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Positive Straight Leg Raise Test after surgery ???

jellyhalljjellyhall Posts: 4,373
edited 06/11/2012 - 8:43 AM in Back Surgery and Neck Surgery

Can anyone say what this could mean? (Just your ideas, I won't take it as medical advice!)

I had my 7 week follow up on Monday, and the surgeon did the straight leg test on me, and the left leg got a zap of sciatica down to my calf. He didn't comment. Now I am wondering if it meant anything. It sounds like it could mean that there is compression on the nerve again. Over the last 3 or 4 weeks, I have been getting increasing leg symptoms again. Not as bad as before surgery, but they are definately familiar sensations. I have also been getting the same muscle twitching and cramps in my toes, top of my foot and even under my foot last night.

I hope that this is all normal and not a sign that I have scar tissue growing!!

My next appointment with the surgeon is in a month's time.


  • I am sortry I have no answers and I never do as I only know things from my own experiences, but I just wanted to wish you well and pray for you that it is not the return of sciatic symptoms, you have been through enough!

    Take care and good luck,
  • sorry to hear about your new pains, Are you taking any muscle relaxers, ill take a wag at maybe muscle spasms. just something to consider. my best to you.
  • At the beginning of my PT sessions, my PT will have me lay on my back and one at a time raise my leg up, I generally can raise it about 70 degrees. Often it will produce pain in my lower back and thigh. She also look at the aleignment of my pelvis by finding my hip bones. I am often out of aleignment. She does her magic, reassessed, and I can then raise my leg higher and with much less/or no pain.

    I know that your hamstrings could and probably are (just my assumption) tight, which will produce pain with a straight leg raise.

    My PT mentioned that later if my hamstrings are still tight we will work on that (but I'm not ready for that yet).

    I know you haven't started PT yet, but try not to give this too much of your energy. When you meet your therapist, I would definately talk to her/him about spinal skeletal aleignment and SI joint function/disfuntion. If you don't have a good match , (in terms of your needs), to the therapist assigned, be sure to ask for another.

    These are just my ideas and I thought I'd share in hopes to give you a place to start! Wishing you the best! xxxxx

  • I will talk to the physio about my various symptoms and we'll see what she suggests.

    This is certainly an interesting ride #:S
    It takes a lot of my attention. I wish I could just get on with the recovery without so many distractions!

    I can do this!! :-)
  • during the times I have been out of aleignment I get significant increases in pain, which mimics presurgery pain. Often with the zings of nerve pain. I've gotten to the point I can tell (based on pain)that I am out of aleignment, but can't realign myself...

    The good thing with therapy starting, you can now begin to strengthen your trunk/core muscles, which will really help!

    Just FYI, it may take a few sessions for your therapist to fully answer your questions as she gets to know you and your functional abilities!

    You may need/want to take something for spasms and pain once your therapy starts as they will be "waking Up" lots of muscles that haven't been activated lately. Mine were definately hibernating, but I've started doing crunches for abs/obliques and working on my quads! :-)
  • jelly just a wag but maybe you are trying to do too much with cleaning at home and you woke some muscles up and they are mad at you. go back to a few weeks ago and relax a little more and hopefully that helps muscles might be stretching out and pressing on nerves, just a wag.(wild a** quess) my best.
  • Hi Jelly,
    I have had similar pains to you. I definately have pain with straight leg raises in PT. My PT told me my tight hamstrings are to blame..and also that if I have back pain during PT it is because my core abd. muscles are not strong enough. My PT is very good at watching my posture during exercises and once he corrects me the pain is gone. I think I have always had bad posture so it is hard to change that.
    I have been having on and off nerve pain..in my rt hip and leg then it goes away. My left leg too, but that one has always been worse.
    I just got done cleaning the kitchen..emptying dishwasher...rinsing and reloading...even though I was squatting instead of bending my back hurts like heck right now...
    Frustrating to only get 1 chore done and be done for the day...arggggg...lol
    Like I have told you before my friend you are not alone in this..we are going through the same thing...
    Every once in a while if I try and walk too much I start getting numb toes..all kinds of different nerve stuff going on during this recovery.

  • Blazer, as I have been doing more lately, and that is when these symptoms started to increase.
    My husband thinks it is because I am doing more too.
    I should listen to him!!! Lol!

  • That's reassuring Shari, that you also get these zings of nerve pain.
    I am really looking forward to seeing the physio now. I hope I don't change my mind about that! :O

    I'll make sure that I have pain killers in the house, but I don't have any muscle relaxers.

  • Sounds like I am only experiencing what lots before me have experienced. I'm in very good company.

    I find when I get pain from doing too much, if I stop and go and lie down, it generally goes away but if I try to keep going, then the pain tends to last for the rest of the day.
    There is a good lesson there!
    Prize for the first one to spot it! =D>
  • lol..I want a prize... :)
    Yes we need to listen to our bodies more. But that is easier said than done when our house is getting messier by the minute.

  • You won the prize Tonya.

