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Post op lumbar fusion "nerve pain"

AnonymousUserAAnonymousUser Posts: 49,900
edited 06/11/2012 - 8:26 AM in Back Surgery and Neck Surgery
I've read a couple of posts of individuals experiencing the same type of "nerve pain" that I have in my leg. I had a TLIFT (fusion) of L5-S1 and stabilization of L4-L5 on Dec 16th. I am out of my mind with burning, stabbing pain in my calf, top of foot and toes. The nurse said "hang in there" and my Lyrica was increased to 150 mg 3 times a day. It helps a little. If I really knew this was temporary I think I could tolerate it better. This pain is worse than what I had pre-op. Can anyone out there give any reassurance that this post op nerve pain, aka nerve root irritation, gets better? Thanks.
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13

Comments


  • Hi Lisa,

    I had a L4-S1 TLIF 18 months ago. Nerves can be very irritated from being manipulated, can even feel initially worse than before surgery. For many people, this does get better.

    My questions for you are-did this pain show up immediately postop or did it take a week or so to show up? What are you doing activity-wise? You should not be bending, lifting, twisting. The first 3 weeks are for healing only. Don't get on an elliptical! I'm sure you don't feel up to that right now, but just covering the bases. There's probably hundreds of horror stories about complications here, but us difficult patients are really not the norm. Most people get the nerves to settle down.

    Have you had a postop appointment? I would like to have xrays done at that appointment just to make sure hardware looks good.

    You said this pain is worse than preop. Is it in the same pattern, tho? Check out www.chirogeek.com and click on dermatones and it shows you what nerve root is involved with the pattern of pain you have.

    But again, did you have this degree of pain in the hospital or did it come back after some time?
  • From one nurse to another - In the hospital I was on a MS pca pump. What I felt was more of a numbness, once weaned, then discharged the burning, searing pain started. Pre-op my only pain was a stabbing sciatic pain that traveled down to my foot. That is completely gone. In the hospital they did a CAT scan and said everything looked great, all the hardware was in perfect position. Right now I have alternated rest with activity. I will walk slowly on the treadmill for up to a mile if I feel well, and I do keep my brace on. I was told my rehab for the first month was to just walk. Truly, I was a very active nurse prior to this surgery, which I really needed as my spine was very unstable from a b/l pars defect and then subsequent spondylolithesis. I plan on going back to my job on Jan 5th, I have to do 2, 3 hour lecures that week and then clinical instruction. I will have additional help with that for 2 weeks then I'm on my own. If it wasn't for the severe burning pain in my leg I'd feel great!
  • Lisa,

    I experienced an increase in leg pain/tingling after my lumbar fusion surgery at L5/S1. For me, this discomfort did not go away until roughly week 10. Over the past 6 weeks, I have had this happen only 2 or 3 times, and very briefly at that.

    I was told this happens because inflammation around the surgery site can put pressure on the nerves. As the inflammation decreases, you should get relief. Unfortunately, that just takes time.

    Hang in there. I'm sure it will get better. :-))
  • I know I'm not your spine surgeon, but I think you're nuts to be walking a mile at a time so soon preop, especially with nerve pain flare-up. I kind of think you might be overdoing it, but just my opinion.

    Nurses are the worst patients. Some people think that doctors are the worst patients because they think they know everything, but nurses KNOW they know everything! :) I applaud you for setting goals, but it sounds like your nerve pain could be from just being too active.

    This whole thing(18 months since fusion surgery and getting ready for my 2nd repair job since surgery) has given me a new appreciation for my patients. Not only pain, but how in the heck does a regular, non-medical person navigate our healthcare system?????
  • I walked around a mile at Lisa's point of recovery and it did not cause my nerve pain. I definitely had pain, but listened to my body and slowed down when it told me to. Actually, by 5 weeks post-op I was walking up to 6 miles/day.

