I had L5-S1 microdiscectomy on 1/24/12 after 5 months of right side pain. I had tried all the other remedies (chiropractor, epidural, physical therapy, narcotics), and nothing worked. Iím 40 and an avid exerciser who was in very good shape prior to all of this. But by the time of my surgery, all I could manage was 30 minutes on the stationary bike.
The surgery went OK. The doctor said there was actually a lot more material compressing the nerve than he had seen in the MRI, so it was a big herniation and the surgery was a necessity.
Now Iím almost 2 weeks out, and although the pain in my leg has dissipated, I definitely donít feel normal. I still get shooting pains down the thigh, especially when I am in the process of sitting down, and also shooting pains (this is embarrassing) when I have a BM. I kind of dread toilet visits. Probably should be taking a softener.
During the day, Iíve been pretty active, walking half a mile to a mile a day on the treadmill. But sometimes I get pain while walking and have to stop. Also, some of the pain has migrated to my hip, which is a new development. Hip pain wasnít a major issue before the surgery.
Iím dreadfully afraid that I may have a re-herniation, but the fact that I can still walk so much more easily is an argument against that, correct? I walked two blocks the other day from my house to a restaurant and felt great.
I realize there are going to be a lot of ups and downs. Iím curious how much I should be walking, and whether itís OK to be sitting long hours at work, as I am.
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Well my microdiscectomy was at L4-5, but to the best of my knowledge...No you should not be sitting for long periods of time like that. At least I wasn't supposed to, nor could I. But that's a whole 'nother ball of wax. And as for walking it is also my understanding shorter amounts and on flat level surfaces several times a day is much better/safer. I think if I were you I would be talking to my surgeon and making sure everything was okay. It probably is, but if you have new/different symptoms, I think you should let him/her know sooner rather than later. But that's just my opinion.
Hopefully nothing has changed or happened and it's just 'healing' pains.
I could have sworn I wrote something yesterday...but since I do not see it, I will post now.
First even though your surgery was "micro" which are sold to the patient as being less invasive with a faster recovery, you are still early in your recovery.
I suspect, based on the fact that you have run marathons, that you are somewhat impatient to get through this period and get back to what you used to consider "normal" activities."
You state that "although the pain in my leg has dissipated, I definitely donít feel normal." You also stated that when the surgeon got in there, he discovered that the herniation was larger and there was more material compressing the nerve. I would like to suggest that with a nerve compression, you will not know what "normal" is for what could be many months. Depending on how long and how badly the nerve was compressed, there can be some residual damage, and/or it may just take a long time to resurrect itself.
So, your expectations may be on a somewhat accelerated timeline than reality.
Second, I went back and read through some of your older threads before surgery had been decided upon. At that time you had two discs that were bulging, so I am wondering about the possibility that the L4-L5 segment may be still be a pain generator??
Usually after a lumbar surgery the patient is advised to not sit for more than about 15-20 minutes at a time. Are you able to get up and take a brief walk around at least once every 45 minutes? It doesn't need to be far...just something to change position and stretch out the nerves a bit. Sitting puts 30% more pressure on the discs than either standing/walking or lying down.
Also, the use of a treadmill is somewhat controversial in that some surgeons will not allow their patients to use them until months into recovery (if then).
At the very least, I would suggest you back off the exercise a bit to see if it helps to alleviate your pain. Use a gel back or ice for pain and after exercise.
That nerve that was compressed was probably man-handled to some extent during surgery. It is angry and the least bit of irritation may be causing some swelling. It is hard to heal and recover from any L5-S1 surgery because it is so difficult to gradually resume activity without aggravating the sciatic nerve.
The piriformis runs across the buttock from the sacrum over to its attachment by the side of the hip. I have found that it is very easy to irritate this muscle. If there is any inflammation, it can press on the sciatic nerve which runs right under the piriformis. Also the nerves at the L5-S1 are fairly tightly packed into a small area and since that lower cauda equina controls sensation and function of bowel and bladder, and feeds into the genitals and groin area as well as branching off into the two sciatic nerves that run down the back of the leg, it is understandable that a patient might have pain and issues in any of these areas both pre and post surgery...like pain when sitting, passing a BM, etc. This is all very normal.
I would suggest you break up your walks into a number of shorter walks each day, get up every so often when sitting at work, avoid all the bending and twisting at the waist, reaching up overhead or to the side (move to the object rather than leaning over or stretching to reach it), and pay attention to whatever weight restrictions you may have for lifting or carrying....you should start to feel better soon.
One thing I always tell people who are new to spine surgery is that the first thing they need to do is develop patience. Recovery always takes longer than the surgeon has suggested, and as we, the patients, feel it should take. Particularly with disc surgery, you can cause yourself a lot of grief if you don't take all these instructions very seriously, particularly early in the game.
Keep in mind that regardless of what time frames you have heard about how quickly you can return to work, to exercise, etc., it takes the disc a good six months to "scab" over and toughen up.
If you have any major concerns, call your surgeon's office. They expect to hear from recent surgical patients!!
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Thank you both for the helpful replies! I'm seeing the surgeon's assistant today and will ask her about the treadmill. I hope it's OK, because it's so convenient. I have one in my basement. And it's too damn cold in this part of the country to walk outside until April at the earliest.
