Microdiscectomy Recovery – Returned Pain Week 5 Post Operation

Brain and nerves
1

Hi Everyone,

I’m a 33 year old, male and I've recently had a microdiscectomy (6.5 weeks ago 21st July 2014) to remove a large L4/L5 herniated disc which was pressing right central on my sciatic nerve. This was causing severe pain in my right buttock, occasionally moving to the left, and pins and needles in my legs. I struggled to sit, drive and for the final couple of weeks before the operation walking had become painful and I would have to rest every 500 metres or so.

I’ve been using this forum over the past several weeks and would like to thank everyone for their contributions which have been extremely useful to assist me (and put me at ease) in my recovery period.

Post operation my recovery was going really well up until week5. Late in week 1 light pain returned in my right buttock, this intensified over weeks 2 and 3. Week 4 the pain significantly reduced and I was feeling really good. Throughout my recovery I have walked every day, building up my distance and I also incorporated swimming into my rehabilitation on week 3. I had been told not to do any Physiotherapy (PT) between the operation and my follow up appointment with my surgeon on the 25th of September (9.5wks post surgery).

So on week 5, I went for an early morning walk, along a flat path. I was well rested and it was my first walk of the day. Pre-walk i felt no pain in my buttock and just a very dull ache remained around my incision area. Approximately 15minutes into the walk I felt a twinge in the right side of my back. I hadn’t slipped or tripped on anything, it just seemed to happen. I immediately sat at the nearest bench to recover and then went home.

The rest of the day I minimised walking as the ache in my back was a little more noticeable, but nothing alarming. The following morning when walking I noticed that the pain returned to my right buttock. This pain intensified as I walked and light glute stretching and priformis stretching intensified this pain. My hamstring on my right outer leg also became very tight when walking. The pain in my lower back was still present but there was also some noticeable swelling of area. I therefore minimise activity but still avoided sitting for periods in excess of 40 minutes.

Although I continued to experience pain when walking, I attended two swimming sessions on the Thursday and Friday of around 20 mins each. These sessions demonstrated that no pain was encountered when kicking, using kick board on front or back. Walking backwards also removed the pain to a degree.

Walking had become extremely painful and I often found that I had to hunch over to recover from the pain in my right buttock, after very short distances, much shorter than pre-operation. On the Saturday and Sunday using a GPS tracker, I undertook several short walks from my house and found that when setting off, I was relatively pain free. As I walked past 100/120metres pain in my right buttock would appear and intensify, this pain spread to my right outer hamstring. At a distance of around 200-220 metres my leg and buttock felt on fire and I could not continue to walk without severe discomfort. I now feel the pain when standing for periods also or sitting down. I find that I am most comfortable lying on my back with my knee slightly bent and my right foot elevated.

I have since been back to the hospital for advice and was tested for Cauda Equina Syndrome. They concluded that I was not at risk and I am therefore waiting to have an MRI scan on the 21st of September (3 weeks from now) and I will then see my surgeon on the 25th as planned originally.

Anyway so that is where I am now. I’m back at home, 6-7 weeks after the operation, in very similar pain I had before the microdisectomy. I’ve decided not to return to work unless the pain lessens.

I’d just like to ask if anyone has had any similar experiences or issues and if so what was the outcome? - It really feels like something is pushing and angering a nerve when I walk and stretch my right foot forward.

To go from week 5 with almost no pain, to week 6 and now 7 with pre-op pain and symptoms is frightening, I’m guessing it could be a re-hernation, but I’m hoping it may be just scar tissue or even just muscular, the area around my wound is still very inflamed, to touch the surrounding area feels like it is swollen and squidgy. There are also small hard lumps assumed to be scar tissue.

Any advice would be most welcome.

Many thanks,

Peter

2

Hi there

imalso had a DISCETOMYApril last year. My symptoms came back but it took me from July to November to get my GP to refer me back to the original consultant/surgeon. Don't let the string u along it hell.

after an MRI, it turns out I had a cyst on my spine growing and inflammation down both sides of spine.

end result I have now had a fusion and have 4 metal rods inserted that was on July 9th and I seem to be getting on slowly but surely. 

I don't want to scar story or anything just being honest. 

I think you best go back to doctor tbh

3

Hi dawnylou, 

Thanks for your advise and for sharing your experience with me, I appreciate your honesty. I'm sorry to hear what happened to your and wish you all the best for a full and speedy recovery. 

I suppose a cyst or infection could maybe explain why my back is still swollen coming up to 8 weeks post operation. 

Thanks and all the best, peter

4

hi Peter

how are you doing now?

5

Hi Dawnylou,

My second MRI showed that my disc had re-herniated quite badly. My surgeon offered to me a fusion and explained that it would involve putting a cage between my vertebra and four steel rods to hold a plate over the cage. But i was worried about losing mobility and therefore he’s agreed to a second microdiscectomy. I’m due in on the 08th of January so fingers crossed for this time.

I hope your recovery from the fusion has continued to go well? Have you noticed a loss of mobility during your rehabilitation, I’m worried about this but at the moment I struggle to put my socks on so maybe I shouldn’t be so concerned. If my op fails it sounds like fusion would be the next step for me too.

