3 Weeks Post Microdiscectomy Pain

Tagged: Back pain symptoms after a microdiscectomy

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zzab
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September 22, 2020 at 7:23 am

Post count: 23

#33022

Hi Dr. Corenman was hoping I wouldn’t have to write you again but I had a mishap this past Saturday and wanted to get your thoughts on what I am feeling. First I want to give you a brief recap on my recovery. Today I am 4 months post op on my L4/L5 (left leg). Recovery had been going well up to this point. I basically had no back pain the entire recovery but some lingering nerve pain that had finally subsided two weeks ago. Past two weeks I felt pretty close to 100%. I am very well read in the teachings of Professor Stuart McGill and have a solid understanding of spine biomechanics and know how to move in all aspects without putting my spine in flexation or extension. Since the 6 week mark I have been rehabbing with one of Stuart McGills practitioners so my weekly rehab program has been very calculated. My current rehab has me doing roughly 1 hour of core work a day and 30 minutes of walking so my capacity is fairly well built at this point.

Fast forward to Saturday. I went on a nature trail hike my with girlfriend and ended up standing on top of a fallen tree that was about 2ft from the ground. I tried walking across the tree but quickly lost my balance and landed straight up on my feet but the compression from the landing did a number on my back. The impact caused a feeling in my back I hadn’t felt before and within a few minutes the area around my shin became hot and numb. It was not sciatica per se, just heat and numbness. I was able to finish the walk and do my rehab for that day but my back felt off. Sunday I didn’t really have back pain but did have more heat and numbness around my shin.

Monday was my big scare as when I woke up I felt sore on both sides of my hips. Other than the first few weeks after surgery, I had yet to wake up in the morning with any back pain. The pain was fairy equal on both sides of my hips even though surgery was on my left side. This morning I woke up with less numbness and heat in my shin and it lasted about 2 minutes. Currently the pain around my hips is gone but my spine just feels compressed and tight right now, although overall I do feel better this morning than I did yesterday but did take an Advil before bed. I can still walk, sit, stand no problem but I obviously don’t feel as good as I did before Saturday.

Scientifically what do you think is going on? Did I likely compress my disc and it is just irritated or could this be a possible reherniation? I thought the annulus scars over after 8 weeks or so I would hope that a straight fall compression wouldn’t be enough to reherniate.

Donald Corenman, MD, DC
Moderator

September 23, 2020 at 7:50 am

Post count: 8660

#33028

You did compress your disc with more force than you’ve been accustomed to and probably caused some annular torque which “makes you feel sick in the back”. I assume your symptoms have improved and are starting to feel better now. You might try an oral steroid to see if this is inflammation driven. If the radiation of symptoms continue and don’t fade over time, a new MRI might be warranted.

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.

zzab
Participant

September 23, 2020 at 8:24 am

Post count: 23

#33029

Hi Dr. Coreman thanks for the response! You nailed it…I definitely have a “sick in the back feeling”. I had a similar feeling the first day I started my core rehab 6 weeks after my surgery but this went away after a few days of my body getting accustomed to the core work. While I am still in pain it does seem like my symptoms have diminished a bit since Saturday. I am currently taking advil every 4-5 hours and that pretty much keeps the symptoms away.

If it was just an annular torque does that decrease the likelihood of possible reherniation? Mechanically can annular torque cause a disc to reherniate? Also if it was an annular torque what is a standard timeframe for ones symptoms to resolve?

Donald Corenman, MD, DC
Moderator

September 23, 2020 at 2:34 pm

Post count: 8660

#33030

Reherniations can occur without nerve compression but if you herniated a substantial mass of disc, you would know it with pain in your buttocks or leg after a day or two. It should take about 4-6 weeks for an annular tear to clear in most cases.

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.

zzab
Participant

September 28, 2020 at 7:03 am

Post count: 23

#33054

Hey doc just wanted to give you a quick update and get your thoughts on how I am feeling. 9 days since I slipped off the tree and on day 5 of a Medrol pack. Each day seems to have improved a bit but turned a corner pain wise yesterday and felt probably 80/90% of my previous self all day Sunday. No pain in the butt or anything like that just a tad achy in the lower back.

Would you say this greatly reduces the likelihood of reherniation given how I felt yesterday or could the Medrol jut be masking my true symptoms? Also how long does Medrol reduce inflammation? Curious when I expect to see a spike in pain once it exists my body.

Donald Corenman, MD, DC
Moderator

September 29, 2020 at 6:36 am

Post count: 8660

#33062

You will have a good baseline of how you really consider symptoms about 2-3 days after the steroid is completed. I think it is unlikely that you reherniated a large fragment.

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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Donald Corenman, MD, DC

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81 reviews

Eric S

Sep 26, 2021

by Eric S on Donald Corenman, MD, DC

Successful pars repair at 46 years old

Back in November of 2018 (at 46 years old) I came from Vancouver BC to have a pars repair done with Dr. Donald Corenman at the Steadman Clinic in Vail Colorado. I'm finally posting this review nearly three years later in late 2021. The reason I waited so long was I wanted to know the final result before I posted my review. Unfortunately in that time Dr. Corenman has retired. Nevertheless, I want to post this review of Dr. Corenman and his staff at the Steadman Clinic in their excellent treatment of my L5 pars interarticularis.