    The key is to pay attention to your body and understand your limitations. It is possible that Lisa's flare-ups are from walking so much. Lisa, as a test, you should walk less one day and see if that makes a difference.
  • Mark, thank you for your post, you have given me some reassurance that the future will be brighter. I'm still early in recovery so I am trying to be patient. I'm so glad for you that your recovery is going well. I am going to hang in there and hope that this pain will subside. Lisa
  • I asked the neurosurgeon's specialty RN about too much walking and she said what I was doing was ok. I have experimented with days of less activity and have found that the pain is actually worse on those days. My mile at this point is pretty slow, about 30 minutes. On my post op recovery papers from the doctor it says to work up to 5-6 miles a day. I gasped when I saw that and thought surely it must be a typo but it wasnt'. Walking or not I just want the nerve pain to subside!!! :)
  • I just had fusion of L4-5, L5-S1 on Dec 4 (3 1/2 wks ago). After a setback due to a bladder infection, I still can't sleep anywhere but in my recliner. Low back and butt spasms still have me living from pain pill to pain pill Soma q 8 hrs. Percocet and Vicoden alternating q 2 hrs. Is this a normal amount of pain after 3 wks? I'm trying to walk the length of the house every time I get up to the BR -- still need the walker to take some of the weight off my legs.
    I started reading your forum a couple days ago -- got some good info out of it already. Thanks
    ERW
  • Dear ERW, My neurosurgeon sent me home on a muscle relaxer, Robaxin, to take every 6 hours as needed for 4 weeks. At the hospital the special neuro nurse said to take it around the clock for a couple of weeks because the spasms are to be expected. Maybe you need to be switched to a different medication or the frequency needs changed. Soma is going to make you drowsy, hence keep you in the chair more. My pain is less when I'm up, but the key is to alternate rest with activity. Keep up your walks and each time try to make them longer. Keep positive, I'm trying to despite the nerve pain I have - just hoping with time it will subside as will your muscle spasms.
  • Lisa, such leg nerve pain and/or sensation appears quite common particularly after L5_S1 surgery. I had such sensations far worse in my first 2-3 weeks post op than prior to surgery. The sensations will subside but it could take many weeks before they disappear - you need to find a way to hang in there. Lyrica helped me.

    As ernurse recommends, I would be considering stopping any significant exercises, such as walking 1 mile or more, for a while and see if that helps. There is plenty of time for exercise later on - in my first few weeks I was resting mainly and doing some basic simple stretches only (that's what my surgeon recommended for me).
    Keep positive!

    Bruce

    ...an old timer here and ex-moderator

  • Thank you for the note -- my first ever :))) Lisa, your reassurance re pain level is comforting. I'll be back...or I shall return...or something. Thanks ERW
  • Man, I thought the surgery was painful -- and it WAS!! I've been dying of this nerve pain in BOTH legs since coming home from the hospital. I can't feel my right foot on the bottom or the outside. The inside of the ankle feels like an elephant stepped on it. The outside of most of my right leg is numb, but the pain down the back of the leg to the knee and the back of the calf is severe. The pain in the left leg is down the back and into the space between my middle and outter toes -- right where I had morton's neuroma surgery a few years ago. I can't walk without a cane, but I too have been walking a mile or more per day. I was told walking was the best thing for me so, by golly, I'm doing it. I also go to PT once a day. I'm praying this nerve pain goes away. It's driving me out of my mind and, at this point, I'm willing to admit that it's a mightly short trip.

    Linda

    3 level spinal fusion, L3/4, L4/5, L5/S1, November 2008. Stiff, but I can walk.
  • Hi everyone, thanks for all of your posts with good ideas and reassurance. I was told today that what we are all experiencing or have experienced is somewhat expected and . . . don't know if this is true at all but . . . the tingling and burning will subside at an approximate rate of 1 inch per month. Can anyone confirm or dispute that?
  • Lisa, there are various figures around saying how long it takes for nerves to repair themselves, e.g. 1" per month sounds a typical figure talked about. But it's not possible to translate this into how many months a patient may continue to feel nerve pain or sensation. Rather, it serves to illustrate that nerve repair or recovery is a slow process, and for those of us who feel or felt these significant nerve sensations or pain after surgery to recognise that it can take several months or longer to finally subside.
    Keep positive!

    Bruce

    ...an old timer here and ex-moderator

  • Wow, read your awesome story, glad you are now giving back to those of us in need. This whole post op experience would be a piece-of-cake if it wasn't for the burning in the calve and foot. I guess from reading many of the posts that I am lucky. Now that I know this is expected I believe I can face my recovery with a much more optimistic attitude. I've dealt with "my" back problem for 15 years - now that I'm on the mend I feel like I'll be a new woman in the future. Even with the back pain I cycled over 200 miles this summer, now I can't wait to do it all over again. Well, guess I better get healed first! Keep up the good work!
  • Hi! I'm back!
    My question now is : what exercises are not contraindicated in this first month post op (it will be 4 wks New Years Day) I am trying to increase my walking but am still not doing enough. The weight bearing is the hardest. I am doing chair exercises:
    one knee & hip bent, st leg raises (about 6 inches) off chair. 5-10 reps
    one hip and knee bent , bend , then straighten hip & knee on other side.
    I do both sides. Also am sure to tighten abdominals before each lift.
    As mentioned, weight bearing is the biggest problem. If I have a really good instance getting out of chair I try to walk a little further after trip to BR but I still can't (for ex) go into a room to look around and find something. The butt spasms and back/groin pain are right there.
    Would any kind of assisted half squats be appropriate or is it too soon to try this. Gotta increase the weight bearing duration.
    Any hints appreciated. I am a Physical therapist but self prescriptiion is not all that easy.
    Thanks! ERW
  • Hi ERW, I am a nurse, however my knowledge regarding post op exercise is simply what my neurosurgeon's specialty RN stated, and that was that for the 1st month the only rehab was walking. After my 1st office visit at 1 month I will be prescibed physical therapy and then that will be restricted to whatever their protocol is. I personally think that you should talk to your surgeon about this. Please don't do squats. Did you ever ask them about changing your muscle relaxer or the frequency that you are taking it. The muscle spasms need to get under control now. You need to be able to walk. Please call your doctor.
  • ERW1308 said:
    Any hints appreciated. I am a Physical therapist but self prescriptiion is not all that easy.
    Thanks! ERW
    Listen to your doctors restrictions!! I am a COTA, and holding back and following restrictions was the hardest thing for me since I knew my legs needed those stretches desperately. Pretend you are not a therapist and just do what you are told to do,lol.

