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When is it safe to return to work after lumbar surgery?

Hi. I just had a discectomy, laminoforaminotomy on L5 the first week of October for massive herniated disc that imprisoned my sciatic nerve. Before surgery, the Dr. told me to take off 3-4 weeks from work and that I would be probably able to return to work probably soon after that. I arranged for a substitute through Oct. 31st. However, my new post-op pain has only gotten under control in the past 5 days, I suffered some complications after surgery, and I still can't sit more than about 10 minutes at a time and then I am exhausted and in nerve or bone pain. I tried to do work remotely from home this week for several hours which made me feel less like an invalid, but I am very tired after 17 days of sleep deprivation and uncontrolled new bone pain. The pain level at times during the day is still high. At night it is generally intensely painful.

I know everyone is different and recovers at different speeds, but I really would like to return to work even though I have a long commute. If I am going to be out another month, I need to let my employer know ASAP so we can make arrangements. I am under 50, I used to walk a lot, I eat healthy food but am a bit overweight. Does anyone have any idea how long I'll be out of work? I do have a long commute and a job that requires some physical activity. I have read that it could be anywhere from 2-12 weeks recovery, but I need to be prepared when I go for my follow-up appointment. I also need to have plans to contact my employer for whatever scenario I have to deal with. I am getting increasingly frustrated and unhappy because my surgeon's team hasn't returned my calls concerning pain and a possible date when I can return to work. If they tell me I can't go back to work for a while, then I will have no paycheck during the time I am out. Does anyone have any suggestions or been in a similar situation? Thank you.


  • I think just about everybody here has been in your situation as far as work goes. Being able to work gives a person purpose and the money helps also. The doctors estimate of when you can go back is just a estimate and can change depending on what was done and how well you heal not to mention if the work that was supposed to be done was actually done and how well it was done plays into things also. Was your surgeon a board certified, Fellowship trained spinal specialist?

    The long commute doesn't sound very healthy for a back that's been operated on let alone the lifting part. Once you have had surgery it is my opinion that you need to be very aware that you are protecting your back going forward. I don't know what caused you to have surgery but you back doesn't/didn't like what you were doing with it. That needs to be addressed going forward. If it was from a accident just throw out what I said other then protecting your back going forward because now its injured.

    You have asked some questions here that need to be addressed to the doctor and then you need to follow whatever your told. You are very, very early in your recovery. You are saying that your pain is very strong while sitting. How do you think a long commute is going to work out if your having lots of pain from sitting?

    A lot of us on this forum have found that doctors are very, very optimistic about when we can go back to work. A lot of people take a good bit more time to be able to go back. I would try to work at home like you tried but keep trying longer and longer time periods. Sitting is one of the worst things you can do to a back by the way so you need to get up and walk, walk, walk. What has your doctor said? Maybe if your doctor contines to ignore you just show up at the doctors office and be a squeaky wheel. Doesn't always work but a slightly elevate voice in a waiting room can work wonders.

    You say you want to be prepared for your follow up visit but unless you have other information then you have posted there isn't much that we can do. You said you are aware of people healing at their own rates and that is true. Maybe you could ask about different drug therapies such as muscle relaxers, or medicine for nerve pain such as Nuerotin, and you may also need some Physical Therapy. Most of all you need to remember that you are very early in your healing and that you may be one of the folks that take longer to heal.

    What in you mind did you feel was going to happen after the operation?

    We all hope your able to get back to your old life and quickly.
  • Thanks, Bkins for your comments. The trigger for my problem was moving something I shouldn't have at work, then I travelled and lifted my luggage to several hotels. I thought I could walk out the pain (I usually walk several miles a day) and ignore my pain. I then caught a cold from someone I work with and had uncontrolled sneezing/coughing fits--the last straw. I spent over 4 months doing research and conservative therapy such as PT, TENS, hydro PT, and 3 epidural steroid injections that didn't help much. The 1st PT I did pre-MRI-it caused more damage as he had me doing incorrect exercises for an extruded disc at S1/L5. After the MRI and epidurals, I did another round of correct PT and hydro but couldn't do much due to pain. I was terrified of surgery (I helped take care of my dying parent with bone cancer and am all too familiar with medical mishaps) and did everything in my power to get better. I tried a lot of different meds for the pain and inflammation but I have bad reactions to most of them so I was taking Tylenol, Advil, and Vicodin at night. Plus lots of ICE.

