[Reagangb]

#34666

Hello Dr. Corenman,

I am a 22 year old male and I had a microdiscectomy on L5-S1 approximately 6 1/2 weeks ago. Prior to having said surgery, I was in extreme pain when standing for even 5 minutes, walking 50ft, or sitting any period of time. (sometimes no relief the whole day) I had a ‘lighter’ version of these symptoms for about 2 months first and tried PT to fix them, which didn’t help. The ‘extreme’ symptoms were there for about a month after those initial 2 months and was prescribed a ‘large dose’ of prednisone, and symptoms returned to the ‘light’ version where standing and walking any more than 3 minutes straight caused me to need to sit down or take a break. Had the surgery about 1 month after that because my leg was getting noticeably weaker.

All said and done I had a herniated disc for about 5 months prior to getting the microdiscectomy. Instantly after surgery, and still, I am able to walk and stand as long as I want with what I would describe as a pain level as 1 or 2/10 sometimes even 0, just kind of there but only when I am thinking about it. The sciatica in my leg is only there after sitting for longer than I should (45 minutes+). So I am doing much better.

My worries come when I do the straight leg raise. Before surgery, even when symptoms were ‘light’, I could only raise my leg about 5 degrees without excruciating pain. Now, sometimes my leg can be raised to 70-80 degrees, and its just because I am not flexible, there is no pain. However, other times, it feels EXTREMELY tight and hurts at about 30 degrees and if I ‘fight’ through it, and restart the raise, I can raise to 70-80 degrees like normal, no pain, until I rest. But then will become tight again after a minute or so of rest, and the process of hurting at 30 degrees begins again. The pain when it is extremely tight feels like a band from my ‘sitbone’ to my SI. When I fight through it, it causes a spot pain in my butt until I lay for around 10 minutes. I also have a sharp pain that is always in the same spot, which is definitely in my SI Joint when I ‘flex’ my pelvis (slouching while sitting for example). Should I be worried about this, or is this somewhat par for the course at about 6-7 weeks in? All my weakness and pain from walking/standing is completely gone until I irritate it stretching my hamstrings.

I go in for my 6 week post-op this week so I am trying to gather my questions/concerns so I can let my surgeon know. I also start physical therapy then too, so maybe it can help somewhat. Thank you for your time, you don’t know how much reading your forum has helped me!

[Donald Corenman, MD, DC]

#34669

Since your symptoms are intermittent, I am not as worried about a recurrent HNP or even a seroma (a collection of fluid). Your nerve had 5 months of significant compression so you can expect slow healing. You might ask for another course of oral steroids. Gently stretch the nerve (when it is not angry). You have to be careful as the nerve might not like overstretch initially and might not complain to you for 24-48 hours after the stretch.

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.

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