[doublehippy]

Hi everyone:

I wrote a while back re: my stenosis/sciatica and possible fusion surgery. Needless to say, I am trying to avoid the surgery and am searching for other options.

I see my pain management doc on Friday for a consult. When I called to make the appt., the nurse did indicate there were other injections they may be able to try (I've had 3 ESI's with no help). Too, I want to discuss using one of the anti-seizure meds....Lyrica, Neurontin or Topomax. I realize it's a toss-up and trial and error as to whether one gets help with the neuropathic pain when going on one of these meds. The side affects seem to be very similar. That said, I would like to try the Topomax, since it seems a "plus" with this med is weight loss? Gaining weight can't be a good thing, especially since my ability to exercise is zero to none with the pain. What do you think?

Also, I have incredible groin/thigh pain. It wakes me in the middle of the night when laying on my side with my leg bent. I suppose I am trying to straighten the leg or change position when I yell out loud with the pain I feel. My back doc doesn't feel this pain is referred from the back....however, the surgeon who replaced the hip on that side does. I cannot lift my leg to put on my pants without the groin pain and coughing is a joke! I have to brace myself to cough. BTW, we ruled out a hernia (I had a colon-resection done 3 years ago). I have to lift this leg to get it into the car, but realize the weakness is from the back. Because I have a hip replacement on the same side where I am experiencing the horrendous sciatica pain, I am so confused as to what pain is what (and, apparently, so are the docs). I see my hip surgeon on the 22nd and, if all looks good on x-ray, I have to insist on further testing for muscle/ligament/tendon issues.

Sigh.....

Have any of you had horrible groin/thigh pain due to degenerative disk disease and stenosis...along with the sciatica pain/tingling and numbness in the foot?

I really need one of these docs to listen...really listen...to me. When you have one telling you one thing and the other telling you another thing, it tends to get old! I might mention that I haven't consulted with a neurosurgeon yet. I am searching my options at pain management first.
Speaking of which, are any of you familiar with the Axia lif procedure? A minimally invasive approach for spinal fusion? I've found a neurosurgeon here in Pittsburgh who does it. Do a google.....interesting.

Thanks so much for taking the time to read. I hope to get some valuable input from you all....people who have "been there and done that!"

Linda

[Dr. Smith]

Hi Linda,

I think we've been down this road before, but... once more with FEELING!

Those drugs can be a polarizing topic - particularly the topomax. Weight loss? Maybe (like weight gain is a maybe with neurontin). With topomax, I'm more concerned about the risk of renal stones and permanent side effects. Nobody really knows how any of these drugs will affect them personally without giving them a try, and more important than weight loss/gain is how well they work for controlling your PAIN - that is, and should be, your primary concern. It doesn't matter which one you try first (most doctors will start with neurontin, then topomax, then Lyrica, but that's partly for insurance reasons - neurontin has been around forever, then topomax, and Lyrica is most expensive because it's still under patent).

If one doesn't work, or the side effects are intolerable, you can back off of it and try another. Please don't get hung up on this weight issue or other "maybes" until they become facts. Be concerned with pain management.

Weight loss - that's really a separate and distinct issue. I'm still doin' the intractable pain diet from Dr. Tennant, and despite a slight backslide (my fault) it's still working, and better still, I'm FEELING better when I'm on it. Less pain - more energy - better mood.

Have you tried sleeping with a pillow between your knees?

Doc

[doublehippy]

Originally Posted by Dr. Smith

Hi Linda,

I think we've been down this road before, but... once more with FEELING!

Those drugs can be a polarizing topic - particularly the topomax. Weight loss? Maybe (like weight gain is a maybe with neurontin). With topomax, I'm more concerned about the risk of renal stones and permanent side effects. Nobody really knows how any of these drugs will affect them personally without giving them a try, and more important than weight loss/gain is how well they work for controlling your PAIN - that is, and should be, your primary concern. It doesn't matter which one you try first (most doctors will start with neurontin, then topomax, then Lyrica, but that's partly for insurance reasons - neurontin has been around forever, then topomax, and Lyrica is most expensive because it's still under patent).

If one doesn't work, or the side effects are intolerable, you can back off of it and try another. Please don't get hung up on this weight issue or other "maybes" until they become facts. Be concerned with pain management.

Weight loss - that's really a separate and distinct issue. I'm still doin' the intractable pain diet from Dr. Tennant, and despite a slight backslide (my fault) it's still working, and better still, I'm FEELING better when I'm on it. Less pain - more energy - better mood.

Have you tried sleeping with a pillow between your knees?

Doc

Doc:

You're right. I have to give one or the other of them a try without focusing on the "what ifs?" I'll go with the Neurontin. Who knows...I may get significant pain relief on a low dose. No way to know unless I try.

I will do the pillow between the knees tonight. Duh.....and why didn't I think of this? Went this route after my hip replacements and the pillows always ended up on the floor. We shall see.....

Thanks....again!
Linda

[Leesa]

Hi ~ I have the horrible sciatica (have had for 26 yrs) and i use the Topamax. It takes away the burning/tingling/water running down feeling. I've been on it for probably 10 years, and it still works fine. When I first started taking it, I lost some weight on it. Neurontin made me GAIN weight -- ACK. (water retention)

Yeah, I have the groin/thigh pain too. Right now, I've got horrible pain right in the butt! Trouble is, it's on the opposite side of where I usually have it. NUTS. Looks like the sciatica is on both sides now.

