JFoxNYCParticipantAugust 18, 2019 at 2:57 pmPost count: 1
Hi Dr. Corenman,
For 10 years I would have periodic sciatic pain in the right buttock, episodes would usually occur every couple of years and last a few months, sometimes alleviated by acupuncture. The episodes became progressively more frequent and severe, and last year it finally got bad enough where I couldn’t do prolonged standing or walking and walking, and it didn’t seem to be going away. I had an X-Ray / MRI / CT, and diagnosed with a herniated disc pinching the nerve at L 4/5 on the right side.
I had a microdiscectomy on June 19th. Recovery seemed normal with decreasing pain until around Week 5 or 6, where I had a week being almost completely pain-free, and I was happy and optimistic. Then right after Week 6, I started having pain again. At first it was in the same spot, the right buttock, and I got nervous – but that pain has honestly been fairly infrequent. The larger source of pain is new, on the lower left side of my back. I don’t understand why this pain developed – could it be part of the post-surgical recovery process, even though it’s been about 8 weeks? The other thing is that friend and family have commented on how much straighter I am now, compared to last year. Is it possible that my left-side pain is from using muscles in such a way that I had been neglecting, due to my crooked / altered posture when I was suffering with the sciatica?
Is it normal to still have periodic pain 8+ weeks after a MD? My procedure did take almost 3 hours because in addition to removing the disc fragment, I believe my doctor also carved some extra room in the canal (or something like that; this is my amateur understanding of what he said). Thank you so much for your insight.Donald Corenman, MD, DCModeratorAugust 21, 2019 at 5:26 amPost count: 6907
Your symptoms of leg pain with standing are more consistent with lateral recess stenosis or foraminal stenosis than with a typical herniated disc which typically causes pain with sitting relieved with standing. See-
https://neckandback.com/conditions/lumbar-foraminal-stenosis-collapse/, https://neckandback.com/conditions/herniated-disc-lumbar-spine/ and https://neckandback.com/conditions/lateral-recess-stenosis/
What is interesting is now your pain is on the opposite side of your back (“I had an X-Ray / MRI / CT, and diagnosed with a herniated disc pinching the nerve at L 4/5 on the right side”) and now you have “larger source of pain is new, on the lower left side of my back”). The fact that there was work to open the canal or foramen (“I believe my doctor also carved some extra room in the canal or something”) which I assume was on the right side might have caused some settling of the disc space and allowed left sided facet or root involvement.
I would first give these new symptoms some time to resolve by themselves. Discs do settle after decompression work and these pains can sometimes fade away without further treatment. Physical therapy might be helpful and if the pain continues, a new MRI would be called for. The possibly an epidural steroid injection could be the next step.
Dr. CorenmanPLEASE 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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