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Post Sugery - walking causes worse pain than before

AnonymousUserAAnonymousUser Posts: 49,671
edited 06/11/2012 - 8:39 AM in Back Surgery and Neck Surgery

I am just a little over 2 weeks post surgery. I had a Kyphoplasty for a compression fracture of L5 and a double Microdiscectomy at the L4 & L5 levels. I was told that I should be doing some walking after the surgery and work up to 3 miles a day or so. I guess this what they tell most people. My problem is that walking even only 1/10 mile 2-3 times a day irritates and brings back leg, hip, and butt pain that is worse than before my surgery. I called my Neurosurgeons office a few days ago and told them about the pain. They prescribed Prednisone 4 mg in a 6 day triangle dose pack. This is in addition to taking Loratab 10 x 4, Lyrica 75 x 2, Mobic (NSAID) x 1, and a muscle relaxant x 1. In addition they moved my follow up appointment from 6 weeks to 2 weeks (tomorrow).

The Prednisone seems to have really helped the leg pain (I'm now on day 4) but it comes right back if I try to go out for a walk, even a short one. In addition I am now experiencing back pain spasms which have only just started a couple days ago usually when doing something like sitting, standing, or bending to try and put a shoe on. I assume that this due to my muscles losing their tone from all of the sitting or laying around I've been dong. I have always been an active person, and I want to do more but every time I do it just makes the pain worse, often more so than before the surgery. I've not been missing any doses on my medications because they are all that's keeping the pain at bay (even though I really would like to cut back).

They say that something like 90% of all people are supposed to feel much better by 2 weeks post surgery But I seem to be going the other way. This is not looking good because at some point I need to return to work. Has anyone else had surgery and been unable to do the walking exercises that one is supposed to do post surgery? This is really starting to get me worried...


  • I'm glad you're going to see the surgeon tomorrow. This just doesn't sound like normal pain, although a Kyphoplasty is a bit more involved than a micro-d or a fusion, for that matter. I would expect you would be in some pain. What did they tell you about normal recovery time? I also think that 3 miles to walk so soon after surgery would be an unreasonable expectation. I hope the prednisone helps. It really does wonders for me, but I hate the side effects, so I try as hard as possible not to need it.

    3 level spinal fusion, L3/4, L4/5, L5/S1, November 2008. Stiff, but I can walk.
  • Sometimes there is a problem with inflammation after surgery. This is why you were given the medrol pack. But it is good to check in with your surgeon just to be sure. I don't know anything about kyphoplasty other than what I have read, so can't be any help in that regard.

    Hopefully it is just a small setback and the prednisone will take care of it.

    Unfortunately, for a variety of reasons, some people have more pain after surgery for a period of time. Hopefully your surgeon can give you some answers.

  • Hi Linda,

    They told me that I should expect to feel better in a couple of weeks and to be careful because the problem they often have is people who feel so good that they re-injure themselves. They also told me not to lift more than 5-10 lbs for 6 weeks and to walk several times a day and work up to 3 miles letting pain be my guide. Of course with pain being my guide that ended up being like next to nothing.

    Actually though for the first 3-4 days I felt much better and had worked myself up to walking maybe 1/2 mile. I ended up cutting it way back and stopping it altogether except for walking around the house, to the mailbox, or around the grocery store, due to the pain returning.

    From the reading I've been doing here and other places I'm afraid of fearful of having sustained long term nerve damage. I suffered with sciatic pains for the last 2-3 years with doctors giving me NSAID's and then Lyrica. Finally with a new doctor and with pain meds failing to give relief I pretty much demanded to get to the bottom of all this and so went through a barrage of X-Rays, nerve studies, and finally an MRI. I was then refereed to a Neurosurgeon who agreed to see me ASAP and scheduled me for surgery the next week after seeing my files.

    Actually, what they found was that my spine was quite a mess. Scoliosis, L5 Compression Fracture, L4 and L5 Bulging Discs, Congenital Deformities, Bone Spurs, and indications of Arthritis. My Neurosurgeon said he was amazed that I had never showed up at a Spine Center years earlier. You would think that some of my previous doctors (one of them at least) would have seen some of this on the numerous back X-Rays and such that I've had over the years and referred me to a specialist a long time ago rather than continue to prescribe pain medications. It finally took me demanding more than prescriptions to get to see a specialist.
  • Hi Andy,

    I don't have any advice but I just wanted to let you know that I'm going through the exact same thing you are right now. I'm curious, where did you hear "They say that something like 90% of all people are supposed to feel much better by 2 weeks post surgery" ? I'm almost 2 weeks post op and I am nowhere near to having my pain relieved, so I think you and I perhaps just heal more slowly. Don't push yourself, if you feel hurt then rest, rest, rest.

