Welcome, Friend!

It looks like you're new here. If you want to get involved, click one of these buttons!

Veritas-Health LLC has recently released patient forums to our Arthritis-Health web site.

Please visit http://www.arthritis-health.com/forum

There are several patient story videos on Spine-Health that talk about Arthritis. Search on Patient stories
Protect anonymity
We strongly suggest that members do not include their email addresses. Once that is published , your email address is available to anyone on the internet , including hackers.

All discussions and comments that contain an external URL will be automatically moved to the spam queue. No external URL pointing to a medical web site is permitted. Forum rules also indicate that you need prior moderator approval. If you are going to post an external URL, contact one of the moderators to get their approval.
Attention New Members
Your initial discussion or comment automatically is sent to a moderator's approval queue before it can be published.
There are no medical professionals on this forum side of the site. Therefore, no one is capable or permitted to provide any type of medical advice.
This includes any analysis, interpretation, or advice based on any diagnostic test

Continued pain after L5-S1 successful Microdiscectomy?

I did as much reading as I can on this site, but I would like to hear people's opinions from experience. As we all know, everyone's situation here unique.

So here is the story - I hurt my back lifting weights in May 2010 (I was 18 years old at the time). I was in a car accident in August 2010 which caused my L5-S1 disc to bulge. Eventually, the pain kept getting worse after trying physical therapy. Then one morning in October 2011 I woke up and could barely walk. January 2012 An MRI showed it became herniated. I went back to college and the pain got so bad that I had to withdraw.

The most logical option for me was surgery after I tried an epidural injection in March 2012 which helped for about 2 weeks. The pain was very bad and radiated down my legs all the way to my feet. On May 8, 2012 I got a Microdiscectomy at the Hospital for Special Surgery in NYC. For those of you unfamiliar, it is one of the best places to get such a surgery and has amazing success rates and world class doctors.

I was feeling better every day until about a month and a half after surgery - the pain leveled out in my lower back and most of the leg pain was gone at this time. I was doing walking and icing my back. About 2 months after surgery, they finally instructed me to begin physical therapy. Initially it was helping but the pain started to get worse after about 2 weeks. They instructed me to stop and prescribed me oral steroids and told me to rest, and told me to take 2 Aleve twice a day after that.

So at the end of August, the low back pain continued and I feel general weakness and constant stiffness in my legs. I got an MRI with contrast and they said to my amazement that it healed properly, and prescribed me more steroids (which i feel did not help). This influenced my decision to go back to college.

Now back at college and approaching 5 months since surgery, I am going to make another appointment as they instructed me to do so if I didn't begin to feel better after a month. I still have moderate lower back pain which becomes severe if I sit or walk for too long. I am still taking the Aleve as well (even though i feel as though it does nothing) and also icing it and doing some stretches. They still haven't instructed me to start physical therapy again. Could my scenario be considered normal? Could my pain just be because of muscle weakness and the fact that ive barely done physical therapy? Should i ask to start physical therapy again or ask about getting another epidural injection? Could it also be a possibility that I am just still getting adjusted to all the walking on campus and not getting enough rest? Any input is greatly appreciated!



  • As you said, everyone is different. I also had a L5S1 MicroD. I am 4 weeks post-op. I am currently doing very good. What stands out to me about your post is that you havent done much PT. I started PT 2 weeks post op, and have been going 3x week past 2 weeks. I feel so much better on days after PT. On days when I am not very active it seems I become more sore. Obviously you need to follow all of your docs orders.

    I dont think anything less then moderate to severe pain is considered abnormal after spinal surgery because we all heal differently. My docs & PT are very adamant about not letting scar tissue form, hence the early & often PT. Check my other posts if you are interested in my pre & post op details. I have put alot of info on the forum.

    Good luck!
    L5S1 REMOVED herniation. Years of pain & compression. Microdiscectomy complete!! Trying to be super smart & safe with recovery!
  • My understanding of microdiscectomies (and I have had 2 and done a ton of research but I'm not a professional) is that they are really a good solution to reduce leg pain/numbness but really have very little success in eliminating or reducing back pain.