    My doctor did approve water movement/exercise at 5 weeks for me, as tolorated, since the water takes so much of the weight off of the spine. For me I was walking almost 2 miles per day at 4 weeks, these were painfull miles with a walker or cane (just for added stability). Now at 15 weeks I am down to less that 1/2 mile per day because of new weakness and pain. What does your doctor say about your lack of mobility?

    I wish you well,
    Shell
  • Thanks shell74 & lgregg.
    Thanks for the reassurance on my current activity level. My husband has been a little "over concerned" shall we say, about my spending all day in the chair. I am able to get in and out of the recliner independently and walk to and from the BR (as well as in the BR activities). I still use the walker for safety and to take some of the wt off my legs.
    My main direction in the "what can I do" questioning was regarding the spasms when I stand still for a few seconds or try to look anywhere but straight ahead (even if I just turn my head and pay attn to not doing any trunk twisting.)
    I don't have my next appt scheduled with my surgeon yet -- office said they would call me. I just got refills on my 2 pain medications (Percocet and Dilaudid) whichI take alternating every 2 hrs. I am going to try to go to q 3 hrs because of concern about overdoising on the acetometaphine in the Percocet at 2 325 mg 12 times a day. I take Soma for a muscle relaxant q 8 hr.
    Thanks again for you input. ERW
  • Hello again folks.
    I need some advice on the big one. When and how is it best to resume sex? My husband and I had (have) a very active sex life (every day -- no kidding), with an occasional miss.
    I am now 4 weeks post op fusion of L4-5, 5-1. My husband has asked me outright at least twice if I plan to "ever have sex again". I tell him of course but I really don't have any idea of when. My biggest problem is really bad spasms in ny butt and low back whenever I try to lay in the bed. I am still sleeping in the recliner every night.
    So...what is your experience, sugesstions of accomplishemnt, expectations along this line? Maybe if I can give him some kind of time line he won't feel depressed and hopeless. As I mentioned, it is a very important part of our like. The last thing I want to do is say "OK, lets try it" and then go into spasms so bad I can't move before anything is accomplished.
    In all respects he is wonderful. He waits on me hand and foot and gets anything I ask for. I couldn't ask for a better helpmate and I hate to see him so frustated and unhappy.
    Help! ERW

    Looking forward to your help.
    Thanks ERW
  • Given that you cycled 200 miles in the summer I would think that despite your backpain, your pre surgery fitness level would have been reasonable. This coupled with a positive attitude should get you to where you want to be - no or substantially reduced backpain, and back on the bike by next summer!

    All the best and good luck with your recovery... Bruce
    lgregg said:
    Wow, read your awesome story, glad you are now giving back to those of us in need. This whole post op experience would be a piece-of-cake if it wasn't for the burning in the calve and foot. I guess from reading many of the posts that I am lucky. Now that I know this is expected I believe I can face my recovery with a much more optimistic attitude. I've dealt with "my" back problem for 15 years - now that I'm on the mend I feel like I'll be a new woman in the future. Even with the back pain I cycled over 200 miles this summer, now I can't wait to do it all over again. Well, guess I better get healed first! Keep up the good work!
    Keep positive!

    Bruce

    ...an old timer here and ex-moderator

  • Dear ERW regarding sex. Well, I'm single and not in a relationship so I can't tell you first hand, however, my written instructions from the doctor said that "passive" sex was permissible. Now the fun part is you get to determine what that means. Seriously, you need to be comfortable and if you are in pain, forget it. Also, don't be upset if you don't respond the way you would like to . . . the medications have a way of dampering that. I'm sure you are not the first to ask that question or wonder aboutit. Ok, others out there, including moderators, you've lived through this, can you help ERW out?
  • You might have read my "happy" post regarding my six week checkup. I still have some burning/tingling/spasms in both calves and feet. I can tell that except for the times I overdo it, I am having a gradual improvement. The key is gradual. I'm an "a" personality and I don't do well with gradual. Regular walking seems to help these symptoms and when they are too bad, I try to get flat on my back.

