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  • KB32
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    Post count: 12

    I am a 32 year old, active female and I had a microdiscectomy surgery about a month ago. This is my second microdiscectomy/laminectomy on my L4/L5 within 9 months due to reherniation. Supposedly now there is not much disc left due to the two massive herniations.

    I am well aware that there is residual nerve pain that lingers during the recovery for a few months. I remember all too well the bumpy recovery from my last microdiscectomy. Some weeks are good, other weeks different pains arise. As you move and start to slowly stretch, the nerve root can become irritated. Its quite the balancing act between stretching/strengthening enough and stretching /strengthening too much. Eventually time, physical therapy, acupuncture and massage therapy allowed me to recover to about 90-95% within 3 1/2 months. I was overall very happy with my recovery up until I reherniated again.

    It’s been 4 weeks now since my second surgery and I am doing pretty well. So far I am happy with where I am. A few minor setbacks here and there depending on activity level, but I feel like the nerve pain I feel is reasonable. Still having residual calf nerve pain and occasional buttock pain. The pain is minimal compared to before surgery. I can do nerve glides and static abdominals without upsetting the nerve. But if I try to stretch the hamstring, I will piss off the nerve and rally irritate it for a few days.

    I am curious to hear your experience with past patients and their recoveries in regards to prescribing them an oral steroid early on after their surgeries. Does a dose of oral steroids help reduce inflammation enough to allow them to make progress with stretching and strengthening earlier on in their recoveries?

    To me it seems like the greatest limitation in the recovery process is upsetting that nerve root. The minute you upset the nerve, it seems to set you back a few days. It doesn’t appear to me with my recoveries that you can stretch through the pain and it will get better. It seems like you have to stop, wait for it to calm down, before proceeding slowly.

    Donald Corenman, MD, DC
    Moderator
    Post count: 8379

    This is the problem with nerve root inflammation. If the root is swollen, any type of stretch can “piss it off” with the annoying pain and paresthesias. With a persnickety nerve root, I am a fan of oral steroids to reduce the root irritation. This does not mean you can stretch it too much as when the steroid wears off, you might pay the price. However, if you know prior to the steroid how much the root can stretch, you can then add 10% to the stretch after the steroid is active to gain some advantage.

    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.
    Donald Corenman, MD, DC
    Moderator
    Post count: 8379

    This is the problem with nerve root inflammation. If the root is swollen, any type of stretch can “piss it off” with the annoying pain and paresthesias. With a persnickety nerve root, I am a fan of oral steroids to reduce the root irritation. This does not mean you can stretch it too much as when the steroid wears off, you might pay the price. However, if you know prior to the steroid how much the root can stretch, you can then add 10% to the stretch after the steroid is active to gain some advantage.

    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.
    KB32
    Participant
    Post count: 12

    Thanks for your prompt response!

    I have one more question for you that has recently come up. At the start of week 4 I recently started experiencing dizziness. I have never had any issues with dizziness or vertigo before. It’s been persistent for 7 days so far. I feel like I am “swaying back and forth” for the majority of the day and feel like my equilibrium is off. The feeling is similar to getting off of a boat after you’ve been on one all day. Spatial awareness is slightly off and I’ve been having difficulty concentrating. My neck has been sore, but could be related to sore muscles from lying down a lot lately. Overall, I feel better when i am lying Down.

    Is there any chance this would be related to the surgery?

    Donald Corenman, MD, DC
    Moderator
    Post count: 8379

    One of the problems that can occur with anesthesia is a breaking off of an otolith in the semicircular canals of the ear. This small stone can cause the hairlike sensors in the canal to trigger with different positions. There are specialized maneuvers to trap this stone and can be found through an ENT specialist.

    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.
    KB32
    Participant
    Post count: 12

    Dr. Corenman,

    Thank you for your quick reply. Your website has been a wonderful source of information for me this past year!

    I have one more question for you. I am now 8 weeks post-op from my revision l4/l5 microdiscectomy. Overall I am still a lot better than I was before surgery. I still have nerve pain in my left calf and buttock as well as some lower back pain, but it’s minimal compared to before surgery. How long does the nerve root take to heal with a revision surgery that occurred within 9 months from the prior surgery? Should I expect this residual nerve pain to stick around longer since its a revision? I started feeling really good about 12 weeks after my first surgery.

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