advertisement
advertisement

Gabapentin a year after laminectomy, will it help w pain?

Had L4-5  laminectomy a year ago, but have been struggling with just as much back, leg, foot pain as before surgery.  Dr. is not convincing that additional laminectomy or fusion will help; he's started me on 1800 mg of gabapentin to try and help with nerve pain (off all other opiods)?  Anyone have success with this drug?  After a month I believe it has reduced leg spasm and some pain in leg and foot (maybe 15%), but hasn't touched any back pain.  What should I expect from this drug and is it for long term use?  thanks

advertisement

Comments

  • My understanding is Gabapentin and like nerve drugs help neuropathy nerve pain, not nerve pain from an impingement.  I had L3-S1 360 fusion and Gabepentin has definitely helped with post fusion neuropathic pains, not present before surgeries, in my experience.  The side effects (lethargy bloating weight gain) are forcing me to wean off a peak 2700mg a day and the neuropathy pains are already coming back with a vengeance.  I was also on mass amounts of opiates until March earlier this year (surgery was Feb/Mar 2018), they helped my core pains (those mostly fixed by fusion surgery) but not neuropathy.   

    What was your original Issues, diagnosis and treatment  options ?    

  • I'm on huge amounts of gabapentin (3600mg) which I have worked up to over many years. I agree with the side effects Joel mentioned. I often wonder if it is helping until I try to cut back and my pain increases. I don't like taking that much but no one seems to be concerned about the long term use. I guess at this point without a miracle, I'll keep taking it. I'm definitely at the max dose. I'd ask your doctor a lot of questions, I know there are other drugs of this kind. Keep us posted. 

    Joanne

  • advertisement
  • memerainboltmemerainbolt IndianaPosts: 4,471

    I also take Neurontin for nerve pain, 1800 mg. day. I backed off several months ago and most of the side effects have subsided. Bt I do know it helps me.

  • Just a heads up...gabapentin withdrawal is horrendous 

  • Many of us on the board are old enough that we don’t have to worry about withdrawal because we’ll be on a med like Gabapentin for life. LOL. (Funny / not funny).

  • advertisement
  • memerainboltmemerainbolt IndianaPosts: 4,471

    L4_L5

    To me funny because this is so true. Well said!!

  • I've been on and off of gabapentin several times over 20 years before and between my three cervical ACDFs.  Now that I've had a spinal cord stimulator implant, I've found that a moderate level of gabapentin (about 1500mg a day) along with the SCS unit has given me back significant quality of life. 

    Please take note, some people have severe reactions to gabapentin.  As earlier mentioned, most people I know including myself, reducing your dosage level after being on it for months can be a significant and slow effort.  It is a drug that can be of great help for a lot of us, but please be careful with the use of it.  If you have any kidney issues, please also be careful.

  • Gabapentin takes time to work if there will be any benefit long term, you may want to wait another month or two to see how it relieves your pain.   The side effects are supposed to level out with time but everyone is different. 


  • thanks for everyone comments.  My original diagnosis was a herniated L4/5 disc, went thru several months of PT and pain meds with no significant improvement so surgeon said next step was laminectomy.  I had a bit of relieve for few months after the surgery, but the back pain returned as well as the nerve pain down left leg and foot.  Another MRI shows scaring, slight protrusion, but surgeon is only suggesting another laminectomy or Fusion; however isn't confident that either will help my back/leg/foot pain issues. Hence, trying the Gabapentin.  Really struggling with the pain which limits working, walking, excercise, etc. anyway, appreciate the comments on this thread.

