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Some common aches and pains after lumber surgery

BruceBBruce Posts: 516
edited 06/11/2012 - 8:24 AM in Back Surgery and Neck Surgery
Many of us have felt new aches and pains after lumber surgery, that were never there before surgery, and which have left some of us thinking whether our surgery has failed or not and whether we will live with this pain from here on.

I am not a doctor, but I am a lumber surgery patient and I suffered from all the aches and pains after surgery (listed below) which certainly led me to believe in the early days that my surgery was a waste of time, leaving me worse off. Happily all these aches and pains resolved over time and I now live a pain-free life.

In my almost 2 years on this spine-health forum I see new lumber surgery patients experiencing similar pains as I did so it leads me to believe that there is a common set of symptoms that lumbar surgery patients might experience in the first weeks or months after surgery. Please, however, always refer to your doctor/surgeon, if you are worried about any new pain or are in any way unhappy with how your recovery is progressing

The aches and pains which I have noticed as reasonably common in lumbar surgery patients on this site, after surgeries are:

1. Sciatic leg pain (or increased sciatic leg pain) for a period of time – usually explained as being caused by the nerve roots which exit between the lumbar vertebrae and make up the sciatic nerves being irritated/inflamed during surgery. Nerves take a very long time to heal/repair.

2. Sacro-iliac joint (SIJ) pain – on one or both sides. This is the joint between the tailbone and the hip bone and it was explained to me that fusing the lumbar spine changes the geometry of the lumbar spine somewhat, coupled with the fusing of one or more lumber joints, puts additional or new stress on the SIJ joints. http://www.hughston.com/hha/a.sacjnt.htm

3. Thoracic spine pain – this maybe is not quite so common but does appear to have cropped up from time to time and certainly I suffered it for quite some time. Again, I believe that it is due to the change in geometry of the spine due to lumbar fusion and a consequent change in posture.

In my case, the sciatic leg pain cured itself over time and I was able to manage the pain in the first month with nerve pain medication. My SIJ and thoracic pain was managed and cured by my physical therapist.

The purpose of this post is to let new lumbar surgery patients know that the pain that they are feeling after surgery might not be as a result of a failed surgery and might simply be ‘normal’ pains following that type of surgery. My comments above are based on anecdotal observations only and as I stressed earlier, always refer to your doctor/surgeon, if you are worried about any new pain or are in any way unhappy with how your recovery is progressing.
Keep positive!

Bruce

...an old timer here and ex-moderator

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Comments

  • Thanks for this Bruce, hopefully it will make some of the newer forum members realise that what they are going through is quite normal.
    Blessings Sara O:)
  • I'd like to add

    4. Cervical spine pain - For whatever reason, whether it be emotional stress or physical stress via compensation, my neck and shoulders would get extremely tight and cause tension headaches

    5. Knee pain - since I was working so hard to bend at the knees and not the waist, my knees took abuse they weren't used to and would ache

    "C"
  • C, yes that's a good one too. Certainly for me too, with the no bending rule my knees take a pounding and would ache too, even after doing one of my lumbar core strengthening exercises which involved squats.
    Keep positive!

    Bruce

    ...an old timer here and ex-moderator

  • Thanks Bruce, I have it all including the cervical and knee pain. Can you tell me what types of treatments your PT did to help alleviate your SI joint pain. That is by biggest issue right now. It actually started after my first PT session, and continues. I am doing piriformis stretches, icing, heating. Any ideas? Thanks, Cali-Sue
  • Cali-Sue said:
    Thanks Bruce, I have it all including the cervical and knee pain. Can you tell me what types of treatments your PT did to help alleviate your SI joint pain. That is by biggest issue right now. It actually started after my first PT session, and continues. I am doing piriformis stretches, icing, heating. Any ideas? Thanks, Cali-Sue
    Well, my SI problem was at about 4 months post fusion surgery which puts it at about 18 months ago. My PT was treating me for all sorts of aches and pains at the time - some directly related to my surgery and some not related. I have severely pronated feet (flat feet) and at the time a right knee that was causing a lot of pain too - my point being I was getting a lot of therapy and doing a lot of different stretching exercises and cannot specifically remember now the exact ones for each! For my SIJs, I do remember lying flat on my back while she moved my pelvis and upper leg around. It was relatively gentle, just to start some movement again.

    The primary exercise my PT got me doing to get the SIJs working again were pelvic rocking (pelvic tilt) exercises – lying flat on my back and doing 20 pelvic rocks, 2 -3 times a day.

    I was doing other stretching exercises that I think also helped the SI joints, such as leg cross exercises and psoas major muscle stretches.
    Keep positive!

    Bruce

    ...an old timer here and ex-moderator

  • Thanks Bruce, I had SI pain immediately post-op, but it went away around 3-4 weeks, everything was good except for back tightness at op site. Then I started PT at 9 weeks. They have me doing pelvic tilts, bridges, some ab stuff, bike, leg press.... so who knows what it was but that first night my SI joints flared up and haven't stopped since. Funny it sounds like the exercises you did for it are the ones that brought mine on. It really feels like inflammation to me, yet no NSAIDS allowed, so what to do. Guess I just got to give it more time. Thanks again, Sue
  • I'm having a 3-level lumbar fusion in a month, so this is good information to have. I know it is disheartening to have more pain after surgery, but you're right, things usually do resolve. Nerve pain seems to take forever to heal.

