I know I need surgery. How do I speed up this process?


Q: This may be too specialized, but you can't say "no comment" with me asking. Ten years ago I underwent successful lumbar laminectomy surgery for spinal stenosis. It bought my aching back and leg ten years of no pain. Every once in awhile I would tweak it -- usually trying to lift something I shouldn't -- but the pain would fade after a week and everything would be good again. Unfortunately, last month I hurt it again. Badly. The pain isn't going away. An MRI revealed additional stenosis in the sections of spine above and below where the original operation took place. I'm told this is normal. It does happen. I'm currently 50 years old. I have the best medical insurance that money can buy. I'm very fortunate. But what's the chance of my insurer signing off on a second surgery to correct a stenosis problem that is once again sending sharp waves of pain into my back, right leg and right testicle? This is a carbon copy of the symptoms I had ten years ago when the first, successful, surgery took place. Unfortunately, the surgeon who took care of this problem up and retired on me three years ago. What are my chances for a second surgery? I'd love another ten years of a pain free existence. But I know it isn't cheap either

Symptoms:  Waves of sharp pain in the back, right leg and right testicle. Prescription pain medication offers some relief, but I don't want to be a junky. I can do a week on Percocet, but that's about it. I've had one epidural, which has helped. But I don't dare bend or do anything physical like gardening (my love in life -- I grow a mean heirloom tomato crop). I throw my back out every single time I try to do something simple, like bend down to get pet dishes. Yes, I am overweight. But I'm told stenosis and weight aren't linked. In other words, it was going to develop over time anyway.

A:   Thank you for your question. As far as insurance issues are concerned, the insurance company is the best to answer that for you.

I see that an MRI was done recently and it is important to rule out other causes of back pain.

With Managment of spinal stenosis, the goal is to avoid surgery unless absoloutley necessary. Weight loss would be beneficial to halt the progression of further stenosis.

For immediate relief, pain medications are a reasonable choice.

Antiinflamatories or narcotics are the medication of choice. If you prefer to avoid oral pills, a topical prescription medication such as diclofenac 10 percent would be idea.

In the short term, regular chiropractic therapy or physiotherapy should help.

Once the pain is gone, you will have to strengthen your core muscles to prevent or reduce future reoccurances. The strengthening of your core muscles will be a life long commitment and usually involves components of weight loss, yoga, swimming and pilates.

I hope this was help full. Have a good day.

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