Whatever medication you decide to use, I pray that it works well for you. Keep us posted, ok? God bless. Hugs, Lee

[swimwithmanta]

Hi Linda,
I have back (bulging disk) and neck pain, and sciatica too, for the last six month, so I am being diagnostic as "chronic" I am not at the stage of any operation, so here what I am doing, and it has helped a lot, yesterday I was nearly pain free, today back down because I am going too fast..
for your hip/groin pain, you may try to go to the egoscue therapie, pain free by pete egoscue, go to the back/ hip section. but the best would be to see a postural alignement specialist, especially if you are trying to avoid surgery.
those exercises, are not exercises per say, but postural stretching. very effective and really they helped me a`lot. like static back and supine groin stretch. I can't really take drugs, as my digestive system is very fragile, and I can't really take anything beside abubrofen so I am stuck with trying to find other solutions. that does not involved drugs or surgery. at the moment I am doing egoscue/ treat your own back by robin mc kensies and yoga for scoliosis. so far ( one month) I am feeling better, moving more with up and down unstead of really bad all the time.. and doing anti-inflammatory diet ie. no sugar, no white flour, ( that one is also helping with my head)
good luck on the road to recovery. virginie

Originally Posted by doublehippy

Hi everyone:

I wrote a while back re: my stenosis/sciatica and possible fusion surgery. Needless to say, I am trying to avoid the surgery and am searching for other options.

I see my pain management doc on Friday for a consult. When I called to make the appt., the nurse did indicate there were other injections they may be able to try (I've had 3 ESI's with no help). Too, I want to discuss using one of the anti-seizure meds....Lyrica, Neurontin or Topomax. I realize it's a toss-up and trial and error as to whether one gets help with the neuropathic pain when going on one of these meds. The side affects seem to be very similar. That said, I would like to try the Topomax, since it seems a "plus" with this med is weight loss? Gaining weight can't be a good thing, especially since my ability to exercise is zero to none with the pain. What do you think?

Also, I have incredible groin/thigh pain. It wakes me in the middle of the night when laying on my side with my leg bent. I suppose I am trying to straighten the leg or change position when I yell out loud with the pain I feel. My back doc doesn't feel this pain is referred from the back....however, the surgeon who replaced the hip on that side does. I cannot lift my leg to put on my pants without the groin pain and coughing is a joke! I have to brace myself to cough. BTW, we ruled out a hernia (I had a colon-resection done 3 years ago). I have to lift this leg to get it into the car, but realize the weakness is from the back. Because I have a hip replacement on the same side where I am experiencing the horrendous sciatica pain, I am so confused as to what pain is what (and, apparently, so are the docs). I see my hip surgeon on the 22nd and, if all looks good on x-ray, I have to insist on further testing for muscle/ligament/tendon issues.

Sigh.....

Have any of you had horrible groin/thigh pain due to degenerative disk disease and stenosis...along with the sciatica pain/tingling and numbness in the foot?

I really need one of these docs to listen...really listen...to me. When you have one telling you one thing and the other telling you another thing, it tends to get old! I might mention that I haven't consulted with a neurosurgeon yet. I am searching my options at pain management first.
Speaking of which, are any of you familiar with the Axia lif procedure? A minimally invasive approach for spinal fusion? I've found a neurosurgeon here in Pittsburgh who does it. Do a google.....interesting.

Thanks so much for taking the time to read. I hope to get some valuable input from you all....people who have "been there and done that!"

Linda

[RhondaIndy]

Hi Linda,

You sound miserable. I've had back issues for about 19 years now. It's interesting that my pain mgt doc would always ask me if I had any groin pain (which I never had) when I would go in for my injections. The type of injections he was giving me were SI facet joint injections.

I agree with you to try conservative treatment before surgery. Surgery is a crap shoot ......you could be better or you could be worse.

I've been on all the meds you listed. It seemed that they would work for a while and then became ineffective.

Most recently I had a laminectomy/decompression L3 - S1 and a fusion at L4-L5. A month before I was to go back to work I developed aweful pain in my SI joint and after a series of ineffective injections to my SI facet, I had a rhizotomy (RF ablation) a week ago.

This is a wonderful site with a wealth of information and ideas. Take care!

Rhonda

[aussiemom]

Linda
I use a body pillow, am a side sleeper, I put it between my knees, then under my are so I'm not " twisted", and putting stress and weight in one spot. Found mine at Target, about $12.

[Dr. Smith]

Originally Posted by doublehippy

I will do the pillow between the knees tonight. Duh.....and why didn't I think of this?

You don't really want ME to answer that, do you?

Went this route after my hip replacements and the pillows always ended up on the floor.

Velcro? Duct tape? My wife sleeps with a pillow between her knees, and it usually winds up between my.... um... pillows....

Doc

[Dr. Smith]

Originally Posted by doublehippy

Doc:

You're right. I have to give one or the other of them a try without focusing on the "what ifs?" I'll go with the Neurontin. Who knows...I may get significant pain relief on a low dose. No way to know unless I try.

Doctors usually prescribe dosages based on guidelines provided by pharmaceutical companies. What possible reason could they have for guestimating on the high side?

We're often admonished that more is not necessarily better, and can even be harmful. Wouldn't a corollary of that be "less is more" or at least "start with less" - that's what titration is all about.

Of course that doesn't apply to everything. Not taking enough antibiotics to inhibit an infection could be catastrophic/fatal. But I don't think it ever hurts to ask a doctor if you can start on a lower dose of something, and increase if/when necessary. They insist on it with analgesics (for good reason) but hand out that 300 mg of gabby without even considering less may do the trick. (Voice of experience here )

Talk about your double-edged swords!

Doc