Post surgery L5-S1 pain managment
I am a 44 yr old Caucasian male diagnosed with degenerative disk disease in 2002. In January 2006 I underwent a discectomy and fusion with the associated appliance at L5-S1. I now have back pain that is directly emanating from the same area where I had surgery. According to MRI, CAT scan, and X-Ray, I do not have significant scar tissue or spinal canal narrowing (spinal stenosis) that I was told would generate this pain. I have been told that I have atrophy and necrosis of the muscles in that area, and also in my middle back where I am now starting to have issues in the T4-T5 area that can radiate into my neck and through my shoulder down to my wrist.. Both area's have a "crunchy" texture when deeply massaged which is what I was told was necrosis. There is some slight compression of the disk in this area. I have tried to stay physically active, but after attempting physical therapy, and functionality testing, it was advised against even physical therapy due to the atrophy and necrosis and overall weakness in the muscles. The pain management clinic I now go to, has recommended either cortisone shots, acupuncture, and possibly a spinal nerve simulator. I have some concerns about cortisone shots due to the fact they can damage ligament tissues, and aggravate the atrophy in that area for a possible short term alleviation of pain that would in the long run be more detrimental than effective. I haven't been able to find much information on the acupuncture except that it seems to be very short term. I currently take Vicodin 3/325 QID to "deal with the pain", and Tizanidine 10 mg BID to relax the muscles and have a tens unit with 4 contacts, but many days it is not even close to being effective. What recommendations could I take back and speak with my doctors about?