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  • post op pain after discectomy with prolonged standing/sitting

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    Old 08-27-2011, 08:36 AM   #1
    ohmyback39
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    post op pain after discectomy with prolonged standing/sitting

    I have been reading these boards for a few days, trying to find some answers. I had a discectomy and laminectomy on June 23 '11 on L4/5 due to a herniated disc that had broken off down into my spinal canal causing 60% spinal stenosis. (This being my second surgery of this type. The first one was in 1997 (on L4/5 and L5/S1) with similar presenting symptoms, leg pain (both) and I had tried pt, injections, tens, etc and then one morning I woke up and couldn't go to the bathroom, so I had to have open back surgery and was doing fairly well until last July, when the back pain and leg pain started up again.

    This latest one, once my toes started going numb, I decided it was time to do it again. (and this was after months and months of injections, pt and medication. which towards the end the pain meds didnt even touch the pain...ice was my ONLY friend)

    SO, at my 6 week post op appt, I got my 17 staples removed and was able to tell the dr that I was in little/no pain...(was off the pain meds at 3 weeks post op) At that point, my ability to stand/sit without pain was about 20 minutes.

    THEN, I decided I had been cooped up too long and decided to go with my family to a local amusement park (yeh, stupid...I know). And although I didn't ride any rides that were jarring, I did do a LOT of standing/walking around and by the end of the day (and a lot of pain meds) I was in SO MUCH PAIN. No leg pain, just back pain...kicking myself for having pushed myself that far.

    (I also started physical therapy around this time and am wondering if this is helping or hurting, due to the increase in pain.)

    2 weeks after that, my threshold for standing/sitting without pain is no longer 20 minutes, but 10 minutes if lucky, especially for standing. I am hoping I just inflamed those muscles vs something more serious.

    Just wondering if anyone has experienced similar? increased pain after surgery after a brief period of little/no pain experienced previously, post op? Is this normal? Just par for the course? Dr had said full healing is usually seen at 6 months and I am just barely 2 months post op.

    (Dr had originally told me that I could be back on my bicycle 4 weeks post op...I could of sworn I had told him it was a road bike vs stationary...but apparently there was a miscommunication...although this was by far a better surgery recovery from the first one...but its hard to pace SLOW, when I have so much to DO )

    Any feedback would be appreciated.

     
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    Old 08-27-2011, 02:46 PM   #2
    teteri66
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    Re: post op pain after discectomy with prolonged standing/sitting

    Welcome to the board. It sounds from your post that you already know the answer to your questions. I'm going to try to respond without sounding like a scold, but I know I will fail, so I apologize ahead of time.

    Sometimes doctors give their patients more credit for using common sense than they should. They don't lay out every single situation a post-operative spine patient should avoid...but just because the surgeon doesn't mention something specifically, it doesn't mean it's necessarily OK so soon after a big surgery.

    A procedure like a discectomy "can" be a relatively straight-forward procedure, but there are many reasons why a patient does not want to repeat having it done over and over. Every time the back is cut open, more scar tissue forms. There is increased chance of the patient developing arachnoiditis or a chronic pain syndrom such as RSD (now called CRPS, chroic regional pain syndrome), infection, etc. and of course, the disc itself will simply not withstand any more and the patient has to move up to a much more invasive surgery like a fusion.

    Do you understand why it might not be a good idea to do activities that jostle your spine so soon after surgery? Many surgeons don't even want their patients riding in cars for six to eight weeks after surgery. Once the body really has a chance to heal up and recover, the disc can be strong again and withstand quite a bit of stress, but the more times it herniates, the weaker it becomes.

    By doing too much too soon, and doing the wrong things, the patient runs the risk of causing the nerves to become even more irritated and inflamed than they already were prior to surgery and then from the surgical assault. It's one thing to cause some tissue inflammation. That will heal. But if a good flare up gets going with the nerves, it can result in what becomes a chronic state of irritation. The nerve itself can actually become scarred and then it cannot reconnect and function in a normal way...and the patient can be left with permanent nerve damage.