    Linda

    3 level spinal fusion, L3/4, L4/5, L5/S1, November 2008. Stiff, but I can walk.
  • I have also found that all the squatting and bending from hip joints (instead of back) to pick things up causes my hip joints to be really tight and sore some nights. It is getting better as time goes on but was really achy at about 8 weeks.
  • Bruce, I cannot thank you enough for your post! The post-fusion "confusion" we go thru....! And the worries about "failed back" etc. when most of the fall-out could simply be our bodies' responses to the tremendous assault we were subjected to. You made it very clear, as did my NX on Wed, that MOST "annoyances" are just part of the healing process, but ALWAYS stay in contact w/ your doc, should things get worse, or SUDDENLY increase, etc. Prudent advice. And right-on target, with what to expect. I also "have it all" and brought these things to my NS attention @ my 9-month x-ray/check-up last Wed. I'm fusing just fine, lots of new bone, everything looks good, nothing has shifted or moved or is out of place, all the screws, rods etc just where they should be ---BUT---as you listed, I have: new sciatic pain, from the damage to the L4/5 nerve root during surgery (normal) SIJ problems due to the changed geometry (normal) throactic pain now, into the upper back & shoulders & my neck, including an annoying "snapping" sound when I turn my head (normal, b/c the other levels are now adjusting to the change in mechanics) leg fasciulations --involuntary muscles spasms in my legs---due to the nerves firing signals randomly (normal) and some sensation loss in the perinium area yet (normal, as he opened from L3-S1 for a wide exposure, due to my priors. Everything he said corroborated w/ what you wrote! I felt so much better after my appt on Wed, knowing that all these little (but very annoying) things are to be expected, esp if one has had priors (I had 2) and/or was used to being flexible/active/almost hypermobile, as I also was. My NS assured me that nothing is amiss, that I'm doing fine, was impressed that I'm teaching again F/T & getting more social active again...so sometime "fresh eyes" and a pat on the back for being a survivor does wonders!

    Thank you again! I am so glad you are pain-free now, after almost 2 years. My NS also said that: to figure the recovery time for 2 years, not the "6-9 months" they tell you--he said that timeline is just the BEGINNING...it takes about 24 months to truly find out where you end up...and I want the best, of course, but would setttle for a little less of the above annoyances and more flexibility.

    Time will tell! And time is the Great Healer. And we are all so impatient, understandably so. But it gets better, or gets "different" and we plough thru.

    Blessings to everyone tonight! If your are about to embark on this journey, fear not. And if you are about 1/3 way thru the recovery, keep plugging away! And if you have come out of the tunnel & are now sailing along, my ice's pack's off to you! :)

    Bruce, thanks again! You helped more than you'll ever know~!

    ~Lakeside
  • I remember at about 9 months still doubting whether I would 'come right' and voicing this to my surgeon. He told me that he would only ever consider my surgery a failure if i still had significant pain after 18 - 24 months. In other words he believes that before this, it is too early to consider fusion surgery a failure and to do so without hard evidence could be jumping to conclusions - I believe he is right.
    Keep positive!

    Bruce

    ...an old timer here and ex-moderator

  • I am not up on the names of bones and joints, but I am 11 weeks out of L5/S1 fusion surgery and am having tons of pain in my hip and pelvic area. When I lay on my stomach for ice at PT or at home I am in tears trying to get up. Pain last for around 20 minutes then starts to die down to toleratable amount. I Don't have a clue if this is normal or it is is, when will it go away.

    My back lower back pain is mimimal, but I do feel like I have a 6 inch 2x4 in my lower back. Not flexible at all. It does still flare up, but like I said most of the time it's my pelvic and hip area. Hard to walk without shooting pain in that area. While sitting it hurts and feels like a lot of muscles pain, but while standing feels more like bone moving.
    I have pain in my leg and numbness still in my foot. I am assuming the numbness will take longer to heal.

    Taking Soma at night for spasms in lower back. WOrking well. I am not sleeping well though.
  • Hopeful, have you talked to your Physical Therapist about this pain? If so, what does he/she think of it? SIJ pain manifests itself as pain in the hip/pelvic area. Is it both sides, or just one side? If it is just one side did you have a bone graft taken from your iliac crest and if so is it the same side as your pain? It is common for the bone donor area to cause quite a bit of pain too in the first few weeks/months and than can also manifest itself in the pelvic area.

    Definitely talk to your surgeon and/or your Physical Therapist about this pain.
    Keep positive!

