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Pain after ACDF surgery

AnonymousUserAAnonymousUser Posts: 49,671
edited 06/11/2012 - 8:35 AM in Neck Pain: Cervical
Hi All...

I had an ACDF procedure performed on July 15, 2009 (C 5 and 6). For two weeks, the pain that I had experienced (neck pain and shoulder/trap pain on both sides, mostly muscle pain) vanished. Then, after those two weeks passed, my shoulder pain began to return, followed by the neck pain.

As of right now, my pain is EXACTLY the same as it was BEFORE I had the surgery. My surgeon tells me that my MRI and XRAYs are perfect, almost textbook example of how the procedure is supposed to play out. He gave me some trigger point injections (lydocane) and topical anti-inflammatory patches. Neither of these worked.

He tells me that he believes that my pain is due to the healing process after surgery. I just don't understand why the pain was absent for two weeks, only to return. I'm not sleeping well, and I completely HATE going to bed, as I know the pain is about to begin.

Is there anyone here who might be able to shed some light on this?



  • I am not sure why your pain was gone and now its back but I can tell you that a little over one month post op I was still in quite a bit of pain. I think its way too soon to see it all gone but I am not sure why it was better and now its back. Are you taking any pain meds? Are they providing any relief? Maybe some muscle relaxers would help? Are you trying heat, ice does anything help? Are you still in a collar?

    I think you are doing the right thing by going to the surgeon he would be the one that can help you the most....Hopefully..
  • HI Liby...

    Thanks for writing. To answer your questions:

    1. I am taking pain meds (Tylenol and Darvocet). It does nothing to help me.
    2. I am taking muscle relaxers. They do nothing to help me, either.
    3. I have tried heat. Sometimes that does me good, and other times it actually irritates my neck.
    4. I have been gradually working my way out of the collar (on the orders of my surgeon).

  • Sorry you are having increased pain. It does seem strange that it was gone for 2 weeks, and now return to your pre-surgery pain.

    A couple of thoughts, but please remember I'm not a medical professional.
    1) It is possible that you have swelling and inflammation causing the increase in pain. I have often read (and had myself) that doctors prescribe a medrol-dose pack for 5 days to get on top of this.
    2) If the pain continues to be this bad, I would push for a CT scan to make sure there are no bone fragments floating around.

    It is true that the post-surgery healing takes a while. The recently decompressed nerve roots like to scream pain. There will likely be stiffness and muscle pain too. But if you feel this is out of the ordinary, be your own advocate and push for more imaging. Do it in a nice way, but make sure your surgeon knows you are concerned. And it never hurts to have a 2nd opinion.

    Surviving chronic pain one day at a time, praying for a reprieve because living another 40 years like this doesn't sound too fun!
  • Have you returned to work? That can do it especially if you do computer work. Are you doing any housework or lifting? I've had to go through the list a few times when I'm hurting again. Today I woke up in terrible pain. I figured it out. I was walking without my soft collar and that sent me into horrible pain. When I do a little "cheat" and pick up something I shouldn't I pay for it. I have 3 little doggies that have hurt me a few times. I can't lift them and they are not happy about that.
  • I went to physical therapy & they loosened up the TIGHT TIGHT muscular pain that came on after surgery. Muscles & nerves were severly disturbed & sometimes can take a very long time to heal. They use tens unit & ultrasound. My shoulder was numb from the surgery for almost 4 mos. I wished I had gone to PT sooner. No pills could make my post op pain better than what I am finally getting now -
    R-E-L-I-E-F! (after just 2 visits) If you feel your recoverery has come to a dead end & you are exhausted from other efforts, I would suggest you give PT a try - that & massages. My surgeon did NOT suggest that - his ONLY concern was if his incision healed properly, then kicked me to the curb. Horrible ordeal dealing with he & his staff. DO NOT let a surgeon with no compassion whatsoever cut on you. There are PLENTY of really good ones out there. Seems like the popular ones are the worst because they have such BIG heads!!!