    I asked my doc yesterday about exercise. He said he prefers that his patients only concentrate on walking for the 1st 6 weeks until he can get a followup xray and see the patient for an exam. He has now turned me loose to swim, stretch and do gentle core exercises with the admonishment that I go slowly and listen to my body. He is a big believer that your body will tell you when it is ready for more activity.

    I asked my doc about my burning/tingling and still some slight weakness in my legs. He said alot depends on how severely the cord is compressed and for how long prior to surgery and how bad the symptoms were before hand. As my cord was very, very bad he expects me to take a FULL YEAR to get to my final results. He cautioned me that at 6 weeks post op - I'm nowhere near how I'll feel even at 3 months and 6 months. I believe patience is truly the key.

    Regarding sex, we had a lively conversation yesterday in chat! Sorry you missed it. I tried at 5 weeks for the 1st time. I made sure that I hadn't just loaded up on narcotics because they can interfere with your success/ability to "feel." My experience - even tho my hub only weighs about what I weigh - 140 - the old "missionary" style was awful for me. I regretably but unconsciously arched my back and I really thought I broke my hardware. Seriously. (My doc thought that was really funny - he said that short of a car accident, those pedicle screws and cage would not break). So my experience (and everyone is very different) is that I did better "on top" where I could control things more. But my dsh (dear sweet hub) is more than happy to experiment with me and that's what I recommend.

    Be patient with yourself. In my case I'm doing my best to have reasonable expectations without becoming impatient. Not always that easy! If I can help you anyway, pm me. You'll be ok. Just wait. And Happy New Year. Kathy in Atlanta
  • Me and my boyfriend also had a very active sex life, and we have figured out a great way to have sex without any pain etc...

    I lay on my side and he spoons me from behind and wel...you can figure out the rest..lol..

    It works and you dont even have to move much. Hope this helps!!
    :P 8>

  • I don't know many people that use a table setting during sex. I guess the fork was too painful.
  • Well, folks, in the interest of marital harmony I gave it a try yesterday -- exactly 1 month post op. Unlike, Dina, I doped up real good. My primary fear was to have a severe spasm before we got started. I really didn't care about any other kind of "completion" So with Soma, Percocet and Dilaudid (at proper doasages and intervals) and lots of pillows, I concentrated on keeping my spine straight and pelvic area relaxed. I managed to make my DSH a happy maan and allay his fears that we would "never have sex again". I'll think we'll have to wait a few days until next time though because I'm noticably stiffer in the low back and front pelvic area.
    The most positive note -- the sciatica for which with the surgery was indicated is completly gone (PTL).
    ERW
  • Hey Lisa - how is the nerve pain now? I'm six weeks post-op and most of my nerve pain in my legs is gone. Unless I've been sitting too long. My right foot is still numb and I have a bit of numbness on my outer right shin, but otherwise, most of that nerve pain has gone. So - hang in there. There may be light at the end of the tunnel. If it's still really bad, have they tried giving you anything like valium? It's supposed to calm the really tiny muscles. I took it for a couple of weeks and I think it helped, but I had to stop because I enjoyed being awake at least a couple of hours out of the day and it really whacked me out, even at small doses.

    Linda

    3 level spinal fusion, L3/4, L4/5, L5/S1, November 2008. Stiff, but I can walk.
  • My partner doesn't think he'll ever get sex again too, but I told him I'll ask the surgeon when I see him next month.
    Spooning method is probably the best option I would think. I liked the little joke about the fork
  • :) Hi Everyone
    I saw a physio today at my local hospital. I have had joggers on all day and even though she did nothing except watch me walk, and showed me how to do pelvic floor exercises and told me not to do the exercise where you bend your knees and pull your leg back to your chest while lying on your back, I can honestly say that in the last few hours the tightness in my right foot has abated so the pain score would be about 2 out of 10. While I was with the physio it was about a 7. What's happened and why? Who cares as long as it keeps getting better. So hang in there all of you who have this leg pain and I'm sure that soon you will all be feeling A ok. Hope so anyway. While I was in the waiting room I saw an elderly lady come in and her right foot sort of turned over so that the front of the foot dragged along the floor then came back as she lifted it up. I am sure glad that I don't have that problem.
    The physio also told me that after surgery we should treat ourselves to some TLC by having a massage to get rid of all the stress in our bodies. So that's what I'm going to ask my partner to do for me tonight. Take care everyone and get better soon. Lorraine
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