    Bruce

    ...an old timer here and ex-moderator

  • I, too, have been plagued by pelvic pain. It is better now than a few weeks ago but does flair up if I sit too long and also after PT. I have not had to lay on my stomach so I don't know if that would cause a flair-up for me or not. No one has really been able to offer an explanation other than muscle tightness. Mine is usually only on the left side but sometimes moves to the right. Ice/heat helps some. Although occasionally the pain is quite sharp this only lasts for a second or two - otherwise it is more like twinges when I move a certain way or just sort of aches like sore muscles. Most of the time - but not always - it occurs along with my hip pain.

    The 6 inch 2x4 is a great description of the lower back feeling! It is exactly what mine feels like. Sometimes I feel it more than others - I think it depends on how tired my back is.

    I hope your pain gets better soon!
  • I have talked to both my Surgeon and PT about the pain. The surgeon said that my xrays look good and I'm healing fine. The PT just keeps trying to get the back centralized to my lower back and away from the side or down the leg.

    Your thoughts on this: Many years before surgery, I was told by a massage therapist during a siatic masaage that my hips roll the opposite way of most people. She told me that it could be corrected with about a years worth of therapy and a lot of pain.
    I asked the surgeon about it before the surgery to make sure that it wouldn't cause complications. He just kinda blew it off and said I would be fine. What my concern is, is that my pelvic bones and or hip bones are not formed to be exactly straight and now that I have these screws and rods making my back stay straight that it is messing with my othter bones. I have had 3 children and was unable to deliver them "normally". My bones would not open to allow them through the birth canal. Thought that may have had something to do with the hip roll as well.

    I don't know. All I know is that I am having this pelvic and hip pain and want to know if it is normal or should I be concerned. The first session of PT he told me that my back was crooked and started having me move my back to one side so I would be straight.

    Pt continues to put me on my stomach. I think I am going to tell him tomorrow that I no longer want to do that. He seems to think that laying on my stomach and doing back arches is the best stretch for this surgery. I am able to do the arches standing though without much pain.

    I know the surgeon took a bone graft, but it wasn't from my hip. Good question for my surgeon as to where it came from. The pain is on the same side as the ruptured disk.

    Sorry this was so long!
  • Not sure if this will give you relief, but it sure helped me! My pain was so severe I could not walk. I believe this exercise is the one that finally broke through and gave me some relief! Lying on your side,with your spine in the neutral position and knees bent, slowly raise the top knee and hold for 5 seconds, and slowly lower it. Do a set of 5 on each side.Once you are able to do these easliy, you can add a foot lift to the part where you raise the top knee. That's where I really felt the most results. But be very carelful to keep your spine stable. My NS developed a PT clinic that has excellent results for improving back pain if you religiously follow their plan. I do one day floor exercise, one day ball and one day weights, and repeat.Per my NS, I will do this for the rest of my life to increase healing, reduce pain, as well as reduce the chances for further surgery. I have lots more exercises if anyone is looking for some.
  • Bruce,

    That post was an excellent idea! I am glad that you are pain free 2 1/2 years later. I am about 7 months post surgery and am much better but I haven't gotten rid of the nerve pain in my lower right leg. But, it's better.

    Delaware Girl
  • Hopeful01 said:
    I have talked to both my Surgeon and PT about the pain. The surgeon said that my xrays look good and I'm healing fine. The PT just keeps trying to get the back centralized to my lower back and away from the side or down the leg.

    Your thoughts on this: Many years before surgery, I was told by a massage therapist during a siatic masaage that my hips roll the opposite way of most people. She told me that it could be corrected with about a years worth of therapy and a lot of pain.
    I asked the surgeon about it before the surgery to make sure that it wouldn't cause complications. He just kinda blew it off and said I would be fine. What my concern is, is that my pelvic bones and or hip bones are not formed to be exactly straight and now that I have these screws and rods making my back stay straight that it is messing with my othter bones. I have had 3 children and was unable to deliver them "normally". My bones would not open to allow them through the birth canal. Thought that may have had something to do with the hip roll as well.

    I don't know. All I know is that I am having this pelvic and hip pain and want to know if it is normal or should I be concerned. The first session of PT he told me that my back was crooked and started having me move my back to one side so I would be straight.

    Pt continues to put me on my stomach. I think I am going to tell him tomorrow that I no longer want to do that. He seems to think that laying on my stomach and doing back arches is the best stretch for this surgery. I am able to do the arches standing though without much pain.

    I know the surgeon took a bone graft, but it wasn't from my hip. Good question for my surgeon as to where it came from. The pain is on the same side as the ruptured disk.

    Sorry this was so long!
    Hopeful, well it is certainly true that skeletally many of us a neither symetrical nor perfectly formed! I learned throughout my ordeal that my right leg is slightly bowed and slightly shorter and also that I have severely pronated feet. These issues are all causing pains which all seemed to surface during my back issues or after my back surgery during the recovery period, and some of which I will have to live with forever - but the point is that they are not related to my lumbar issues but are somewhat influenced by them.

    Now regarding your PT - I wonder just how experienced your PT is in rehabilitation of lumber surgery patients? It sounds like he may simply be 'going through the motions. If you feel this too, you might want to consider seeking out a good PT who specialises in rehabilitation of lumbar spinal surgery patients.
    Keep positive!

    Bruce

    ...an old timer here and ex-moderator

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