    The prize is a bar of your favourite chocolate.
    I'll send it straight away, but if it doesn't arrive, just go to your local store and buy yourself one. :D
  • Jelly, I am a few weeks ahead of you and I remember being in your shoes! I wake up feeling good (that hadn't happened in so long) I feel energetic, start walking or exercising in the pool, do a few activities, then horrible deep aching would start and I was miserable!

    I was going to take a break from PT for a while, I was just so tired of feeling bad. I talked to my PT, crying in front of many. She helped me to "see the light" reminding me of how bad I had gotten physically before surgery and how early I was in my recovery.

    I had been logging my meds, my activity/pain levels and my exercise. What she suggested was rather that logging my exercise (this comes naturally to me) to log my rest/icing. And while icing to lay with my hips and knees at 90 degress with my feet on pillows (decompressing). I had to "give myself permission" to rest! So, now, I only do 2 activities a day and rest/ice/decompress atleast 3 times a day. It has made a huge difference and I don't have that horrible night time aching any more (atleast for now).

    This is just my experience, but I hope it will be helpful!

  • I think I have probably been overdoing it. I need to ease off a bit, and see if that helps.

    Thanks for the support.
    So nice to know that others have experienced the same thing. :D
  • Are you taking any B6? I had some mild sciatica in my left side post op that I didn't have pre-op and they put me on b6 100mg at my 1 mo and I now have started to notice it getting better. I think that the increase in activity is a big factor!! Today was the achiest day I have had in a long time and I'm sure it was cuz of working all week. I know my hamstrings are tight and my legs felt soo tight, like I don't think I could have raised them 30 degrees, but just starting to feel better tonight. I rested a lot of the day.

    Don't get too crazy about the nerve sensations. They told me I would have this stuff for a while with all the nerve regeneration. The pyriformis muscle(runs through the butt) is another muscle that gets really tight with people like us and the sciatic nerve runs right under it. So even that muscle can irritate our very easily irritated, healing nerves and cause symptoms. It's going to take some time to get all these muscles stretched back. I am so glad i wasn't starting pt when I was starting work or I think I would have had problems. We'll get back there!!! Lynette
  • Hi there...just seeing this now.

    I get foot and calve cramps...they come and go.
    Last week was bad but things are settling down a little. I found drinking water helps and I've started my vitamin regimin again.

    I'm not sure about the leg pain. I do know that when I first went to PT, they did those tests and it helped them judge how to start my stretching and what to watch for. My hamstrings were so tight the first few weeks of PT b/c I essentially hadn't done any stretching for 6 months.

    I'm still tight but a bit better. I was amazed that PT in 4 weeks improved that 'stiffness' and my core starting feeling a bit stronger. I didn't have a fusion so a lot different but as much as PT kicked my butt...it did make me feel better.

    Good luck.
  • Just thought about something that my physical therapist said to me last week. My back hurts on the left down thru the back of my leg and causes my foot to become numb. I do have muscle spasms too.
    Well, she said that sometimes those contracted, spasmed muscles(like the psoas) can actually mimic sciatica...so, we are kind of working on that notion right now. I just thought it had to be the nerve itself, but maybe it's the muscle over the nerve. It still could be the nerve, but I'm just throwing that out there to you.

    Learn something new everyday!!

  • Hey Jelly! I am surprised you aren't taking a med for muscle spasms. You may want to talk with your doc about this. It is very normal and common to have significant muscle spasms after back surgery. Between all the muscles that were cut, and muscle weakness, all can create spasms which are painful.

    I can really see a difference when I am taking something for spasms. There are times when I am walking where I can just feel the spasms "grabbing" my back.

    Just food for thought as you begin the rehabilitaion phase of your journey this week. :)

    Hope you are having a happy, peaceful, painless Sunday! :)
  • I am having various muscle pains all over the place. I am forming a list so I can remember them all at my firt physio appointment next week. I would explain that as muscles that have been disturbed during the surgery (especially those that had to be removed from the laminectomy and facetectomy).

    But in addition to this, I am getting increasing amounts of the neurological pains that I was getting before surgery. Stabbing pains in my toes, tingling, numbness and twitching and cramps in my calves and feet. After my surgery, I was hardly getting any at all! I just hope that this is all part of the normal healing, but it seems strange that it is increasing. Then getting that electric shock of sciatica when my leg was lifted up, has me worried as to what it means.

    I am not taking any meds now, apart from Paracetamol at night sometimes to help me sleep. Perhaps it is normal to have all these feelings, but generally they are covered up by the meds that people take! Lol! :))(

    How are you doing now?

  • I have read before about people being given B6 after spinal surgery. I think I'll try taking it, as it can't do any harm (as long as I don't take too much).

    Thanks for reminding me! :D
  • hi jelly, ive noticed flexirel is pretty popular here, i am also taking that as a muscle relaxer, might want to ask your doctor bout getting some of them. there is also SOMA and VALIUM but you need to be very careful if he gives you valium that stuff is extremely strong and addicting. i also have both of them but very seldom take the valium, very leary of that stuff. my best.
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