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Spinal Decompression,surgery,sciatica Pain,back Pain,foot Drop,ibuprofen,lexapro

Posted on Sat, 26 May 2012

Question: Hello I have had a spinal decompression surgery (S1-L4&5) 2wks ago. I had been commenced on Endone 8hrly and Panadol 4hrly post surgery. It was not quite working as the sciatica pain and numbness to my left leg was not improving. My GP has now placed me on Tramadol 8hrly and Panadol 4hrly, with a little bit more of an effect but the pain can still become very chronic at times mainly in between taking the Tramadol with the break thru pain that I am having. Is there anything else that I can take in place of the panadol either with the endone or tramadol, ? panadine, Ibuprofen etc. My other current meds are Lexapro and Mobic. My age is 65yrs weight 57kg. I have had back pain for over 20 years and I had started to deteriorate, symptoms being foot drop, unable to raise my legs off the bed, unable to climb stairs as my left leg would get left behind which was causing me to become unstable when walking. I had been on the public waiting list for over two years and still had not even being seen by anyone in OPD so I could be referred to the appropriate surgical team. I ended up having the surgery done privately. Do you have any sugestions on my pain management or if I need to see a different type of specialist. Your help would be appreciated.

Regards XXXXXXX

Answered by Dr. Atul Wankhede (5 hours later)

Dear XXXXXXX

Thanks for your query.

I hope the surgery was done following an MRI to support the diagnosis of a disc prolapse at the aforesaid L4-5 L5 S1 levels.

If so I believe, you need to re-evaluate the completeness of surgery by MRI so as to see if your persistent post operative pain is either due to a part of unremoved disc. If that turns out negative then we have nothing major to worry about. Then your pain can be attributed to the manipulation that takes place near your spinal cord and exiting spinal nerve roots. It is expected to slowly reduce.

Endone belongs to a category of 'narcotic analgesic'. I would suggest you discontinue its use since its side effects on a long term use are hazardous. Panadol can be used as a pain subsider if used once in a while, but again should not be used for long. Mobic is a relatively safe non steroidal anti-inflammatory drug. You may continue using that as recommended by your physician. And I'm also not sure why you have been prescribed Lexapro? It belongs to a group of anti-depressant and anti-anxiety drugs. Discuss with your doctor about it.

"In my opinion, we need to establish a cause for the pain and treat it accordingly". Let us diagnose if there is a persistent part of disc still hurting your nerves.

We'll appreciate if you could kindly send us the soft copies of your previous MRI
/Xrays to my attention at YYYY@YYYY .

Hope this answers your queries.

Awaiting your reply to discuss more.

Regards

Above answer was peer-reviewed by : Dr. Prasad