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Leg Pain After L5 - S1 Fusion

I had surgery 5/21/2013. The problems I had the surgery for are gone but now my right leg is experiencing nerve pain. It seems to start mid way up my thigh on the bottom side of the thigh. Then the pain travels down my shin, the right side, into my ankle where it bends and my big toe is numb.

If my wife massages my leg, especially the shin, ankle and toe it goes away for a period of time, up to 2 hours.

My surgeon says that it is post-operative and is irritated nerves. My PCP, who had the same surgery from the same doctor said my nerve is cranky.

I am also experiencing atrophy of the right thigh muscle. That leg is weaker than the left leg. I walk 1.5 miles a day as instructed, I do "band" exercises where I stretch a thick band used by PT to stretch and work the muscle.

Has anyone had this problem? Is there hope? Will this eventually go away?


  • Hi golfwest. Yes, I had new leg pain after my L5-S1 fusion where I didn't have it before. My surgeon gave me a round of steroids and it went away within a couple of days. As you said..."angry nerve". I haven't had the atrophy problem. I hope things improve for you soon.
    4 level ACDF C4-C7 5-2-11, laminectomy & discectomy L4-L5 1/26/12, ALIF L4-5, L5-S1 12/10/12.
  • doc said it will go away but may take time. if you had a pinched nerve before surgery that nerve is going to start to wake back up. this can cause these issues. they said they could give me steroids for it but didn't because ant-inflammatory can hinder the healing of the fusion. its a long bumpy road :)
    injury 12/29/09. L2 henamgioma L3-S1 desiccation protrusion narrowing, L5-S1 nerve rood displaces, L4-5 annular tear DDD L5-S1. surgery 4/24/12
  • I had pain down my left leg before my fusion on 5/1/13 and just saw my doctor for my 3 month checkup. However, the pain has seemed to have returned- he tested out my left leg strength and was concerned that it was still weak, but reminded me that I had the compression and issues for 4 years (my fault for not getting in the doctor earlier to get answers). We both concluded that physical therapy could have irritated the nerve because they used resistance bands once and then I couldn't move.... I go see him in 6 weeks after returning to no bending, lifting or twisting and only walking for exercise to see if it has improved. He checked my x-rays that were taken 3 days before my appointment and said all looked okay, solid hardware and no fractures.

    However, now I am having some mid-back pain, and it has been there for 2 days now. I've tried both heat and cold therapy and ibuprofen. I wonder if I twisted something or pulled something OR if it is just the added pressure on my mid back since my lower back is fused?
    Olivia Douglass
    MIS TLIF L5/S1 on 5/1/13
  • Olivia, give your doctor a call and let them know since this sounds like something new.

    I hope you feel better soon.
    4 level ACDF C4-C7 5-2-11, laminectomy & discectomy L4-L5 1/26/12, ALIF L4-5, L5-S1 12/10/12.
  • I have nerve pain in my right leg after two discetomies, in Feb. I also had a dramatic weakness in my thigh, to the point of falling down if I bent it much. I worked a ton on strengthening it, with squats, lunges, and single leg squats. The strength is pretty much back, but still have the numbness.

    Give it up to six months and see where it's at. I would hope with a fusion that it would go away. Good luck!
  • I went in for right leg sciatic issues for an l5 s1 fusion and came out with left leg nerve issues.. they all say... wait wait wait.. right now on a round of steroids, which is my last chance effort... my leg is numb down to my calf to my toes to the bottom of my foot.. that's what makes walking tough. the bottom of my foot pain is horrible... I use a cane for distances longer than a block surgeon is 'done', has sent me off to pain mgmt.. lots of PT and lots of physical work to get the calf muscle back... it's gone - so is my ankle reflex... i am stronger today than yesterday but still walk with a hitch. and cross my fingers that eventually, this goes away.. I've heard it can take 2 years.. I have plenty of time, but tired of the pain... wishing everyone well...
  • Hello all friends of the back! Feb 2013 I had L4-S1 fusion with all the hardware. I have intense pain from the nerves in my right leg. I have been told the same information, it takes time. I guess we all hang in and support one another! Keep smiling and we will make it!!!
  • HOPE so... seeing yet another pain mgmt. dr on Saturday... they claim an epidural might work to chill the nerves out enough to let them heal.. either that or epidurolysis to wash out scar tissue??? more internet searching... the sterioid by mouth did not work. I cannot do lyrica or gaba again.. I was way too scattered and have to work for a living (!) wish I had a few more month off before I HAD gone back to work... the pain is ridiculous during the day and have no choice but to tough it out w/ just Tylenol until the evenings.... then... it's percoset or oxy and passing out... sad... :-( trying so hard daily to be positive...
  • Hello!!

    I finally saw my doctor and mentioned the nerve pain returning in my left leg and the notice that my calf muscles are constantly in a knot. His response was that that hardware looked good according to the x-rays of the fusion, but I could've irritated the nerve by doing too much in PT. He suggested that I go back to the NO bending, lifting, twisting and try to do some of the easier stretches.... instead of wanting to see me at the 6 month mark (I saw him at the 3 month), he wanted to see me at the 6 week mark. I go back on Friday-- pain/weakness/numbness comes and goes but when it comes it is just like before my fusion.
    Olivia Douglass
    MIS TLIF L5/S1 on 5/1/13
  • I have spent the last 12 months in various stages of pain numbness, tingling etc. The treatments I tried include:
    1. PT including water therapy
    2. Cold Laser Therapy
    3. Essential Oils
    4. Melaluca Pain-A-Trate
    5. Stretching morning and evening
    6. I spent a lot of time in the Psalms
    7. I spent a lot of time in prayer for my friends suffering from various maladies

    I can say after 11 months, 4 days, the only issue I now have is tingling and numbness in my big toe on the right foot. Oddly enough, I would say that my back still hurts when I do manual labor in the yard and other things but only for a day or so.

