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Have back pain, had lumbar surgery. Medicine, yoga and exercise are of no help. Further?

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Orthopaedic Surgeon
Practicing since : 1994
Answered : 10364 Questions
At what point does a person have to be resigned to a life of pain and disabilities due to many failed back surgeries? The last surgery lumbar, 2008..but spine is a continual mess and pain meds, yoga, exercises ate no longer cutting it, so I will see an excellent surgeon Dr XXXXXXX Wolf of camp hill, pa for advice, buy wonder of I should get a second and third opinion as the painful recovery is a strong memory yet something has to be done to make my life, livable again. My back problems started in 1998..I want some hope that there is something to be done to improve my life.
Posted Sun, 15 Sep 2013 in Back Pain
Answered by Dr. Praveen Tayal 25 days later
Brief Answer:
Please do not be hopeless.

Detailed Answer:
Thanks for posting your query.
I can understand the pain that you have been through due to the multiple surgeries. The surgery is always done for the betterment of the symptoms but the post surgical complications like persistent pain or the cramps that you are having due to fibrosis in the area are difficult to predict and even more difficult to treat.
I am sure that you can find some solution to your problems after consulting Dr. XXXXXXX Wolf. You can also consider consulting a neurologist for a second opinion.
I hope this answers your query.
In case you have additional questions or doubts, you can forward them to me, and I shall be glad to help you out.
Wishing you good health.
Dr. Praveen Tayal.
Above answer was peer-reviewed by
Follow-up: Have back pain, had lumbar surgery. Medicine, yoga and exercise are of no help. Further? 10 hours later
Thank you Dr. Tayal. I really am frustrated. I am on an obscene amt. of pain meds which basically the dosage has been the same for 8 years. of course I have build up a tolerance. I cannot take NSAIDS, have tried various anti sezuire meds, SSRI s to supplement the pain medication to know avail. Methadone worked the best but I won t take it again as I put on 40 lbs in 3 yrs. I was off all meds for a good 8 months but my pain levels were so high I could not function. We switched opioids and the dose was supposed to be titratrated but my doc will not up it. I spoke at length with the pharmacy, p.h.d. gal for my care team, she said in regards to the pain meds, you are darn d if you do, darn t if you XXXXXXX t.? My primary doc who deals with my back issues, keep telling me I all feel better pain wise on less meds, which I get conceptually, but geez how
long will that take for my tolerance to go down, endorphins to work etc? I get that I have to deal with some pain but not at the levels that are so disabling....hence my upcoming surgery consult, he s going to look at the amt of my doses, and his eyes will pop out. :-) I wonder from a surgeon s point of view if he thinks my prognosis for a good outcome with pain after surgery is dependent upon me being on much lesser meds going in. My doc who did my gall bladder surgery saw my Med list and blurted out "you are an addict". I replied, not so, yes unfortunately I am dependent upon these meds to treat my pain, and of course they could not just be stopped or I would get I'll. Duh. Anyhow thank u for your help. My appt. is in 3 wks I all post how it goes, and indeed I will also consult with. neurosurgeon. The VA hospital pain clinic told me no surgery, but that is not their specialty,and I have to see. I have said a lot. sorry and thanks again.
Answered by Dr. Praveen Tayal 11 hours later
Brief Answer:
A pain management clinic might also help you.

Detailed Answer:
Thanks for writing again.
It is right that decreasing the doses of oipoids for 10-12 weeks will decrease your tolerance for these medicines. You can get some muscle relaxants prescribed till then and see if it helps in decreasing the spasms.
Do keep me informed regarding your progress.
Hope my answer is helpful.
If you do not have any clarifications, you can close the discussion and rate the answer. Wish you good health.
Above answer was peer-reviewed by
Follow-up: Have back pain, had lumbar surgery. Medicine, yoga and exercise are of no help. Further? 4 hours later
Thank you again Dr. Tayal. Your answers are quite helpful. I didn't feel the need at first to ask another question, do need a little clarification. Did you mean that in a 4 month period or so, that decreasing my meds during that time will decrease my tolerance for good? If I have surgery and meds are then increased for post open pain, won t my tolerance be right back where I started? I feel as if I have more pain in general as some days are tolerable but a some are at a 9 pain scale wise. I guess what I am getting at is that after my 8 months of no meds, I first started with ultram, but within 2 months I was back up on my regular higher dose of opioids. Pain clinics I have used extensively, the shots, spinal implant trial, scar removal, you name it, I tried. It was suggested at my last clinic in 2009, that I have a Medication spine implant, but my thinking at that point was a medication implant was a finality...if I could take meds orally why risk it? however I do have a referral to a pain clinic, specifically to consult about that. XXXXXXX The VA hospitals pain clinic consult a year ago gave 4 options to me, NO more surgery, switch opjoids and titrate, no meds at all, or a spinal Med pump..which the VA does not do in my state. I appreciate your discussion and guidance here, as the V A does not have many answers for me or resources, fortunately I have other insurance. I will keep you updated doc. The cramps you spoke of, are in my front quadrant of my stomach, occur occasionally and dissapate. I think maybe they are caused by the spine surgery on 2001, when they cut thru the front to get to the spine. OK thanks again. It s helpful to talk this through with an orthodox surgeon as yourself, allows me to prepare questions for my upcoming surgery consult.
Answered by Dr. Praveen Tayal 19 hours later
Brief Answer:
Yes. The tolerance can return.

Detailed Answer:
After stopping the pain medicines for few weeks, the tolerance will decrease for good. But if the medicines are used again for post op pain, the tolerance might return in few weeks.
Switching the opioids and dose titration might help.
You can also consider alternative techniques like acupuncture for pain relief.
Take care.
Above answer was peer-reviewed by
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