curbelojMemberAugust 1, 2013 at 6:26 pmPost count: 1
I had surgery 6 days ago to repair a ruptured disc. Prior to the surgery, I had intermittent pain in my left leg as a symptom. Since the surgery, I’ve been having progressively worse pain in the same leg that increases when lying down and decreases when standing or sitting. What do you recommend as a course of action?
Thank you.Donald Corenman, MD, DCModeratorAugust 1, 2013 at 10:46 pmPost count: 8652
The differential diagnosis of increased leg pain after a microdiscectomy is a recurrent disc herniation, mass effect (hematoma), nerve irritation (the nerve is manipulated during surgery and this could irritate the nerve) and nerve injury (heaver handling of the nerve during surgery).
Since it has been only six days since surgery, an oral steroid would be helpful. If the cause is either irritation of the nerve or hematoma, the nerve symptoms will improve and most likely stay improved with some mild drop off of improvement when the steroid is stopped. The hematoma can resolve (by reabsorption) over time and the nerve irritation will improve over time.
If the pain is from a recurrent disc herniation or from a non-resolving hematoma, the pain will return to the previous level after the steroid is stopped. A new MRI will be necessary and will reveal the compressive mass. If the mass is a hematoma, commonly, an outpatient procedure using aspiration with a needle will resolve the compression. If the mass is a recurrent disc herniation, a new surgery is in order to remove this fragment.
If the pain is from nerve damage, time is needed for some resolution of symptoms.
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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