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  • 5 weeks post-op ACDF muscle spasm

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    Old 04-23-2003, 01:51 PM   #1
    DariusTDog
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    Post 5 weeks post-op ACDF muscle spasm

    Hi all, first post for me. I'm 5 weeks post-op from ACDF C4-5 w/locking plate and allograph (donor bone). I'm back to work full time and found this site, so I decided to post my experience and ask a couple questions.

    First of all, my surgery (3-18-03) went amazingly well. I went to John's Hopkins in Baltimore, MD and have been thoroughly impressed by the entire staff there. I woke up in recovery without a neck brace and haven't used one at all since. My incision site was glued closed (no stitches or steri-strips) and I had a drain below it. I was walking that evening and discharged the next morning at 8AM. I used painkillers for several days, primarily due to very sore trapezius muscles, but managed to get off them within about 1 week. (I had been looking forward to NOT taking painkillers for quite some time!) Of course, I had to deal with a little sleeplessness for several days after stopping, but I expected that (I don't sleep well to begin with). I was walking several miles a day within 1 week of the surgery and feeling really good.

    About 2 weeks post-op, I talked with my surgeons office and got the OK to drive, so I did! That evening I paid for it, though. Just a little soreness from my neck telling me to slow it down a bit. Bounced right back within the next few days, though, felt great. Started back to work after 3 weeks post-op; was able to work 6-7 hours without too much problem. I got kicked out of work a few days later when HR found out I was back since my doctors note said I wouldn't be back for 6 weeks!

    At 3 1/2 weeks post-op I woke up in the middle of the night with a muscle spasm bewteen my should blades that made it painful to move my neck in almost any direction. Talked to the surgeons office and they said it was quite common and suggested muscle relaxers (which I had a hefty supply of) and also said they would fax a release for me to work to my employer. They also said it would be ok to see a massage therapist so long as I told them about the surgery and to stay off the neck. So, I started on Flexeril 3x daily. The spasm subsided a bit, but was still quite noticeable and painful. I saw my massage therapist a couple of times that week and it did help, but the spasm isn't gone quite yet and its starting to remind me of my chronic pain before the surgery (its now 5 weeks post-op).

    Based on some other posts I've read, I'm getting the impression that I may be pushing things a bit harder than maybe I should. Unfortunately I work for a small company and don't really feel comfortable taking any more time off work. I'm back on painkillers to help with sleep for the interim while this muscle spasm is bothering me. Anyone else have similar experiences with muscle spasms following ACDF? Any comments are welcome....

    Tone



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    ACDF C4-5 w/locking plate and allograph
    3-18-2003
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    ACDF C4-5 w/locking plate and allograft
    3-18-2003

     
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    Old 04-23-2003, 02:59 PM   #2
    cnewmann
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    Tone,

    I had my surgery on 3/20/03. It was C6 & C7 with titanium plate and donor bone. I started back to work 6 hours a day this week. I am an accountant and sit in front of a computer all day--(then I get on it here at night.)

    Until I started back to work I was only using tylenol pm to get to sleep at night. Now, I am having to use muscle relaxers because the muscles in my neck and shoulders seem to spasm more. Driving still hurts a bit if I have to do a lot of backing and changing lanes. (Too much turning of the head).

    I think you are just doing too much too soon. I wore a collar for three weeks and couldn't drive for three weeks. I wasn't suppose to even ride in a care but cheated some.

    I stayed home for four full weeks and then went back to work parttime. We seem to be having about the same problems so it must be normal.

    By the way, I had a massage too and I let them massage my neck gently. Hope I didn't do any damage.

    Connie

    ------------------
    ACDF C6 & C 7 with plating and donor bone 3/20/03
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    ACDF C6 & C 7 with plating and donor bone 3/20/03

     
    Old 04-23-2003, 03:13 PM   #3
    DariusTDog
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    Thanks for the post, Connie. To tell the truth, the massage therapist did work on the back of my neck a bit, also. For a second I thought she had completely forgotten that I had just had surgery, and I had to ask her to stop. I don't think we have too much to worry about as far as the massaging goes, though...