    That being said, if your back is still hurting, perhaps you need a little more PT to help learn about maintaining good core muscle strength. Also, the better you get, the more you may have focused less on posture, especially when sitting. I know I do this and if I do it for 1-2 weeks, It takes me about a week of refocusing to reduce my pain.

    I also have issues with my lower back and night and had to get help to figure out what was going on b/c essentially suspected I was getting arthritic.

    You may want to reach out to your surgeon or general practitioner for a PT prescription - but maybe ask for one that specializes in back surgery recovery. I had great luck with my most recent PT who worked in a group that had a muscular/skeletal doctor (Physiatrist) that my General practitioner recommended.
  • The above comments are great.

    My consultant mandates swimming (forward crawl stroke - the commonest stroke) after Discectomies and as surgery prevention. Starting at a single pool length and working up to 600m per day over 3 months. Goggles and snorkel to prevent twisting for breathing. Was told that the scar tissue needed to be stretched a lot to become subtle and for the nerve to be flexible and less irritated. Builds core strenght too. I haven't started again - waiting 4 months post op for bones to completely fuse after fusion op (PT instruction).

    You are walking which is great PT. hope your not carrying heavy weight with you.

    My PT instructs use of Hot packs 4 times a day for muscle relaxation and encouragement of additional blood to injury site for healing. Sitting limited to 20 minute periods with short walk / movement in between. Apparently sitting is quite harsh on the spine / discs.

    A few thoughts for you.
  • coastirishccoastirish Posts: 19
    edited 10/10/2012 - 9:05 AM
    Hi Anthony,

    Our stories are similar in that I had a disc herniation 9/30/11, was put on steroids and rest, then returned to work. Overdid it with a overly long walk/hike in late December and was put bad on steroids and off for a few days. Returned to work after the new year and made it 3 weeks before I woke up one morning and could not walk. I had an MRI, confirming the herniation, and went in for MicroD in April 2012. 2 weeks post-op, I felt "wrong" and had another MRI, which confirming a slight re-herniation. After more rest, I started PT. By 3 weeks into it, the pain had gotten much worse. Consulted with NS in September and am scheduled for fusion at L5/S1 in early November (ALIF with posterior pins). I also have DDD and Spondylolisthesis.

    I recall that one of the things my surgeon was very concerned about was not starting PT too soon, because he felt that pushing too hard/soon after surgery might do more harm than good.

    Fusion is a drastic step. After all my research and consulting, I believe it is right for me. I'm glad you joined the site, because there is a lot of information here for you to review. There are also many others here who, thankfullly, share their stories about various treatments, both successes and not-so-much-success.

    You don't seem to be getting a lot of direction from your doctor. You may want to consider a 2nd opinion at this point. Another thing I've learned through this process is that I have to be very proactive with the doctors. They rarely volunteer any advice unless you are very persistent with questions. I don't know if they are worried about malpractice or what, but I've learned I need to go in with a list of questions and follow up questions to get anything more than general information and statistics.

    Hang in there, Anthony, and keep seeking answers and solutions to your continued pain. I hope to post updates on my surgery and recovery so others will have yet another perspective to the treatment option I've chosen. Best wishes to you.

  • Thank you all for the useful input, it means a lot to me.

    Colleen, you pretty much got my situation spot on. I have just come me to that realization that I need to be more proactive then I've been. In fact, I am in the process of getting another appointment with a different doctor (neurosurgeon this time instead of orthopedic) because I feel that I am not getting the attention I need with this one, and their entire staff just seems extremely incompetent. I will be sure to keep posting updates to my situation. I just had my records sent over to the new office (which was a nightmare with about a dozen phone calls) so I should hear back from them tomorrow.

  • DaveFusionDDaveFusion Posts: 476
    edited 10/10/2012 - 4:33 PM
    Fusion is a big step. I decided to do it for reasons detailed in another post. Risk verses benefit. I had progressive nerve damage.

    I got 4 opinions and EMG study.

    Agree with Colleen and yourself that you do have to become quite knowledgable, be proactive and probing with the surgeons and other medical providers to get the best result.

    Encourage you to continue to be proactive in exercising your way to recovery and avoid more surgery.

