Viewing 6 posts - 1 through 6 (of 19 total)
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  • Chris86
    Participant
    Post count: 5

    Hello Dr. Corenman,

    my L5 / S1 disc herniation mainly lead to severe left-side buttocks pain when stretching the nerve. So for example moving my chin to my chest or trying to form a “round” lower back would immediately provoke this pain on the left side of my buttocks.

    After 6 months of phyiscal therapy and epidural steroid injections I opted for surgery which was done 4 weeks ago. The surgery was a success in a way that my buttocks pain is much less severe now. But it’s still there with the same movements as before but “later” in the movement. So I can move my chin to my chest further, for example.

    Even after reading through all the answers you gave to others with similar problems, I am not sure this is normal. What would cause movement-releated pain that is otherwise completely gone in some situations (like standing up straight) but another obstacle that is touching / disturbing the nerve?

    Thank you for input on this. Understanding why this might be normal would be really helpful to keep going without loosing hope.

    Donald Corenman, MD, DC
    Moderator
    Post count: 8660

    Since you are only four weeks out and better than prior to surgery, the nerve is probably still swollen. The movements you notice that increase symptoms all stretch the nerve root so this would be expected for 4-12 weeks. You can develop a seroma (a collection of fluid post-operatively) that temporarily will partially compress the nerve after surgery. This seroma should resolve in 2-3 months. I would say be patient and gently perform hamstring stretches (which is the main exercise that stretches the sciatic nerve) GENTLY to try and cautiously squeeze the edema out of the nerve root. These stretches performed too aggressively will piss off the nerve.

    Dr. Corenman

    PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
     
    Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.
    Chris86
    Participant
    Post count: 5

    Thank you very much for your reply. So, possibility of a seroma aside, a swollen nerve could mimick the same (but in my case less severe) pain from the herniated disc because it would swell at the same place where it was pissed off for months? Did I understand that correctly?

    I will keep going with my phyisical therapy, perform gentle stretches additionally and contact my surgeon again if things haven’t improved after 12 weeks? Does that sound like a reasonable way to proceed with these leftover pains I’m having?

    Donald Corenman, MD, DC
    Moderator
    Post count: 8660

    Yes, a swollen nerve can mimic the same, but less severe pain from the herniated disc. Your plan is good.

    Dr. Corenman

    PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
     
    Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.
    Kateyberry
    Participant
    Post count: 1

    Hi, I am new to the forum, I suffered gunshot injury to my left buttocks and I have a footdrop, numbness on the foot and on the parts distal to the nerve… Its been 6months of physical therapy. Although weakness has improved, pain and burning sensation has also reduced, I cannot stil lift my foot from the ankle or make a single twist or movement of my toes.. No dorsiflexion or plantar flexion…

    MRI results revealed thickened edematuos(10mm) sciatic nerve plexus on the left side with grade 1 muscle edema within the gluteus maximus, sub acute denervation muscle changes in the form of combination of athropy /fatty replacement along the territory of the injured sciatic nerve

    During therapy, when The (EMS) machine pads are placed on myL5region using interrupted currents, my muscles contract and my foot is lifted up but when faradic current is set… It doesn’t contract, what could this mean?
    What should I do, other than physical therapy.. My leg is getting slimmer than the other and I am scared… Its been six months already. My

    Donald Corenman, MD, DC
    Moderator
    Post count: 8660

    Nerve injury from a GSW (gunshot wound) is highly unpredictable for recovery. It depends upon the caliber, velocity, distance from the muzzle and the path of the bullet. Recovery may not take place but read this to understand the type of nerve damage that can occur and how muscles recover from this injury. https://neckandback.com/conditions/peripheral-nerve-anatomy-neck/

    The current used is determined based upon the nerve injury. I found this: “faradic current having short pulse duration cannot be used to stimulate dennervated muscles as dennervated muscles require pulses of longer duration for having its effects. Galvanic current has long duration impulses selections that can be used to stimulate dennervated muscles”.

    Dr. Corenman

    PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
     
    Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.
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