    I also work at a computer all day... its odd though, I feel my worst an hour or two into the day and it lasts until a couple hours after lunch... then it isn't quite as bad. Its amazing how much my posture has changed since before the surgery.

    Tone
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    ACDF C4-5 w/locking plate and allograft
    3-18-2003

     
    Old 04-23-2003, 06:19 PM   #4
    DariusTDog
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    Question

    So... five weeks after surgery, how much motion should be allowed in my neck? I can turn my head almost 90 degrees to each side (although the muscle spasms make it hurt when turning to either extreme), I can almost touch my chin to my chest (again with muscle spasm pain), and can extend pretty well also. I don't think I should be pushing the limits of my range of motion at all yet, but I am constantly tempted to stretch the muscles that are in spasm. Does anyone know if there is any pain involved with interfering with the fusion? My surgeon seems to have lots of confidence in the locking plate holding the vertebrae, but I don't really know what the limits are, especially this early on in the process.

    ------------------
    ACDF C4-5 w/locking plate and allograft
    3-18-2003
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    ACDF C4-5 w/locking plate and allograft
    3-18-2003

     
    Old 04-23-2003, 06:31 PM   #5
    BWL
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    Hi Tone,

    Welcome.

    Sounds like you're doing great. I was way to zapped to get back to work and only recently am I able to keep my normal schedule.

    You'll know if you move too much. As my doc told me, when you irritate the site you'll feel it. For me, it aches like it did immediately after surgery when I do too much.

    I waited about 6 weeks before I drove - I also bought a bigger car- how's that for a rationalisation?

    I had a massage three weeks post-op and it irritated my nerves enough to make me uncomfortable for a week. I love deep tissue, but not just yet.

    Remember, there's no harm in taking it easy in the beginning. You can do more for yourself by going slow for a little while. You'll see your range of motion comes back gradually and you'll do more without even realizing it.

    all the best,
    bruce

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    ACDF with plating and donor bone C6-7 (1/29/03)

    [This message has been edited by BWL (edited 04-23-2003).]
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    ACDF with plating and donor bone C6-7 (1/29/03)

     
    Old 04-23-2003, 06:53 PM   #6
    Debbie2
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    Hi Tone and Welcome!
    I too had my surgery at Hopkins, who was your surgeon if I may ask? I did not drive for six weeks, but the doctor said I could when I felt I could move my neck safely and comfortably. I still waited, just because I did not want to try to drive and didn't feel I had the range of motion I needed. Not to mention paranoia! Also I won't up in a philly collar and I was fitted with the Miami J, which I was told to wear a week or two. I wore it two. Wore it in the car for over 2 months, again to be safe... in the car.
    I did not work for six weeks and could have stayed out 8, with the doctor permission. I agree, you did too much too fast... slow down and back up a week or two. I am also at a computer all day long, and doing nothing else much besides...
    So you need to take a step back and slow down a bit. If that means coming home and resting, doing nothing much of anything, than that is what you need to do.
    Just my opinion of course.
    Debbie


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    Debbie2
    ACDF fusion (c5c6) with titanium plate and screws using donor bone -
    September 4, 2002.
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    Debbie2
    ACDF fusion (c5c6) with titanium plate and screws using donor bone -
    September 4, 2002.

     
    Old 04-23-2003, 07:02 PM   #7
    Carla Sue
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    Hi
    I just want to say to you, that there is a possibility that you may not fuse.
    The possibility is small, BUT if you do too much, you are almost trying to not heal.
    this was a bigtime major surgery you had, and it has to heal perfect, RIGHT?
    SO just take it easy ok,find a way to do it.
    and you will feel better every day.