  • BillOregonBBillOregon Posts: 12
    edited 01/03/2020 - 10:02 AM

    I, too, am on gabapentin, 2400 mg per day. I began suffering serious back and right leg pain about three weeks ago beyond the "normal" pain and numbness I have lived with since a hardware fusion of L4-5 last May. This was to correct the failure of a laminectomy at the same joint in 2017 that never really helped. (L2-3 and 3-4 were fused by XLIF in 2012). Had an MRI Monday that showed some new "suspects" for the pain. I think the gabapentin has given fractional relief -- maybe 15-20 percent, as the original poster mentioned.
    A "side prescription" for cycIobenzaprine has helped control the spasms and cramps. I am hoping I am a candidate for an injection, but have only had relief from one of the eight or so spinal injections I have undergone over the past five years. It's a real slog of a battle to find back pain relief when you are under a slow, steady onslaught of osteoarthritis. 


    Here are the radiologist's conclusions on my MRI:
    CONCLUSION:

    1. Hardware is present as above. Note that the hardware is suboptimally evaluated by MRI. If there is concern for hardware complication, consider CT of the lumbar spine without contrast. MR is also suboptimal for the assessment of bridging ankylosis, and CT of the lumbar spine without contrast could be considered to assess for this.

    2. Multilevel spondylosis with the following noteworthy findings:
    -L3-L4: Mild right neuroforaminal stenosis, unchanged.
    -L4-L5: Severe bilateral neuroforaminal stenosis, unchanged.
    -L5-S1: Unchanged mild spinal canal stenosis. Unchanged moderate bilateral neuroforaminal stenosis.
    -Multilevel hypertrophic facet joint degeneration.

  • I had a lamenectomy to remove a synovial cyst, I still have sciatic pain and was told that if sciatica doesn’t improve after three months, i pretty much am stuck with it, is that true, I am 7 weeks post op, and I am no big fan of gabapettin and would hate to have to go back in it 

  • ArizonaAArizona ArizonaPosts: 165

    "Many of us on the board are old enough that we don’t have to worry about
    withdrawal because we’ll be on a med like Gabapentin for life. LOL.
    (Funny / not funny)."


    Or until they tell you, no you can't have it anymore.  The pharmacist just told me he thinks that's the next drug they will start "controlling".  It's never helped me anway.

  • I think in opiate abusive states like Kentucky, it’s already been classified a schedule C drug, as there are some saying combining it with opiates increases the intensity of the opiates.  At this point It depends on the state, like medical cannabis.  

    I probably fall on the young side of those CP patients on this board and can’t take the side effects of Gabapentin. At least I think it’s Gabapentin, but maybe Amitriptyline or some other of the 10 different meds I’m on, it’s the most likely   

    And the wean IS horrible.  I was sort of force weaned but a recent hospital stay when they would only prescribe 1800mg a day, two 900mg doses am and pm So when I was discharged a couple months ago I maintained that level, then as recommended by a new pain Dr reduce 300mg each 1-2 weeks and spread them into 5 doses about every 3 hrs.  Day ONE was crap, I couldn’t take it.  I went back to 1800 split in to.  Then last week I fasted for weight loss purposes and forgot to take anything until 5pm.  I did 3 - 900mg - and it seemed fine.   Trying to find the happy medium now.  My recommendation is do t start unless it works, at 3 months you’d know and the wean would be much easier.   

    To Bill’s point, cyclobenzaprine or muscle relaxers du jour (I was taking zanaflex) helps immeasurably with the spasms.  I would try that before dreaded Gabapentin now, knowing what I know.  The problem is I think the Gabapentin works for my nerve pain but I don’t want to be lethargic and tired and fuzzy brained forever.  

  • Joel1QJoel1Q Posts: 374
    edited 01/15/2020 - 12:51 AM

    I’ve had success in the last week dropping 300mg in morning and night, now am just taking 1200mg Gabapentin total per day,600 in am and pm,  it may have worked better this time because I obtained drs approvals to go back and try non inhaled medical cannabis remedies, taking 12.5mg of CBG (G as in George, not D as in David) At night and if neuro pain lights up I add 12.5mg of Delta 8.  Both are tablet format, no more inhaling, and it seems to be working to diffuse the increase in pain due to gab wean.  

advertisement
Sign In or Join Us to comment.