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Recovery from L5/S1 Fusion -- SLOW

John KevinJJohn Kevin Posts: 9
edited 05/17/2015 - 3:09 AM in Recovering from Surgery
This is my first posting here. In late march of this year, I had L5 S1 fusion with a metal support installed (I'm now the proud owner of a piece of titanium). My recovery has been exceptionally slow, to say the least.
Here's my scenario. I'm a 53 year old male. I'm in good to very good physical shape, prior to this adventure I was a committed runner; I generally ran 2-3 half marathons per year, with the necessary training being done on a weekly basis (20 miles per week, more or less). About 2 years ago I started noticing pain in my left calf. It was worse if I was standing still; walking, running or sitting mitigated the pain nicely. I did what pretty much any guy would do, and ignored it for a year. At that point, it got worse to the point where it hurt walking, running, or standing. Diagnosed as sciatic issues, I began PT and cortisone injection therapy. It continued to get progressively worse, to the point where my doctor decided surgery was the only answer. The MRI indicated a bone spur, a collapsing disk, and a little stenosis that may or may not have been a problem. During surgery, he discovered a lot of arthritis, two grape-sized cysts, and also noted that I actually have 6 lumbar verteba. He cleaned up the arthritis, removed the bone spur and the cysts, and performed a diskectomy along wiith installing the titanium appliance. He informed that he did "nudge" the nerve during surgery, and that I could expect pain for a while.
Fast forward to today, exactly 7 weeks post procedure. The scar has been healing very nicely, no issues whatsoever. The pain in my leg, however, is still bad. Really bad. I can BARELY walk half of a mile. Pain is on the left side, in the foot, calf, knee region, and left gluteal region. I'm taking percocet (5/325 * 1.5) in the morning and Advil (600mg) in the afternoon, which barely take the edge off the pain.
Here's my question. Given the extent of the procedure, is this amount of lingering pain normal? Can I expect it to continue for another month or so, and then gradually improve? Added to this scenario is that I had to relocate for my job 4 weeks ago (three states away from my old residence), so it isn't easy to get back with my original surgeon. I am in the process of locating a good Orthopedist, but it isn't easy (my employer moved me from an eastern seaboard city where doctors are pleniful to a small town area).
Am I "normal?" When, if ever, should I begin PT? And, longer term, when can I think about running again?
THANKS!
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Comments

  • I had the same procedure in December and am 52. I'm back to work full time but its tough. There's always some pain and some days are better than others. I don't know what's normal. Doctor says I'm doing great and fusing but I guess I didn't expect so much pain this far out
  • I had the same procedure in December and am 52. I'm back to work full time but its tough. There's always some pain and some days are better than others. I don't know what's normal. Doctor says I'm doing great and fusing but I guess I didn't expect so much pain this far out
  • pittpeteppittpete Posts: 19
    edited 05/17/2015 - 9:56 AM
    Advil is an anti-inflammatory and can prevent fusion..Did your Doc tell you to take it?
    Also, i would ask the Doc for the surgical report..What does nudge mean?
    How long was your nerve being compressed for?
    You need to schedule a post-op and have xrays to check the hardware...
    Also walking helps with the scar tissue formation.
    96-Right disc frag L4-L5 disco-On/off back pain,no leg pain/2007-Right herniation L5-S1 unbearable leg pain/08 L5-S1 discectomy /leg pain relieved/14-chronic LBP,rhizo relieves facet pain on right side/15-L4-S1 collapsed,facets shot,PLIF scheduled 4/13/15
  • Thanks Pittpete, I'll discontinue the Advil. I need the Percocet in order to get moving in the morning, but I hate the side effects (e.g. constipation). So, I'll switch to plain Tylenol in the afternoon instead of Advil, and continue to attempt to counter the effects of the Percocet by eating truly heroic quantities of fiber. I'll also get all of my medical records for my new orthopedist.

    Christiben, that's exactly how I'm doing - some good days, some bad days. I agree, I thought that the healing process would be a lot faster. I went for a walk tonight, about a mile or so. I did good right up to about the .75 mile point; after that, it was a real "character builder" getting back home.

