denny3027ParticipantFebruary 12, 2020 at 2:42 pmPost count: 7
Hey there Dr. Corenman,
So the cold has caught up with my family and friends. I’m trying really hard not to get sick but if the sucker gets me…
1. Any recommendations on best position/ what to do when a coughing and sneezing attack happens?
2. Do you find your patients reherniate if they catch a cold ( one of the variables that led to my herniation was a very bad coughing spell when I caught a cold in October so I’m anxious about catching a cold while recovering)
I am 7 weeks post L3L4 microdiscectomy.
Thank you!Donald Corenman, MD, DCModeratorFebruary 14, 2020 at 7:23 amPost count: 8468
Coughing and especially sneezing does increase intrathecal pressure (inside the nerve sack) and also cause ballistic maneuvers in which these contortions can cause a new HNP. It is best to prepare for these episodes immediately after surgery by bracing and holding slight flexion while being braced (use your hands to lean on a counter).
Dr. Corenmandenny3027ParticipantFebruary 15, 2020 at 10:31 amPost count: 7
Thank you doctor.
Also, I started PT this past week and my lower back has been achy. At first my PT said it’s my glutes and that they were overcompensating (really tight) but now I feel it’s also in my lower back. Not near my incision at first but now I feel it at the lower part of my incision (LEFT L3L4 microdiscectomy going on week 8). I’m also finding it hard to sit comfortably for longer than 30-1 hour without the lower back increasing in pain (4/10). Before the pain would be about 8/10 sitting for long (only in my leg, my back pain has been gone for a while before this) but after surgery it was better and now after PT the back pain is going up to this level. Also, I had some lingering pain in my left leg but this week it’s been more constant (only at 2-3/10 and also having minimal muscle twitching in the leg. Before surgery I had what felt like a big tight knot in my left lateral thigh and that’s still there and where the pain is from. I’m not sure if I should call my surgeon or not. He always tells me it’s inflammation and I’m still healing. Do you think this is the case? How far along after surgery is back pain still from the healing of the surgery? I keep telling myself I haven’t used these muscles in 6 weeks and my body is just getting back to using them. Is this thinking correct or should I be more concerned?Donald Corenman, MD, DCModeratorFebruary 19, 2020 at 12:30 pmPost count: 8468
Discs will “settle” after an annular tear and herniation (and after surgery). This can cause lower back pain for as long as 4-6 months. 10% of patients will have long term lower back pain. A nerve that had been significantly compressed can take as long as six months to “settle down”. If your leg symptoms are not improved since surgery, that is an issue. If improved and then worse, think of a recurrent disc herniation. If very slowly improving, think of inflammation and the need for an epidural steroid injection. If back pain getting worse, possibly infection.
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