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What Causes Persistent Back Pain After A Laminectomy?

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Posted on Wed, 15 Mar 2017
Question: I had a laminectomy 5 weeks ago on L4 and L5. everything went well. But I still have pain. about level 4.
my doctor stays it takes time. How long and are there ups and downs? I use celecoxib and some prednisolone.
for pain relief. Can I take prednisolone pills like celecoxib? use only when needed?

How does this work? Can I ask more questions or is a one time only?
I have a good surgeon but not very informative on pain care. He says it takes time?
doctor
Answered by Dr. Ahmed Aly Hassan (2 hours later)
Brief Answer:
Under physician supervision

Detailed Answer:
Hi i am Dr Ahmed Aly
thanks for using healthcaremagic site ,
I had gone through your question and understand your concerns ..

No actually prednisolone pills dosing should be under your physician supervision as it is a kind of corticosteroids and these substances may have undesirable effects when using it unproperly , i think the add of some lifestyle changes will be effective for your case

In my opinion i think prednisolone pills dosing for your age is from 5mg to 60 mg per day may be give once a day or in divided doses as a start .
then a maintenance doseis added to adjust or maintain initial dose until a satisfactory response is obtained; then, gradually in small decrements at appropriate intervals decrease to the lowest dose that maintains an adequate clinical response .
so i think prednisolone pills dosing should be under your surgeon permission as steroid therapy may cause unwanted side effects .
You may add some lifestyle changes that helps alot with most of patients and that include chiropractor , physiotherapy , spinal straightening exercise , hot massages with topical gels , and even yoga helps .
Using B12 supplements with adding pregabalin tab 400 mg daily will help also wearing a spinal belt is helpful with avoiding heavy lifting , vigorous exercises , bad sleeping and sitting postures , muscle relaxants are also recommended like 5 mg of cyclobenzaprine (Amrix) .
I think you will feel better and your physician will stop using painkillers soon enough it may take up to 6 months to completely be cured but medical treatment alone without the physiotherapy will not be efficient so i personally recommend lifestyle changes with medical treatment will be effective for most of cases .

Wish you good health,
Any further clarifications feel free to ask.

Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Ahmed Aly Hassan (1 hour later)
Hello Doctor
I think 5-60mg is a large spread when considering a six day typical prescription consist of 21 tab @ 4mg/tab = 84 mg total.
I will try a muscle relaxant as you suggest and lite exercise also.
You did not mention anything about celerbex. Amount to take? Ok with lite dose of prednisolone? You did clarify that we are looking at SIX months. Wow!! That is a long time. I will also look into physiotherapy.
XXXX
doctor
Answered by Dr. Ahmed Aly Hassan (1 hour later)
Brief Answer:
prednisone 8 mg / tab /12 hrs will be fine for your age group , celecoxib 200 mg /tab/12 hrs both drugs are given when needed so by time the doses will decrease as healing takes place .

Detailed Answer:

I had gone through your question and understand your concerns ..

Dont worry but usually the first 2 weeks are a bit painful but then pain subsides by time anyway , the Prednisone dosing is prescribed according to your history but the commonly used dosing is 5 to 60 mg orally per day then when you reach the desirable relief of pain stop increasing your dose and maintain the number of pills per day .
Celecoxib is a NSAIDs ( non steroidal anti inflammatory drug ) used to treat pain or inflammation caused by many conditions such as arthritis, ankylosing spondylitis,acute pain management etc .
The lowest effective dose for the shortest duration consistent with individual patient treatment goals should be used for example :
Day 1: 400 mg orally once followed by an additional 200 mg orally if needed while the usual dose: 200 mg orally twice a day as needed .
Try to be patient and follow instructions and gradually by time the medical requirements will decrease i hope you feel better soon .

Wish you good health,
Any further clarifications feel free to ask. i will be willing to answer any further query from you whenever needed
Above answer was peer-reviewed by : Dr. Prasad
doctor
Answered by
Dr.
Dr. Ahmed Aly Hassan

Orthopaedic Surgeon

Practicing since :2002

Answered : 441 Questions

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What Causes Persistent Back Pain After A Laminectomy?

Brief Answer: Under physician supervision Detailed Answer: Hi i am Dr Ahmed Aly thanks for using healthcaremagic site , I had gone through your question and understand your concerns .. No actually prednisolone pills dosing should be under your physician supervision as it is a kind of corticosteroids and these substances may have undesirable effects when using it unproperly , i think the add of some lifestyle changes will be effective for your case In my opinion i think prednisolone pills dosing for your age is from 5mg to 60 mg per day may be give once a day or in divided doses as a start . then a maintenance doseis added to adjust or maintain initial dose until a satisfactory response is obtained; then, gradually in small decrements at appropriate intervals decrease to the lowest dose that maintains an adequate clinical response . so i think prednisolone pills dosing should be under your surgeon permission as steroid therapy may cause unwanted side effects . You may add some lifestyle changes that helps alot with most of patients and that include chiropractor , physiotherapy , spinal straightening exercise , hot massages with topical gels , and even yoga helps . Using B12 supplements with adding pregabalin tab 400 mg daily will help also wearing a spinal belt is helpful with avoiding heavy lifting , vigorous exercises , bad sleeping and sitting postures , muscle relaxants are also recommended like 5 mg of cyclobenzaprine (Amrix) . I think you will feel better and your physician will stop using painkillers soon enough it may take up to 6 months to completely be cured but medical treatment alone without the physiotherapy will not be efficient so i personally recommend lifestyle changes with medical treatment will be effective for most of cases . Wish you good health, Any further clarifications feel free to ask.