All the best, Peter

6

Hi, Peter!

Just wondering how you're doing? Did you have the 2nd microdiscectomy yet? I am 2 weeks post op from my first one at L5/S1 and the past few days the sciatica pain has worsened quite a bit and it's really scaring me... I'm hoping it's just the nerve still healing!

7

Hi Jackibar,

Yes I had the 2nd operation, although this didn't turn out to be a typical microdiscectomy. 

My symptoms had improved leading up to the operation but had not completely disappeared. I still struggles with pain in my buttock and right calf on a daily basis, but this was mild compared to the pain suffered before my 1st op and following the reherniation of the disc.

So during the pre-op consultation on 8th of Jan, I discussed the situation with my surgeon who then offered me the option of not going ahead, but I was keen to sort things out once and for all and so opted to progress.

When he opened me up, he found that the disc had moved back but there was a large build up of scar tissue on my sciatic nerve. I still don't have a good understanding of this, but he commented that he considered abandoning the operation and rescheduling for a longer operation window. Thankfully he persevered and said that he managed to successfully free up my nerve and then found and removed a small fragment of disc from within the scar tissue which could have been causing my problems. He explained that it was rare for this to happen as he had wrapped something around my nerve after the 1st operation to prevent this. If this happened again then he would have to consider decompression.

Anyway fingers crossed it won't come to that so I'm just continuing with my recovery at home. Things seem to be going ok at the moment and after been pain free for the first week, some of the symptoms have returned (mild pain in right buttock and calf as i write this ), but I think this is expected as the nerve takes time to repair. I'm therefore continuing to take regular short walks and do my physio moves four times a day as recommended and am still hopeful of a full recovery.

Regarding your situation, I think pain is normal after a microdiscectomy. If it’s worse than before your operation, I would ring your surgeon for advice.

If it’s similar or slightly improved to your pre-op pain, then I wouldn’t panic. I understand that it takes time for your nerve to recover depending on how bad the disc compressed your nerve and the length of time it was subject to this before the operation. To share my experience and going back to my 1st operation, the first few days i felt fantastic, I suppose this is due to the medication and anesthetics. Also some surgeons wrap the nerve in a steroid coated layer of fat (or something) to protect, promote and aid recovery.  After the first few days my pain returned, although much improved to my pre operation condition. This pain intensified over weeks 2 and 3. I therefore rang my surgeon to discuss and I was advised to  reduced the length of walks i was doing  (I was doing 5-7km a day over 4-5 walks and 30mins every other day in the swimming pool with a kickboard (front and back kicking)). Then during week 4 the pain started to reduce, by week 5 it was almost gone and I was very confident of a full recovery at this point. But for some unknown reason it went again mid week 5, Having read numerous stories and discussing it with various physios and my surgeon, I understand that this just happens sometimes and it’s no one’s fault.

Anyway I hope my experiences are of use and that you improve and make a full recovery over the coming weeks. If you need any further info I’ll do my best to help. All the best, Peter

8

Hi, how are you doing now? I had L5S1 bulge removed 4weeks ago. All has gone reasonably well so far, apart from leg spasms when I turn onto my back during the night. I have another MRI scan booked in for next week as there maybe a problem higher up my back!

anyone else had spasms?

9

Hi Polyman,

 

After a bit of a scare at week 7 post op, I’m now doing really well thank you and continue to get stronger every week.

I saw my surgeon at week 6 and he seemed happy with the remaining symptoms (slight lack of sensation in the right calf and light soreness in my buttock) and discharged me. At the time of discharge I asked to see a physio to help my recovery but as the nhs is short of funding, he advised I go to Pilates classes.

Well I never got the opportunity as one week later I found myself experiencing crippling nerve pain in my backside but also in my lower back during which time I couldn’t move or even get up off the floor without been in agonising pain, but after a few days rest I recovered and then relapsed into the same crippling pain. I was basically going round in circles and I couldn’t understand why.  I spoke with my surgeon, who gave me the crappy advise of seeing how I was in 6 weeks and if it still persisted to get refereed back to him through my doctor.....very poor advise looking back and knowing what the problem was now. 

Luckily a colleague recommended a private physio he had used in the past, although it cost £40 a session, he’s proven to be worth his weight in gold. After a couple of sessions with him, he was able to explain exactly what was wrong with me this has allowed me to cope with pain management better and aid my recovery. Basically as I’d had two operations in relatively short succession, I’d lost a lot of muscle in my glutes, I was fatiguing myself doing my basic physio exercises and walks to the point my muscles weren’t able to support me. As I’d had a microdiscectomy the disc in the back is reduced in height and the vertebra are therefore slightly closer together, the facet bones coming off the vertebra are therefore slightly closer together with less room for my nerve to run through. When fatigued I was unable to support myself and my nerve was getting trapped/inflamed as my back slouched in poor posture. So this explained why I was going round in circles, I was doing very basic physio moves which weren’t tailored to me and so  didn’t help repair my muscle loss or correct my posture. In doing so this fatigued me to a point that I was aggravating my nerve, I’d then rest and recover and repeat the process. 

