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Old 01-11-2013, 11:45 AM   #1
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microdisectomy/hemilaminectomy 8 months

Any advice appreciated. I had microdisectomy l5-s1/ hemilaminectomy 8 months ago. Surgery per say went well. I still have sciatica here and there. My main constant issue is the deep deep butt ache as well as the area of the lower right back towards top of hip that just aches all the time. I walk for maybe 15-20 minutes at a time. I would love to go for a longer period but it aches. This has been the one area since surgery that consistently feels weird. I still take small dose of tramadol at night to help with the ache or I would toss and turn all night. Which i'm not happy about. Is this just the way it is or is it still healing?

 
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Old 01-11-2013, 05:23 PM   #2
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Re: microdisectomy/hemilaminectomy 8 months

One would think that by eight months, you would be healed. However, if the nerve or nerves were badly compressed, there can be residual pain for a long time. It can take 1-2 years for nerves to fully recover...sometimes even after that point symptoms can continue to improve.

There is always the possibility that the disc has reherniated or that some instability occurred due to the laminectomy, which can result in nerve pain.

Have you had a recent visit with your surgeon?

Also it is possible that since the surgery you are using your muscles differently...perhaps compensating for some of the pain. You may have some issues with structural alignment or some inflammation -- there is a large muscle that runs across the buttock, the piriformis, that can get irritated during rehab. The sciatic nerve runs directly underneath the piriformis. If there is any inflammation or if the piriformis becomes taut due to a rotated pelvis, it can result in pain in the hip/buttocks and sciatic nerve pain.

Last edited by teteri66; 01-11-2013 at 05:30 PM.

 
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Old 01-11-2013, 08:43 PM   #3
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Re: microdisectomy/hemilaminectomy 8 months

Massage therapy might be good, lots of stretching...wish I knew a lot more to give advice...but learning everyday....best wishes

 
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Old 01-11-2013, 09:25 PM   #4
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Re: microdisectomy/hemilaminectomy 8 months

Teteri66,
The sciatica is 90% better which thrills me. I actually injured my back from doing yoga. I originally went to a chiropractor which said I had piriformis syndrome. Every time he worked on me i could barely walk the next day. Long story short ended up going to a neurosurgeon which said no way do you have piriformis syndrome. Mylegram showed hnp. I have always said since this injury my hip just doesn't feel right.
I did not have pt after surgery because doc doesn't recommend unless you have a fusion.

Is the butt and back achiness considered part of nerve irritation?
If instability did occur can this be fixed?
Also, if there are issues with structural alignment how would one diagnose that or fix it?

I have not been back to my surgeon because he intimidates me and his attitude is very arrogant. He is a man of very few words. Also i am leary of having anybody start poking and prodding because i know it will stir things up.

Thank you so much for your advice.

Last edited by omc1234; 01-11-2013 at 09:27 PM.

 
Old 01-11-2013, 10:28 PM   #5
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Re: microdisectomy/hemilaminectomy 8 months

You may not have "piriformis syndrome" but the muscle could still be tight and pulling a bit on the sciatic nerve. Yes, people often have continued achiness and pain after this type of surgery, particularly if the nerve has been irritated or compressed. Sometimes, depending on how the disc is damaged, it can leak a chemical that is irritating to the nerve...this would occur prior to surgery of course, but the nerve could still be irritated. Nerves are incredibly fussy and it takes little to get them riled up.

Someone like a PT that specializes in orthopedic issues, someone who does bodywork, perhaps a trainer, chiropractor could advise you on structural alignment. Take a good look at your feet to see if you have a pronation. This causes the legs to rotate inward which causes a tilt to the pelvis, which causes problems with the spine. If you suspect this may be a problem, it is worth getting professional orthotics, as good structural alignment begins with the feet.

I just wrote a long post to another member about hip pain often being associated with a herniated disc at L4-L5 or L5-S1. I know several people, including my mother-in-law, who were under the impression they had a problem with a hip...either arthritis, bursitis or similar...and in every case it was referred nerve pain for a herniated lower lumbar disc. My MIL had a x-ray of her hip and of course it showed some arthritis...so the doctor gave her a steroid injection. But the pain continued. I visited her after I'd had a fusion at L4-L5 and when she described her symptoms, I suggested she get her spine checked out. A couple months later, she ended up with a matching fusion! After she recovered from the surgery, she noticed her hip pain was gone.

If it turned out you were unstable, it might require a fusion to create stability. Have you had a flexion/extension x-ray to check for spondylolisthesis?

