Spinal stenosis so much pain

Hi Dawn,

On January 24th, 2019 I had spinal fusion of my L3/L4 vertebrae. They removed the disc and put hardware in for support. I also had stenosis in that area, which is a form of arthritis. The nerve to my upper thighs was severely constricted, causing numbness. They removed the bone causing that constriction.

While I am still recovering, it has relieved the symptoms. My advice is find a surgeon who does this work often. There is no surgeon you will find that will guarantee results, since every case is different. I do believe mine has been a success, but I can't swing a golf club for 6 more months!

Get on a surgical schedule to have it done, and keep researching both techniques, boards like this, and if you can get a second/third opinion, do so. I actually had four (my nephew was one!).

I also feel a neurosurgeon is preferable over an orthopedic surgeon, but that is strictly my point of view. There are many great ortho's doing this work. Good luck!

There is no coping...IMHO, it has to be fixed. I got stenosis 8 months after a knee replacement so it was back to back challenges for me. Pain and weakness down both legs, could barely walk...it was like double sciatica. Went to my neurosurgeon. Here's what happened...

1. MRI showed severe foraminal stenosis at L2/L3 (there are different types)
2. This was confirmed by a CT/Myelogram with contrast.
3. To please the insurance company, I had a pain shot at that location as additional confirmation.

Once all that was done, doc gave me a choice of removing my existing L3 to S1 TLIF fusion (rails and screws) and replacing it with the same fusion but including L2...OR...

Having him do a Lateral Lumbar Interbody Fusion (LLIF) where they go in from your side, not your back. A General Surgeon makes the incision and clears "a path" to your spine for the neurosurgeon who drills out the disk and insets a device that expands the vertebrae...kind of like a car jack. He sets it in place, opens it up to where the foraminal canals are no longer pinching the nerve roots, back fills with a tiny bone graft from your hip and then closes...90 minutes.

When I had the original fusion, I spent 12 days in the hospital, did 4 months of rehab and spent 6 months in a brace. With the LLIF, it was one night in the hospital, no rehab, no brace...IMMEDIATE relief of ALL the stenosis pain. This was like a magic bullet op.

Go to YouTube and search for "Globus LLIF Technique" for a cool animation. Then search for "Globus Calibur" to see the expansion device in action. Note: There are many versions of the device (Calibur, RISE, Intercontinental, etc.)...your doc makes the choice depending on your case.

If you have confirmed stenosis, I would seriously find a neurosurgeon experienced in this technique. It will save you a lot of pain and recovery time...if your case qualifies as a candidate for it.

So sorry to hear you are in such unbearable pain. The good news is that spinal stenosis is generally fixable with a minimally invasive surgical procedure. The bad news, of course, is that it can probably take a couple of weeks to get it scheduled and you are in pain right now.

You said that painkillers do nothing at all for you but have you truly tried strong painkillers? Often people who are new to back pain don't know their options when it comes to stronger medications for pain relief and express frustration when they try to use only over-the-counter meds or low-grade opiates like tramadol. You need to try stronger pain meds, like vicodin, oxycodone or even stronger. Since you only need this pain relief until you can get the surgery (and maybe for a short time after the surgery as you recover), there shouldn't be that much risk of addiction. Also there are separate, non-addictive medications that treat the neurological pain down your legs - meds like gabapentin. These have been very helpful for me and it is a very safe medication - little chance of overdose and almost no chance of addiction, yet they are very effective for the leg and butt pain.

And also another option you should consider is, don't just seek out a solution to your pain via your general practitioner and/or your potential spinal surgeon. Go find a pain management specialist who will work with you and the surgeon to find short-term pain relief solutions until you can get your surgery. Don't rely on just the spinal surgeon for your pain management needs because that isn't the core competency of a back surgeon - they only know mostly about post-surgical pain treatment (and your general doctor might also be less skilled, and perhaps even less willing, to give you strong pain meds), whereas a pain management specialist will have many other options to discuss with you. (FYI, a pain management specialist is often called a "physiatrist" if that helps you to find one).

In the meantime, try icepacks on your lower back, use a lumbar pillow when you sit or drive, and don't walk significant distances. But don't stay sedentary either - throughout the day try to mix up your routine between sitting, standing and walking. Staying in any one of those positions for hours can aggravate your condition.

Good luck...

Seafarer's advice is spot on.