Viewing 6 posts - 1 through 6 (of 6 total)
  • Author
    Posts
  • Codym
    Participant
    Post count: 3

    Hello, I had a discectomy of my L5-S1 3 weeks ago. Initially my pain had vanished. I walked 5 miles my second day out of surgery and many days after that I was walking 6-7 miles every other day. Felt great. Then In one day into the ladder part of the second week after the surgery I had walked almost 10 miles. The next day I was experiencing similar nerve pain as before the surgery. By that night it was so bad that I could not get into bed. I had to take multiple hydrocodone to manage the pain for the next couple of days. I called my doctor and scheduled a MRI and my doctor called back after receiving the images stating it doesn’t show anything that should be causing so much pain. He ordered a steroid pack and said if that doesn’t work we can try to go back in and see what might be causing the pain. I read the MRI findings and the only thing that caught my eye was it said I had a “enhancing soft tissue measuring 4.8mm in AP dimension and 5.4mm in cc dimension that likely represents post operative granulation tissue”. Could that be causing the pain? Also I forgot to mention I am a 28 year old male and have always been fit. This pain coming back and my doctor telling me there is no reason I should be having this pain is really putting me in a depressed state. Hoping to find some clarity. Thanks

    Donald Corenman, MD, DC
    Moderator
    Post count: 8455

    You note the “second week after the surgery I had walked almost 10 miles” which is more than I think is acceptable (a one mile walk each day two weeks out from surgery should be the limit even for an athlete). You then note after severe increased pain; “I called my doctor and scheduled a MRI and my doctor called back after receiving the images stating it doesn’t show anything that should be causing so much pain” so I assume there was no recurrent herniation.

    “Granulation tissue” is essentially inflammation and I can imagine that walking 10 miles within 2 weeks of surgery would “stir things up”. Don’t forget that the nerve is like a cable that moves in a pulley-like mechanism and the repeated motion of walking will create increased inflammation. Starting an oral steroid is the start of appropriate treatment.

    Dr. Corenman

    Codym
    Participant
    Post count: 3

    Thank you for your prompt reply. The oral steroid has helped quite a bit but the pain is still there. If after the oral steroid is finished and I am still in pain, how long should I wait before taking the next step. And what are some next steps? I have been trying to study about granulation tissue and how it might affect my situation. Is it possible that the growth that the MRI showed is a hyper granulation and is pushing on the nerve root? And if so is that something that will go away on its own or would it be best to get it taken out? Thank you very much for your time.

    Donald Corenman, MD, DC
    Moderator
    Post count: 8455

    The next step is an epidural steroid injection or TFESI at the level and side of the surgery. A large epidural mass of granulation tissue takes weeks to months to shrink down.

    Dr. Corenman

    Codym
    Participant
    Post count: 3

    Thank you again for the response. If I don’t want to wait that long would a surgery to take out the mass more than likely fix the situation? Thanks

    Donald Corenman, MD, DC
    Moderator
    Post count: 8455

    Without a frank reherniation, surgery is not indicated at this point.

    Dr. Corenman

Viewing 6 posts - 1 through 6 (of 6 total)
  • You must be logged in to reply to this topic.