    OH and to answer your question, I didnt really get any spasms until I started reusing muscles that I hadnt used for a long time.
    I can sympothise with you,I would get sick to my stomach from them.
    ALSO I was concerned at different times in my healing that I was feeling pain that felt like pain before my surgery.
    Keep your doctor informed,and if you trust him,and he says you are just feeling healing pains,beleive him and dont worry.


    Hey BWL I also got a bigger car after my surgery.
    I got a minivan.
    I am still afraid to drive too much though,I am afraid of getting in an accident,ALSO when I tried to go in a hot tub even at about 6 months post op,it was horrible.
    VERY aggrevating on my nerves.
    I was very bummed as I was looking for relief.
    Take care and I hope you can get a massage soon.
    Sounds good
    See ya on the boards.

    Carla Sue http://www.healthboards.com/ubb/dance.gif

    ACDF C6-7 11/30/2001
    donor bone with titanium plate and screws


    [This message has been edited by Carla Sue (edited 04-23-2003).]

     
    Old 04-23-2003, 07:18 PM   #8
    Carla Sue
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    Tone
    I just noticed about your computer job,and excess computer nighttime play http://www.healthboards.com/ubb/cool.gif
    My physical therapist had a great suggestion.
    Prop your monitor up on books,or a milk crate,and that way you wont be leaning down with your head and neck,to look down toward your monitor.

    Doing this will help your neck ALOT.
    Bye
    Carla Sue

     
    Old 04-23-2003, 07:19 PM   #9
    winged phantom
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    I know the thought ran through my head before surgery that I was glad I had a huge car: just over 4000 pounds. DH also has a big, heavy car, for which I'm thankful. Funny how inquiring minds run alike! I wanted to plan a trip to (a very crowded, major city very far from here and also in a HOT climate) this summer but could not bring myself to do it, as I did not want to have to put on my hard collar everytime I went outside into a car.

    wr
    __________________
    • 12/29/89 C5-6 Microdiskectomy (no fusion)
    • 4/9/03 ACDF C4-7 with plating and donor bone

     
    Old 04-23-2003, 09:06 PM   #10
    joprud
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    Hi Tone,

    Just wanted to jump in and say Hi and welcome you aboard.

    Take Care,
    Joanne


    ------------------
    • Sept‘63,fall on back on stairs,compression fractures of T6 and T8
    • 1993 X-ray Diagnosed DDD
    • Nov,2002 MRI C4-C5 posterior osteophytic bar effacing ventral thecal sac, stenosis of neural foramina.C5-C6 posterior disc protrusion effacing VTS. Stenosis of neural foramina.C6-C7 posterior disc herniation effacing VTS.stenosis of neural foramina.C7-T1perineural cysts in both neural foramina.left convex scoliosis mid thoracic spine.wedging of T7. wedging of T5.degen.end plate changes at T8-T9. L4-L5 diffuse disc bulge effacing VTS.hypertrophy of facet joints,central spinal stenosis.L5-S1 posterior disc protrusion with associated tear of annulus fibrosis. hypertrophy of facet joints.S1-S2 Perineural cysts involving S1-S2 nerve roots.
    • So far have tried: meds,physio,acupuncture all to no avail.

     
    Old 04-24-2003, 06:48 AM   #11
    DariusTDog
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    Debbie2, I don't mind, my surgeon was Dr. James Campbell. I thought he was terrific, although somewhat difficult to get to see. My rheumatologist was the one who referred me to him, and he said this guy was supposed to be the best. He also warned me that I would have to be persistent to get to see him.

    Carla Sue, thanks for the dose of fear and the computer monitor tip. I have been dealing with neck/shoulder pain for the last 3 years, so I have tried to address any ergonomics that I could, and raising the monitor is definitely a good one.

    Thanks to everyone else for the responses. I think I'll schedule another appointment with my massage therapist...

