[dorisk]

#7790

I have a herniated L5-S1 with compression and displacement of the S1 S2 nerve. have had 4 weeks of PT with minimal relief. Thinking of having a discectomy. Am afraid of epidural injection because I’m told that will cause pain due to the added pressure on the nerve. Night time is the worst. Have been wearing a back brace which does help. Taking Neurontin 600mgs daily and Aleve. I have a few questions. 1. if I have the surgery will it keep this from happening again? 2. how soon would I be able to fly? (my son is graduating from boot camp and I don’t want to miss it) It would be from NY to Texas. 3. If I don’t have the surgery will the herniation cause permanent nerve damage? 4. If I hold off for several weeks am I causing harm? and lastly 5. why is the pain so bad at night after getting only a few hours of sleep. Thank you for any information you can share with me.

[Donald Corenman, MD, DC]

#7794

Do not fear an epidural injection if performed by a skilled and experienced injectionist. Yes- I have talked to patients who have had painful injections but these typically are performed more likely by impatient injectionists. If the injection fluid is “pushed” quickly into a site, there is a large pressure wave which can cause pain but if the fluid is slowly introduced and allowed to follow its own path, there should be little or no pain.

Surgery will not guarantee that the herniation will not recur but even without surgery, it can recur with about a 10% rate.
You can typically fly within 4-5 days of this type of surgery.
If there is no significant motor weakness, the chance of permanent nerve injury is low. Waiting several weeks (without motor weakness) is standard of care and generally nothing to worry about.
Pain can increase from a disc herniation at night as the herniation material will absorb water at night which makes the nerve compression greater.

Dr. Corenman

[Author]

Posts