[deritis]

#9930

Hi Dr., I’m currently taking a 6-day prednisone pack. Results have been good, but as I taper off my symptoms seem to return. There is a clear effect for a few hours or more after taking one, but as I take fewer of them, I experience more symptoms. Not as bad as pre-op, which was explosive pain on rising that hit level 10. I am nearly 6 weeks post-op. My current symptoms have been present for nearly two weeks. Those are a continuous ache in my right buttocks, rear thigh, and occasionally my knee and rear calf. Level 5-7. These symptoms began the day after a more intense gym session. Prednisone can bring it down to a 2-3. Although I’m not taking Advil, when I do it can work even better. The pain is there whether I sit, stand or walk. No position seems to relieve it or make it worse, though the pain does recede a little after a few minutes settling into a new position. Certain stretch positions hurt more as well. Does this sound more like a reherniation or an inflamed nerve?

[deritis]

#9938

Quick update, and very very curious about this. I finished my prednisone pack, which helped some. But as the dosage tapered, my pain returned. Now off the prednisone pack, I woke up with pretty bad leg and buttock pain this morning. Two advil have pretty much cleared it up. Still there, but only if I stretch to feel it. If this problem were a reherniation, would it be so easily treated with just two advil? It’s been two weeks of straight sciatic pain as of today, after about 3-4 weeks of milder, and diminishing, pain following a MicroD at L5/S1. I am hoping that maybe this indicates an unusually long flare up after the nerve had been trapped for 3 months pre-op. Thank you for your opinion.

[Donald Corenman, MD, DC]

#9957

Some nerves can remain “persnickety” for up to six months and there are always some mild “ghost symptoms” that can occur for up to two years. Your pain that is so easily removed with Advil does not necessarily remove the possibility of a recurrent herniation but is a good sign.

You could continue on the Advil if you can tolerate it and have no adverse effects. If you can function on a day to day basis with this medication, then you can give the nerve more time to heal.

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.

[deritis]

#9961

Thank you Dr. One final question. My surgeon and I both feel confident it is a reherniation, albeit with symptoms less severe than the original herniation. Advil does help a lot (2-4 per day). I don’t believe, based on my current symptons, that a second surgery is necessary. Are the odds with this reherniation the same as an initial herniation — that is, the majority tend to resolve themselves over the course of several months? With PT, epidurals and/or OTC medications such as advil.

[Donald Corenman, MD, DC]

#9963

A recurrent herniation should be treated just like any other new first herniation. Time is your friend as time can shrink down the volume of the herniation if the symptoms are livable. PT, epidurals and medications are the mainstay of treatment.

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.

[deritis]

#9978

Hi Dr.,
The MRI results are in and they are surprising – no recurrent herniation. Here is the text:

“At L5-S1 postsurgical change is seen status post right laminotomy. Extensive epidural enhancement is seen on the right surrounding the L5 and S1 nerve roots. No residual or recurrent disc fragment is seen. A single enhancing nerve root is seen in the cauda equina without clumping. Epidural enhancement surrounding the right L5 and S1 nerve root status post right laminotomy consistent with scarring. No evidence for residual or recurrent disc.”

Does this mean the nerve root is being compressed by scar tissue? Or does this mean the nerve is just inflamed? Or does it mean the general area around the nerve is swollen? What does this mean in terms of recovery? Thank you again for all of your help.

[Author]

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