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    Old 01-28-2016, 08:51 PM   #1
    jesfierro
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    Unhappy Hip socket pain and buttocks post spinal fusion ALIF surgery

    I am a 40 year old male that has had two back surgeries. First Surgery February 2014 Lumbar Spine Posterior Discectomy Micro-discectomy on L4 & L5. Surgery failed no improvement. My Second surgery March 2015 Anterior lumbar interbody fusion (alif) surgery on L4, L5, & S1 with cage implants and bone grafts harvested from my own hip bone. I experience sciatica on my right leg and most frequent on left leg ;shooting pain down my right/left hip/buttocks, goes down the back of the leg. The last 3 years left foot numbness. My worst pain is in bed getting up is very painful. Before my ALIF surgery I suffered from sciatica foot numbness and pain in mostly my left le region. After 6 weeks post ALIF surgery or so I started getting pain in my buttock/hip region. This actually started during my physical therapy. At first I was doing water therapy this is when it started. My last day of water therapy I was literally about to go to ER from P.T clinic. From there on it just had gotten worst, no real improvement. I went back for more P.T sessions stretching and other exercises . What Physical Therapist did notice that my hip motion was very limited and not much improved happen during all my sessions about 40 or so. Itís being about 10 months after surgery and 4 months of P.T. and pain on hips doesnít not go away. I have to be careful going up or down stairs. Getting out of bed or moving around in bed itís a battle. I have spoken to my surgeon and he says it will take more time for recovery and possible have to live with this pain as a fact of life. I have also spoke to other doctor s and pretty much same response. Once thing I just found out recently is about Hip Bursitis. I was diagnosed with Arthritis. My surgeon keeps on saying itís my Arthritis causing pain but prior to ALIF surgery I never had this buttocks pain , specially getting in and out bed. I was wondering if anyone has had same symptoms after spinal fusion surgery having Hip Pain From Arthritis or Hip Bursitis?

     
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    Old 01-28-2016, 11:32 PM   #2
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    Re: Hip socket pain and buttocks post spinal fusion ALIF surgery

    Hi

    I was reading your post and it sounds exactly like my own experience. I had a lamy/discetomy in 2013, then ALIF interbody cage fusion on L5 - S1 in march 2015, also. The only difference is my surgeon saw on mri that my L5 nerve root was pinched by scar tissue that developed postop. I was feeling better until about 5weeks into PT and my symptoms are similar to yours. I've been through the ringer though, I was referred to pain management and had 2 different Spinal cord stimulator trials done, the medtronic and then the Nevro, and just last week had the Nevro permanent one placed. I'm about a week post op from that and I'm experiencing complications already. So, maybe giving the Fusion a full year to recover is best before trying out all these other procedures. By the way I'm only 37, so I totally relate. Gave they looked for scar tissue on MRI or CT scan since your pain returned?

     
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    Old 01-29-2016, 10:18 PM   #3
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    Re: Hip socket pain and buttocks post spinal fusion ALIF surgery

    Hello

    All I have had are x-rays. I have seen alternate neurologist and my pain management doctor both say give it more time. Also my family doctor, says might have to live with pain for the rest of my life. Itís depressing at times that I canít even get under my cars to work on or work my honey do list on my house. This is a first I heard about scar tissue creating more problems. This scar was created because of ALIF surgery I assume?
    What complications if I may occurred after Spinal cord stimulators? I ask pain doctor about getting a Neurostimulators for Pain but doctor said to wait more time. I am just experiencing that I'm not getting any better. Plus pain meds really donít do much now, it feels like they stop helping.

     
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    Old 01-30-2016, 02:28 PM   #4
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    Re: Hip socket pain and buttocks post spinal fusion ALIF surgery

    Do not allow anyone to talk you into a neurotransmitter unless and until you have explored all your options pertaining to resolving the issues from surgery. At the very least you would want a new MRI to see what is going on and to see if you are still unstable. I am appalled at how quickly neuro stimulators are being recommended these days! In my mind I link it with the ever-increasing numbers of pain management specialists there are now!

