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Pain back 2.5 weeks post L5-S1 discectomy

AnonymousUserAAnonymousUser Posts: 49,671
edited 06/11/2012 - 8:32 AM in Back Surgery and Neck Surgery
O.K. I've seen postings that say, "As the sciatic nerve heals, a return of pain is a normal part of the process." I'm paraphrasing. Still ...

Until now, I had to keep reminding myself I'd had surgery. No pain, and the only remaining symptoms were a lack of ankle reflexes and a bit of numbness in my heel. Then yesterday morning when I got out of bed, I noticed some of the old pain deep in my left cheek and down the path of the sciatic nerve. It isn't by any means the intensity it was before surgery (an 8-9); this is more like a 3-4.

But why now? (I guess I'm just looking for someone to respond who has had the very same thing happen only to have the pain dissipate once again as progress continued to be made toward healing.)

Thanks for listening! :/


  • The usual explanation given is that at the end of the surgery, the surgical area is doused with a steroid and an antibiotic before closing. The idea is to aid healing and prevent infection. The steroid gets you over what is hoped is the worst of the surgical pain before it (the steroid) wears off. As a result, we feel great for awhile after surgery...and we assume the healing will continue on an upward arc. Then one day, anywhere from one to two weeks after surgery, we get hit with pain and think something has gone wrong. But it is the meds wearing off and we are feeling the pain that has been there all along, but was masked by the closing meds.

    The second, less common, alternative is that the disc has "reherniated." What this means is that the surgeon did not get everything out and something has rearranged itself enough that it is pressing on the nerve and/or irritating it. It is not that the surgeon was neglectful. He is trying to remove as little as is necessary so the patient is left with something between the vertebrae. So he takes what he feels is needed to make the patient comfortable. Sometimes a little piece moves after surgery and causes more pain.

    Many people assume that a discectomy removes the entire disc. This was the case many years ago, but it often resulted in more pain afterward as there was no cushion between the vertebrae. Now, the surgeon tries to remove as little as possible, but to still decompress the nerve, or to "fix" whatever is the problem. Hope this makes sense!
  • Hi Rose,

    I had the same surgery as you, same level, one day before you on the 16th.

    Like you, I've had some of the old pain return. They warned me about this. Apparently, this happens for several reasons: No. 1 is as Gwennie so excellently outlined, No. 2 is we are more active than we were before, and it is irritating an already ticked off nerve. Nerves can take a very long time to heal. I tell myself that it will probably take as long to heal as I had the original problem in the first place (around 5 months).

    I find walking to be pretty helpful, and that serves another purpose, so that scar tissue won't form in the wrong places. Also, Advil is great for keeping the inflamation at bay. I am still taking it and it works better than the "hard stuff" ever did.

    Also, I feel that even if this was as good as it gets, I'd still be pretty happy as I would rate it as about 95% better than it was before surgery, and it's only 20 days out!

    If you promise not to panic, I won't either, deal?

    Take care,


  • Awwwww ... you ladies are the best. Thank you for putting my fears to rest. I THOUGHT my neurosurgeon said I may feel the pain again 3-4 days after surgery, but hey, I'm finding that a lot of things during that time of pain just didn't sink in, so maybe he said 3-4 weeks!

    I took Motrin yesterday and the day before, thinking it would help with any inflammation that might be starting up. It didn't really seem to do much for me. This morning I took two Tylenol, and that did the trick. I went on my walk this morning (to beat the forthcoming heat of the day), and ended up walking a couple of miles. (I've been walking about 5 miles a day for the last week.) Of course the walking helped loosen things up. And it just felt great to be walking the neighborhood again! I'd been a walker for years 'til last September when my KNEE started causing trouble. (I had knee surgery April 22.) Things are getting back to normal. But you're right, gwennie -- it isn't a linear process.

    Maryanne, do you work full time? If so, how long before your surgeon says you can return to work?