    I am grateful this is almost over; it was terrible and an experience I would not like to repeat anytime soon.
  • TfoleyTTfoley Posts: 5
    edited 05/11/2014 - 10:08 AM
    Reading all of these posts, I see very little positive posts or feedback. I'm not sure that me posting this will even attain helpful feedback, but here goes...I am 6 months post op from the above stated procedure, and I have no back problems now...NONE! What I do have is a severe case of radiculitis, and if you don't know what that is, trust me...you don't want to. Day 3 post op, my foot has felt like it is on fire. If you slightly rub the top of my foot with your finger, I will go through the roof. I was washing the dishes and a drop of water splashed out and hit my foot....I almost jumped through the ceiling....A DROP OD WATER!!! Anyway, I was walking about 3 miles a day after 3 days out of the hospital as it was the only way I could get relief, and the surgeon put me on lyrica and a handful of narcotics, and it didn't help. Moved me to an insane dose of neurotnin along with the same narcs and any improvement is slow to be seen. One good day three bad ones. CT scan looks good, and pain mgmt already shot me with a steroid in L4/L5 because of the scar tissue, they said hitting the L5/S1 would cause a spinal headache (wth???). I am pretty frustrated and I know it will be a slow recovery...I get it. What I want to know if anyone has had the same foot issues (it's not both feet, just one), I don't have leg or back pain, so that is not my problem. Anyone have problems with foot issues and what was recovery like?
  • morphia1957mmorphia1957 Posts: 84
    edited 06/25/2014 - 5:03 AM
    I went in for right leg sciatic issues for an l5 s1 fusion and came out with left leg nerve issues.. wait wait wait.. my leg is numb down to my calf to my toes to the bottom of my foot.. that's what makes walking tough. the bottom of my foot pain is horrible.. though, off a cane now... and balance is better (so there might be a silver lining) distance is still really tough.. my surgeon turned out to be an EDITand was 'done', I've been with pain mgmt. since last February. have had many nerve blocks (mild relief) lots of physical work to get the calf muscle back... which IS gone - so is my ankle reflex...my toes are all scrunchy now, more like RSD, I still walk with a hitch.- one day would love to wear SHOES again.. I cross my fingers that eventually, this goes away.. I've heard it can take 2.5 years or never...

    Post edited by Sandi for inappropriate forum language. Use of foul language is not permitted on Spine -Health.

  • in nerve pain.........and yes, it can take two years or longer, especially if the nerve damage was extensive or prolonged.
    It took me years literally to see improvement in the nerve pain. I have bilateral afo's to keep my feet from tripping me.......it's called foot drop and unfortunately, it may or may not improve. In the meantime, the use of afo's allows me to walk without falling or tripping over my own two feet.
    Gabapentin and Lyrica, amitryptaline, cymbalta, topamax and some other medications are used to treat neuropathic pain but the dosage range is wide and varied, depending on what medication is used. It may not relieve all of the pain but it may relieve some of it.

    FOOT drop
  • did you have any leg /foot pain before your surgery ? if so you will be hard pushed to see that go as it will be permanent nerve damage .however you could have sustained surgical nerve damage during your operation and that can be temporary [just whilst things settle down } the fusion was to stabilise your spine and not for pain relief .I am happy for you that you mechanical back pain has gone [ I wish mine had} give it time it can take 3 years to heal as a fusion is a massive operation .I found the gaba type drugs did more harm than good and my doctor took me off them .I just take oxycontin and diazepam ...give it time
    I have had the leg and foot problems from before the ALIF and I have been told its permanent I even received a name for the on going pain apparently I have a cross between cauda equina syndrome and arachnoiditis the consultant told me ..call it what you want !! its nerve pain and it here to stay . .lets hope ..in your case its a temporary situation and will resolve itself when things settle down ..have you thought about swimming instead of walking? you may find that helps as its not load bearing again ..just give it time
    1997 laminectomy
    2007 repeat laminectomy and discectomy L4/L5
    2011 ALIF {L4/L5/S1}
    2012 ? bowel problems .still under investigation
    2014 bladder operation may 19th 2014
  • sorry all.. didn't mean to cause a fuss.. calling my surgeon a horses' behind.. my back pain started when I was swimming, so a little hard pressed to go back to doing that again... but.. you never know... time time time and have been told, it's a bit of RSD and nerve damage. horrible. I didn't have THIS kind of pain before the surgery... and yes, the surgery was needed to correct what could have been a much bigger problem moving forward.. like, not being able to walk at all.. it was quite a year.. and it never seems to end. When damp out, and or cold, the pressure is worse. I have found that supplements like ribose, l carnitine, and coq10 work on nerves/muscles / recovery. what are bilateral afo's ??? I have the opposite of foot drop. it appears that my arch is always pulled up and I cannot point my toe... numb to the touch. painful to the touch...
  • I have been experiencing my foot burning on one side primarily. This only occurred if I do physical activity for to long. Inclination Seems to irritate the nerves in my low back. Doc is removing hardware next month
  • 5 days post op. sciatica was slight before surgery, now it dominates the back pain. old back pain gone, replaced by sciatica and its own form of back pain.

    hows everyone doing now
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