I'm also reading this threat with great interest. I'm now 12 weeks post op and have mild sciatica (not the paralising sciatica I used to have), but it's more constant. The pain is moving around all the time and I feel a lot of aching in my back especially after sitting. I feel lumps along my spine and tightness in my muscles that I'm trying to push out. The physio can find some sweet points in my back (lower lat area)which when she pushes on them make a feeling I can only describe as a 'nice sore sting' in some of the areas where the pain is. Most of this pain is higher than my op area so I'm hoping I can sort that. I had my op in November and getting outside to walk is a real problem as it's slippy with ice (-1C most of today in northern England) so 30 mins on the treadmill after work is the best I can do. I think I may have overdone it a bit today as I'm especially sore tonight. I've been this way since day 17. All I can say is that I'm struggling every day, but I am having more better days than I was a month ago. I'd love to sit down but I can only get comfy walking or lying down. I was expecting to e back to normal after 6 weeks and keeping positive mentally is tough. Yesterday I felt good about things, today I feel very down. Thanks for your comments Tetonteri66. They make a lot of sense. For the record, I'm a slim, fit, 42 year old.
Totally understand what you're going through: good days/bad days. Good hours/bad hours.
Best thing for me is walking. It's worlds better just two weeks out. It feels so good to walk again not bent over and moaning with pain, and being asked what's wrong by everyone you know.
But for me, the pain seems to come back late at night when I'm going to bed (it was very painful getting into bed last night), and I feel very stiff and sore early in the morning. I always feel better after the ibuprofen and Lyrica kick in, but I'd be glad to get off of those in the near future.
Like you, I've been trying to walk every day. My doctor's assistant told me to keep it around 3 MPH, and treadmills are OK, for 10-15 minutes a few times a day. Fine with me, but I look forward to when I can get back to the elliptical.
Let's keep up this conversation. I enjoy hearing from you, especially since you're so much further on.
I'm 40 and slim, too. I was running 5K races less than a year ago. In fact, I finished fifth in the last one I ran. So this is quite a comedown.
Five weeks out now and I feel like I'm doing worse. I upped the walking over the weekend, and was doing 40 minutes to an hour a day, divided into increments of no more than 30 minutes and always at a slow pace. But the last few days, the sciatica has been definitely back, especially if I don't take my pain medication every four or five hours. I just went six hours without it, and by that time a lot of the same sort of pre-surgery sciatica was running up and down the back of my right leg.
Things are still better than before surgery; I'm not getting shots of electric bolt-like pain, nor are the nerves acting up in a way that makes every position uncomfortable. But even sitting here typing, I can feel the tingling in the back of my right leg, and it hasn't gone away all day. Things definitely feel better when the medication kicks in, but I feel I was doing better over the weekend and have regressed since then.
I left a message for my surgeon saying the leg pain is back. I have an appt. to see him in a week and a half. Should I try to move it up? Does this sound like a re-herniation, or could it be another issue like scar tissue from the surgery wrapping around the spinal nerve?
This message is for Smithio, although it is also for everyone. I had a microdiscetomy 11 wks. ago (12/13/11) on L5-SI, and have been searching for someone at my stage of recovery to compare notes with. My neurosurgeon told me that he removed only fragments (hitting the SI nerve), but did not touch the disc itself.
My recovery was good the first 3-4 wks, pain was gone, walking every day; I started PT, but that made things worse. Now I am just achy, and try to live normally, but the achiness persists. 1 Advil or Excedrin back and body works to relieve the achiness, but I get cranky and tired if I try to do without some relief. My question is how long does this achiness persist? I'm going to swim when I feel comfortable, but I keep putting it off, because I'm afraid of making things worse. I could go back to PT, but right now I do isometric exercises and stretch the hamstring and quadriceps muscles. Anybody have any further suggestions? I'm a female in late sixties, in good physical condition. I love to swim, walk, play golf, but right now walking is the only thing I feel comfortable with. Anybody who can give some advice, I'd love to hear from you.
Danimal~ From your description of your symptoms, I think it is safe to wait to see your surgeon without moving up the appointment. You probably just did a bit too much and caused a flare which will take awhile to settle back down.
It is quite normal to have ups and downs as you recover. Things rarely just go on a smooth even keel trajectory toward complete recovery.
You might want to cut back on your walking for a couple days to see if that resolves the increase in pain. You may have caused a bit of inflammation. I would suggest you try using ice or a cold gel pack when uncomfortable.
Location: San Francisco, California, United States
Re: Two weeks post-microdiscectomy questions
I am post-fusion from Dec 6, and this response is to danimal and arlenebt. I was trying to walk 40 minutes three times per day as recommended by doctor (two hours total!!!) but would get nerve pain/twitching after about 25 minutes, so I cut my walking back. Since cutting back, my leg pain has lessened. I try to use heat before exercise and ice after.
I am also using a stationary bike, sitting straight up, not leaned over. A recumbent bike would work, but cycling should augment, not replace, your walking. I have not been cleared to swim, as the doctor and PT have said that the extension is too great and would stress the back. I was a competitive swimmer for 12 years, so I mean SWIM (1.5 miles pre-surgery, 3/4 times per week). However, I go weekly to hydrotherapy and walk in the water. I think the surgeon will clear me to kick on my back soon. Be sure to check with your doctor before starting a new activity.
I am able to use a certain brand of elliptical trainer after my 3 level fusion...but I didn't start until about 16 months post surgery. I cannot use the machine we own, but there is one at the sports club that I can use....but, only one. The others have too much action that causes a "shearing" of the hips, which aggravates the sciatic nerves. But hopefully that won't be the case for you!
Location: San Francisco, California, United States
Re: Two weeks post-microdiscectomy questions
No experience with ellipticals. I am by no means a serious cyclist, just keeping my hip moving to keep the synovial fluid happy. My back pain is mostly the muscle spasming, so I find that alternating heat and ice helps. When I said "exercise" earlier, I meant walking and PT exercises. Not anything particularly strenuous or exciting.
Last edited by SweetPeainSF; 02-29-2012 at 07:17 PM.