    All the best to both of you! >:D<
  • After my L5-S1 md, I was basically paralyzed. Bedridden for about a month! It turned out to be inflammation, swelling and edema.
    An ESI into the area resolved it for the most part.
    NSAIDS like Aleve, ice, and PT also were very beneficial.
    On the sunny and mild Central Coast of California

    L4-L5 endoscopic transforaminal microdiscectomy June, 2007
    L5-S1 endoscopic transforaminal microdiscectomy May, 2008
  • I am going to have my 3 month check-up tomorrow for L5 S1 microD, and like you, I still have pain in the right rear and down the hamstring (around level 0-4).
    It's annoying when you think that the pain will disappear (or was told by a surgeon (MINE!) it would. Anyhoooo, it is just a waiting game.

    I still go to physical therapy which is awesome. Just today my therapist suggested new things to prevent the pain. She said once a nerve gets irritated it can get into a vicious cycle, so now we are going to try some things before my pain returns which happens in the afternoons or the evenings.
  • Paul, I can't imagine what a disappointment (and surprise) it was to be bedridden after your surgery! Thank goodness it wasn't an unsuccessful surgery. I take it you're doing just fine these days?

    Hi, Lovinggardener! My neurosurgeon didn't prescribe any PT (not yet, anyway). All I'm to do is walk, walk, walk.

    Why I was concerned is that my pain was all gone from the time I woke up from surgery 'til now. It caught me unawares, as I was sure it wouldn't be back. Thanks to the kind people who have responded to my over reaction, I feel fine about the pain. I'm so much more active now than before!

    I wish you the best at your follow-up appointment! I'll see my NS the first time since surgery on July 27th.
  • Hi Rose,

    I joined the ranks of the unemployed in April. But it worked to my advantage as I make more $$ collecting unemployment than I did working. We had been asked to cut our hours prior to being layed off since business was bad.

    And, this has allowed me to deal with this spine stuff head on. My health insurance is not tied to a job either, thankfully.

    I have been a paralegal for 19 years, and needed a break anyway. I'm sick of law firms and would rather do some public interest work when I start looking again.

    At least I'll get to see the entire Michael Jackson extravaganza tomorrow, lol. After that, I'm going to the beach. Life is too short, time for some fun.

    Take care and please keep in touch!

  • I had 2 level diskectomy 2 years ago. The inflammation around the surgery site could be touching the nerve too. May I ask why you stop taking the motrin? The only way motrin works is if you keep taking it. I take it every day twice a day and it helps. Also my doctors put me in aqua therapy to reduce surgery pain.
    2005-ACDF with Corpectomy at C3-C-5.
    2006-L4-L5 diskectomy.
    2009-Cervical laminectomy at C3.
    Steroid injections series x 4.
  • I took ibuprofen like candy before my two surgeries for a long time. My pain doctor and surgeon advised me to switch over to tylenol because it is gentle on the stomach (not that Tylenol has no side effects).
  • You mentioned you took a couple of Ibuprofen, but I believe Ibuprofen actually works best in cases of chronic inflammation, if you use it consistently for a certain amount of time.

    Gwennie: I wish you could give that explanation to my surgeon so his office could use it! I never ever got ANY explanation for my returning pain either before surgery (never told it may return) or after surgery, and when I did learn about it here, I had already called their office so many times they were practically ready to start screening my calls!

    Sending everyone well-wishes and cyber-hugs!


  • Hi, Shortfuse.

    I hadn't taken Motrin for some time even before my surgery. I had been taking Vicodin & Flexeril. So the Tylenol was just the choice with the least amount of side effects.

    But ... drum roll, please ... I woke up today feeling great! No pain like the last two days. <:P

    I'm sure it's just the more-exercise and meds-wearing-off. Before the surgery, not only was there excruciating pain, but there was a significant lack of well being. The well being part is intact now, so I know it's nothing actually wrong. (My body and mind work together pretty well to keep me in-the-know about my health status. Though I don't always know WHY when everything isn't right.)

    My continued thanks to all!
  • I am 4 weeks post op and was instructed to return to taking my anti inflams because the steroids injected in my spine before they closed me up are wearing off now. But the anti inflams take a week to work at least. I am glad you feel better. I am still struggling with muscle pain and fatigue. Went back to work yesterday for a few hours and I am ready for a vacation already.
    2005-ACDF with Corpectomy at C3-C-5.
    2006-L4-L5 diskectomy.
    2009-Cervical laminectomy at C3.
    Steroid injections series x 4.
  • I hope this recurring pain isn't serious and it's just part of the healing process. Even so, I think your progress is coming along well and you're doing things that I never could post op.