    Implanting spinal cord stimulators is profitable and doctors are encouraging their use much earlier in the process than they used to. Now I hear of them being "offered" instead of surgery and they are almost always presented in a casual way that too often does not explain the potential risks and rate of failures that are higher than most patients realize. They used to be reserved for the "last resort" when absolutely nothing else could be done surgically or using other methods of pain management!
    O
    OK...I am done with that rant.

    Now, do not be discouraged...but get ready to start looking for some answers. It is not unusual to have an adjustment period after a lower lumbar fusion. Developing hip/buttuck issues is really fairly common...and, it can really be made worse or aggravated by too much activity too soon, including physical therapy that is too intense.

    ...more shortly...

     
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    Old 01-30-2016, 02:29 PM   #5
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    Re: Hip socket pain and buttocks post spinal fusion ALIF surgery

    Do not allow anyone to talk you into a neurotransmitter unless and until you have explored all your options pertaining to resolving the issues from surgery. At the very least you would want a new MRI to see what is going on and to see if you are still unstable. I am appalled at how quickly neuro stimulators are being recommended these days! In my mind I link it with the ever-increasing numbers of pain management specialists there are now!

    Implanting spinal cord stimulators is profitable and doctors are encouraging their use much earlier in the process than they used to. Now I hear of them being "offered" instead of surgery and they are almost always presented in a casual way that too often does not explain the potential risks and rate of failures that are higher than most patients realize. They used to be reserved for the "last resort" when absolutely nothing else could be done surgically or using other methods of pain management had all failed.

    OK...I am done with that rant.

    Now, do not be discouraged...but get ready to start looking for some answers. It is not unusual to have an adjustment period after a lower lumbar fusion. Developing hip/buttuck issues is really fairly common...and, it can really be made worse or aggravated by too much activity too soon, including physical therapy that is too intense.

    ...more shortly...

    Last edited by teteri66; 01-30-2016 at 02:31 PM.

     
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    Old 01-30-2016, 02:58 PM   #6
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    Re: Hip socket pain and buttocks post spinal fusion ALIF surgery

    I absolutely agree with the previous reply. MRI is the next step. I have had a total of 5 back surgeries in a little over 2 years. 4 in which have been done in less than 1 year. I tried two scs trials, then the permanent placement on 1/21 this year which will already be removed shortly due to complications. I agree that scs are being pushed way too quickly and without proper waiting times. My fusion is still not completely healed and having 3 more surgeries and 1 more upcoming before a year has past after the fusion in march 2015. At this point i am done. I will accept taking pain meds at this point until my body can fully heal. I was in a rush to get off the narcs because I can not work in my field on them so I allowed these procedures unknowingly of all the risks associated with them. It is ridiculous how some doctors are so quick to cutting and the education on things are nonexistent, at least in my case here. Its ashame because now i have put my body through unnecessary stress and am in a worse spot than before. So, my recommendation is to get the mri done and get a couple opinions from that before being talked into any new surgery. And educate yourself on things because trusting these drs, reps, nurses, insurance companies, etc...isn't always the best. They may not be lying to you, but they nay not be educated enough on all the risks. Especially on the newest scs that was only approved in the US in may of 2015. It sounds great on paper but you just never know.
    Unfortunately, a back injury seems to be a chronic issue so my advice is to decide what route you really want to go with and accept that pain may very well be a permanent condition and how to make the best of it for your life

     
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    Old 01-30-2016, 10:33 PM   #7
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    Thumbs up Re: Hip socket pain and buttocks post spinal fusion ALIF surgery

    Thanks for experiences. I will keep on educating myself other wise might end up worst, "heaven forgive". Another surgery is out the question for me unless life threatening. I just feel that maybe just maybe, I shouldn't of done ALIF surgery. Then again , I had three doctors --first Neurologist, Second Pain doctor and then my surgeon telling me that I needed ALIF surgery. I felt that was the best and appropriate option. Hopefully giving it more time will get a little better. Hope the best for all too.

