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Suggest Treatment For Paraplegia
Question: I'm on gabepentin ,Zydol two BD also have a morphine pump inserted last XXXXXXX for a spinal stenosis.Had a decompressioñ done 7th XXXXXXX all doing very liyyle for me .My consultant not happy to do fusion .
Brief Answer:
First start with function
Detailed Answer:
surgery would be strongly considered if there are signs of paraplegia:
loss of strength, sensation, bowel or bladder dysfunction. if the spine is compressed enough to be dangerous you need surgery.
then, the strongest evidence is...to focus on function:
work on mobility with physical therapy. but also psychologically not focusing on pain to the exclusion of all other things in life.
about a third of people on this service ask for refunds when I cannot get narcotics for them in this context even though that is at best impossible and at worst a felony. that would be a thought disorder that needs therapy. focusing on adaptions to do more.
that being said. here are some considerations on pain.
the response to morphine is uniquely genetically determined and it doesn't work well on everyone and perhaps something else in the pump. muscle relaxants that damp down spinal nerves such as methylcarbamol are often helpful. other nerve acting drugs such as amitryptiline, lidocaine, lyrica, cymbal ta might be helpful. other pain modalities such as accupuncture,massage could be tried.
First start with function
Detailed Answer:
surgery would be strongly considered if there are signs of paraplegia:
loss of strength, sensation, bowel or bladder dysfunction. if the spine is compressed enough to be dangerous you need surgery.
then, the strongest evidence is...to focus on function:
work on mobility with physical therapy. but also psychologically not focusing on pain to the exclusion of all other things in life.
about a third of people on this service ask for refunds when I cannot get narcotics for them in this context even though that is at best impossible and at worst a felony. that would be a thought disorder that needs therapy. focusing on adaptions to do more.
that being said. here are some considerations on pain.
the response to morphine is uniquely genetically determined and it doesn't work well on everyone and perhaps something else in the pump. muscle relaxants that damp down spinal nerves such as methylcarbamol are often helpful. other nerve acting drugs such as amitryptiline, lidocaine, lyrica, cymbal ta might be helpful. other pain modalities such as accupuncture,massage could be tried.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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