Burning Pain

[liby__0]

Posted by Hanson on April 24, 1999 at 09:32:55
I had cervical laminectomy c-3c-4 about 6 months ago. Prior to surgery I had some burning in my right hand, sensitivity in my right chest, and some tingling and numbness in my right leg and foot.  Also I had hyper reflexes on my left side.  I was informed that these symptoms might always be with me even after surgery, however, they should not get worse.  They were much worse after surgery.  The burning was now in my back and upper right side, right arm and hand and knew  and foot on right side.
As the surgery was performed by a neurosurgeon away from my home town, I was refered to a neurologist in my community.  He prescribed neurontin with dosages gradually increased  up to twelve 300 mg per day.  The pain seemed to decrease but not go away.  I fortunatly did not have side effects from drud.  Since then I have been taking nine tablets  of neurontin per day plus nortriptyline at 10mg..now up to 4 of these per day.
The burning pain has continued but is not as frequent nor as intense.  I even have a week of little pain at times.  My daily activities do not change and I can not find anything other than the possibility that stress might trigger it and also lifting also triggers it.
My Questions:
1.  Could there be a problem with the fusion?  Should I have a post surgery MRI.  I was told that a tiney wire was inserted during surgery, would that prevent me from having an accurate MRI?
2.  Do the damaged nerves that apparently cause this burning heal?  
Steve

Posted by CCF Neuro[P] MD, RPS on April 24, 1999 at 10:19:46
Dear Steve:
Sorry about your problem, sounds like you have been in some agony.  Often what you describe occurs after an operation that you describe.  The pain is usually worse right after the operation due to nerve manipulation and inflammation.  It sounds like your doctor has been right on track with what most do after an operation like you have had.  The wire they inserted is usually compatible with MRI (at least it should).  Another MRI is not a bad idea if the pain is not improving.  Yes, the nerve is the problem.  As time progresses, this usually gets better, but how much better depends on the problem to begin with and the individual.  I hope that yours gets steadily better.
Sincerely,
CCF Neuro[P] MD

Posted by Joe on April 24, 1999 at 22:42:56
What meds are good for burning pain, whether from MS or back surgery?

Posted by CCF Neuro[P] MD, RPS on April 25, 1999 at 18:10:08
Dear Joe:
Neurotin, tegratol, elavil are good medications for this type of nerve pain.
Sincerely,
CCF Neuro

Posted by A few quick questions about this ....... on April 26, 1999 at 19:29:17
I have been diagnosed with probable MS.  Male, mid 30s.  I have burning knees and feet and sexual dysfunction.  Numbness in leg and slight numbness in fingertips.
If taking Neurontin (400 mg 3x/day)... is acetaminophen, ibuprofen or naproxen sodium better for back or other pain?  Can these OTC drugs worsen the burning?
Can neurontin cause sexual dysfunction (inability to maintain or produce an erection...morning erections are intact)?  The sexual dysfunction of course is depressing.
Would a steroid help?

Posted by CCF Neuro[P] MD, RPS on April 29, 1999 at 10:51:18
Dear "A few quick questions"
Yes, neurontin is a good medication for the neuropathic pain that you are describing. The other medications might help the pain but would not worsen the pain.  There have been some described cases of neurontin inducing sexual dysfunction.  However, this is really rare.  I would think that your MS might be the real culprit and would investigate this initially as the cause.  In a male MS patient, this would be more likely.  Steriods would not be indicated for this type of pain.  This would be especially true if the neuropathy is chronic.  However, if the pain is due to an exacerbation, steriods would help reduce the exacerbation event.
Sincerely,
CCF Neuro[P] MD