     
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    Old 01-31-2016, 08:18 AM   #8
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    Re: Hip socket pain and buttocks post spinal fusion ALIF surgery

    Sorry about the delay in writing....life interfered for awhile! As I was saying, it is common to have issues like yours post surgery especially when L5-S1 is fused. Due to anatomical structure, the structure after L5-S1 is the sacrum and sacroiliac joints which have and are designed to have little movement. Suddenly your body wakes up from surgery, after having quite a bit of movement at L4-5 and L5-S1 for 40 years, in your case, and discovers there is no movement! This creates a block of immobility that takes some time to get sorted out...and it is a matter of balance...doing just enough activity to get things engaged without setting off nerve flares and causing additional issues. In my case, it took a good 18 months to resolve the hip pain issues...and to this day I need to remain vigilant and avoid certain activities and positions. But I am mostly pain-free now and able to do most things.

    Believe it or not, you are still healing and recovering from surgery and the fusion may not be complete. I would encourage you to stay optimistic but vigilant, and keep exploring options. It helps to understand a little bit about how the spine, buttocks, pelvis and hip have to all work together in harmony to achieve the results you want. The problem with Western medicine is that the body gets all carved up among different medical specialists...spine surgeons tend to only consider the back and spine but do not like to get too involved in soft tissue, musculature and things that relate like structural alignment and kinesiology. People assume they are developing a hip problem when in reality it is a secondary issue often caused by the cascade of symptoms set off by imbalances after surgery.

    One common problem is that the SI joints become inflamed from the new stress caused by the immovable block that was two movable vertebral segments. This can set off issues in the muscles of the buttocks, piriformis and the gluteus. The piriformis tends to become inflamed which can cause pressure on the sciatic nerve, which is the largest and longest nerve in the human body. It runs underneath the piriformis muscle, But in some people, the nerve runs through the muscle. If the muscle is inflamed it often tugs on the sciatic nerve.

    The piriformis also runs across from the Si joint and attaches over by the hip, which can cause what feels like hip pain when walking...and this has an effect on the hip flexors as well. I personally found that I was not able to go through physical therapy without causing a lot of nerve flare. I began PT and stopped for awhile, then restarted about six times. I found that walking did the most for me until my body kind of caught up, then I would go back to PT for a couple weeks. From about 12 to 16 months I was still having issues and wondering what else to try...but I kept up my routine and finally everything began to work together at about 18 months.

    During this time I went to a bodywork guy who uses acupuncture to warm up the body, and then various techniques to break up focal adhesions, to get lax muscles firing again, to realign the fascia...which is a very interesting topic that many surgeons completely overlook.

    In your case, before you contemplate what else to do, you need to know how the fusion is setting up, and whether you are stable, whether the hardware is in the proper place and has not broken, etc. this is best done with MRI that includes the sacrum and sacroiliac joints. If you feel your surgeon isn't listening to your concerns, take your new MRI and get an evaluation from a different spine surgeon in another practice. You are not seeking to have another surgery, but you need to know what is going on....If you can determine that there is no instability, then you might want to consider or look into some bodywork such as Active Release Techniques (ART) or other manual bodywork.

    Try to remain optimistic and don't waste energy on whether surgery was a mistake. Keep reading and learning and don't be afraid to try different practioners if the ones you have now are not helping. Try eating an anti-inflammatory diet too. Inflammation can be a big issue after surgery and with the various arthritic conditions.

    Good luck.

     
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    Old 02-09-2016, 09:24 AM   #9
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    Re: Hip socket pain and buttocks post spinal fusion ALIF surgery

    I had a fusion L5-S1 1 1/2 yrs ago. It changed my hips so they hurt and I don't get around much (pain). I get the nerve burning down left butt into leg; that's new from surg. I get epidural shots.

