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neuromd2012, Board Certified Physician
Category: Neurology
Positive Feedback: 95.5 %
Satisfied Customers: 6334
Experience: General Adult Neurologist. Board Certified. Experimental Neuroimaging and Neurodiagnostics
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I had lumbar stenosis and disc space collaspe which required

Resolved Question:

I had lumbar stenosis and disc space collaspe which required an extreme lumbar surgery. It has been 9 weeks since the surgery, but the pain in my knee caused from this has not gone away. I can't sit or drive without severe pain. Is this normal and what can I do to help it. I walk 1 1/2 miles each morning. Thank you!

Submitted: 12 months ago.
Category: Neurology
Expert:  neuromd2012 replied 12 months ago.


neuromd2012 :

Hello

neuromd2012 :

I am waiting for you to come online

neuromd2012 :
neuromd2012 :

I do not know what an "extreme" lumbar surgery is?

neuromd2012 :
neuromd2012 :

the pain is in your knee? is this "radicular" pain down the back of your thigh? or coming around your lateral hip and then crossing your kneecap?

neuromd2012 :

Or is this "nociceptive" pain within your knee (osteoarthritis pain)

neuromd2012 :

Since you are not here, I am forced to guess, so that is what I will do, and I would think the former here. You have radicular pain going down your thigh to your knee when you sit for prolonged periods.

Customer :

Disc 4-5 blew out 6 years ago and I had surgery that releaaved the pain immediatley. The pain was in the front of my right let from my knee to my ankle.

neuromd2012 :

oh hi

neuromd2012 :

ok so that is what you are getting with prolonged sitting?

neuromd2012 :

did you have an autologous bone/ disc fusion at L4/5?

neuromd2012 :
neuromd2012 :

are you there?

Customer :

Then november 2011 I had low back bain, pain in groin area, would almost fall from pain when I moved certain ways, and the pain is in my right knee just right above where it started 6 years ago. The disc had collasped and the dr. thought the surgery would make the leg pain go away. b So on May 1, 2012 I had the surgery, but my knee still hurts. The bain comes down the back of my right leg and stops in my right knee. I did have the disc fusion of L45

neuromd2012 :

maybe you are having trouble with the chat line

neuromd2012 :

oh hi there u are

neuromd2012 :

ok

neuromd2012 :

so this is the same nerve.

neuromd2012 :
Customer :

yes, I think so

neuromd2012 :

this is the L 4 root crossing over from the lateral thigh, over the knee and supplying the top of your foot

neuromd2012 :

but it hasn't been that long so I would not give up hope

neuromd2012 :

the walking is a good idea

neuromd2012 :

do you want to take a med for neuropathic pain?

neuromd2012 :
neuromd2012 :

like lyrica or neurontin?

neuromd2012 :

these would help to reduce the pain to the top of your knee

neuromd2012 :

and you might not need to take a lot, just for a few months until your surgery healed fully

neuromd2012 :

I would put you on lyrica, 50 mg starting dose, 2 or up to 3 times a day for starters.

Customer :

I took neurontin before and 2 months after the surgery. Do you think I need to take it longer?

neuromd2012 :

oh

neuromd2012 :
neuromd2012 :

how much?

neuromd2012 :

yes, take it longer

neuromd2012 :

exactly, a few more months, and then try to wean off again

Customer :

3 times a day and I do not remember the dosage.

neuromd2012 :

probably just 100 mg , how much to you weigh?

neuromd2012 :

have you ever taken Lyrica? I think it is a little better drug, they are similar lyrica is more expensive

neuromd2012 :
neuromd2012 :

you still there?

neuromd2012 :

again maybe a problem with the chat. I will switch this to the question and answer. please get back to me to discuss your meds. I will leave you with a webpage on pregabalin. If is more efficacious at a lower dose (less side effects)

Customer :

I weigh 140 lbs. 5'6' tall I have never tried lyrica.

neuromd2012 :

well then I would try it first as you may need to stay on this for some time, and lyrica causes less sedation. You can ask your neurologist of course.

neuromd2012 :

they are both renally metabolized

neuromd2012 :

so no liver issues

neuromd2012 :
Customer :

no

neuromd2012 :

no,, I mean you don't have to worry about hurting your liver with these drugs

neuromd2012 :
Customer :

OK

neuromd2012 :

do you have any other questions I could answer?

Customer :

Are there any more exersice that I could do other thatn walking? Will any kind of ice pack or heat help?

neuromd2012 :

I know you aren't thinking this way, but they have these new little "spacers" that they can install with very minimal surgery to lift up your pedicle and take pressure off that nerve root

neuromd2012 :

it is too early to think about more surgery, though

neuromd2012 :

you need to do stretching and a back exercise program with strengthening

neuromd2012 :

we call it back school

Customer :

sounds good can you explain how or what to do?

neuromd2012 :

I don't have any good webpages in my computer for back school, you need to find a therapist

neuromd2012 :

do you have time for PT?

neuromd2012 :

you could go to PT for a few visits and get them to build you a home program

Customer :

Not really, but I guess I can find time. Do I just need to ask my doctor for on of the prescriptin you suggested and them. I will also ask for some PT then o them onmy own.

neuromd2012 :

Yes. ask your doctor for PT prescription, but three times a week for 6 weeks (18 visits) that is what the insurance usually covers. Then when you go to PT, tell them you need a home therapy program and you want their back school program

neuromd2012 :

this is going to be a prolonged recovery, but you can do it.

neuromd2012 :

if you are walking 1.5 miles a day, this will get you over the bump in the road

Customer :

Thank you. You have been a great help. I was afraid that my knee and leg pain was not going to get any better!!!!!I Can I get a copy of our conversation so I can go back and read everything, just in case I missed something important?

neuromd2012 :

yes I will switch this to the question and answer section. you just right click on it and print it ok?

neuromd2012 :

take care, come back anytime ok? and please rate my service as that is how I am compensated Dr Frank t.

neuromd2012, Board Certified Physician
Category: Neurology
Positive Feedback: 95.5 %
Satisfied Customers: 6334
Experience: General Adult Neurologist. Board Certified. Experimental Neuroimaging and Neurodiagnostics
neuromd2012 and other Neurology Specialists are ready to help you
Expert:  neuromd2012 replied 12 months ago.

Our chat has ended, but you can still continue to ask me questions here until you are satisfied with your answer. Come back to this page to view our conversation and any other new information.

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If you haven’t already done so, please rate your answer above. Or, you can reply to me using the box below.

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