Did you read the article that appeared in the New York Times about six months ago on the number of people that are injured doing yoga?

I would suggest you begin using heat and ice on a regular basis for a couple weeks to see if it will get rid of your remaining pain. You'll have to experiment to see what makes you feel better. I imagine you have some inflammation going on. As one feels better it is a natural reaction to pick up the activity level, often more than the body is used to...and it results in inflammation in the tissue around the area where it was "altered."

Just keep walking and try not to worry. I think you'll see that eventually this pain will gradually fade away.

 
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Old 01-27-2013, 04:38 PM   #6
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Re: microdisectomy/hemilaminectomy 8 months

Only five weeks out from l5/s1 discectomu but I would recommend self myofascial release with a tennis ball and foam roller on tense muscles. Since working out knots in my calf and foot and leg Ive personally seen GREAT improvement in my residual muscle soreness. My nerve was compressed for about six months.
The technique itself hurts but the results that followed for me were great. The tennis ball on my tight glute trigger poi at ESP where the piriformis is located has improved.

 
Old 01-29-2013, 04:39 PM   #7
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Re: microdisectomy/hemilaminectomy 8 months

Hi, glad to meet someone with the same achiness I have after microdiscectomy in Dec. 2011. I get achiness every day, of varying degree, and position in my butt. Sometimes its more focused in the disc area; other days, it's all over achiness in my butt. I know walking doesn't make it worse, so that's what I do nearly every day, for about 30-45 minutes. Today I signed up at a nearby gym to try swimming, and will be evaluated by a trainer tomorrow. I can back out of the contract within 10 days; it's worth a try. Don't take pain medication. Achiness is annoying but not terrible. Lying down for 1/2 hr. helps a lot.

I wonder if any of the more senior, experienced members on this board know whether they can tell if this achiness is due to muscle or is it the disc. Can you treat muscle with the right amount and type of exercise? Probably cannot change if it's not disc. I'm not ready to go back to the neurosurgeon without trying any other ideas first. Comments are greatly appreciated, if this sounds familiar.

 
Old 01-29-2013, 08:50 PM   #8
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Re: microdisectomy/hemilaminectomy 8 months

Arlenebt,
You described how I feel much of the time. My frustration comes from wondering if this is normal and will eventually go away or is this just the way it is. Also trying to know what exercises i should be doing. If any at all. I'm with you my best position is lying down. Helps to alleviate much of the symptoms. Sitting is absolutely the worst. Good luck on the swimming.

 
Old 01-30-2013, 08:56 AM   #9
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Re: microdisectomy/hemilaminectomy 8 months

OMC1234, everything you've written sounds exactly like me, so we need to keep in touch, including the desire to know what, if anything, can make the achiness better. I will post tomorrow, after I go the gym this afternoon and have an evaluation by a trainer. Then hopefully, I will swim a little. Tomorrow I will tell you what he said, and how I feel the next day. The only exercise that works so far is walking. And remember, my surgery was 13 months ago, but I can say it's better than it was in the summer. Otherwise I wouldn't be even thinking about joining the gym. I agree with you that sitting for more than 20 minutes makes it worse. Changing position helps. But how long does this go on? Indefinitely? Anyone out there with this experience? I know many of you have far worse problems, but OMC1234 and I have an annoying problem that limits what we can do.

 
Old 01-31-2013, 09:04 AM   #10
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Re: microdisectomy/hemilaminectomy 8 months

[QUOTE=arlenebt;5125235]OMC1234, everything you've written sounds exactly like me, so we need to keep in touch, including the desire to know what, if anything, can make the achiness better. I will post tomorrow, after I go the gym this afternoon and have an evaluation by a trainer. Then hopefully, I will swim a little. Tomorrow I will tell you what he said, and how I feel the next day. The only exercise that works so far is walking. And remember, my surgery was 13 months ago, but I can say it's better than it was in the summer. Otherwise I wouldn't be even thinking about joining the gym. I agree with you that sitting for more than 20 minutes makes it worse. Changing position helps. But how long does this go on? Indefinitely? Anyone out there with this experience? I know many of you have far worse problems, but OMC1234 and I have an annoying problem that limits what we can do.[/QUOTE]

I have had the same sharp pain in the upper butt where it meets the lower back for 7 years. It bothers me most after sitting or after a high level of activity, such as vigorous walking or tennis. I had a synovial cyst removal 2 months ago which got rid of sciatica down the leg, but the pain in the lower back was there 6 years before the cyst formed and may always be there. I find it frustrating because it is unidentified, so I don't know how active I should be. I may go for some diagnostic tests to make sure nothing else is putting any pressure on a sciatic nerve root. I also have a bone spur and a slight foraminal herniation at L5-S1, so that could be the issue, or it could be piriformis syndrome. Or it could be residual nerve root irritation after my surgery. Who knows. Back problems are so hard to diagnose.

