So I went to a NS consult today for SCS permanent implant. He used a term I have heard but I guess I thought the definition was different.

Mechanical Pain. The NS said that Discogenic pain = mechanical pain.

I am scratching my head because mechanical pain to me seems more in line with Facet Joint Pain. If the disc is degenerating, torn, innervated, and upsetting nerves causing pain (which mine are at 3 levels) - HOW IS THAT MECHANICAL?

I also have documented radiculapathy at L4 and L5 from and EMG done last year. Is that also "mechanical pain"?

I guess in the long run it doesn't really matter since he is willing to do the SCS implant. Its just that the NS kind of dismissed this as just pain and NOT NERVES, so SCS can help, but no need to do real surgery. I will just need to strengthen my core and deal with the pain.

I guess I should be happy he doesn't want to do what another NS suggested - 3 level ALIF L3-4 through L5-S1.

I apologize in advance for not properly searching before posting. I will go do that now, but wanted to get your opinions on the matter. What do you guys think is "mechanical pain"?

Thanks,
Brent

We gonna git together for coffee?

Allright, now that the trivialities are out of the way.... yep, discogenic pain is generally treated either as mechanical..... or not, depending whether in the opinion of the professional the discs are capable of generating scar tissue which might abate the impingement of the nerve at the location of the annular tear...... or not.

Interestingly, one of my layers did self repair.... otherwise during fluoroscopy while I endured the worst medical torture called discogram.... during which 6 people were attempting to hold me on the OR table as I screamed my lungs inside out while my dearest blessing of a doc [who by the way hated to administer the discogram] intoned "it is like a seive in there!!!!!" So imagine my wondering ears when later a local surgeon, whom I hold in the lowest of life form esteem, proclaimed he would NOT help me- then he wrote a letter to my file which would inform anyone esle who ever saw my file the ugly foul deed of my life "the patient is a lawyer." Now I have never threatened any physican with suit, but I dang well felt like taking that slimy worm apart at the witness stand.

Within seven weeks after such despicable medical behavior.... I was suffering cauda equina- everything below my waist stopped working, period. Mechanical could you suppose? I reckon THAT WAS MY PROBLEM FROM THE BEGINNING. Would SCS have helped me at that point? ABSOLUTELY NOT!!! Even the said practitioner of the medical arts would have had to agree. I praise God the neurosurgeon I saw thereafter was willing to go in, disassemble my ruined back and put it back together again via fusion.

Seems weird to me someone may believe you have a mechanical problem, yet wants to wire you........ Does this seem like a disconnect to you? It surely does to me.

Confused in abundance,
Mark56

Also, confused as well. Huh????

(ger)

I get confused with diagnosis as well. survived a discogram as well, which showed a blown disc. My Mri showed a bulge, and all didnt see what I certainly felt.
So I still have mechanical pain from bad discs and surgery, but nerve pain from nerves being squished. My scs surgeon told me today that no surgeon would do surgery on me at this time ..... So I will go on and get some relief on monday with reprogramming

May you truly find relief on Monday, even if transitory because that which you may be provided is not the needed blessing to eliminate causation.

About this I am praying,
Mark56

Seems we are always getting conflicting opinions and advice, such as the case with Brent. I do recall my attending SCS doc saying that these units do wonderfully for neuropathic and radiculopathy.....and not so good with mechanical issues. I've always been under the impression that mechanical pain is having to do with skeletal issues whereas radiculopathy, peripheral neuropathy, etc are all nerve related.

I see Brent's frustration in this because it seems his Dr is being a bit dismissive. Viv puts it in good perspective because the mechanical pain can be a CAUSE of the nerve pain, so I would think that the SCS would at least cover the nerve pain which is being caused by the spinal affirmities.

I can see how it can all get clumped together because both of these types of pain are related to each other....they are each other's culprits. If the pain is burning or numbness in nature, I would consider it nerve pain. I was diagnosed radiculopathy (amongst other dandies) and my unit does a great job of covering the pain.

I guess what it all boils down to is the trial.....how did it help or not help the pain. 'Tis a complex issue, innit?

This would all make me feel better if I could SMACK the NS who told you to live and deal with the pain

If wishes were GOLD, then would be salt that makes kings.

Wish..... yes, but act...... no. Assault become battery as though pepper thrown in eyes. Ahhhhh, but the time comes when those who savor disregard for their downtrodden surrounding humanity ultimately reap the reward of the chain forged by them in life. Have you forgotten your Dickens? Nay, Scrooge is brought to us year after year as a lesson.

I so often say reach out in outreach, a lesson Scrooge ultimately learns. Those who n'er lessons learned become much the worse for it methinks.

Even the fella who refused to touch be because I am a lawyer. Somehow he will either learn the lesson or bear the burden of discarding it.

I move on in life. Bringing all of you with me,
We reach out in outreach to SO MANY who need gain, not pain,
So we bring them prayers, we bring them solace, we even bring a smile,
Rae is our PRO at smiles,
Yep,
Mark56

......but once in awhile my humanity overtakes....
I know a guy who does 'favors' for folks............and he can make it LOOK like an accident ....

Nahhhh. You're right Mark.
I will pray for his everlovin soul .........but I do hope they have pepper in Heaven

The Truth Wagon
Mark56 20120203

Now hearken back to days of yore
when wagons labored with pull of horse
to carry forward the things of life
from places unknown so far and wide.

