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Post ACDF: Why do I ache so much at night?

BuelaBBuela Posts: 67
edited 06/11/2012 - 8:59 AM in Recovering from Surgery
I'm just coming up on five days post ACDF (C5-6-7). I'm trying to figure out why I feel so much worse at night. I've been trying to take my meds on schedule (nucynta plus zanaflex) instead of waiting for the pain to hit me (since I'm very prone to waiting too long), but for whatever reason the meds don't seem to make nearly as much of a dent at night - they don't make me nearly as tired, and they don't sooth nearly as much of the pain, which makes this near-impossible task of sleeping even more impossible, even before I even attempt to sleep. It's a combination of this feeling of just an overall body ache, plus a very intense ache/tightness in my shoulders and back, and to a lesser degree in my arms. I'm not feeling any specific pain related to the surgery site. I have a powered lift chair which isn't soft enough and doesn't recline enough to really work for sleeping, and I've been otherwise trying to sleep on the sofa.

Any clues or suggestions at all on how to deal with this? I had a very ugly night last night and seem to be having another one tonight. It certainly isn't helping me physically or emotionally to go through this.


  • Welcome to the other side. Recovery is a long road and you're very early in, so pain is to be expected. However, I'm not sure about why nighttime is so difficult. I remember that I also had a hard time sleeping and only slept in fits and starts for a while.

    At night, it's all quiet and it's just you and sleep doing battle - with no other activity, it's much easier to have your mind focus on the pain, especially when you just want to sleep.

    I'm wondering if you need a different medication. Nucynda is a strong morphine derivative, but you may want to talk to your surgeon about a different pain med, like Percoset or something else. It also sounds like the Zanaflex may not be a strong enough muscle relaxant for you. There are a lot of options out there, so try talking with your doc to see if there are other options that will help better.

    Take care and remember, measure your recovery in weeks, not days - it's a long road.

  • I don't know why pain increases during the night. It could be because stress on the neck during the day. It could be putting weight on the neck while laying down.

    I sometimes still take hydrocodone at night (6 mo post op). I took a painkiller at night, 2x a night, every night, for about 3 months post op. I am not sure what nucynta is, but maybe your doctor can prescribe something stronger for bed time? I also take zanaflex and I consider it a miracle drug!

    Recovery is a slow process, remember you are only 5 days post op!!
    ACDF C4-5 June 23rd, 2011

    Another surgery in the near future. I am 26 years old.

    Current Meds- Norco 7.5/325, Cymbalta 60mg, Gabapentin, Adderall 20mg
  • Had C4-C7 fusion, bone spur removal, titanium plate on August 25th. My neck itself is good, awful pain and muscle spasms across shoulders every morning. some numbness down arms and into little fingers. MY neuro, said that it is from the nerves and muscles growing back, or regenerating themselves. Heat helps, but if I get groceries, do laundry, even sweep the floor it gets A LOT worse. He prescribed voltaren and a muscle relaxant, but they put me in la la land. Also i waited a long time to have the surgery and I am 64, does anyone else have these problems. The pain radiates into my chest and really can scare you at times. Had to back off of the exercises for a while, they were making me dizzy. Thank you, I would like to know is this normal for this surgery. Not too sure i would do this again.
  • I only had a one level ACDF at C5-C6 and certain exercises make me dizzy and pain around my eye. I am not certain if it's "normal", but it happens. You need to find the right exercises that do not aggravate your muscles. I'm still working on getting the right "formula". Good luck!
    2011 ACDF C5-6 for Spondylosis with Myleopathy
    2012 L4-5 herniated disc and hernated disc at C4/5 2013 Taking Amitriptyline for headaches
  • My pt told to cut back on the exercises for about 2 weeks. He thinks that the muscles and nerves are regenerating themselves. Everything is moved when they do the surgery, and it takes time for them to get back in their usual places. The bad part is when you restart the exercises, you start at square one, and make sure that you apply heat BEFORE you do the exercises. Hope it helps.
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