Continued Pain Post Surgery

  Back injury occured July 98. Back surgery performed Oct 98. Both disc at L5-S1 removed with gages, rods, screws and fusion. Approx. 2 months after surgery pain in lower back, left buttock and left leg returned with greater intensity. Leg foot began to feel like it was burning and was unable to be touched without creating severe pain. MRI, myelogram with CT were done. At the time of surgery the Dr. said the nerve was severly damaged. The results of the MRI, Myelogram and CT were GRADE 1 SPONDYLOLISTHESIS of L4 on L5 with SPINAL STENOSIS. My Dr. says that as of this time he knows of no medical procedure that can be done to correct the nerve damage I have substaned. At this time I am unable to sit, walk or ride in a vehicle for any lenght of time. Laying in bed helps for awhile but I cannot sleep for over 3 hours at a time without waking up with severe pain.
  Do you have any suggestions?
  Respectfully,
  Ed Perry

[CCF Neuro[P] MD RPS]

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Dear Ed:
Wow, sorry to hear that the surgery didn't help much and the pain is so bad.  I guess the good news is that these things do get better, but we can never predict how much better.  The usual recommendation is rest, and I mean bed rest, then intensive therapy.  Of course there are pain medications and the industry is well funded by the drug companies as you know.  Some of us feel that there is a balance with medication, therapy and how much a person can handle pain-wise.  There is a fine line with how much therapy will help and how much pain the patient can handle.  So, we let the nerve damage heal as best it can (usually allow the initial inflammation and irritation to calm down), then began to try and rehab with therapy.  The area of the innervation of the damaged nerve needs to be exercised so function is retained.  So, in this period is the balance with therapy, medications, and allowing the nerve/body readjust to the new environment.  
Sorry, I probably haven't told you what you don't already know.  Try and find the best therapist and rehab physician (who will work with the neurologist) you can.  Pain will either be your companion as a friend or worst evil.  Medicate to your tolerance and no more, otherwise your senses will become dysfunctional.  Hang-in there, let us know how your doing.
Sincerely,
CCF Neuro[P] MD