response
Nortryptilline at lower doses than are administered to a pt for depression have been shown to aid sleep. It is a fact that pt's with better sleep require substantially less narcotic medication. It sounds like the L5/S1 disc and the scar tissue present are you biggest problems. Endoscopic discectomy/ decompression would be my advice prior to a SCS assuming you have reasonalble disc height. A new herniation usually responds well. As for the scar tissue, a Racz procedure would be my next rec. to one of my patients. With both of these procedures, you need to find a well trained physician in these procedures or you won't get the best results. A SCS is ultimately a good thing in that we are having a lot more success covering axial LBP. It just sounds like there are other options for you prior to a Stim trial. Also, watch that combination of Oxycontin and Valium-both are HORRIBLE drugs in my opinion and work synergistically and not just additively. Good luck-I hope this helps.
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