     
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    Old 02-09-2016, 12:32 PM   #10
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    Re: Hip socket pain and buttocks post spinal fusion ALIF surgery

    [QUOTE=teteri66;5401924]Sorry about the delay in writing....life interfered for awhile! As I was saying, it is common to have issues like yours post surgery especially when L5-S1 is fused. Due to anatomical structure, the structure after L5-S1 is the sacrum and sacroiliac joints which have and are designed to have little movement. Suddenly your body wakes up from surgery, after having quite a bit of movement at L4-5 and L5-S1 for 40 years, in your case, and discovers there is no movement! This creates a block of immobility that takes some time to get sorted out...and it is a matter of balance...doing just enough activity to get things engaged without setting off nerve flares and causing additional issues. In my case, it took a good 18 months to resolve the hip pain issues...and to this day I need to remain vigilant and avoid certain activities and positions. But I am mostly pain-free now and able to do most things.

    Believe it or not, you are still healing and recovering from surgery and the fusion may not be complete. I would encourage you to stay optimistic but vigilant, and keep exploring options. It helps to understand a little bit about how the spine, buttocks, pelvis and hip have to all work together in harmony to achieve the results you want. The problem with Western medicine is that the body gets all carved up among different medical specialists...spine surgeons tend to only consider the back and spine but do not like to get too involved in soft tissue, musculature and things that relate like structural alignment and kinesiology. People assume they are developing a hip problem when in reality it is a secondary issue often caused by the cascade of symptoms set off by imbalances after surgery.

    One common problem is that the SI joints become inflamed from the new stress caused by the immovable block that was two movable vertebral segments. This can set off issues in the muscles of the buttocks, piriformis and the gluteus. The piriformis tends to become inflamed which can cause pressure on the sciatic nerve, which is the largest and longest nerve in the human body. It runs underneath the piriformis muscle, But in some people, the nerve runs through the muscle. If the muscle is inflamed it often tugs on the sciatic nerve.

    The piriformis also runs across from the Si joint and attaches over by the hip, which can cause what feels like hip pain when walking...and this has an effect on the hip flexors as well. I personally found that I was not able to go through physical therapy without causing a lot of nerve flare. I began PT and stopped for awhile, then restarted about six times. I found that walking did the most for me until my body kind of caught up, then I would go back to PT for a couple weeks. From about 12 to 16 months I was still having issues and wondering what else to try...but I kept up my routine and finally everything began to work together at about 18 months.

    During this time I went to a bodywork guy who uses acupuncture to warm up the body, and then various techniques to break up focal adhesions, to get lax muscles firing again, to realign the fascia...which is a very interesting topic that many surgeons completely overlook.

    In your case, before you contemplate what else to do, you need to know how the fusion is setting up, and whether you are stable, whether the hardware is in the proper place and has not broken, etc. this is best done with MRI that includes the sacrum and sacroiliac joints. If you feel your surgeon isn't listening to your concerns, take your new MRI and get an evaluation from a different spine surgeon in another practice. You are not seeking to have another surgery, but you need to know what is going on....If you can determine that there is no instability, then you might want to consider or look into some bodywork such as Active Release Techniques (ART) or other manual bodywork.

    Try to remain optimistic and don't waste energy on whether surgery was a mistake. Keep reading and learning and don't be afraid to try different practioners if the ones you have now are not helping. Try eating an anti-inflammatory diet too. Inflammation can be a big issue after surgery and with the various arthritic conditions.

    Good luck.[/QUOTE]

    Not to interfere with this post but i wanted to let you know that you give extremely important information to us that are going through this recovery. I enjoy reading your responses to different questions regarding this topic. I am almost a year post op and have been through the ringer now with experimenting with different medications and trialing scs, and now have a permanent one in that can't be activated due to complications. I definitely have learned from you and appreciate your input.

     
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    Old 02-17-2016, 06:17 AM   #11
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    Re: Hip socket pain and buttocks post spinal fusion ALIF surgery

    I had the same procedure L4/L5 follow by a fusion with hardware. My fusion was done about 6 weeks ago. I am also having pain with getting out of bed. I just associated the pain with the healing process.

    I just had my second post op visit with Doctor to go over my post op XRay. My doctor said that everything was good. However the hospital that took my XRay is right across the street from my doctor office, so I went there to get a copy of the XRay report.