    Sometimes people are so eager to get back to their activities that they don't stop to think of the permanent damage they may be causing themselves that may end up causing them problems for the rest of their lives. Instead of being inconvenienced for a six month time period, they end up dealing with nerve pain into old age. If this discectomy doesn't heal properly, your next step will be a fusion, and I can assure you that is something you'd just as soon avoid.

    Please back off on your activities, try using ice or a gel pack on a regular basis to try to get the inflammation under control and for pain relief, and see if you can't get that pain under control. Then resume walking for your main form of exercise. Walking short distances frequently is the best exercise in the weeks after spine surgery because it stretches out the spinal nerves, brings fresh oxygen to the surgical site and most importantly, it keeps scar tissue from attaching itself to the nerves as it fills in. Hopefully this routine will resolve your pain issues and get you back on the healing track.

    Also, keep in mind that sitting puts 30% more stress on the discs than standing or lying down, so try to limit the amount of time you spend sitting at any one time. If you are careful now, your disc will have an opportunity to heal and toughen up and in a matter of months, you will be able to resume most activities. Try to remember the "big picture" when faced with some of these tempting choices and your back with thank you in the long run.

     
    Old 08-28-2011, 09:31 AM   #3
    sherwoodman
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    Re: post op pain after discectomy with prolonged standing/sitting

    hello and welcome,,,this is a great way to meet ans share with people who r and know what its like to suffer,,with back probs,,,anyway i too am 17days post op..from the same,,and so far doing ok,,,,i too am finding it very hard not to push it..lol but when i think of the pain i was in pre op,,and how this can take a turn for the worse,,i slow down ,,talking and post here also helps ,there r some good and some bad,,but never any bad advice,,though it may be hard,we must remember that feeling good is not being healed,and ready for more,,,teri said it best i have also been told by my doctor,,u may feel great,,but take your time and dont push it,,baby steps ...even when u return to work and other activity/?slow and steady,,baby steps,,like the first walk was not very long,,,u slowly increased it,,approch all that you do this way...anyway hope you feel better,,thanks brian

     
    Old 08-29-2011, 09:27 AM   #4
    ohmyback39
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    Re: post op pain after discectomy with prolonged standing/sitting

    Thanks for the feedback, from Teri and Brian. I had talked to my Dr prior to going to this amusement park and he said it should be fine, provided I didn't go on the more jarring rides. So, I just assumed he was right.

    Its so hard, as I am sure you know, to pace yourself when you feel FINE. I also have MS and so on my GOOD days, I feel like I need to get what I can done, before my BAD days hit.

    I am reading more and more about what I should and shouldn't be doing post-op. Prior to the surgery, I was only trying to read about the actual surgery itself and its outcomes. I have done more sitting than anything and that's probably the worst I could be doing (in a recliner...but still). dumb dumb dumb.

    I feel like my Dr isn't doing so well on the followup, as I have learned more from these boards, than from my visits at the Dr's. No sitting...I thought I was ok on my recliner in a semi-reclined position, but I suppose not. I think I will take Teri's advice (and I appreciate your feedback...even if you were shaking your head at my lack of common sense ) and try to increase my walking to several times a day, at least for the initial first 6 months. I had tried walking previously, but it seemed to increase my pain; however my pt recently told me to set my treadmill at an incline to decrease the impact to my back and that REALLY helps. But I apparently need to do more walking vs sitting and laying down vs sitting (not many things a person can accomplish laying down but I get that I am still healing...just easy to forget when I LOOK fine.) I think my husband has forgotten as well, so this is a good reminder.

    My Dr said no driving for 2 weeks and I just assumed that was because of the 2 percocet 10's every four hours that he had me on + 5mg of valium..According to my husband this cocktail left me rather loopy. Although with my first surgery, I wasn't allowed to drive for 6 weeks...So, I guess I just assumed that surgery outcomes were speedier than the old days. Ok, less assuming and back to educating myself.

    Brian thanks for the reminder that "feeling good is not healed". That is so hard to remember...but now that I am in pain, it will be easier to remember. And I will keep my ice handy.

    Lets hope it all subsides with a little more care and a lot less "doing more". (did I mention, I have LOTS to do...LOL)

    Thanks again,
    Paula

     
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