    I had a microdiscectomy before and I wound up reherniating L4-5; I was still in pain and then all of a sudden it worsened exponentially. My surgeon raised the Norco I was already taking and sent me for an MRI which found the problem. He had me do 2 post op ESI's which didn't help, and then a few months later I had a 2 level fusion.

    Hang in there and I hope you continue to do well :H
  • When my pain doctor found out that I had been taking 6-8 ibuprofen for around 14 months, she asked me to stop. Yes, ibuprofen has an anti-inflammatory agent and works effectively, but too much anti-inflammatory med. for extended period of time is not recommended. Leg swelling, stomach ulcer are few of the side effects. I would check with your doctor before resuming a long-term pain med. treatment with ibuprofen. I actually alternate: one day ibuprofen and the next day Tylenol.

    After my surgery, the doctor gave me vicodin which has no ibuprofen. He prefers pain med without ibuprofen.
  • Goodness. I feel so blessed by the results of my surgery! I always hate to hear of anyone struggling, and it's especially discouraging when something significant has been done with the intention of alleviating the problems.

    Although it was only those two mornings when I felt that sciatic pain a bit, I decided this morning to start taking Motrin just to be safe. It's good to know that someone (shortfuse) is even a week further out than me and the effects of the steroids are just wearing off. I've been walking a lot, lot, lot, and no doubt that has speeded up the process of getting all those drugs out of my system (ick!)

    Meydey, do you know what caused your re-herniation? How long after your surgery did it occur?
  • I'm actually about 9 days post-op from a microdiscectomy at L4/L5 and hoping for some pain to return. I know it sounds crazy, but I had this surgery before at L5/S1 and know what to expect.
    In both cases I had severe (10 on the pain scale) pain in my left leg and foot, followed by numbness and loss of motor function in my calf prior to surgery. After the first surgery when the nerve started to repair, I had pain and odd sensations in my foot and leg before everything returned to normal.
    This time, my foot and calf are still numb. Only some sensation has returned, but I still have "drop foot". It's almost like I didn't even have surgery, except for the incision pain and some back pain.

    In this case I don't think pain and odd sensations are necessarily a bad thing.
  • Hi, Jes!

    Just checking to see how you're doing. Has some of your feeling (pain) returned? Are you feeling better about the outcome of your surgery?

  • I reherniated L4-5 1 month post op and I don't recall doing anything that may have caused this. I just remember the pain escalating so badly that I called my surgeon crying, and I went back to be examined. They sent me in for a post op MRI which found the problem, and I went through 2 post op ESI's which didn't help. After 3 months of this I was dismissed from the surgeon's service and referred to pain mgt. A few months later I scheduled a 2 level TLIF with a NS this time around. I had other problems besides the recurrent herniation including vertebral slippage, severe DDD on L4-S1, and nerve compression.

    Anyway, I hope you continue to improve and your pain goes away completely.
  • Hi, again.

    Just wanted to update everyone to say that the pain I'd felt about 6 weeks ago was fleeting and certainly must have been, as suggested, the steroids used to irrigate the wound wearing off. All is well!
  • Hello, fellow back-pain sufferers. As you can see by this thread, I was a frequent attendee in this forum two years ago--almost exactly. Now I have sciatic pain on the RIGHT side (my diskectomy was on the left in '09). Went to the doctor last week thinking it was my spinal stenosis causing the pain, but he seems to think it's another herniated disk. UGH. I am scheduled to begin PT on Wednesday, then we'll go from there.

    Anyone out there ever been in this same situation: Diskectomy on one side one year, and on the opposite side down the road?

  • if you're lucky is a long term fix. For most it is just stalling time on the disc wearing out. Re-herniating the same disc or one above/below is common. No surprise.

    Do your PT and all the non-invasive stuff you can.
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