    The report had stated "There is incidental bilateral hip degenerative changes". This is something new. My doctor never told me this and I would not have known if I didn't get a copy of the XRay report.

    I had a pre op XRay with the same views and there was nothing noted about hip degenerative.

     
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    Old 07-03-2017, 07:47 AM   #12
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    Re: Hip socket pain and buttocks post spinal fusion ALIF surgery

    [QUOTE=teteri66;5401924]Sorry about the delay in writing....life interfered for awhile! As I was saying, it is common to have issues like yours post surgery especially when L5-S1 is fused. Due to anatomical structure, the structure after L5-S1 is the sacrum and sacroiliac joints which have and are designed to have little movement. Suddenly your body wakes up from surgery, after having quite a bit of movement at L4-5 and L5-S1 for 40 years, in your case, and discovers there is no movement! This creates a block of immobility that takes some time to get sorted out...and it is a matter of balance...doing just enough activity to get things engaged without setting off nerve flares and causing additional issues. In my case, it took a good 18 months to resolve the hip pain issues...and to this day I need to remain vigilant and avoid certain activities and positions. But I am mostly pain-free now and able to do most things.

    Believe it or not, you are still healing and recovering from surgery and the fusion may not be complete. I would encourage you to stay optimistic but vigilant, and keep exploring options. It helps to understand a little bit about how the spine, buttocks, pelvis and hip have to all work together in harmony to achieve the results you want. The problem with Western medicine is that the body gets all carved up among different medical specialists...spine surgeons tend to only consider the back and spine but do not like to get too involved in soft tissue, musculature and things that relate like structural alignment and kinesiology. People assume they are developing a hip problem when in reality it is a secondary issue often caused by the cascade of symptoms set off by imbalances after surgery.

    One common problem is that the SI joints become inflamed from the new stress caused by the immovable block that was two movable vertebral segments. This can set off issues in the muscles of the buttocks, piriformis and the gluteus. The piriformis tends to become inflamed which can cause pressure on the sciatic nerve, which is the largest and longest nerve in the human body. It runs underneath the piriformis muscle, But in some people, the nerve runs through the muscle. If the muscle is inflamed it often tugs on the sciatic nerve.

    The piriformis also runs across from the Si joint and attaches over by the hip, which can cause what feels like hip pain when walking...and this has an effect on the hip flexors as well. I personally found that I was not able to go through physical therapy without causing a lot of nerve flare. I began PT and stopped for awhile, then restarted about six times. I found that walking did the most for me until my body kind of caught up, then I would go back to PT for a couple weeks. From about 12 to 16 months I was still having issues and wondering what else to try...but I kept up my routine and finally everything began to work together at about 18 months.

    During this time I went to a bodywork guy who uses acupuncture to warm up the body, and then various techniques to break up focal adhesions, to get lax muscles firing again, to realign the fascia...which is a very interesting topic that many surgeons completely overlook.

    In your case, before you contemplate what else to do, you need to know how the fusion is setting up, and whether you are stable, whether the hardware is in the proper place and has not broken, etc. this is best done with MRI that includes the sacrum and sacroiliac joints. If you feel your surgeon isn't listening to your concerns, take your new MRI and get an evaluation from a different spine surgeon in another practice. You are not seeking to have another surgery, but you need to know what is going on....If you can determine that there is no instability, then you might want to consider or look into some bodywork such as Active Release Techniques (ART) or other manual bodywork.

    Try to remain optimistic and don't waste energy on whether surgery was a mistake. Keep reading and learning and don't be afraid to try different practioners if the ones you have now are not helping. Try eating an anti-inflammatory diet too. Inflammation can be a big issue after surgery and with the various arthritic conditions.