  • There is one thing that comes to mind during surgery. During the procedure itself the surgeons put medicine directly on the effected areas, many times. They essentially block everything out. When you wake you feel incision pain but not the actually surgery itself. That medicine should ware down in a few days. I have seen many who post right after surgery they felt ok, and then spiraled downward. This is true as everything wakes up from the surgery itself and the medicine used. Continue to do as your surgeon has requested. Each person going to surgery is going for different reasons so therapy is ordered at different points. Same reason some ppl don't need a brace and some do. Just depends on what surgery is for. If they are fixing a stability issue, more than likely therapy will be a ways out. Good luck and Keep us posted.
  • There are so many things that could have calmed your pain down after the surgery,but it really sounds to me like your experiencing post op nerve pain from inflammation around the nerves. They can remain inflamed for a very long time after your surgery and narcotics don't help nerve pain,only nerve pain meds. will help that. I had alot of nerve pain after surgery when i was starting therapy and i didn't want to start taking my nerve pain meds. again so i made an apt. with a very good accupuncturist and it took about two months of going twice a week and my nerve pain was gone and i was feeling normal again.Just something to think about.
  • The muscle tightness was causing severe nerve pain. All associated with positioning & the clamps during surgery. Accupuncture is very good for relief too. I appreciate your commenting. Might need to entertain that if this ultrasound doesn't do the trick. But so far it's great! These PT's have been around a very long time & they do not make me do any execises or anything to further disturb the muscles, as they are healing still. You take care & talk to ya later. Thx again for the input.
    Your scar is long like mine, but mine is in the back.
    Oh, PT's told me that in the front it is alot less painful of recovery & they've been doing it like that for about 10 yrs. I still am clueless why they did mine from the back of neck. I would like to tell the world that if they had the option of front or back, to go through the front, anterior. I know it is also painful, but not like posterior. Or what do you think? Describe your pain. Most say they had trouble swallowing. Makes sense.
  • Hi neck.... that was GREAT advise there.... I wish I would've read your remark when going through the ever so painful post op pain.... felt like I had a "charlie horse" up in my shoulder - it was there for about 4 mos. & finally the ultrasonic machine from PT released it! Pain from that too, but a good pain.
    Have a GREAT DAY! :)
  • I had C4-C7 ACDF with hardware in 2005. The general feeling of tightness has never gone away. Theres good days and bad days, stare too long at the computer screen and it will definately be a bad day.

    What helped me the most during the ordeal were muscle relaxers, pain meds were worthless, I was on 2 Norco's q 8 hours and all they did was amke me constipated and loopy. I found that SOMA and Ultracets seem to be the best combination, yeah they make me a little drowsy but at leats I was able to return to work. and being a nurse thats saying a lot. (6-7 hours on my feet, bending in weird ways to facilitate Pt care etc)

    When all that doesn't work, I found soaking in a hot tob helps as well.
  • I'd say painful,but i can't compare it to a back entry because i've never had on done.They say back is worse because they have to cut through alot of muscle.I was told before my surgery that if something goes wrong when he's opening my throat i could loose my speech for good,thank goodness that didn't happen.The only reason i would have preferred have the incision in the back is obvious its very noticable.If it was in the back my hair would hide it. Dressing up to go out is always a downer because i look nice everywhere else but the ugly scar on my neck.It does look a lot better now from when i took the picture thats on the site.I should do another one and show everyone what it looks like now.Over a year later.
    My recovery pain was so much lighter then the pain that i was used to before the surgery,it was like night and day. My neck was definitely sore but i would never complain about the healing i went through after the surgery in my neck.
  • Hi All...

    Thank you for replying to me. The bad news is that my pain has not gone away on its own. I have gone back on Neurontin, which is what I was on before I had the surgery. The Neurontin has made it possible for me to sleep. I am a bit "loopy", though, as this afternoon I went to put an item in my grocery cart, making a comment to my wife, when I heard "I'm sorry sir...I think you have the wrong cart." :-)

    I'm still attending physical therapy. I'm hoping that the meds will keep me able to sleep until the muscles have a chance to heal themselves.