 
Old 01-31-2013, 05:05 PM   #11
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Re: microdisectomy/hemilaminectomy 8 months

So glad to hear from others with this type of achiness/pain. Went to the gym for an evaluation, and the trainer (who had back surgery on L4-L5) had me do Pilates type exercises as follows: pelvic tilt, bridges, planks, child's pose (in child's pose, you get better stretch with your knees apart), airplane (balance on 1 foot and the other arm while kneeling on a mat), and back roll from side to side--bring knees up with neutral spine and slowly roll from one side to the other, not twisting, but rolling to each side. Knees should be close and you let your upper foot lift off the floor as you roll to the side. After exercises I felt good, but achiness got worse later in the day. Today, the following day, achy back feels a lot better..very mild ache...so I will repeat these exercises. She said to do these exercises very day. They are to strengthen the abs muscles, which helps to support the back muscles. Also, you can do a form of acupressure on yourself. Get a tennis ball or a firm, but flexible rubber ball (not a baseball). Lay on your back and put it under your lower back, and gently roll back and forth over the ball. It loosens tight muscles. Move the ball from one side to the other. Also you can do this standing against the wall, to release muscle tension in the shoulders. Press or lean as heavily as you are comfortable with. Hope this helps. I will watch this board and post if this really helps.

 
Old 01-31-2013, 05:53 PM   #12
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Re: microdisectomy/hemilaminectomy 8 months

Be careful, because my personal experience is that physical therapists or trainers can't feel exactly where your pain is, so sometimes they wanted me to do exercises that irritated the area. The wrong move could make my back ache the next day. I learned especially not to do anything involving twisting the spine. I also found every other day with most of the exercises gave me the same strengthening effect without as much irritation.

 
Old 02-01-2013, 08:23 AM   #13
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Re: microdisectomy/hemilaminectomy 8 months

Agree with you that every other day is best with Pilates exercises, rather than twice a day that the trainer recommended. At least until the constant achiness improves. On the other day, I just walk, since that doesn't irritate anything. Also agree that twisting is potentially looking for trouble. I really want to get back to golf, but I'll be patient. Regarding the session with the trainer, she pointed out that I should be keeping the abs engaged (tighten) more than I was doing, even when walking. Has anyone else been told that?

 
Old 02-02-2013, 11:16 PM   #14
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Re: microdisectomy/hemilaminectomy 8 months

[QUOTE=omc1234;5115911]Teteri66,
The sciatica is 90% better which thrills me. I actually injured my back from doing yoga. I originally went to a chiropractor which said I had piriformis syndrome. Every time he worked on me i could barely walk the next day. Long story short ended up going to a neurosurgeon which said no way do you have piriformis syndrome. Mylegram showed hnp. I have always said since this injury my hip just doesn't feel right.
I did not have pt after surgery because doc doesn't recommend unless you have a fusion.

Is the butt and back achiness considered part of nerve irritation?
If instability did occur can this be fixed?
Also, if there are issues with structural alignment how would one diagnose that or fix it?

I have not been back to my surgeon because he intimidates me and his attitude is very arrogant. He is a man of very few words. Also i am leary of having anybody start poking and prodding because i know it will stir things up.

Thank you so much for your advice.[/QUOTE]

 
Old 02-02-2013, 11:23 PM   #15
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Re: microdisectomy/hemilaminectomy 8 months

I understand your resistance to revisit your surgeon. For some reason, once they have done the surgery they feel that what they have done should cure you of whatever it is that was wrong. They DO NOT LIKE the idea that their surgery was not good enough to cure what is wrong with you. I went round and round with my spine surgeon when he did my fusions and he repeatedly told me there was no reason for me to be in pain (he was wrong). A lot of these doctors think they can do no wrong and their abilities are only outweighed by their arrogance. After they do your surgery they feel they are done with you. They have your money (and that of your insurance company) and that's enough for them. Definitely get more opinions and don't go back to your surgeon after he has done your surgery (except for 2-3 times)! PS-You are, however, lucky to only have this pain after surgery. Some people are not as lucky, trust me!

Last edited by fmgal; 02-02-2013 at 11:35 PM. Reason: PS

 
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