So what my physio has done is given me stretches and exercises which have corrected my posture and started to rebuild the muscle loss. I’m at the gym three times a week now doing a lot of work on a ‘bosu’. It makes me correct my posture and improve my stability, I do squats, single leg squats, leg flutters (planking on a swiss ball), and one leg lunges all on the bosu. Basically anything targeting my glutes, I’m now moved onto to ‘normal’ leg exercises, just the standard machines you find in any gym. 

Another change that really helped me was to sit on a swiss ball when at home or at work. In doing so I’m unconsciously working and  strengthening my core whilst I work or watch tv. I started off doing this for 5-10 minute periods and build up over time. 

Another tip was to take a teaspoon of turmeric everyday (with black pepper corns to aid cumin absorption), this has anti-inflammatory properties without damaging my stomach lining by taking ibuprofen or diclofenac everyday. I’m now totally off any pharmaceutical  pain killers or anti-inflammatory tables.

So as I stand things are going well and I couldn’t be more please with situation at the moment. 

I’m glad your operation has gone well and I hope your leg spasms settle down. I’ve not suffered from spasms myself so not sure if it’s normal, I’d probably speak to the surgeon if it’s something you’ve just developed following your operation.  All the best with your next MRI I hope they don’t find anything serious and I wish you the best for a full recovery. 

10

Glad to hear you have gone through the pain barrier. Sometimes after an operation it can be worse for a while as you have experienced.

I am experiencing some pins and needles in my left hand on occasions, so maybe another problem higher up.

glad you are on the mend

11

Hi peter.

How are you doing now?

12

Peter1980,

Thank you for sharing your experience with all of us! How are you dong now!

Thx DaveS

13

Excellent Explanation!!

I'd like to hire your trainer....please advise

14

Hi Peter,

I was wondering how you are doing now?

Thank you,

Sheri

15

Hi Dave,

My Physio was Ian Blackburn based in Cottingley, Bingley, West Yorkshire BD16 1TZ, I'm not sure if I can post a link so just google Elite Physio.

All the best, Peter

16

Hi Everyone,

Sorry for the late response, just seen the questions. So it's been a year and seven months since my second microdisectomy and I have to say although I'm not perfect and probably never will be, things are still going very well since my last post and I'm still pleased with the outcome.

I still continue to get the odd set back, which i believe is still the pinched nerve when I over do things, but the last time that happened was early February 2016. I did go back for a third MRI (registered a problem with my GP in November 2015, finally saw my surgeon in April 2016) but this didn’t show anything wrong with my disc. I queried the pinched nerve theory but my surgeon (working on a Saturday) seemed very disinterested and dismissed it as scar tissue problems.  It still feels as if it is something pinching when I do get problems, but I'm thinking that I've now built up enough strength and also have enough experience to recognise the warning signs as to when I start to overdo things (I still probably exercise too much at times).

I still get days when I feel very tight pain in one of my glutes, either side, but never both at once, and I just take things easy and do a lot of stretching or Pilates classes from youtube (Amy bodyfit seem to work or her bosu class is good low impact exercise).

I find if I live a sedentary life, problems seem to build, so the more I keep moving the better I seem to get. I still do Bosu work and bought one for home use, they aren’t cheap but I use it in several workouts every week so it’s worth it for me.

Overall I have to say I’m happy with where i so i will continue to push myself and find ways of exercising whilst trying to minmise impact on my spine, Thanks for the interest and wish you all the best in your own recovery, Cheers Peter

 

17

Hi Please see response above for update

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Hi Please see response above for update

19

Thanks Peter for your reply and ESP glad you are doing better.  Out of curiosity I assume when you say you are mostly pain free it's also while you are Med free.  Take Care!

20

No worries. Yes I’m completely med free now. When I say pain, I’m free of the crippling sciatica pain that used to be constantly in my backside and leg.

I wake up every day feeling stiff in my lower back, where I’ve had two incisions, but this is down to the fact I’ve had my muscles cut open twice and a bit of movement and stretching and I start to feel much better. I’m resigned to the fact that it will probably be like this from now on and something I just have to live with. It doesn’t really bother me and I now consider this the norm.

The pain I refer to is when, I either feel a pinch in my lower back, which can flare up following the next several days, this is the bad extreme pain which can immobilise me. I get it in my backside and have sensations in my calf so I just have to rest until I recover when this happens. The sensations I feel fit in with the theory of a pinched nerve getting inflamed and I find complete rest is the only recovery to this for around two days before I reintroduce walks. If I rest for longer than a couple of days then I found this can be counterproductive.  I used to get this every few weeks but, I’ve built up strength and the last time this happened was early February.

The other more frequent pain I get is just very mild pain which occurs in either my buttocks, usually when I’ve done a lot of exercise, again, I ease off any impact training and limit myself to pilates or walking until I recover.

I still take the Turmeric, I’m not sure if this does anything, maybe just a placebo effect to pain and inflammation control, but reading the articles online there must be some benefit to taking this daily.