Constant sciatic pain 13 days after Microdisectomy

///Constant sciatic pain 13 days after Microdisectomy
Constant sciatic pain 13 days after Microdisectomy
Viewing 6 posts - 7 through 12 (of 13 total)
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  • Donald Corenman, MD, DC
    Moderator
    Post count: 6457

    With return of left leg pain and a fragment still present (” there is a small approximately 2.2 mm AP x 6 mm transverse dimension, non enhancing left foraminal disc herniation with mild left-sided foraminal narrowing”), this might indicate continued compression of this left nerve root. You have had many epidural injections so to consider another one would mean some risk from steroid complications but if the pain is significant, this injection can be helpful diagnostically as well as therapeutically.

    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.
    If this forum has helped you, please let Dr. Corenman know!

    Nyc22
    Participant
    Post count: 7

    Thank you, Dr. Corenman. Unfortunately I have seen two pain management doctors who refuse to give me an ESI because I had surgery so recently. Are you aware of any risks for having an ESI close to surgery? It’s now been 4.5 weeks since surgery. Thank you!

    Donald Corenman, MD, DC
    Moderator
    Post count: 6457

    You can perform an epidural (transforaminal epidural steroid injection or TFESI) even one week post-op. This is what is necessary if there is a developed post-op hematoma. The pain management docs you are associated with do not have that experience but I assure you, it is not uncommon.

    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.
    If this forum has helped you, please let Dr. Corenman know!

    Nyc22
    Participant
    Post count: 7

    Can you perform an intralaminar injection. That was more helpful pre-discectomty for pain in both legs than the TFESIs. Thank you.

    Donald Corenman, MD, DC
    Moderator
    Post count: 6457

    A TFESI should deliver the same quantity of medication as a standard epidural if performed by a skilled practitioner. If there has been surgery at the level of problem, then a standard epidural steroid injection cannot be performed due to the removal of at least some of the ligament flavum at that level.

    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.
    If this forum has helped you, please let Dr. Corenman know!

    Nyc22
    Participant
    Post count: 7

    Hi Dr. Corenman, I am finally getting an epidural in a couple of days. It will be a caudal epidural. The pain has been gradually improving due to the use of a TCA drug and meloxicam as well as physical therapy. Since I’m still in some pain 7 weeks after surgery, I’ve decided that I still want to do the epidural. Today in physical therapy, however, my physical therapist performed some “gentle” traction exercises on me. Though I didn’t feel any differently immediately after therapy, I have gotten in much worse pain a couple of hours after therapy. I’m afraid this might be the proverbial straw that broke the camel’s back or a cause of a recurrent disc herniation. Do you think manual traction could have caused a recurrent disc herniation—is manual traction dangerous in the postoperative period? Thank you for your continued advice.

Viewing 6 posts - 7 through 12 (of 13 total)

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