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  • AvatarBattista85
    Participant
    Post count: 12

    Hello Dr. Corenman,

    Forgive me cause I’m not too good with all the medical jargon. I’m now roughly 11 days post microdiscectomy on the L5-S1 lumbar. I had extreme sciatica pain for roughly 2 months before the procedure and then roughly 2 weeks before the procedure the pain dissipated but I had a lot of numbness, especially in the foot and buttocks, and I was unable to do a single calf raise on the effected leg. Since the surgery, I still have the same numbness and weakness but now I seem to have some pain along the nerve again as well.

    I was nervous that I possibly reherniated again so I went back to my surgeon, who did the straight leg test with me (negative) and figured it was just residual pain from the irritated nerve. He put me on steroids for 6 days (now 2 days in) to see if that helps calm the nerve. In my infinite boredom between walks and laying around doing nothing I read about the slump test, something he did not do. I attempted to do it myself with the help with my wife and sure enough I got pain along the nerve. I haven’t spoken to my surgeon about it yet but I’ve been reading your forums for awhile and wanted to see your thoughts. Main question I have, is a slump test post surgery an accurate way to determine if there’s still compression of the nerve/possible reherniation or am I causing myself undue anxiety for no reason?

    Thanks in advance

    AvatarDonald Corenman, MD, DC
    Moderator
    Post count: 7982

    Numbness after a root decompression is very typical and might take as long as 6 months to fade away. Motor weakness may slowly improve but there is a process for recovery. See: https://www.neckandback.com/conditions/peripheral-nerve-anatomy/

    The slump test is really an offshoot of an old meningitis test (Kernig’s) associated with the straight leg raise test (SLR). If the root is irritated (which is still should be in your case at 11 days out), the test will be positive but this is of minimal concern. The root still is swollen which will generate positive tension signs (positive SLR and Slump)

    If your initial leg pain is 50% better than before surgery and improving, you should give it more time.

    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.
    AvatarBattista85
    Participant
    Post count: 12

    Thank you Doctor. You have put my mind somewhat at ease. I was just nervous because for about two weeks before the procedure all my pain seemed to have vanished and I was just dealing with numbness. Since the procedure, I seem to get pain especially after my walks and it seems a bit more “consistent” when I’m laying flat on my back. Though I will say it’s fairly mild compared to what I dealt with before (if a month before surgery was a 10, this is a more of a 3 or 4). I guess I just freaked out a bit because of not having any more pain in the days leading up to the surgery.

    One other question if you dont mind me asking. I’ve also noticed since my surgery that when I clean my anus I seem to get a slight tingling in my left foot (the sciatica side) Also when I pee (standing up) sometimes I also get that tingling. I have no other issues with bladder or bowel control nor any saddle numbness of any kind but I’m curious why this is as it was not something I had prior to the surgery. Thanks again!

    • This reply was modified 3 weeks ago by AvatarBattista85.
    AvatarDonald Corenman, MD, DC
    Moderator
    Post count: 7982

    I am not worried about peri-anal tingling if there is no numbness in these regions and you have normal control of your bowel and bladder functions.

    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.
    AvatarBattista85
    Participant
    Post count: 12

    Thanks again Doctor.

    One last question (until I think of more I guess). I occasionally get very sharp foot pain (despite the numbness) if I clench my buttocks or move a certain way (doing all I can to not bend, twist and so on). And normally the firmer the mattress or seat I’m in the more I feel a bit of that old sciatica pain (though again comparably mild to what it was before). I haven’t noticed any improvement in the pain since the steroids started (2 days left). I know these things take time but I get so anxious about any pain as I don’t want to think for a second the nerve is still compressed as I know the longer it is the harder it is to come back from. Anyway, thanks again for alleviating most of my concern. I’ve had a lot of surgeries in my time (only 35) but this one has scared me the most because of how much uncertainty there seems to be in the healing process. Your forums have been very helpful

    AvatarDonald Corenman, MD, DC
    Moderator
    Post count: 7982

    You are very concerned about your symptoms even though you have significant improvement of your symptoms (in spite of the disappearance of pain immediately preop). Give yourself 6 weeks and as long as the symptoms don’t escalate, the root needs time to calm down.

    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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