-
AuthorPosts
-
I am new to this forum and would like your opinion on my recent surgery. I had a microdiscectomy on L4/L5 back on June 21st. I felt great for about 2 days. After that the terrible sciatic pain I had pre-surgery returned in my left buttocks, thigh, calf and foot. I know residual nerve pain is common after surgery and takes time to heal but mine got progressively worse. It got to the point that I could barely stand or walk at all. Finally at week 5 a second MRI was ordered which showed a re-herniation. I was so upset because I didn’t do anything at all that I could remember that would have caused it.
I was scheduled for a second micro D and just had that done last Friday (6 days ago). When I woke up I had a small amount of pain in my leg. I was kept overnight and returned home the next day. That first day home was kind of rough, but by Sunday I was feeling a little better. The next 2 days I continued to feel ok. I basically laid in bed most of the time, but was up and around several times each day. I walked slowly approximately 1/2 mile down the road in front of my house each day.
As you can imagine, I am terrified of a 3rd herniation. When I woke up yesterday (day 5) I was very sore and achey. My leg pain feels worse with most of it in my tailbone and calf. Could it have been the way I slept or was I overdoing it by walking that 1/2 mile (I walked twice, 1/4 mile each time).
I know I am very early in my recovery but I just want to make sure this could be normal. I feel more able to be up and walking this time around, but am very nervous and want to make sure I do everything right this time.
I have decided to take it very easy today and only walk around the house when needed. The back of my thigh, tailbone and calf are bothersome today.
I guess I should tell you too that I was given Vicodin for pain and 800 mg Ibuprofen for inflammation. I hate taking the Vicodin so I have been trying to control this with the Ibuprofen.
Any direction you can give me is greatly appreciated.It is somewhat uncommon to have a recurrent HNP immediately after a microdiscectomy but it does happen. The surgeon will try to clean out whatever loose fragments are found within the disc space. Most, but not every “nook and cranny” can be reached due to the very small size of the opening in the annulus (the hole that allowed the disc herniation in the first place) and the angulation of the surgical incision. Residual “hidden” loose disc material can work its way out in the first couple of days and cause a recurrent herniation.
The nerve just had two compression insults to it in a short period and recovery can take some time (up to six months on occasion). Don’t forget that there is always some small seroma (hematoma) that can occur and this might take as much as six weeks to resorb.
The nerve needs to be “moved” (an action called nerve flossing) so that adhesions do not constrict nerve motion but not so much as to aggravate an already angry nerve. This is an example of the art of medicine; don’t do too much but not too little either.
Hamstring stretches move the nerve roots and gentile stretches are generally called for. Consider asking the surgeon for a therapy script to a good and referral to an experienced therapist for education on these exercises. Patience is called for now to allow the nerve to heal.
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.It is somewhat uncommon to have a recurrent HNP immediately after a microdiscectomy but it does happen. The surgeon will try to clean out whatever loose fragments are found within the disc space. Most, but not every “nook and cranny” can be reached due to the very small size of the opening in the annulus (the hole that allowed the disc herniation in the first place) and the angulation of the surgical incision. Residual “hidden” loose disc material can work its way out in the first couple of days and cause a recurrent herniation.
The nerve just had two compression insults to it in a short period and recovery can take some time (up to six months on occasion). Don’t forget that there is always some small seroma (hematoma) that can occur and this might take as much as six weeks to resorb.
The nerve needs to be “moved” (an action called nerve flossing) so that adhesions do not constrict nerve motion but not so much as to aggravate an already angry nerve. This is an example of the art of medicine; don’t do too much but not too little either.
Hamstring stretches move the nerve roots and gentile stretches are generally called for. Consider asking the surgeon for a therapy script to a good and referral to an experienced therapist for education on these exercises. Patience is called for now to allow the nerve to heal.
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.Thank you so much for the reply. I am going to try and be patient and positive.
Super interesting detail, thank you so much! :-)
You mention that for functional recovery, “it should happen quickly.”
I thought that this was the process that took 6-8 weeks on average.I had a MD to decompress the nerve after only 8 days of acute pain accompanied with numbness and weakness in the leg. Basically, the neuropathic symptoms decided me to act quickly and get the decompression right away. I was really hoping that right after the surgery the feeling and strength would come back, but was disappointed, because though the pain went away immediately (and did flare up later on, but only because of residual inflammation, we think), the weakness and numbness is still very much present two weeks after.
My surgeon says to be patient, as “recovery” can take 6-8 weeks on average, up to 18 months. I’ve read this in many other places as well.
Now, you’re adding on a bit more detail to this- that the “budding” type of recovery takes 12-16 weeks; but how long does functional recovery take? (In other words, if my symptoms did not go away immediately, does that imply that my recovery may only be of the “budding” form?)
Just to be clear: I replied to your very first reply in this thread that is becoming way too long, so my question is in-thread, about the different types of nerve damage recovery.
BTW, I would like to thank you for your detailed responses Dr. Corenman. Your website is the only place online for some of the information you’ve provided, even just in this thread – I looked everywhere and I’m pretty good a this kind of thing. The resource you’ve created is precious, thank you so much for taking time to reply so clearly. As an alternative, the Spine Health forums have some info, but are mostly filled with patients-informing-other-patients and lacks the authoritative detail that you able to provide. I’ve just bought your book (the light version) and it’s excellent, and I’m pretty sure I’ll get the handbook for clinicians next (which I assume is similar material with more detail).
-
AuthorPosts
- You must be logged in to reply to this topic.