    Good luck.[/QUOTE]

     
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    Old 07-03-2017, 08:23 AM   #13
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    Re: Hip socket pain and buttocks post spinal fusion ALIF surgery

    Re: #10 post: Thank you so much for this post. You have provided valuable information. I am only 2 weeks and 3 days in recovery after ALIF for my L5-S1 disc segments. I have had one follow-up with my surgeon (submitting the required X-Ray). He says everything looks good, but I let him know that I was having difficulty sleeping at night due to severe pain in my gluteus (right side) and extending down the back and outside of my leg into my calf/shin, and right foot. I also have a sensation similar to that of stubbing my right toe. My Dr prescribed some nerve pain meds, and sleep aidsbin addition to the muscle Relaxer and narcotic pain meds that I was already prescribed. The narciotic pain meds only seem to take the edge off, as does the muscle Relaxer, but neither were helping me sleep. During the day, when I walk, the pain subsides to something that is somewhat bearable. I get sore after walking, but the pain is manageable. Sitting for periods of more than a couple of hours causes increased pain. At night, the pain increases to the point of interfering with my sleep, and I wake up after about 1 1/2 hour, have to walk around a bit, and am up for an hour or so before I am able to get some sleep. At times, I wake up and cannot get to sleep until the time where I can take another pain med or muscle relaxer. I sleep in a recliner as lying in bed creates more pain in the hip/gluteus area to the level that it prevents me from sleeping. I have arranged for a total of 8-weeks off work, so am hoping that this nerve pain subsides to bearable by then. I am an Engineering, and mostly have desk work, and staff that I manage, but occasionally I do need to do field work. My surgery was needed as my disc at the L5-S1 was completely gone, and was putting pressure on nerves to the point that the pain was keeping me from doing normal recreational activities (tennis, yardwork, skiing, exercise). My right leg was also going numb and at times, sitting was making my leg hurt so that it was affecting my concentration. I am hoping that I made the right decision in having the ALIF surgery, as I was told by my Dr. that in time, I would be able to be active (playing tennis, skiing, hiking, etc.). Again, your post highlighting muscle and nerve interaction after surgery was very helpful.

    Last edited by robaire; 07-03-2017 at 08:25 AM.

     
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    Old 07-03-2017, 08:29 PM   #14
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    Re: Hip socket pain and buttocks post spinal fusion ALIF surgery

    Keep in mind that different surgeons , due to their training and experience, have different restrictions for their patients post surgery. My first surgeon, who did my PLIF at L4-5, didn't believe in the use of back braces and his advice consisted of "if it hurts, don't do it."

    Due to a change in insurance carriers a few years later, I moved to a different spine surgeon who was much, much more conservative with my recovery. I have subsequently learned, his advice is similar to many other spine surgeons. I was restricted from sitting for more than 15 minutes at a time...for the first three months post surgery. The reason for this is because sitting puts about 35% more stress on the discs than other positions. New bone can grow more easily when it isn't having to deal with this stress.

    Also you are probably aggravating the sciatic nerve by sitting so long. Another tip that you may not have been told: you need to take short walks frequently. The reason for this is because walking is the safest way to stretch out spinal nerves. This must be done to keep scar tissue from attaching to a nerve as it forms and fills in during the first twelve weeks post surgery. It is really important that you get up and walk around your house for a couple minutes every hour or two during your waking hours. If you wake up in the night, take a short walk then, too. Pain from scar tissue has ruined many an otherwise successful procedure, so do what you can to help your body. (Oh, and I'm not talking about your incision. These are adhesions that form inside the lumbar area.)

    It is very important that you not tire yourself out. In a few months you can walk for exercise...walk further, take longer strides, worry about pace, etc. for now you are walking for the spinal nerves! Be sure to get lots of rest. It takes energy to grow new bone!

    Try very hard not to aggravate the sciatic nerve. The hip/buttock pain should gradually go away as you get further out from surgery. When you return to work, you should still break up periods of sitting. Stand for awhile, get a desk that goes up and down, for example; walk around your office for a couple minutes every hour or so. Remember to drink lots of fluids. Get plenty of rest.

    Try to get back to sleeping in your bed...using various pillows to support the natural curves of the spine. (Try to sleep on your side.). And finally, be patient. It is not unusual to be tired for 3-6 months...some people say they don't feel like themselves until the one year mark. Twelve weeks is often a turning point for many people.

    So hang in there. Things do get better!

     
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