14 months post accident

Chuck - ChuckSigars@aol.com

I slipped and fell on some stairs in November 2000. I bounced on my backside several times and had immediate pain. I sought help that day from a physician, who prescribed pain medication and rest. Eventually I had x-rays (not dynamic) that demonstrated a fractured coccyx.

Over the next six months it got increasingly frustrating. I make my living sitting in front of a computer, and for various hardware reasons adjusting my work station to a standing position was not feasible. It got to the point that I could sit for 15 minutes, stand and stretch for 15 minutes, etc. An eight-hour work day got very long.

My family physician, a very sensitive and caring person, finally suggested Neurontin (gabapentin) along with adding the anti-inflammatory naproxen and changing pain medication from Tylenol with codeine to Vicodin (hydrocodone and acetaminophen; a small amount, as with the T #3). Upon reaching the prescribed dosage of 900 mg/day I almost immediately had near-complete relief. I was ecstatic; I could work at a normal level again (and a normal income). This lasted about three weeks, then the constant pain began to creep back in. We kept adjusting the Neurontin dose upward until I reached 2500 mg/day. I felt it helped, although I never got the complete relief again.

I had a steroid injection, which gave very transient relief (possibly two days; it was hard to tell, since the injection point itself caused discomfort) and saw a physiatrist, who found no evidence of a spinal problem (e.g., a disk problem), and advised that it would eventually heal but might take two or more years. He suggested stretching and walking more also. This was not a frustrating experience, by the way; he didn't try to minimize my problem, just stated his opinion and prognosis.

On straining my low back at about the one-year mark from my accident, I had a few physical therapy visits and the therapist noticed that my piriformis muscles (runs along your thigh, essentially) were very tight, either from a lot of sitting or possibly my body trying to adjust to pain. He gave me a list of stretching exercises and I felt some improvement from those.

I would say that my pain has improved monthly in the last six months, which I attribute to time and whatever "healing" process there can be in neuropathic pain, and the Neurontin. A side effect of the Neurontin, at least in my mind, is a slight elevation of my mood (I mean an antidepressant effect), which helps, of course.

Nothing works for everyone, of course, but from my perspective I can endorse Neurontin as giving some relief. I still take 1-2 Vicodin daily but even that probably could be reduced soon. Some caution and thinking ahead is always useful; any seat that forces the coccyx backward (theater seats and a lot of church pews, as it turns out) can be horrible. I also can't overstate the importance of avoiding depression, through whatever means.


Updated 2002-01-13

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