    I am back full days at work (Computer Operations Manager) with a brand new desk system to keep me a little more ergonomically sound.

    I will post more info later.
  • Hi all...

    I'm still on Neurontin, and my pain has not really subsided. I just passed my four month since surgery point. My surgeon does not have any ideas as to why I'm still in pain. I think I wasted the time off, the money, the trouble...

  • HI, I had 4 level acdf surgery on August 25 2011 and have had 2 checkups with the neurosurgeon and x rays. He said everything is going as expected with one main problem, my VOICE is awful. I feel like I have heavy post nasal drip and a nasty cough. H e prescribed valium as a muscle relaxant and it really isn't helping very much. My neck itself is great, but i get rally tired fast and if I over do it I KNOW it-get sore across my shoulders and between my shoulder blades. Do you have these too, or am I jsut expecting too much too fast? My next appointment in 12/27 and he said that if the voice hasn't improved he wants me to see an eye, ear and nose Dr. Not sure what he can do to help but maybe a good idea. Thanks
  • hi guys. I had c 56 c 67 fused Nov. 2nd. Still have all the pain and numbness, plus more arm and shoulder pain than before. I swear it is getting worse, or easier to aggravate than ever. Is this normal? I'm a new member, but I have also had 2 L 45 surgeries (not fused), back in 2006 and 2007, with the second one being quite successful, but I knew after the first week or two that I was going to get relief from those procedures. I got about 6 months out of the first L 45 before the old pain crept back in. I just havent seen any light yet after surgery at the end of the tunnel with the shoulder pain and numbness from this c 56 c 67.
  • Hi all. I'm just a few days shy of 5 weeks post op and my burning arm pain is just as bad. In fact, it comes more often now than before surgery. I can't sleep due to the pain so I must rock in a recliner until it subsides. Methocarbamol, valium does nothing for me. I refuse to take narcotics as I don't feel any relief from them. At my post op appoitment, the doc said everything looked good but when I mention the arm pain, I'm told it will take time. I start PT next week, so I am hopeful that it may help. I see that some of you have had to go back on neurontin. I'm hoping for another solution as that didn't really help me before surgery only made me gain weight and swelling in the legs. Now, I'm back down to my normal weight and want to keep it that way. Trying to remain positive.
  • i had single fusion ACDF surgery 8-1-13, and have progressed well and at 6 months was cleared to return to the gym. I have had no issues or setbacks until recently and have experienced pain in both elbows, and numbness in my left hand. Has anyone experienced these symptoms.
  • I am 9 months out from surgery. Pre surgery I had excruciating neck pain 24/7 and some right arm pain, definitely the lesser of the toe. My neck pain has not been alleviated, in any way. I went back to work 3 months post, I had a desk job. By mid day I was in tears and on weekends only rested. ALL conservative treatments were tried prior to surgery, finally I caved and went through the surgery. Mind you, I'd been dealing with the pain for over 13 years. My neck pain has never been relieved; my GP finally took me completely off work about 6 weeks ago. I'm 50 years old and am unable to do even basic house chores without "paying for it". I'm constantly in pain. My GP stated that I'll likely have this pain for life and the lack of the quality of my life was a driving factor in pursuing disability. My family always tells me to do more, not meanly, but I can't explain the pain of just holding my head up for greater than 1/2 hour. My fear is that I waited too long to have the surgery, which showed severe damage, and I am stuck with the pain. I have minimal range of motion without shooting pain and terrible muscle spasms. Have done the PT and massage with no relief. What about others out there? One of my spinal docs, and I saw numerous, told me ACDF has a 60% success rate for neck pain. I'm curious how others are handling such a significant life change.
  • Tired of the painTTired of the pain Posts: 197
    edited 07/26/2014 - 12:29 PM
