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What inflamed a nerve after a discectomy?

rolorrolo Posts: 52
edited 06/11/2012 - 7:30 AM in Back Surgery and Neck Surgery
Hello,
I have a few other posts floating around but one thing I haven't found out yet is this....after a discectomy, where a disk is no longer pressurizing the nerve, what gets inflamed and pushes on the nerve and causes the similar pains we had before surgery?
I keep hearing that nerve flare ups are normal, but if the disc is gone, what is pushing on the nerve? What is inflamed? I have read you need nerve irritation AND pressure to cause the sciatic pain, if that's true - what is pushing on the nerve after surgery?
Thanks in advance for helping me try to understand this, it's really confusing me and making me think pain is coming from a re herniated disc.

Thanks!!!
Steve
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Comments

  • Another way to phrase it... if my disc has been fixed and is no longer compressing the nerve (like right now) - then why do I get sciatic pain when I sit down and COMPRESS the spine? What is moving or compressing when I compress my spine by sitting that is making the nerve get compressed again and thus shooting pain down my leg?
  • If the nerve root is inflammed (all puffed up and bigger)it's possible that a structure (within it's normal parameters) in the spine is compressing it more than usual when moving. Looking at an axil view mri, you cab see,..that space is pretty small (foramen). Just a theory.

    Maybe I'm in denial too! LOL!
  • Could it be scar tissue pressing on that nerve? I've heard some other people have that problem after lumbar surgery. Or maybe I'm just ignorant and talking to hear my head rattle.

    Cath
  • I'm so sorry. The same thing happened to me. For almost 3 weeks post-op I felt wonderful. Absolutely wonderful. And then the pain came back overnight, exactly as it was before I had the surgery.

    I AM NOT A DOCTOR. EVERYTHING YOU READ BELOW IS BASED ONLY ON MY OWN EXPERIENCES, CONVERSATIONS WITH VARIOUS MEDICAL PROFESSIONALS, AND MY OWN RESEARCH.

    First of all, and I didn't know this until I joined Spine Health, during the operation your nerves are bathed in a steroid. There is a lot of manipulation going on in there while the doctor is working. Everything that is in the way gets moved or lifted or pushed aside, which makes the nerves very very mad. They put the steroid in there to reduce nerve inflammation and irritation. This wonderful, wonderful steroid tends to wear off in approximately 2-3 weeks. That is why many of us who experienced immediate pain relief after surgery find that after 2-3 weeks they are suddenly in pain again.

    Secondly, your nerve was compressed for a while. At least from the time you first experienced pain from the herniation until it was removed, which for most people is many months if not years. You feel the same, or similar pain because that nerve is trying to heal itself and repair the damage that was done from the actual material that was pushing on it. The nerve needs time to heal after all that compression. Sometimes its a few months, sometimes a year or more.

    Third, there doesn't necessarily have to be anything actually touching the nerve to create pressure, and thus pain. There is a hole (foramen) that the nerve travels through. The hole is a fixed size (different for every person). If the nerve is inflamed and irritated (larger than normal) it displaces the fluid giving the nerve less room than normal, possibly creating pressure. Some positions put more pressure on the whole area, which is why you might feel more pain when you move/sit a certain way.

    Fourth, this is your second surgery on the same area. You could have a buildup of scar tissue that is either directly pressing on the nerve, or giving the nerve less room within the foramen as in the above scenario, putting indirect pressure on your nerve.

    CALL YOUR DOCTOR.

    Since you're only 3 weeks out, they may tell you to rest and give it more time. They might give you a steroid dose pack (oral steroid) to reduce inflammation and irritation, or some other kind of pain relief medication. My first dose pack did nothing for me (6 days) but I'm on a second one now (12 days) and I am feeling almost no pain right now.

    A post-op MRI would put your mind at ease--either proving that there is something physical pressing on the nerve, or proving that there isn't and it's just residual inflammation/irritation/normal healing process of the nerves. The trick is persuading your doctor to order one. My doctor got me one right away, but various doctors/insurance companies may make you wait a while.

    I hope this was helpful. Good luck, don't give up hope.
  • It was helpful - but I already replied saying what my Doc said ;)
  • marksinpainmarksinpain Posts: 41
    edited 10/01/2016 - 1:23 AM
    @jeq1977 This is an old post, so you may no longer be a part of this forum, but I just wanted to thank you for alleviating some of my fears.  I'm three weeks out from a microdiscetomy and am suffering the return of my symptoms.  I've been terrified that I've suffered a new prolapse, but your post helped me understand that this may not necessarily be the case.  THANK YOU.
    Easter 2013 : Onset of sciatic pain.
    Sep 2016 : L5-S1 minimally invasive microdiscectomy.  Pain returns in full 10 days after surgery.
    Oct 2016 : MRI rules out a re-herniation. 
    Oct 2016 : ESI (cortisone and nerve block).  Increased Sciatic Pain from 2 days afterwards.
  • LizLiz Posts: 7,888

    This is an old discussion created by a member no longer on the forum so I am closing it.

    You can search for articles on this subject or I suggest you create a new discussion


    Liz, Spine-health Moderator

    Spinal stenosis since 1995
    Lumber decompression surgery S1 L5-L3[1996]
    Cervical stenosis, so far avoided surgery
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