    I will be thinking of you and checking back on your posts to see how you're doing!
  • Thanks, although it looks like you went through a little more than I did from the posts in your surgery thread.

    Aside from needing to get better so I can get back to work though this pain is a walk in the park for me as I almost didn't make it through a very severe case of Acute Necrotizing Pancreatitis just 2 years ago that landed me in the hospital for 3-1/2 months and in CCU for almost 3 weeks. Now that was pain!

    I saw where they had you on the pain pump after your surgery, I had that for several days after my abdominal surgery.

    Anyway, yes they did told me that around 90% of people have very positive outcomes and most have their sciatic pain (not surgical surgical pain of course) relieved very quickly after surgery.

    I guess I've just not been very lucky with surgeries in general as my pancreatitis that almost killed me was caused by an outpatient surgical procedure that went bad. (Yes, I was the less than 1/2 of 1% patient that they tell you about on those release forms that you have to sign). Anyway thanks for the reply and I'll post up after seeing the doctor tomorrow.

  • after microD. The spasms are pretty normal and so is the nerve pain. The nerve will take a good long while to heal. I have heard that the longer it was compressed the longer it takes to heal. I could not even lift my R leg after surgery. I had to lift my leg by my pant leg in order to get in and out of the car. My opinion is that you are experiencing very normal things. I only had a microD and was not told to do that much walking after surgery. At the 2 week mark I was back at the docs for medial branch blocks and a 3 level rhizotomy. Try not to worry too much about this. Post and let us know how you make out at the follow up.
  • Hi Everyone,

    Well I saw my doctor today. When I questioned him about my recovery he said I'm progressing slower than some of his patients, but also said that I probably just need more time to heal, and that my sciatic nerve was most likely still quite inflamed.

    In the meantime I'm scheduled for PT in a pool 3 times a week to get some exercise without 'gravity' being as much of a factor. I guess I'll know how it's proceeding when I can start cutting back on the pain meds. I will let you know how the pool thing goes.

  • I seem to recall a couple of people on the boards having pool therapy and they did really well. I was not allowed in the pool for a long, long time after surgery and often have felt that if I were, I would have done better. I truly hope it helps you out.


    3 level spinal fusion, L3/4, L4/5, L5/S1, November 2008. Stiff, but I can walk.
  • Immediately following the hydrotherapy I usually feel better even if I have aggravated things a bit. After my routine in the pool the put me on a table with a heat pad and hook me up to an electro-stimulation machine. They put four pads on my back above and below the level of my surgery and crank the machine up to where it just starts to hurt and then back it off a little. I can feel my muscles tensing and contracting, afterward I feel a a little sore but in a good sort of way... kind of like what you might feel after lifting weights.

    My biggest problem right now has been the shooting pains that have gotten worse usually from sitting, standing, bending or twisting even though I am being very careful and moving slowly. Leg pain is now substantially improved but it has been replaced with these back pains which I never had prior to surgery. As you might guess I'm not very happy with my progress to date.
  • I'm sorry to hear you are still having the nerve pain. I still have mine too :( I guess our nerves are just going to take longer than most people to heal.

    I know we had different surgeries but I'm starting to wonder why my surgeon hasn't mentioned physical therapy. I have a gym membership that includes a salt water pool and hot tub, so I'm wondering if I should just go walk in the pool during the day a bit. I bet I should be asking this to my surgeon, but I can NEVER get a hold of him. *sigh*

    You said your biggest problems occur from sitting, bending, or twisting. I thought those were big no-no's during recovery?

    I hope you're feeling better very soon!
  • "I have a gym membership that includes a salt water pool and hot tub, so I'm wondering if I should just go walk in the pool during the day a bit"

    They have me walking forward and backwards, marching (leg lifts), side steps, stretching backwards, and doing a nerve glide (hamstring stretch).

    "You said your biggest problems occur from sitting, bending, or twisting. I thought those were big no-no's during recovery?"

    Well yes you are right but one still has sit down somewhere, and then get back up (which I do very carefully), as well get dressed (it's kind of hard not to bend when putting on pants or shoes), and of course if I need to get something from the refrigerator etc... Normal everyday activities even when you are taking it easy just lying around the house require some degree of bending or twisting. No mater how much you try to avoid them.

    Anyway, thank you for the well wishes and all the best to you.

    Please do ask your doctor about physical therapy. My two therapists are quite good. I asked them what kind of background they must have to become a PT. The owner of the center has a doctorate degree and the assistant PT has a bachelors degree. It seems that physical therapists undergo a lot more training than I was aware of.
  • In the U.S. the minimal degree to get licensed by the state is a bachelor's degree that includes a hands-on internship. A lot of therapists are now going on to get a doctorate, according to the gal I worked with. Some of them use assistants to do various parts of the treatment, but the PT in charge should have at least a bachelor's degree.

