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#34070Topic: Spinal cord injury in forum BACK PAIN |
Hi my 6 year old has a t4 spinal injury, has gained back core strength and on and off sensations below level of injury. 8 months into injury. Do you see much possible returns after swelling and intensive therapy has calmed down?
#34066 In reply to: Discitis / Osteomyelitis Pain Trajectory |Update: On Monday I was given an additional oral antibiotic called Zyvox. I still have 3 weeks left on the IV Irtapenem (Invanz).
Today is the first day where I feel like there has been any improvement in the intensity of my pain and energy. Getting labs tomorrow which I hope will continue to show numbers going in the right direction.
Fingers crossed this day of (seeming) progress is a trend.
#34044 In reply to: buttock nerve pain post microdiscectomy |Nerve glides also known as nerve “flossing” are the repetitive motion of the straight leg test (SLR). This is hip flexion with a straight knee (knee extension). Since the sciatic nerve attaches to the foot and travels around the back of the pelvis like a cable in a pulley, the SLR motion stretches the nerve. This action prevents adhesions after a decompression surgery from clinging and binding down the root. However, if the root is swollen and then stretched too far, radiculopathy symptoms can become worse.
This is the “art” of medicine and therapy. How far to stretch the root without “pissing it off”. Sometimes, the symptom aggravation is delayed by 12 hours so feedback from therapy is not direct.
Dr. Corenman
PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.Good afternoon Dr.
i did not use my original thread from months ago..(titled severe Coccyx pain) as i do not have that any longer. the 2nd injection back in December worked really well. I am only just now having some of that discomfort come back and pain dr. said he would burn the nerves next time if needed. Anyway.. i am always hearing about Flare Up? my question is how do you determine if it is just a flare up? I was told from a surgical standpoint i no longer had restrictions (back in November) so i went on vacation and have been living life normal. I am careful and do not get carried away with things. i started back exercising and small weights. (16lbs total) I am up to 4.5 miles pe60 r day walking. I love to walk, it is the best exercise i get. I have managed to drop another 20lbs since my 360 (L5 S1) fusion last June. I noticed about 5 weeks ago, that i started feeling low back pain. Not as intense because it is not keepin me awake at night. Leg pain is awful though! Same left leg as before.. i am not taking anything other than gabapentin 300mg at night before bed and 800mg of ibuprofen. this is driving me crazy.. and i am concerned and have been taking it easy for the past few weeks. I do not want to experience that type of back and leg pain ever again. It has not let up but has not gotten worse either. I am worried about it, so called the doctor and they said i could be in a flare up? how do you know? thank you so much for your help#33961 In reply to: 5 Level Cervical Laminectomy w fusion |“So it probably safe to say C3-T2 is fused, with T2-T3 pending”? Yes
“My pain management physician states the following: His pain is most likely due to a combination of post laminectomy pain syndrome, cervical radicular pain, facet arthropathy, and myofacial pain”. I don’t like the term “post laminectomy pain syndrome” as it does not describe the pain generator and blames the pain on prior surgery.
You do not have facet arthropathy pain as your facets are fused and motion is required to cause facet pain. Of course, you could generate pain from the movable levels above and below the fusion levels.
Radicular pain is possible if you have chronic radiculopathy (See; https://neckandback.com/conditions/chronic-radiculopathy-neck/) but you don’t have any evidence of severe foraminal stenosis at the operated levels. You do have significant narrowing at the C3-4 level on the left above your fusion, so that level can be evaluated.
“Patient is interested in spinal cord stimulation therapy. I explained to patient that he had undergone ten C-spine surgeries. He has extensive scar tissue and altered anatomy in his cervical spine epidural space. The risk of complication outweighs the potential benefit of the SCS. I do not rec this procedure for him” This might very well be true but you could still be a candidate for peripheral nerve stimulation.
If you have a solid facet fusion, RFA would be pointless.
Dr. Corenman
PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.#33956 In reply to: Residual pain or possible reherniation? |Numbness after a root decompression is very typical and might take as long as 6 months to fade away. Motor weakness may slowly improve but there is a process for recovery. See: https://neckandback.com/conditions/peripheral-nerve-anatomy/
The slump test is really an offshoot of an old meningitis test (Kernig’s) associated with the straight leg raise test (SLR). If the root is irritated (which is still should be in your case at 11 days out), the test will be positive but this is of minimal concern. The root still is swollen which will generate positive tension signs (positive SLR and Slump)
If your initial leg pain is 50% better than before surgery and improving, you should give it more time.
Dr. Corenman
PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books. -
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