Back & Neck Pain Forum
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Avatar universal

Please help? Detox?

I have failed back surgery syndrome.  I had spinal cord sytimulator surgery in Oct.  I am still in pain.  I am a workman comp patient.  I  injured my back 12/9/05.  The insurance co. wants me off the meds so they can settle and I will be out of their hair.  I am so sick of this.   My lawyer wants me off the meds also.  I am taking avinza 90mg, xodol 3x daily,  zanaflex 3x daily,  20mg lexapro, 60 mg cymbalta, lunesta,.  I asked my pain doc to send me to detox.  He agreed to this and said after all meds are out of my system we will start over and find the level of meds I need to relieve the pain.  The problem wiith the meds I am presently taking is I can't afford them after settlement.

I am really scared of the amount ot pain I am going to have after detox. Could someone please give me an opinion of this      

13 Responses
412913 tn?1213498587
I asked you some questions about your problem in replay to exactly the same question you posted earlier in this forum.
Could you kindly reply to those questions?
Avatar universal
I injured my back in Feb 2000.  I Had MRI Dec 2000 that showed a ruptured disc at L-5.  I had surgery Feb 2001 for the ruptured disc.  I still had problems from time to time after the surgery, yet nothing major.  On a cold rainy morning  12/9/05 I bent over to pick up a love seat and the pain almost drove to me to my knees.  I have had 2 MRI's,  a mylaterial ct scan and these tests show nothing  wrong  with me.  My pain management doctor has diagnosed me as having failed back surgery.  He reccomended the spinal cord stimulator and it has helped.  But I am still in pain.  The pain worsens as I become more active.  I have problems walking, standing for any length of time, and sitting for any length of time.  I am so depressed and frustated by all this and on top of it all it is a workman comp case.  I have only seen an orthopedic surgeon and my pain doctor.  My testosterone level is very low and the wc won't pay for treatment.  I am 54 years of age.
I think I should go to detox and then start over finding the amount of medication I need and that I can afford.
Avatar universal
There may be possibly another issue here that may be worth considering.............Conventional MRI  has bee proven not to tell the complete picture in a number of cases.   You might want to consider having a "positional MRI" performed since in a number of cases it helps to better qualify Dx on average of 20-50% and sometime find the correct problem area and even change the Dx of injury....Please investigate them @ their website  ......FONAR....    and you be the judge!!!!!!!!!!!!
You might even want to consider having a MR-Neurography Scan performed by Dr. Aaron Filler of The Neurography Insitiute   to better qualify nerve damage.................
There may be a distinct possibility that your true Dx has not as of yet been achieved!!!
Please let me know how you make out.        Take care
401890 tn?1372717129
I have been told by my neurologist that he thought that I should go to a pain management doctor. My neurologist suggested that I may want to look into a spinal stimulator. I have arthritis, mild scoliosis, level 2 osteoporosis, spinal stenosis, herniated disk at L4-L5, degenerative disk disease, and chronic nerve damage. I am only 45 years old. Could you tell me about your experience with this device or whatever it is? Did you have to spend time in the hospital or is it done in an outpatient situation? Also, how long did it take you to recover? I am scared to death about what my future holds.
454186 tn?1388978568
Hi,I suggest you go to acupuncture clinic,in particular deep and intensive acupuncture which is very good for FBSS.
Avatar universal
You will not regret going to pain management.  My doctor has been wonderful to me.  He is an advocate for the patient and not the insurance company.  He decided against detox for me.  I've been approved for social security disability so he is changing my meds to generic so I can afford them.
If your doctor suggests the stimulator you will first have a Psyche exam.  This is standard.  Then you will, under local anesthesia, have a temporary stimulator placed.  They will place the wires near your spinal cord and the wires for the battery pack will extend out of the incision.  They will be connected to a battery pack that you will wear in a belt.  You also will have the remote that you use to adjust the electrical impulses.  You cant shower or bathe while you have this.  If the trial stimulator helps then you will be scheduled for the permanent stimulator.  The temporary is a little uncomfortable, but you will get used to it.

The permanent stimulator is done in the or. You will be put to sleep.  There will be 2 incisions, one for the leads, one for the battery pack.  My battery pack is under the skin, above my waist, on the right side. I went home the same day of the surgery.  The surgery is a little painful.  You can't bend over, hold your hands over your head, or pick up anything over 5 pounds for 6 weeks.  This is for the flesh to heal around the leads.

This surgery didn't help me as much as hoped.  I know people who was able to cut their meds by 60 to 70%.  Some are able to return to work.  

I have rambled I know but I hope I helped some.  I pray you get a pain doc that you connect with.    Good Luck
441382 tn?1452814169
The disease that I have, iatrogenic adhesive arachnoiditis, is often misdiagnosed as failed back surgery syndrome.  Iatrogenic adhesive arachnoiditis is a chronic inflammation of the arachnoid, the covering of the spinal cord.  If you Google "adhesive arachnoiditis" you'll get loads of links that you'll find useful.

