[Donald Corenman, MD, DC]

#7325

Your surgeon is correct in that “nerves take a long time to heal” if they had been injured. Granulation tissue is “healing tissue” but that is always the problem in the nervous system. All the rest of the body needs this granulation tissue to heal (tendon, ligament and even disc) but it is deleterious to nerve tissue.

Too much granulation tissue can attach to the nerve and tether it to the disc or the canal. There are two ways to try and prevent this attachment. One is with physical therapy during the first six weeks. You will hear the term “nerve flossing”. The therapist will constantly have you “move the nerve” in the this time period to “stretch” the forming scar tissue and prevent the adhesions from forming.

The other technique, at least in my practice is to use epidural steroid injections to coat the nerve and surgical area. This medication will tend to reduce the formation of inflammatory tissue and reduce the inflammation within the nerve.

Yes, inflammation can persist even six months after surgery. I do think that oral steroids can be useful at this time. There are some side effects that are uncommon but generally tolerable to most people.

Lyrica or Neurontin are two good medications to help reduce the symptoms. There are side effects that some people find intolerable but many use these medications to good results while the nerve is “healing”.

If you have noticed significant increased return of symptoms, there is the chance that you might have suffered a recurrent disc herniation. A new MRI might be indicated.

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.

[bill335]

#7340

Thank you so much for your reply Dr. Corenman. I think I will start off by asking for the steroid pack, hopefully it will be enough to calm things down and nothing is too serious. I did ask about a epidural during my last visit but was told no. As for the additional leg pain, there is a slight increase, not very significant, but I understand you can’t tell how bad the problem is unless another MRI is done.

I also noticed that you are a chiropractor? Do you think decompression will help my situation? I was thinking about just laying on a table and having the chiro stretch/pull me apart on one of his chiro table and having a machine (forgot the name of it) apply heat treatment to my lower back. I had some friends who done it and they told me it helped out a lot with their back aches but my situation is different since I have had a micro-d done.

Again, thank you for your advice Dr. Corenman. Will update and share my experience as it goes.

[Donald Corenman, MD, DC]

#7346

The decompression (traction) table typically used by chiropractors (DMX 9000 and others) I am generally not a fan of. The two problems are the costs and utilization. Generally, there is a “program” you have to sign up for. This programs consists of 20 visits regardless of the success of traction and traction can aggravate symptoms in some patients. The charges of using the machine are also very high.

Now I am not against traction but to state that this modality “decompresses” the disc is not valid or accurate. If traction is to be effective, you should know in 2-3 visits and if the initial treatment aggravates symptoms, do not continue.

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.

[bill335]

#8055

Hi Dr. Corenman,

I’m back and here to tell you that you were right on the money when you said it was inflammation. The last time I was on here I guess was November of 2012 and felt like the world was ending for me especially after the extra pain down the leg.

Well, I decided not to sit around and do nothing. From spending countless hours reading all the doom and gloom on line, one thing I noticed was the folks who had good results after surgery were the ones that moved and moved. I purchased a electric heat pad, got my ice gel packs, and hit the thread mill twice daily along with doing my PT stretches. Surely enough, the first week of this, the pain was intense but I noticed as the weeks went by, the pain down my leg was getting less and less. I manage to be completely off the Ibuprofen by the end of December and Lyrica by early January. My back does have the occasional “ache” but is nothing compare to the previous pain. I’m doing my PT stretches to help strengthen the area.

I forgot to mention in my other posts but before December, I could not sit more then 30-45 minutes but it has improve to 2 hours now. I could probably sit more but I’m not pushing it. I do use a small ice gel pack in my lower back when I’m sitting for more then a hour, probably don’t need it but hey, it helps and works.

Anyway, I would like to send out a heart warm THANK YOU, especially for interpreting my MRI and telling me I had inflamed nerves. Crossing my fingers the relief will be a long time but if it doesn’t, I”m be back asking for your expert advice.

[Donald Corenman, MD, DC]

#8058

It is good to know that the inflammation subsided and you are doing better. Nerves do take a considerable amount of time to heal. You can read the new section on the website (Nerve Injuries and Recovery) to understand more completely what to expect.

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.

[bill335]

#8060

Dr. Corenman,

There was actually one thing I had forgot to asked about. I haven’t really thought too much about it but it has crossed my mind. Now that the disc at the L5-S1 has lost moderate space and hydration, what should I expect down the line from that disc and any potential problems? I have seen the MRI after surgery and it’s thin as expected after surgery. There is still disc space but thin (not paper thin).

I have read that some people with really bad degenerative disc have no pain at all while others do. What should I expect down the line from the disc that had the surgery? I have read that bone spurs can occur also from thin disc. Is there anyway to prevent any of this stuff from happening?

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