I fractured my pars at age 42 back in 2014 when rolling on the gym floor, and was denied treatment by the Canadian healthcare system, probably due to my age. First my GP told me there was no surgical option for a pars defect, which was quite incorrect! I tried to live with it, but the symptoms worsened (periodic random spine slippage and weeks of resultant pain after just bending over to tie my shoe, so I eventually learned to mostly squat and hardly bend). When I finally consulted with Canadian spine surgeons, I was told they believed my pars defect had been congenital (since birth). This was absurd, considering I had done extreme martial arts (including jiu jitsu) for years prior, as well as 5 years of reinforcing steel full time in my 20s, probably the hardest job on the back you can find. No pars defect like mine would possibly have allowed this--ergo it was impossible that I had had the defect since birth. I did however have an asymptomatic congenital spina bifida occulta that made me more susceptible to a pars fracture. In 2014 in one instant, I went from having the strongest back people I knew said they'd ever seen, to being unable to safely bend over and tie my shoe without a non-negligible risk of my spine slipping randomly (which would lead to weeks of pain after each occurrence). This was due to the unilateral L5 pars defect, otherwise known as spondylolysis. It was when lying in pain on the floor 4 years later after maybe the 6th spine slippage event post injury, that I had had enough, and resolved to have surgery. If Canada's "universal health care" said no, I would make lemonade from lemons, and find the very best surgeon in the world at pars repairs. That was Dr. Donald Corenman. Dr. Corenman back in 2018 ran a website https://neckandback.com/ that dedicated many pages to the science of every aspect of pars repairs, from eligibility (good discs on MRI), to best surgical techniques (minimal open compared to minimally invasive), best imaging to use (i.e., O-Arm with Stealth imaging vs. older fluoroscopy), the ideal amount of BMP to use and why not use too much or too little, and much more, all to do with pars repairs, pages upon pages of his site just on the pars, with scientific references and his own extensive expert opinion. As a health research statistician, I was very impressed with this. It was in stark contrast to the websites of other spine surgeons which barely gave the pars a word or two, focusing almost exclusively on fusions. I had found the best surgeon in the world for pars repairs, and so after Dr. Corenman personally screened my MRI to ensure my discs were healthy, I booked the surgery.

Being 46 years old at the time of surgery in 2018, with a 4-year-old pars fracture from 2014 combined with a congenital SBO meant my pars fragment was somewhat atrophied, but it was "very solid", said Dr. Corenman in the operative report. Nevertheless, it was challenging with two things to fix, the pars and SBO, and OR time was around 4 hours. Recovery over the following months was guided by a very clear "Spine binder" from the Steadman Clinic with strict rules of "no BLT" (no bending, lifting or twisting), and illustrated physiotherapy guidelines. They even warned patients to avoid fish oil supplements, which could excessively dampen inflammation and hence slow bone healing. They answered many questions I had during months of recovery, with responses coming from the very supportive Lori Fugate (then director of Dr. Corenman's practice), and Ehrich Bean (then physician's assistant at the practice), as well as a couple calls with Dr. Corenman himself after two of the CT scans. Ehrich Bean offered great advice for taking the spine binder conservatively due to the nature of pars repairs vs. fusions. The final post-op CT scan I had was a couple weeks ago at 34 months post-op, and Dr. Corenman had retired, but I got a very positive and informative call from Eric Strauch (current PA at the Steadman Clinic under Dr. Corenman's replacement there, and who had also worked with Dr. Corenman previously). The staff at the Steadman Clinic were extremely supportive all the way through the process. I should mention, the local Canadian spine surgeon did offer me very good post-operative support including antibiotics as needed to deal with a mild surface incision-site infection early on, booking numerous x-rays when I felt something was amiss, as well as booking all four of my post-op CT scans. I am very grateful for that support also.

My final result shows plenty of solid bone across the pars and a healed SBO, with my vertebral body now a solid bone ring instead of being broken at two places as it was pre-op. Does my spine hold up in the real world? You bet! I have recently dug and moved several yards of dirt and sand and gravel by myself (shovel and wheelbarrow!) to fix our water main, pulled roots from the yard, moved several "portable" (these are HUGE) air conditioners up several flights of stairs my myself, and lifted weights. I now run 2 miles (3.2 KM) several times weekly with a hard 100 meter dash in the middle. I bend deeply before each run I go on, with no spine slippage. My spine feels amazing. I can bend over to do exercise, or real word tasks, with no risk of spine slippage.

My sincere thanks to God, Dr. Donald Corenman, Lori Fugate, Ehrich Bean, Eric Strauch, and the Steadman Clinic, as well as the Canadian spine surgeon who offered me excellent post-operative care back in Canada. You have all given me a new lease on life.

Sincerely,
Eric S

Robert S

May 11, 2021

by Robert S on Donald Corenman, MD, DC

Back Fusion Surgery

I had my entire lumbar spine fused in November of 2018. I had scoliosis , with pinched nerves that were so painful I could hardly walk - and standing for more than a few minutes was impossible. Even sitting was painful.
The fusion surgery produced immediate relief! And the recovery was much easier than I expected.
To this day I can do all the activities I love from hiking, to standing in a stream fly fishing to riding my bike long distances - or just walking down the street with my wife.
Kudos to Dr. Corenman and his staff, (including the two Erics) for taking such good care of me!

Leslie R

Jul 9, 2020

by Leslie R on Donald Corenman, MD, DC

TLIF

I had my TLIF surgery on 6/24/2020 by Dr. Corenman, I can not say enough good things about the Dr or his staff. I was always treated with respect and explained everything throughly, that made it easy for everyone to understand. I highly recommend Dr. Corenman and the Steadman Clinic.

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