    However, you may wish to consider artificial disc replacement. I believe that in Europe, Spain, they are getting good results and have done lots. (google it). ADR retains mobility where fusion results in reduced mobility and increased load on adjacent discs.
  • I got another opinion which I am happy with and I'm going to try his suggestions. He said that I did heal correctly after the surgery and I definitely don't need more work done. He also said that the nerves had healed. However, he said that the pain I am having is muscoskeletal pain from the muscles in my back and my joints, and can be difficult to treat. He gave me a prescription for a new NSAID called meloxicam which will replace the Aleve I've been taking, and a script to begin physical therapy again as well. He also recommended that I go for injections again, which I scheduled to go for Wednesday the 24th. I will let everyone know the outcome. Aside from that, I have been trying heat instead of ice lately and I noticed that it works better, so what the doctor said today does make sense to me.
  • And that further surgery is not on the cards.

    Remember sitting more than 20mins in a stretch is bad, need to get up and move a bit. Tell your lecturers at college and I'm sure they will understand to stand, stretch, move.
  • I've had severe sciatic pain, down my left leg for over a year. Mostly when I stood up from any sitting position, severe spasms in my left butt cheek. This created most of my discomfort, however, I did have some numbness in my left foot/calf for a bit at the beginning, but that subsided, I think due to how active I was and remained for the entire year that I've had this issue. After many opinions, shots, massages, and almost every other alternative, I decided to have the L5/S1 Micro Discectomy 9/07/2012. After the surgery all of the pain was gone, to my amazement. Now 5 weeks after surgery, I am feeling the same nerve pull in my left butt cheek ( outside of my hip), and down the outside of my left thigh. however, the Spasms are gone, so that is good. I have not had any PT, as they examined me at the hospital and said that they didn't feel I needed it. I have my 6 week check up with my surgeon tomorrow, but I'm afraid he will say it didn't work. Has anyone had this after surgery and because the Nerve was pinched for so long, does it take time to heal?
  • @ DaveFusion, yea I was very happy to hear surgery is not needed again. Whenever I sit I always try to shift positions and get up as needed. You're not the first one to suggest telling my professors I need to get up, usually I just get up and go to the bathroom regardless. The fact that I actually have a plan now and things to try verses just sitting and waiting on it to heal is making me a lot more comfortable in dealing with pain.

    @Gkrause, Sounds like you had a similar situation to me. After my surgery, I kept feeling better and better every day (don't forget to factor in the painkillers you are probably taking). Then after about a month and a half, the pain leveled out. Looking back on it for me, I think I should have continued physical therapy sooner. I would definitely talk to your doctor about that tomorrow, the fact that they said you don't need it doesn't sound right. Make sure that you are walking every day too as that itself is important for recovery. It is important to restrengthen the muscles in the legs and become flexible again. Most importantly, DO NOT OVERDO IT! Just because you might be feeling better rapidly doesn't mean that you're healed. I'm at 5 months post-op and still feeling pain, so don't underestimate it. To answer your question, the nerves do take time to heal. My leg pain did recur a little bit after my microdiscectomy, but eventually it went away. You could be having pain due to muscle weakness or stiffness, which I found heat to be very useful for relieving that.

    Good luck, and let me know how it goes! Again, I will continue posting my updates here after I get the injections on Wednesday next week.

  • So its been 2 weeks since I got the epidural steroid injection and to be honest I really don't think it helped at all. I am supposed to go back in 2 weeks for a second one. I was looking up my symptoms and it seems like I need trger point jections which I will talk to about with my pain management doctor. I believe I'm suffering from what is referred to as Piriformis Syndrome. This page that I found describes it very well in detail and i can definitely relate to most of the symptoms as those muscles always seem to be tight.
  • NHbackNNHback Posts: 35
    edited 11/06/2012 - 10:15 AM
    Gkrause said:
    . Now 5 weeks after surgery, I am feeling the same nerve pull in my left butt cheek ( outside of my hip), and down the outside of my left thigh. .... I have my 6 week check up with my surgeon tomorrow, but I'm afraid he will say it didn't work. Has anyone had this after surgery and because the Nerve was pinched for so long, does it take time to heal?

    At 4-1/2 weeks post L5/S1 micro-D I am experincing the exact same. I see my surgeon on 11/14 but would love to hear what your Dr had to say and how you are doing since if you read this. Thank you
  • All the best with talking to your PM about PS
Sign In or Register to comment.