Tinnitus. Other pain. Help please

[Jtal19305]

Hi

I had spinal surgery 6 months ago due to sudden leg weakness. Mri showed large disc bulge and bone spurs at T12-L1. Also had bad stenosis at L2 L3. So I underwent a decompression surgery. T12-L1 laminectomy disectomy with interbody fusion and instrumentation and a L2-L3 hemi laminectomy left side. I awoke from surgery with burning pain in the sole of my left foot. Over the next several weeks and months the burning pain moved to my calves and was in my feet still. I still have these nerve pains despite the decompression surgery. I did not have this pain prior to surgery. I've been taken lyrica 2x day, percocet 10mg/325 mg 3 to 4 x day, clonazepam 0.5 mg 1x say and occasionally tramadol 50 mg. I developed tinnitus in my left ear a few days ago too.

I'm not sure why I have all this burning pain post surgery. One doctor suggested that may spinal cord may have been irritated during insertion of interbody cage. I also wonder if my csf flow is changed. I don't have headaches. I'm also trying to get another mri done and maybe a

I need a ct myelogram too.

Any help with why these symptoms are with me would be appreciated. Also is the tinnitus due to a medication or something else?

Thanks and happy new year

Jerry

[Jtal19305]

I forgot to add that I had started getting fasiculations in my calves a month prior to surgery and I still get them now. So that's my story. I hope someone can provide some insights. Thanks. Jerry

[Taliswood]

Hi Jerry

I don't think I have any answers for you but some of the things that have happened to me and answers I have been given just might help. I had decompression surgery in Sept 2015 on L3/L4 because of a broad based prolapsed disc and severe central spinal stenosis both at that level. In 2012 I had decompression surgery on L4/L5 because of a spondylolithesis (vertebrae slip) and severe central spinal stenosis and like you I had a fusion and interbody cage of rods and screws.

I had different symptoms before each surgery. In 2012 I had severe sciatic spasms in the back of both legs from buttock to big toe which really limited my mobility and what I could do, although I managed to work right up to my surgery. I also had back pain although I could control it with NSAIDs. The surgery and rehab went without a hiccup and I was back to work on a phased return after about 8 or 9 weeks. It was perfect all pains in legs and back had gone and I felt great.

A very different story with my 2015 surgery done by the same top surgeon. I had really really bad thigh ache and knee pain and weakness in the front of both legs when I walked along with severe back pain which felt like I was dragging a concrete weight most of the time. I could only walk a couple of hundred yards before I had to stop and was off work for a month before my surgery. Following this surgery I had lots of random tingling and shooting pains in my legs and vibrating and buzzing in my feet. I was told this was fine and was expected as the nerves were now no longer trapped. The first two weeks were relatively uneventful and then as soon as my physio said I could do a little 5 minute walk things changed and I started to experience really bad back pain and all sorts of burning, pricking, tingling, stabbing and shooting pains in my legs and the vibrating and buzzing in my feet is constant. I am also urinary incontinent. I was put on Gabapentin 3x300mg per day, Paracetamol 2x500mg 4 times day, Ibuprofen 3x400mg day.

I have been told by all three of the professionals that I have neuropathic pain and also my autonomic nerves are affected. This is because my spinal nerves were squashed so tightly this time and as they regenerate they are causing the pain I am experiencing. Could this be what is happening to you?

I also have worse pain in my back now than I have ever had in the form of massive electric shocks when I move. I have hardly been able to do any rehab exercises apart from some walking in water and backstroke swimming which has helped to get me out of the house and see people. I am still off work and so frustrated as I am normally a really active 53 yr old.

I can really empathise with you Jerry, wanting to know why these things are happening is natural but I don't think it is always known. I see my physio again on Monday and am deciding what approach to take as I really need someone to listen to me and help more than they are at present. They have said that maybe an anti inflammatory injection will be needed as my nerves are really irritated and inflamed now to be causing such severe shocks. I am not sure if it will be a general or targeted. Have you been offered one of these?

Hope you don't mind me asking what you would hope to show on a ct myelogram and also what leads you to think your csf flow may have changed? I would certainly ask for a post MRI and a standing plain X-ray. As you probably know the interbody cage will not show on an MRI as metal work just shows as a black area. The person scanning will do something to make the scan better to view once they know you have metal in there. I didn't have to have any dye injected. The X-ray will show the cage but as you know the nerves will not but it will show if your spine is now stable. I have had both and the surgeon and physio says they look good and the op was successful.

Sorry I can't comment on the Tinnitus, it may be a side effect of one of your medications. I do know that Gabapentin gave me so many side effects that I had to reduce down to my current dose so I could function. what has your GP said, can they offer any answers to your questions? Google neuropathic pain if you haven't already and you will see that it comes in lots of forms, burning pain being one of them.

I hope that you will be able to get some answers and reduce your pain soon. I would be interested to know how you get on. Take care Suzanne

[Jtal19305 in reply to Taliswood]

Hi Suzanne

Thanks for your reply. I really appreciate sharing experiences. I will keep my reply short as I am feeling some discomfort in my legs and the tinnitus is now bothering me. I hope it goes away. I look at my pre and post MRIs and I wonder how my spine got so bad. I never played football. Probably bad genetics although I look fit and healthy. I did try the epidural injection and it did not help me at all. Made it worse in fact. I was told be a well known doctor at Rutgers care community to just leave the spinal area alone so it can settle down and reach a new equilibrium. I should have listened. Now I'm doing PT. Taking my meds. Also just time will be needed. I get a stingy pain in my calves and behind knee back of the leg area. I get tired easily and I'm not motivated to do much. I will try return to work soon so that should be interesting. I hope you feel better. We need to hang in there. Life is not easy for some of us. Well it was for me and now it is so different. I have to keep trying.

Thanks Jerry

[Taliswood in reply to Jtal19305]

Oh yes we have to keep trying Jerry, that is the only way to move forward! I too am always tired and have no energy and lack motivation to do most things which I put down to the amount of pain I am in. If only the pain was not there from the moment I open my eyes.....It's very true how life can change so quickly but hopefully we will both be able to get back to the active life we knew. Don't write yourself off just yet!! Take care

[Bexcd]

I'm not sure you would be able to have an MRI with an interbody cage, depends what it's made of. CT myleogram might temporarily make your situation worse, it gave me spinal headaches only satan would prescribe for weeks afterwards. Accupuncture might help as might vitamin D3 supplements.