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Post Op recovery L5/S1 Micro

RookieRRookie Posts: 21
edited 06/11/2012 - 8:41 AM in Back Surgery and Neck Surgery
Good morning. Looking for a bit of advice and you guys ahve guided me well so far. If any of you recall I had a disc fragment, large, on my sciatic nerve.
I did under go surgery on Dec.4th. Microdiscectomy L5/S1.

Things have gone well. Did a ton of walking. NOw doing some upright riding and have done some very restricted weight training again off and on.

However. My surgeon did a 3 week follow up and I am scheduled ofr a 3 month follow up. His only post Op advice has been what to avoid and when to come back. No PT. NO guidance on recovery work other than walking and riding.

I am starting to get bummed. Here we are about 10 weeks post op and I am still dealing with leg discomfort. Not really pain but just general discomfort and tingling from time to time. I took this last week off again from working out and it does not change anything.(And my working out is very restricted anyway)

What should I be doing? Is this normal? Did any of you do PT post OP and can offer some advice on what I should be doing?

I have found a good PT. Seperate from my surgeon and he will work with me once the surgeon clears me which I expect to eb at the 3 month mark. But what about until then?



  • Hi,

    Sounds like you were doing well so your doctor is expecting you to just continue following the 'plan' until your 3-month post-op. I would say this doesn't mean you can't call him if you are feeling set backs or discomfort.

    I would avoid weight training until you are cleared. I was told no lifting for 3 months nothing more than a gallon of milk and nothing over my head).

    If you are feeling discomfort or intermittent tingling, have you tried to ice in 10-min increments?

    I would ask him about PT at your 3-month (or 6 week) check up. Some doctors will not prescribe any. My original doctor said he may or may not but then when I was having problems he said he definitely would. They taught me some basic core muscle strengthening exercises that were good for abs without straining the back (I new most of them). I was also having hip pain (and was given exercises to ensure I didn't develop bursitis).

    The thing with back surgery is that even though it is minimally invasive, it's still back surgery. It takes 3 months for the inner incision/surgery area to 'scar' over. Even if you feel good on the outside.

    Are you allowed to take anti-inflammatories yet?
    I know I am coming up on 2-weeks post op (of a revision microdiscectomy) and am not cleared for anti-inflammatory yet.

    If you have concerns (though sounds like your appointment is in the next 2 weeks), I would contact the doctor....that's what he's there for. Let me know what you have been doing, how you have been feeling, and what your concerns are. He will probably give you tips on how to "get by successfully" until your 3-month appt. But, at least you have given him a heads up.

    And, he should send you to PT. If he doesn't, ask him to send you to at least 6 sessions with someone who specializes in lower back surgery recovery. They will teach you some key tips.

    It's a slow recovery for long term positive results.
    Last time I pushed it too much too fast which is why I think I reherniated.

    This time, I'm following instructions and being patient. I'm not even cleared for stationary riding. Just walking and lying flat. No driving, sitting for more than 5-10 mins, etc. Walking seems to be my best results. I would love to do some light bicep/tricep work but I know it would not be wise. So, I walk and try to focus on keeping my abs tight so at least they have a chance of looking good this spring.

    Not sure if any of this was helpful but maybe others can comment.
  • Thanks. Well he told me I could lift. And I am following his advice. His advice was...just be careful. Along with a short list of things to NOT do. He said I could bench press and row all day long and that would have zero effect on anything.The discomfort is nothing bad, just there. It does not change any activiites I do. Except of course I am still not doing the things he told me not too. After my 3 wk appt he said he expects to give me a full release at the 3 month mark.
    I guess I was just wondering how long others still experienced some leg issues post op?
  • It all depends on how much the nerve was compressed or damaged prior to surgery. There is no way anyone, including doctors, can predict how long it will take or even whether the nerve will recover completely.

    I'm afraid this is just something you'll have to be patient with. Keep following all your doctor's instructions. The first three months are critical in healing and you don't want to cause a reherniation or other problem in that surgically repaired disc.

    I'm really surprised he told you it was OK to lift so soon after surgery. With a microdiscectomy, some surgeons recommend PT after surgery, but it is not routine. Walking remains the most effective exercise as it stretches out the spinal nerves without causing other stresses on the discs.

    You are still early in your recovery. Try to be patient and give the nerve sufficient time to recover from the trauma it has been through.
  • Wow.. I'm not sure what your particular case entailed, but, I wouldn't do any sitting exercises.

    Sitting is the worst thing you can do for your L5S1 area, I was told the majority of your weight through your spine is supported by the L5S1 and it's REALLY easy to blow it out again.

    Read up on the experiences people have had here.. especially those who have needed revisions.

    FWIW, I was told 6 weeks before I can do any PT other than walking.

    I'm 18 days post op on an L5S1 MicroD as well.
  • Thanks for the advice. I have back off the weights the last few days and it has stared to calm back down. I got on the eliptical the last two days and got a good cardio workout though. :)
  • Rookie...so glad to hear that you are feeling a bit better. I know how tough it is to back of weights but it's all good for the longer win! Cardio is important so glad you are finding satisfaction in that.
  • I am shocked that you went back to lifting so soon.
    What made you want to do that? (not criticizing, just curious)

    Of course, every case is different, but it took a good 6 months for my leg symptoms to fully resolve after my micro-d on L4-L5.
    (it had been compressed for a good 9 months previous to the operation)
    On the sunny and mild Central Coast of California

    L4-L5 endoscopic transforaminal microdiscectomy June, 2007
    L5-S1 endoscopic transforaminal microdiscectomy May, 2008
  • Paul said:
    I am shocked that you went back to lifting so soon.
    What made you want to do that? (not criticizing, just curious)

    Of course, every case is different, but it took a good 6 months for my leg symptoms to fully resolve after my micro-d on L4-L5.
    (it had been compressed for a good 9 months previous to the operation)
    Doc told me I could bench press and row all day long. He did give me guidelines of what to avoid. I do think I just over did it some. My nerve was NOT compressed. At all. I had zero herniation at the time of surgery. I had a disc fragment that have fallen along the nerve and caused damaged. The surgery was to remove this frgament. And all this was in a matter of weeks. Not months from when it began.
    Anyway...I do just have to slow down. I will start back with some BW work after a couple weeks then move to weights down the road.

    Thanks all.
  • Saw doc today. 3 months. Told me to get back to living my life as normal. Weight training is fine as long as I am careful and work back up slowly. Said to avoid squats and if the tingling worsens to back off. Meeting with PT on Friday.
  • Met with PT today. PT was also encouraging me to continue to lift and progress. Should me several things to add to my routine for core and mobility and checked my form on many other things.
    Not returning for ongoing PT unless I request it. Overall a very good session.
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