    T




    ------------------
    ACDF C4-5 w/locking plate and allograft
    3-18-2003
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    ACDF C4-5 w/locking plate and allograft
    3-18-2003

     
    Old 04-24-2003, 01:10 PM   #12
    Carla Sue
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    Wink

    Hey Tone

    You are welcome,
    and ANYTIME! http://www.healthboards.com/ubb/blob_fire.gif


    Carla Sue http://www.healthboards.com/ubb/dance.gif http://www.healthboards.com/ubb/dance.gif http://www.healthboards.com/ubb/dance.gif http://www.healthboards.com/ubb/dance.gif

    [This message has been edited by Carla Sue (edited 04-24-2003).]

     
    Old 04-24-2003, 06:38 PM   #13
    winged phantom
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    Hi Tone... just wanted to say "hi." I think you are overdoing it... just take a few steps back and slow down a bit for a few weeks. I know I'm not looking to drive for about a month, probably, but I know when I do, that my muscles will have to be ready for all that head-turning. Looking up and also looking down (yeah, like at the keyboard.. drat) are both bad at this stage of the game.... at least if done a lot.

    Take care...
    wr

    ------------------
    • 12/29/89 C5-6 Microdiskectomy (no fusion)
    • 4/9/03 ACDF C4-7 with plating and donor bone
    __________________
    • 12/29/89 C5-6 Microdiskectomy (no fusion)
    • 4/9/03 ACDF C4-7 with plating and donor bone

     
    Old 04-24-2003, 08:19 PM   #14
    Niki47
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    Hi there!

    Glad that you are doing so well, and wanted you to know that the muscle spasms are very common.

    I have heard alot of people using Flexerils, and am not sure how differant they are from the Somas I take... but my Somas are working VERY well. I take 1/2 every 4 hours. Perhaps you need to consider a switch???

    Using a rice bag (sock filled with raw rice, popped into microwave for 45 seconds) draped over the shoulder will help bring temporary relief.

    Were you given actual range of motion "exercises"? Just cranking your neck to the 90 degree point is NOT such a good idea. The idea is to turn in each direction, slowly, to the point of least comfort, stop, hold it for a count of five and then return to the starting point. "Reps" like that will do you more good than just the quick, "far as Ya can" stretch.

    Also, make sure that you are not drawing your shoulders UP in a guarding motion. This will help everything tense up. Since you are doing computer work, try to keep an eye on your posture. Rounded shoulders will contribute to the spasms too. Elevating the monitor was a wonderful suggestion! You may even have to play with the height of your chair and your keyboard.

    My physiotherapist did a LOT of massage, so I am not sure who advised you against that. It is QUITE beneficial when done correctly.

    It is all a matter of muscle memory... give your self some time, stay diligent, and you should be good as new soon!

    Good luck and health to you!


     
    Old 04-25-2003, 06:44 PM   #15
    DariusTDog
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    Niki,

    My understanding is that Soma is similar to flexeril, maybe just a bit less potent. I've tried Soma before (way back in the beginning of this ordeal) and it didn't work as well as Valium or Flexeril. For my spasms post surgery, the Flexeril seems to have worked well. They are almost gone and certainly tolerable now.

    The surgeon did not give me any specific range of motion exercises, and I certainly don't want to push the limits. The limits I describes were what I could comfortably reach without pushing it. I will wait until after I visit the NS on May 8th for more information on what I should and shouldn't do.

    I have a natural "head forward" posture which has hindered my disc herniation from resolving itself naturally. I have been paying a great deal of attention to my posture both before and after the surgery. Its amazing how much my posture has actually changed since the surgery, its much more natural for me now to sit straighter, with my shoulders nice and square. I think the collapsing disc made my head forward posture even worse!

    Went to the massage therapist today... it was great! Still some knotty spasms on the edge of my right should blade, but I think with a few more visits and some good rest it will be fine. Now if we could only convince the insurance companies to cover massage therapy! (I haven't found a PT or Chiropractor that does massage quite as well as my massage therapist)

    Hope everyone else is doing well,

    Tone

    ------------------
    ACDF C4-5 w/locking plate and allograft
    3-18-2003
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