    And you will see that you are not alone. I had ACDF levels C5-7 in January 2011. I kept waiting to be healed. I called my excellent surgeon often and complained about neck pain, headaches, popping in my neck and pain in my shoulders and shooting pain down my arms to my fingers. I was told that my nerves and muscles that had been immobilized for so long were coming back to life and that was the reason for all my pain. After 6 months I was told that the fusion was progressing well and he would see me after another 6 months. He did not want to hear about my continuing pain. I was very frustrated because I had spoken to several people that had the same surgery, some of them were his patients and they had great success. Why was there no miracle for me. I was referred to a. Pain management doctor. When I got my receipt for my first appointment my diagnosis was Failed Neck Surgery Syndrome! That was about three years ago. Since that time I have found out that I had permanent nerve damage at the root of C7 on both sides. This explained the pain in my arms and hands. During this time, I have seen my pain meds increase and the pain, mobility and quality of my life deteriote. I am working full time. I have a job that requires some standing, desk work, computer work and extensive driving. My coworkers can tell most days how I am feeling by my face. I try not to cry, but there are days when the pain is unbearable.
    My family really understands but I absolutely hate how everything revolves around my pain and my medication schedule. My marriage has become stronger because my husband's commitment has been so obvious. Things are not bright, but we support each other.
    This group and the forums have been a great place for me to get information and understanding. I hope you find the same thing and that you might find a way to deal with the cards you have been dealt.
  • I have the same issue the pain is more intense and now I have been dropping things more which sounds like a nerve issue. I'm also taking strong pain and muscle relaxers to ease the pain, and if I miss a dose boy I know it. My follow up is in August and hopefully they can figure out what the issue might be. I hope that you feel better and figure out what is going on.
    David Ramsey
  • I had C3-7 done in June 2010. For the past 6 months I have been dealing with a lot of pain again in my neck and left shoulder. I had knee surgery June of this year so I was kind of focused on that. I did very well with the meniscectomy I had done on my right knee. I informed my orthopedic surgeon about this pain in my neck which has been more severe this past month with a lot of radiculopathy down my left arm and pain and muscle spasms in the left shoulder.. He said he felt it was surely coming from my neck and has prescribed physical therapy and an anti inflammatory cream which was compounded at a specialty pharmacy. Insurance wouldn't cover it so I paid a whopping 60.00 for only 2 ounces. It has ketoprofen, tramadol. baclofen, cyclobenzaprine, gapapentin, bupivacaine and menthol. I tried it this evening. Its very sticky mixture but seems to help with the pain. Before was just doing ice and biofreeze with no relief. Anyone else heard of/using this anti inflammatory cream I described? Thanks for your input.
  • My orthopedist prescribed some kind of compounded cream that has not come yet. I don't know what is in it, but he did say only use it twice a day one dollop the side of my palm
  • ....still with pain and what I call "brittle neck syndrome"- any physical insult sends me into a spiral of pain. Have pain at base of skull as well as T5 and L5/S1 all relating to the original injury. Also developed Chronic Pain/ Fibromyalgia Spectrum Disorder after the injury, making any kind of excercise challenging. Get relief from Narcotics and Gabapentin, althogh like others have said, the gabapentin makes me feel "loopy", sort of fogged up mentally. Would love to get off these drugs, but need tofigure out where the pain is coming from. New pain doc this week; heres's to hope!
    To get the best results from a spinal injury, a patient should listen to their doctor, and the doctor should listen 10 times as hard to the patient.
  • lannallanna Posts: 3
    edited 01/14/2016 - 6:17 AM
    Hi I had ACDF surgery on October 19th 2015 and after that I had no pain in my left arm or numbness. However now over two months after surgery I'm experiencing pain in my neck the pinky and ring finger on my right hand is tingling and numb and on my left hand which is the one that was hurting to begin with still have pain in my index finger and my thumb in the upper arm. Why is the pain coming back now. Can anyone answer my question. I would sure appreciate it. Thank you

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