    You might want to get in the habit of sitting to put on pants, shoes and socks. That way you can avoid any bending at the waist.

    It is not uncommon to have a major flare after PT is started post surgery. If you continue to have the new back pain you might want to ask your doctor for a course of oral steroids. They are often given after surgery to help reduce inflammation that may be a cause of the pain you are feeling.

    It can be a long, slow process to get rid of all the little pains that crop up post-op.


  • "It is not uncommon to have a major flare after PT is started post surgery. If you continue to have the new back pain you might want to ask your doctor for a course of oral steroids."

    I finished up a course of Prednisone about a week ago. It helped to reduce but not eliminate my leg, hip and butt pains.

    What has me worried is the emergence of these shooting back pains that feel like being stabbed with a hot knife. They only last a second or two and are associated with movement, and they have become more frequent. The leg pains last longer but are usually less severe. The strange thing is that when all this started I didn't have any back pain it was all leg pain.
  • Hi Andy - do they have you on any nerve pain meds like Lyrica, Neurontin, Gabapentin? I have a prescription for Lyrica. They gave it to me right after surgery because of the severe nerve pain in my legs. I've had a couple of flare ups since surgey and have taken it with a medrol pack when this happens. Actually, I started getting severe hip and leg pain this past week and just caved in to the Lyrica last night. Now that I have three doses in me, I notice a marked difference in the pain level. It is now tolerable, which it was not last night. I thought I would go crazy -- I had taken four oxycodone over the course of the day and still couldn't kill the pain. Today I haven't needed the oxy at all. Luckily, I have my one-year check up with the surgeon on Tuesday, so I can tell him what's going on.

    3 level spinal fusion, L3/4, L4/5, L5/S1, November 2008. Stiff, but I can walk.
  • Hi Linda,

    I am on Lyrica (75mg twice daily), plus Loratab 10/500 x 4, Mobic x 1, and Amerix (a muscle relaxant). The Lyrica does work albeit only if I double the dosage and take 2 capsule at once. I read that may people take 350 mg or more per day so I think I'm safe when I tried this. I hate having to take all of these drugs though! I had hoped that by this point I could be weaning myself off of them but that is clearly not happening.

    Anyhow, what has me concerned now is that while my leg pain is subsiding I get these shooting back pains (by shooting I mean like an electric shock that lasts for a second or two and is about a 9 on the pain scale) this all seems to be posture or movement related... If I move a certain way or assume a certain position, that will bring the pain on.

    My surgery was on the right side, and this pain is on the left side and a little higher. All of this has me worried that my surgery may have created a new 'weak link' somewhere else in my spine that may require yet another procedure. I am keeping my fingers crossed that this is just a muscular thing and that in time it will resolve itself. I'll be calling my doctors office tomorrow to inform them of his new development.

    Anyway Linda good luck and I hope that your pain issues are now resolving.


  • Hello All,

    Well I am now 4 weeks post-op and have finished my 2nd week of Physical Therapy which involves about 45 minutes per session of exercises and stretching in a small pool, and 20 minutes on a heat pad with electrical muscle stimulation. Additionally I was given a stretching routine to do while at home.

    The good news is that the PT has relieved the terrible back spasms I was getting. The bad news here is that 4 weeks post surgery I still cannot really do anything. A trip to the grocery store for instance will bring on my sciatic pain resulting in my limping in pain back to my car in the parking lot. I am usually fine as long as I DON'T DO ANYTHING. I have the feeling that I may still have something wrong and I am fearful that perhaps something didn't go right with my surgery.

    For those out there who had problems with post surgical pain did you have it most of the time or did come on as a result of activity on your part? At some point I need to return to work... here I am 4 weeks post-op and I am in worse shape now than before I had the surgery.

    I realize that things do take time to heal but I am getting apprehensive about my apparent lack of progress. I've seen where one should be walking after surgery and gradually working to up to several miles per day. Right now I am challenged to do a mere several hundred feet without pain. For someone who needs to be on his feet a lot to perform his job this is not looking good. Also I cannot work on these pain medications I have to be off 100% of anything that could cause drowsiness or confusion and I'm not even anywhere close to being able to start tapering off my medications.

    I last saw the PA ant my NS office 2 weeks ago. I will be calling them again this coming Monday. I'm going to have to demand some answers.
  • I'm sorry you are still having problems.

    What you describe sounds like you still have some nerve compression. The tissue may still be swollen or there is some mechanical reason for nerve compression. Perhaps you are doing too much activity in PT and it is aggravating the nerve.

    I know you know this...but four weeks really isn't very far out from a big surgery. But call your surgeon and see what they say. Hopefully as time goes by the situation will resolve. Unfortunately not much can be done to speed the process along.

    Let us know what your surgeon has to say...and try not to get discouraged.


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