Back Pain

[LindaC.]

I had microdiscetomy surgery in May 99.  I've been seen by the ortho surgeon that performed the operation for a year after because was I'm still in constant pain.  I've been prescribed elavil, neurontin, darvocet, vicodin you name it.  He referred me to a neurologist who sent me to a pain management specialist.  After reviewing my records and examining me the pm specialist says I have scar tissue wrapped around the nerve causing it to protrude some and that's why I'm still in pain.  He wants to send me to have a procedure where they would inject a saline solution into the spine and flush out the scar tissue and inject novacaine to ease the pain.  I may not be saying this exactly the way he put it but he says it will help get me off of the vicodin that I'm currently taking because that seems to be the only thing that helps.  He says over time the vicodin may not work as well which seems to be happening.  He says there may be some pain with the needle and I'd need to rest for about a day or so.  Why didn't the neurologist suggest this?  I'm a little scared and just wanted to know if this is a safe procedure and if it really does help and if so for how long?  Are there any other alternatives? He wants to schedule this for two weeks from now.  I'd appreciate any information you could give...thank you.

[CCF Neuro[P] MD, RPS]

Dear Linda C.

Sorry to hear about your pain.  I am not sure what the pain specialist is telling you.  Scar tissue adheres to the nerve or compresses by blocking the nerve exit from the foramen.  A simple injection of saline, I don't think it would remove the scar tissue.  But, I have not done this technique.  I think I would get a second opinion about the procedure.  I am not sure what to recommend as I do not know what your exam is like nor what the MRI shows.  Most of the time we recommend vigorous rehab and PT for recovery.  But your far enough away from surgery that it may not help too much at this point.  Some recommend surgery to remove the scar tissue, but this is not always successful.  Nerve blocks sometimes help as well as TINS stimulators.  

I would get a second opinion before using the injection method mentioned.

Sincerely,

CCF Neuro MD

[LindaC.]

Thanks, I am going to get that second opinion. What are nerve blocks and TINS stimulators?