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  • kevak115
    Participant
    Post count: 5

    Hi Dr. Corenman,

    Right before the holidays I had an emergency discectomy on a very large herniation in my L5 S1. I am just about 3 months removed from my discectomy. At around 2 months I had a week of feeling great. I was getting around and able to be on my feet all weekend. It was in the next few days I noticed fatigue around my incision and some sharp pain when bending down and to the left. That pain increased and I noticed a burning/aching sensation return in my lower back, hip and side/back of the thigh.

    I had a followup with my surgeon and they said it sounds like facet syndrome because they had to remove part of a bone and to take naproxen twice a day for a week and begin physical therapy.

    Does this make sense to you or could it be something else? They did lab work to rule out an infection.

    Thanks,
    Kevin

    Donald Corenman, MD, DC
    Moderator
    Post count: 8455

    Advancing pain could be from increased inflammation due to greater use of your leg, hematoma/seroma, infection. mechanical deformity and recurrent herniation. You have been ruled out for infection (labs). Your symptoms don’t really match with facet syndrome as your pain is “some sharp pain when bending down and to the left” where normally, facet pain occurs with extension, the opposite of your complaint.

    That leaves inflammation (seroma-most likely) or recurrent disc herniation. Your current examination would be helpful. Any change in motor strength or significant increase in particular findings (SLR, increased area of numbness) could indicate a recurrent disc herniation. Your doctors advice “take naproxen twice a day for a week and begin physical therapy” is a good first start. If you don’t start to see improvement, a new MRI soul be helpful.

    Dr. Corenman

    kevak115
    Participant
    Post count: 5

    Thanks you for such a quick response. My surgeon doesn’t think it’s a recurrent herniation since I didn’t have any pain with the straight leg test. I also don’t have pain bending straight forward except for some hamstring tightness. It’s really just a twinge when I bend forward and left at the same time. The naproxen has reduced the consistent pain significantly, but not sure what will happen when I stop taking it. He also said he doesn’t think it is scar tissue as I am not having symptoms when I perform nerve gliding exercises. I have an evaluation with my physical therapist this afternoon and I will update with her examination. Do you agree with his assessment of the scar tissue? I searched online for symptoms, but I really didn’t find anything.

    Donald Corenman, MD, DC
    Moderator
    Post count: 8455

    He is probably on the right track. You probably will need to be on the NSAID for months and not weeks.

    Dr. Corenman

    kevak115
    Participant
    Post count: 5

    Just had my first PT appointment. Hopefully my back responds well. How long could it take for my nerves to calm down if the inflammation is because I over used my legs that week?

    Donald Corenman, MD, DC
    Moderator
    Post count: 8455

    Nerves can take as little as 2 weeks or as much as 3 months to “calm down”.

    Dr. Corenman

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