Suggest Medication To Treat Backache From Abdominal Nerve Frazzled During Surgery

Posted on Tue, 3 Oct 2017

Question: What can be done to alleviate back pain from an abdominal nerve frazzled during surgery?

Answered by Dr. Ishu Bishnoi (1 hour later)

Brief Answer:
Back pain treatment

Detailed Answer:
Hi Bxxxxxx2, thanks for asking from HCM.

I can understand your concern. Your back pain can be managed only after diagnosing cause of it. For knowing cause, you should undergo clinical examination of back and few investigations like

- X ray Lumbosacral spine

- MRI lumbo-sacral spine

- If abdominal pain is radiating to back, ultrasound of abdomen.

After ruling out the cause, it can be managed. Please let me know the reports. I will be help you better with reports. Till then, back pain can be treated by

- Apply hot fomentation over local site

- Apply painkiller gel like diclofenac gel thrice a day, after prescription

- You can take tablet pregabaline or gabapentine-nortriptyline after prescription.

- If there is acute pain, you can take tablet methylprednisolone after prescription. It will relieve inflammation and edema. It should not be taken more than 10 days.

Hope it will help. If any doubts, do let me know.
Thanks. Take care.

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Ishu Bishnoi (22 hours later)

I had a 7 hour back surgery at Stanford Medical in February, 2015, for stenosis & scoliosis. The back surgery relieved the pain I was having, however I developed this pain where they cut through the abdomen to place graph material on the front of my spine.
I had to go back for X-rays four times to make sure the surgeon was satisfied with his work. I told him that the back was fine but I had pain at the point of surgery into the abdomen. He said it would go away, or that it might be coming from my hip.
After two years, and no change, I went for a hip X-ray, and was told that my hip was fine. The orthopedic doctor thought that a nerve was "frazelled" during surgery and that I would have to live with it.

Answered by Dr. Ishu Bishnoi (2 hours later)

Brief Answer:
Neuropathic pain treatment

Detailed Answer:
Hi Bxxxxxx2, welcome back.

I got your point. You are experiencing neuropathic (pain originating from nerve) pain. Such kind of pain are severe and disturbing. As it happened after abdominal surgery for spine, it is almost impossible to treat it by surgery. You need medication to control it. Kindly consult doctor to get prescription of any of following neuropathic pain alleviating drug

- Pregabaline - Usual starting dose in an adult is 75 mg twice a day and can be increased upto 450mg/day.

- Gabapentine - Usual starting dose in an adult is 300mg once a day and can be increased till 600mg.

- Combination of Pregabaline and nortriptyline or Gabapentine and Nortriptyline - Usual adult dose of nortriptyline is 10 mg once a day and can be increased till 30mg/day.

- If still no relief, you can ask for morphine derivatives like oxcodone or pantozocin. These must be tried after every drug fails.

Some procedures which might help in your case is

- Local neurolysis drug injection - If the doctor is able to localise the nerve, local nerve killing agent can be injected to destroy nerve and thus pain. The injecting drugs are phenol, alcohol.

- Radiofrequency ablation (RFA) of concerned nerve

- Local anaesthetic or steroid block - Both RFA and local anaesthetic block effects are temporary. Usually a patient gets relief for maximum 6 months.

I hope these options might help you. If you have nay doubts, do let me know.
Thanks. Take care.

Above answer was peer-reviewed by : Dr. Yogesh D