    I had lots of recommendations (one from a neurologist I've known for 10 years who helped my mom) for my board certified spine-specialist neurosurgeon--he has a great reputation, although his team and the teaching hospital has a mixed record. The surgeon said the surgery was a success and my sciatic nerve is now free from its entanglement near my sacrum. I have less pain in the upper thigh/rear bone area and less pain radiating down the leg with numb toes. But, that pain returns if i sit too long. The pain has moved to my lower thigh, and the new post-surgical pain is primarily in all the bones of my pelvis, hips, greater trochanter. The surgeon's PA and nurse team didn't believe that I had this new intense pain. They kept saying that it wasn't possible after my surgery. They had me try Neurontin again but had to stop due to migraine, heartburn and severe chest pain. Steroids cause serious problems. I can't take muscle relaxers and a series of common drugs they usually use because I have adverse drug reactions. I went to my GP and am now doing better (sleeping more than 4 1/2 hours now) on higher Vicodin, Celebrex, and Valium at night. I want to get off these drugs as soon as I can but I think I need them right now to get rest. With surgery, I expected to get some relief from the horrible pain in my rear end that radiated down my leg and was spreading to my other leg. I expected to have some pain from the incision and the surgery itself. I took a long time to injure my nerve/back, so I suppose it'll take a while to recover.

    I think I already know that I won't be returning to work soon, but I feel I am letting my employer and the people I work with down. I miss everybody a lot and it is hard for me to not be active and do things that bring me joy. I just wish there were something else I could do. The occupational therapist who came to my home (I had to fight my surgeon's team to get some help) has been awesome. I can now put on socks (I couldn't for 16 days-thank goodness for a sock aid!) and I now have a lot of practical ways to go about taking care of myself and getting some stuff done around the house in a safe way. I just wish that I had known that this "outpatient" procedure was going to involve a lot more recovery time and life change so that I could prepare for it better. I hope I can go back to being myself in a month or so- with less excruciating pain. Thank you for sharing your knowledge and experience with me. It makes me feel less isolated.
  • you seem to be in a tough spot and it sounds like your body doesn't like foreign stuff in it. Mine doesn't either if it helps any.

    All you can do is try to get moving. If that means going from a bed to a chair then that is what it is. I think you know the drill if you have been to PT as you said. After having been to PT many, many times over the years I will always search out a PT spinal specialist. They are out there but are hard to find. For me mine was a godsend and had me doing exercises that I had not seen or done in 10 years of PT. I am trying water PT next as I've hit a wall on my land based stuff. As my PT lady says your core is pretty strong but legs are weak so onward I go. Yes, very frustrating.

    Sounds like you might continue to have issues with your doctor/or his office personel. I like my PM doctor but absoultely hate the office group he is with. I have considered leaving him because of the way things are handled and some of the womens attitude which I feel like muffeling.

    Can't offer any more help other then give it some time to heal. Sounds like you have tried most options.

    Again, Good luck.....
  • Carlton FordyCCarlton Fordy Posts: 15
    edited 11/07/2012 - 9:57 PM
    You're right, everyone is different. Don't feel like you're letting people down, this more than ever is a time to be selfish and pay attention to your own body.

    I had a microdiscectomy in April 2011 - it was awesome. The pain was gone immediately (of course not the surgery pain!!).

    I took a full 4 weeks off and then returned to work (only an office job) on a graded return to work program.

    2 weeks at 3 days x 3 hours
    2 weeks at 3 days x 5 hours
    2 weeks at 3 days x full day (7.5)
    2 weeks on 4 full days
    2 weeks on 4.5 full days

    It was probably a bit conservative, but I worked awesome. In the down time I walked, did pool sessions, stretched etc. And after about 4 months post op I was able to play sport, run, cycle what ever.