Then every now and once again
a wagon would halt gate of a home to everyone's ken
this wagon at once beautiful and terrible within
was drawn by such perfect steeds, white stars on their heads.

The spirit inside of the Wagon of Truth
would carry potential to wield means to loose
some lips long sealed shut, oh their secrets thus held
and set upon them, truth to set free, family spirits to heal.

Set loose, some words wrenched from deep in the heart
seemed easily would tear spirits apart
as the steeds stood uneasy, matched pairs, eyes in fear
they knew hard work was going on ever so near.

For the spirit of truth breaking open the hearts full of dread
was carrying out much healing, none dead
but cries and some screams could be heard in the house
as the spirit of truth moved inside about.

Each person within was touched, none were spared
for they carried within sick memories and cared
that if loosed from within they might damage without
and work harm to them or to others no doubt.

Thus the spirit of truth set to work hard on these
who attempted to hold tight to secrets, "NO! Please!
these spirits of people so bound in their world
of fear choked on feelings long pressed down, entwirled.

Release them, these secrets, the spirit of truth heard to say
so the spirit may heal at the end of the day
give truth in full measure, hold not to the past
hold secrets too tightly, for breath you will gasp.

The work was so hard with each dweller of house
from the oldest of old to the youngest whose mouth
could scarcely form words to release things within
but the spirit of truth would not leave lest there be truth here again.

At last when it seemed all this work was in vain
secrets came forth, emerged, so the truth came like rain
and the spirits which had held fast to the secrets were freed
to be self once again grasping truth, glad indeed.

When the spirit of truth was restored to the house
the atmosphere lightened within and without
all the people within restored, happy again
and it seemed flowers bloomed outside, fragrant bouquets of them.

No one noticed the Truth Wagon pulling away
and the horse team of four were now settled underway
so the spirit of truth had done good work therein
all were purged of the tragedies held deep within.


Now why did the spirit inspire me with this one just now? Perhaps it was as Rae points out, it would feel good just to let someone know the DAMAGE THEY HAVE DONE. Oh, how I have wanted to stop a certain surgeon who practices out of ######### and give him a piece of my mind as I lean on cane or am in wheelchair most likely because he refused to treat when my body was demanding it. How I hate being discriminated against by one of the medical brethren because of my profession. It would be darn near like the "concentration camps" of the USA during WW II wherein Asians were placed for fear of their appearance. No doubt many of them harbored bitterness toward "their" country as I have harbored bitterness against a surgeon who would not touch a lawyer.

So, how to release the bitterness, the anger, the desire to strike out not only at the surgeon but the illegal alien who precipitated the wreck which changed my life. God had to enter this scarred heart of mine to purify. He sent the Truth Wagon for me. The spirit was cleansed from within. I no longer harbor a desire to harm someone for working or by omission allowing harm to befall me. I had to let go.

Were Fiona here she could apply an appropriate term of dx to the phenomenon of releasing/forgiving/catharsis one must pass through as they grieve a harmed or ruined body. Anger must be set aside and replaced with a spirit of joy. I found that, frankly, in reaching out to others to help whenever, and wherever I can. It is why I write so much on here, because a hurting world is a needful world.

I reckon I might be slammed by the Gods of Off Topic, but, Rae, now we have come full circle. Now Brent, I am sorry if I hijacked your thread, but recognition of physicians as mere humans is cathartic in a way. Their opinions we don't always appreciate. Each must gain our trust, and we must have hope they may help us.

Your case, Brent, is indicated by two opinions conflicting. In the law, my solution for multiple conflicting opinions has been to seek yet a third, in case it might align and bolster one or the other. This is why sometimes boards of arbitrators are sets of three individuals, mid-level courts of appeal are panels of three, and so forth.

Were I confused with a two opinion scenario, I would be asking my gatekeeper doc in charge of my case for a third opinion as a means to support one course over another. This is ALL about patients making informed consent bound decisions regarding their care. Also, were I you, Brent, I would pray.

And so I will for you,
Mark56

I think my pain could be called mechanical pain.

Facet joint disease, spinal stenosis, degenerative disc disease, and scoliosis to the side. All of this just aggravates itself like a machine with one part coming loose and everything else creaking, groaning and warping. It really is the result of good old fashioned osteoarthritis. Everybody gets it, some never know, and the rest of us, well, not so good.

I had read that the stems could help but only to a level of about 50% pain relief in the lower back.
I just finished the trial and I can say, depending on the intensity of the stimulation, I could get total relief. Maybe I'm a rare case.

I'm going to assume that the permanent implant will lose some of the effect eventually but that would still leave a major level of relief.


As I write this my back is punishing me for going a week without pain.

I can easily imagine how well the stem works on people with leg pain. I didn't know my legs were sore from my 'test' walks until today.

So, yes, the stem is helping with mechanical pain. Oddly, even though I lost muscle mass in the right leg, I never had pain in my legs. No warnings about losing the right leg until about 3 years ago. Then a laminectomy without fusion and I got almost all of the leg back. I was told the surgery would not help with pain and sure enough, it didn't.

I've had shots and radio frequency (burning the nerves in the facet joints). They all helped for a little while but then they helped less and less. I was put on tramadol which is a weak simi narcotic. It still works great and I know that because of the arthritis pain in my hands. The back just keeps getting worse.

If this sounds like you, maybe give the stimulator a chance? The odds might not be as good but with this pain, anything I can get, I'm using it short of mind numbing drugs. Yes, that includes pot.