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Suggest Remedy For Pain In Sacrum Area

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Posted on Sat, 21 Feb 2015
Question: ask an Anesthesiologist”
I had an epidural for pain meds going to surgical site. Would you know approimately what nerves/bundle of nerves could be hit with epidural. I was in excruciating pain in sacrum area where I had mesh tacked from a failed surgery. Could the needle have hit this area? I was writhing in pain and broke the tube. I'm trying to put a puzzle together as to why the pain wasn't in the surgery site at all put in the area of another surgery.
doctor
Answered by Dr. Grzegorz Stanko (1 hour later)
Brief Answer:
Such pain is most likely caused by a surgery, not catheter insertion.

Detailed Answer:
Thank you for the query.

No, epidural catheter could not reach nerves responsible for your pain. Of course if it had been inserted property. Epidural space is a layer located above the spinal cord and above the nerves. So inserting the catheter you do not get into a space where the nerves and spinal cord is located. And even if the needle is inserted too deep, nerve injury is hardly possible. Its because spine level where such catheter is inserted do not contain spinal cord, just nerve branches. This nerves branches go downward to legs. So in case of such injury, legs pain and back pain would be present.
Sacral area pain is most likely caused by colorectal surgery. Please note that during tissues preparation for rectum removal, there is a risk of nerve plexuses injury. This plexuses are located on the sacral bone (lie on the surface of the bone). Second surgery in this area makes the risk of such injury much higher. Second surgery in the same area is much harder. Moreover, inserting the mesh creates a scar. It is also possible to put a stitch on the nerve. It can be the cause of chronic pains in sacral area.

I suggest you to have an MRI of this area to determine if there is any nerve and stitch conflict.

Hope this will help. Feel free to ask further questions.
Regards.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Grzegorz Stanko (4 minutes later)
The pain was in my back and pain; I can't desscribe it, but, it was so excruciating I was weritihing in pain.
I don't know enough about the complexities of nerves; and having had a disaster from colorectal surgery where he resectioned on side of rectum I was hip shooting thinking the needle hit this area.
So, because the pain was in back and leg (ie attributed to Chronic Pain as has been the case for four years) it went unnoticed or addressed after surgery.
Thank you.
doctor
Answered by Dr. Grzegorz Stanko (14 minutes later)
Brief Answer:
MRI would be the best idea to diagnose the source of your pain.

Detailed Answer:
Now, it will be hard to establish the exact reason of such pain. So it is better to start over with it. To do that, MRI will be the best idea. This test can diagnose spine problem as well as compression of nerves located in the sacral area.
With the result of MRI, you should consult neurosurgeon and discuss the possible options to get rid of this pain.

Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Grzegorz Stanko (4 hours later)
Thank you. How can it be that doctors on your site know exactly the road to take and I'm lost in the cracks? I went to a neurologist, two weeks ago who said "I don't want to get mixed up with your mess." Am I doing something wrong?
When the agony occurred after surgery, I probably should have asked then. Being my own advocate isn't working, but thank you very much. This is the most informative, thoroughly thought through site - but, it seems like explaining to anyone here is like talking to a wall. Appreciate your ansswer. Too complicated because I was lost in the cracks for 20 months after surgery; treated with drugs. Again, thank you.
doctor
Answered by Dr. Grzegorz Stanko (51 minutes later)
Brief Answer:
It is sometimes very hard to help from the point of this service.

Detailed Answer:
I can not respond for all other doctors. Doctor is a human. Every one is different. Every one has different knowledge. And not every one is good enough to deal with complicated problems.

If its about this service, please note that all we can give here are only advises. But there is a long way from advice to real treatment. Its because here we are unable to see a patient. We can not perform physical examination. We also very often do not know what tests have been done before. Usually we have only a small piece of information. That is why, even having best knowledge, it is very hard to give 100% accurate solution.

Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Grzegorz Stanko (11 hours later)
But, the information provided by doctors like you and some of the others, is so informative; so obvious, because I know how little time is spent trying to solve issues; I've been through a meatgrinder; left to search on my own; labeled with chronic pain after MVA and a surgery I didn't not lead which led to another; this was reported, surgeon agreed he failed; yet, reporting issues to my doctor, I still was treaed for chronic pain; with drugs. Thankfully I knew drugs were a copout; yet, finding the right team; the right dedicated doctor; has been exhausting and, why I keep trying is beyond me but knowing that many doctors rely on a test and not what the patient has gone through or is saying. I know my body; I know that no guidance; just "pain will go away" after MVA to drugs after surgery. I was complimenting you. I'm waiting to hear if there is a doctor/doctors in any area who will take the whole picture; not just pieces of my disaster, and treat me as a human who has been at the mercy of doctors, not all, who just didn't want to handle a complicated case; complicated because they made it so. I have doctors in my family; I have seen tremendous ones; but,I got caught in a web I couldn't get out of. No need to respond. I appreciate your insite. I probably confused you with my question as the hernia repair was because of infection from colorectal surgery; the epidural was placed in such a way that I experienced pain so great, but, I didn't report to doctor; I just kept the nurse informed and, she could do nothing as my blood pressure dropped so low (first time) during hernia repair, that nothing for pain in addition to epidural, could be administered. Thanks for listening. I will not sit here at rot; I will, find the right team; but, it is not easy to go on. My best to you and thank you.
doctor
Answered by Dr. Grzegorz Stanko (12 hours later)
Brief Answer:
I hope you will find correct doctor.

Detailed Answer:
I hope you will find correct doctor who will be able to help you. Your situation is complicated, but the source of pain is clearly known - surgery in rectal area. So you should consider contacting experienced in colorectal surgeries teams. I`m pretty sure they have had such case before. It is not so rare.

Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Grzegorz Stanko (2 hours later)
I'm glad it is not so rare; Having had the Motor Vehicle Accident, it was hard for doctors to change their way of thinking after the two surgeries. Thank you for you kindness. I'm amazed at the response from doctors on this site; rare, indeed.
Hope your involvement in this site is as rewarding to you as it is for me. I've received such in depth, thorough, obviously educated answers. For some reason, I got into a bad situation. My best to you.
doctor
Answered by Dr. Grzegorz Stanko (3 minutes later)
Brief Answer:
You are welcome.

Detailed Answer:
You are welcome. And all the best for you.
Note: For further inquiries on surgery procedure and its risks or complications book an appointment now

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
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Dr. Grzegorz Stanko

General Surgeon

Practicing since :2008

Answered : 5795 Questions

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Suggest Remedy For Pain In Sacrum Area

Brief Answer: Such pain is most likely caused by a surgery, not catheter insertion. Detailed Answer: Thank you for the query. No, epidural catheter could not reach nerves responsible for your pain. Of course if it had been inserted property. Epidural space is a layer located above the spinal cord and above the nerves. So inserting the catheter you do not get into a space where the nerves and spinal cord is located. And even if the needle is inserted too deep, nerve injury is hardly possible. Its because spine level where such catheter is inserted do not contain spinal cord, just nerve branches. This nerves branches go downward to legs. So in case of such injury, legs pain and back pain would be present. Sacral area pain is most likely caused by colorectal surgery. Please note that during tissues preparation for rectum removal, there is a risk of nerve plexuses injury. This plexuses are located on the sacral bone (lie on the surface of the bone). Second surgery in this area makes the risk of such injury much higher. Second surgery in the same area is much harder. Moreover, inserting the mesh creates a scar. It is also possible to put a stitch on the nerve. It can be the cause of chronic pains in sacral area. I suggest you to have an MRI of this area to determine if there is any nerve and stitch conflict. Hope this will help. Feel free to ask further questions. Regards.