    If you want you can see some of my scans and hear about my recovery at http://l5-s1fusionrecovery.blogspot.com.au/

    Best of luck,

    PLIF L5 S1
  • I wish my pain had also gone away or at least decreased a LOT after my surgery. Unfortunately, because my nerve was affected for so long, I think I am going to have a much longer recovery period than I anticipated. I have been trying to work part of my job from home which was very difficult, but my employer has some ideas about how to make it better and more effective. I am trying to work a couple hours a day but I've figured out that I need a BREAK between those hours or the pain returns with a vengeance. I had a friend physically drive me to work for a couple hours the last 2 days which hurt a lot when I was there, but once I was back in my work environment and seeing everyone, I felt better emotionally. However, It took me all day yesterday to recover from the previous afternoon's work, and I have a feeling it will take all day today to recover from last night's work. I am also feeling tired, exhausted, more so than I ever have felt in my life. And I am having leg/foot edema (swelling) from CELEBREX which is causing another layer of discomfort and pain. My Dr. said I can't drive for probably another month but that I can now go upstairs (once or twice daily) and walk outdoors gradually. I think that'll be an improvement. I also can't return to my job until January 1st, because they want me to really take my recovery slowly. That is the real kicker because I am not used to being inactive. I am making lists of things I can do during the long recovery but I miss the human contact, my job, activity, and the income. I have got to discover what I can do to bring myself some measure of happiness for myself and others as I go through this experience. Thank you both for your help.
  • Sorry to hear how rough its been. Have you had any more recent scans to see whats going on?

    If your employer is letting you take the time off, go for, take it nice and easy, engage professionals to help with the recovery where possible
    PLIF L5 S1
  • No, I asked at my 4-week post-op with the PA if I could get another MRI to check if I re-herniated the disc but was told since I AM recovering slowly that it wasn't "needed". Evidently my herniation was so large (2CM) and had cemented itself to the lamina and foramen that they had to remove more bony substance than usual. Instead of the breezy 3-4 weeks recovery, they are now talking 8-12 weeks. That was why I have so much bone pain and nerve pain. The PA gave me a form for my employer that says I can't come back to work until January 1st. However, at the visit, I had so much foot edema that she sent me up to get an ultrasound ASAP to check that I hadn't developed DVT. That came back negative. My GP started my on Lasix a couple days ago and said that if I'm not better by tomorrow, I need to call. I may also ask at that point if I need another MRI. I have been having a bladder problem since the surgery, too.
    My employer has been great, and they've hired substitutes for me (after sort of letting me go) through December. I was working with people via SKYPE and having people come to my house (2 hours a day for 4+ days a week), but it was too exhausting and wasn't working that great. I am trying hard to work with everyone subbing for me so that I get rehired again in January after the holiday break. Now that my pain is somewhat better, I seem to be taking long naps in the afternoon, something I couldn't do the 1st 3 weeks after surgery due to uncontrolled pain. The other thing that made me feel great today was that I walked outside in the sunshine! it was great and I plan to slowly build myself up again so that I am walking several miles a day again. I just have to be careful because they don't want me to re herniate . I have hired people to help, which has been wonderful. Thanks for your suggestions and for being there.
  • DJDDJ Posts: 15
    edited 11/12/2012 - 5:04 PM
    Just listen to your body. I rushed it, partly because I had run out of sick and vacation leave...and had to burn another week because of a blood clot.

    Your body sends terrific signals if you pay enough attention.

    You're right...sunshine is an excellent therapy!
  • I just got a notice today from my employer that they want me to return my last paycheck. (That would've covered my work through 12/15 as I work part-time there.) I have tried to work from home since 20 days after surgery but this is a real kick in the pants. They are finding out if I really need to return the paycheck (already cashed) and carry it over to when I start back in early January, God willing. I have to cobble several part-time jobs together since I lost my full-time job several years ago. I just don't know how I am going to do it and I hate having to depend on my family not only for driving me around but helping me get through this surgery plus the financial situation. I think I can possibly swing it till January but it is going to be really rough. I was a mess when I got that call this morning and then a new visiting nurse called for me who didn't help matters any--she hadn't looked at my file. Afterward I took a long walk in the sunshine but I cried half the way (thank goodness I had no witnesses.) I was able to go out with a friend to a restaurant this afternoon which made me feel better, but I am having some of the same sciatic pain I had before surgery tonight. I am icing it down and hoping for the best. I feel like a country western song with everything gone wrong. I know I'll figure this out, but I don't have many reserves right now.
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