MRI with contrast will be the most likely way of showing if this condition exists.  If it does, the only thing that can be done to manage it is lifelong pain management.  Unfortunately, there is no cure.  It is extremely painful, and its symptoms are myriad.  It also affects the body's immune system.   It causes the body to lose its ability to regulate its own temperature, so profuse sweating from time to time is not uncommon.  The most common symptoms are severe pain, extreme fatigue, numbness and tingling of the extremities, and the feeling that shards of broken glass are stuck in the soles of the feet.  A doctor who suffers from arachnoiditis has described it as living with the pain of cancer without the release of death, the pain can be that severe.

Many doctors try to avoid giving a diagnosis of arachnoiditis because to do so would be implicating other doctors as the cause since it is iatrogenic.  Therefore, the umbrella term "failed back surgery syndrome" is often used because it's nebulous enough to encompass any number of causes for the pain.  Ironically, one of the treatments of choice for back pain, epidural steroid injections, have been discovered to also be a cause of arachnoiditis, so what people think are going to help them can actually cause more problems.  

In some cases, the arachnoiditis is fairly mild, causing a moderate amount of pain that comes and goes and doesn't interrupt the person's life to any great degree.  In a small percentage of cases (I am in this group), the nerves in the spinal column begin to stick to each other (that's the adhesive part) and fuse together into clumps, eventually blocking the flow of cerebro-spinal fluid to parts of the spine.  I was told that I would probably be in a wheelchair within 5 years, but it has been 5 years since my diagnosis and fortunately I have to use my wheelchair only part of the time.  Last May I lost the use of my right leg entirely for three days, after which time it slowly came back and with physical therapy I was walking on my own again with the use of a cane.

I think it would be helpful to you to Google adhesive arachnoiditis to see just how much of the information applies to you, and then perhaps you could bring it up to your doctor.  to see what his opinion is.  I sincerely hope that this is not your diagnosis, but if it turns out to be, you need to learn as much as you can about it.  

401890 tn?1372717129
Do you know why they do a Psyche exam? What is the purpose???

Also, when I was reading the paperwork they sent, it said I would have to have blood or urine tests done at my own expense to test for (I guess) narcotics.  I realize there are people who abuse every system, but all you have to do is look at all the test and their results to know I am in no way faking any of this. If I was just in it for the pain medication, I could get that thru my regular doctor. It kinda felt like a slap in the face to read that. And why at my expense. The only reason I am going to these people is because the Neurologist said he thought Pain Management would help.

I am constantly feeling like I have to prove that I hurt. Can they not tell by the results of all the tests I have taken?? I mean, who wants to have needles stuck in their spine. It's not like it's fun. I suffered with a spinal headache for almost a week and a half.

I am just so aggravated.
401890 tn?1372717129
I have been told by my neurologist that he thought that I should go to a pain management doctor. My neurologist suggested that I may want to look into a spinal stimulator. I have arthritis, mild scoliosis, level 2 osteoporosis, spinal stenosis, herniated disk at L4-L5, degenerative disk disease, and chronic nerve damage. I am only 45 years old.  I am scared to death about what my future holds.

Could you please give me your opinion?
Avatar universal
The Psych exam is standard procedure.  Its' the same for a morphine pump.. These procedures are life changing.  I never turn mine off so I feel a constant buzz in my back and legs.  I guess it is to make certain you can deal with it for the rest of your life.  

I know what you feel like.  Chronic pain patients feel they must prove their pain is real and how bad it is.  I think a good pain management doctor is who you should see.  They know you are in pain and they will keep working until they find what brings you the most relief.  When people find out what and how much medicine I take they look at me like I'm a crazed wild eyed crack smoking junkie.  What they don't see is when I fall down trying to get up from a chair,  lying in bed crying because I hurt so bad.  It takes a little while but your mind set will change and it wont matter what people think.  Even some doctors
will look down.

I  will keep you in my prayers.
401890 tn?1372717129
I have gone to the pain management doctor. I also have been referred by my PCP to a Neurosurgeon. I go see him on April 15th. The pain management doctor says that I have multiple issues, but he believes that I can get some relief with the herniated disk by probably getting the spinal fusion done. Also, I found out from him that my Arthritis is a MAJOR factor in this also. I will know more once I see the Neurosurgeon. At least I feel more knowledgable about what is going on.
472661 tn?1207526560
PLEASE read THIS! A bit of research will show you the huge differences in treatments and surgeries that are offered from spinal orthopedists-vs-neurosurgeons. Be certain you atleast meet with a neurosurgeon whose bread and butter is spinal discectomies before making a committment to fusion. There are many new options depending on the level of disc injury. Like Fruitcakes238, I'm in pain management and meet many spinal injury patients...I've been in various programs, treatments and undergone surgeries since initial injury in 1982, with most recent surgery just 3 months ago..so 26 years. No doubt every hour in pain is one hour too long, however please be patient and insist on second + opinions for every proposed treatment. I wish you the best. Let us hear after your neurosurg. appt.
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