased pain, I think my mood has also dropped. I'm still having trouble falling asleep, but at least now I only toss and turn for 2 -2.5 hours before falling asleep. I really don't want to stop taking the Cymbalta because it has really helped my pain. As a matter of fact, I'd like to be able to go back to the 60mg dosage, but I have to be able to sleep. Spending hours every night trying to fall asleep is very frustrating. Has anyone else experienced this and did anything help? Appreciate any feedback. Thanks, John

John,

Welcome to HW and the CP forum.... glad you found your way here, but sorry for the issues you are dealing with....

I wish I had more suggestions for you.... but I have terrible insomnia, so I'm probably not the best one to ask about all of this :)

I can, however, confirm that lack of sleep makes everything worse: pain, mood, being able to function properly, just everything.

I, too, deal w/ painful sciatica. It's helped some by the Gabapentin (I'm on 1800mg daily)... but it doesn't take it away by any means. Cymbalta never worked for me - so can't help you there.... other than wondering the same thing that Jim asked - did you try taking the 60mg in the morning to see if that helped?

Hopefully, someone else will be along that will be more helpful than I've been! But I just wanted to take a moment to welcome you.... and I really do hope you can find something that works for your pain AND that you can get some sleep.

Take care --Tina

I'd have to suggest good old melatonin. I have found it beats ambien by a mile for me and I took the ambien 20mg for years. I love that I can take 6mg and drop off to sleep pretty easily in most nights. Of course there are still a few that I don't sleep...mostly due to stress, but at least I sleep most nights now pretty well without the ambien nightmares and hangover..lol

Good luck!

Yes you can buy melatonin OTC and it can be found at most pharmacies and in many health departments of places like Wal Mart. It is typically located either with the sleep aids or with the vitamins/supplements and no it is not that expensive. Last time I bought it the price was about the same as a bottle of lower cost multi vitamins.

I had a laminectomy in October 2013 to clear up scar tissue, bone spurs etc, due to a fusion in the L4-L-5 area. The surgery was extensive and I ended up with 37 staples closing the incision. I woke not being able to move my left leg. I was rushed for a CT scan and apparently the surgery went well, but I had a lot of swelling. Over one year later, I am walking with some discomfort, but I take my cane for support. After going the route of acupuncture, cortisone injections, nothing seem to be helping. My final route took me to a spine and sport clinic. There I met a physio therapist who worked strictly with my scar tissue the scar tissue was impeding the flow of the sciatic nerve. Finally I got relief. The horrible pain I was experiencing just below my left buttock is almost gone. I still have soreness there, and some nights are bad with restless legs. I take 300 mg of Gabapentin before bed, and it helps to get me to sleep. Staying asleep is my problem. We are wintering in California, so will not see my physio therapist until April again. He did show my husband what to work on if it gets bad, and I have had to resort to that a few times. I am much better than I was, so for that I am thankful. I prefer to stay away fro Meds if I can, but looks like the Gabapentin is here to stay.