    Question for any and all: how long do people take off from work following spinal fusion surgery? My doctor was exceptionally vague on the recommended period of time - he said I'd know when I could go back to work.
  • I had 2 level L4-S1 PLIF April 13 2015..Doc said i'd be out minimum of 3 months...
    Get the surgical report for you..
    Walking is also the best exercise to keep scar tissue from trapping the nerves.
    96-Right disc frag L4-L5 disco-On/off back pain,no leg pain/2007-Right herniation L5-S1 unbearable leg pain/08 L5-S1 discectomy /leg pain relieved/14-chronic LBP,rhizo relieves facet pain on right side/15-L4-S1 collapsed,facets shot,PLIF scheduled 4/13/15
  • I'm a 60 y/o that is 7 days post op from L4 L5 S1 TLIF. Incision site is healing nicely, but I'm experiencing the same symptoms as you...when I walk I have pain from lower back, across butt cheek, and down leg. I feel as though I'm having to relearn how to walk (right side only). Worse pain is at night and getting out of bed. I'm sure a lot of this will resolve over time or I'm hoping it will. I'm walking daily, but trying not to overdue it (though I'm unsure about what overdueing it is...). I'll be reading this forum posting to see what happens to you. Good luck.
  • I am 53 years old and two weeks ago I made a spine surgery with TLIF system in the L5-S1. I eliminated a herniated disc and extrageron impaired, placing me a titanium implant bone. In turn they placed support four titanium screws and bars to give better support to the column. And ten day in my house all been in pain. Sit, sleep and walk is painful. My doctor has told me that with every passing day the pain is mitigated but has not been so. I recommended I walk twice a day for 15 minutes I go increasing the time with the passing of days and as I feel better. For now I'm not taking medications with Tramadol Acetaminophen alone if I have a lot of pain. Now, I have constant pain just to sit and walk. At bedtime also just trying to find a good sleeping posture. Several night I had to get up and walk as it has been presented to me a sharp pain in my left leg. Writing from Caracas-Venezuela busacando somilares a forum to share problems and got this in English. If the translation is bad please excuse me. I have faith that with the passage of time the pain goes away. I think there is common point is the walk. Walking as it helps a lot. The point is, do u stra slowly and I despair because he wanted to run
  • Recovery seems to be a "three steps forward, two steps back" proposition. Mornings are an unmitigated disaster for me - I have to wake up at 5:30 AM and take my pain pills, so I can lurch out of bed by 6:30 and hobble to the shower. I'm a train wreck until 8:00 or so. Surprisingly, however, after that I seem to to pretty good for the rest of the day. The folks at work commented today that I seem to be moving a lot faster than I did a few weeks ago, so I'm going to take that as a positive sign.

    It still seems to me that the sciatic pain that I'm experiencing on my left side, especially first thing in the morning, is actually worse than the paint experienced prior to surgery. After reading this forum that doesn't seem to be too uncommon, so I no longer think I'm the only patient in orthopedic history to go through it. I'm still counting on what my surgeon said - it will really start to improve at about the three month mark (I'm at 8 weeks on Friday, May 22).

    Here's something new. Both before and after the procedure I've had pain in my left foot, and numbness on the superior lateral region of my left foot. The pain is still there, but the numbness seems to be morphing into itchiness. Not garden-variety itching, either -- this is a major league, high-yield, "scratch it until you hit bone" sort of itchiness. Is this common? And is it indicative of the nerve healing?

    Thanks!
  • christibencchristiben Posts: 121
    edited 05/21/2015 - 3:19 PM
    I went back to work after three months but it was really hard. Went back out for three more weeks and at five months. Its getting better but a struggle. I'm also in a new town at a new job. I'm surprised they didn't fire me. I'm trying to workout more and increase muscle tone. Energy is still a problem. I take a Tylenol three about midday. I miss my strength and mobility.
  • I'm still out of work recovering from a fusion of L3,L4, L5, & S1 on February 3, 2015. This surgery was a revision of a failed L4, L5, S1 fusion in 2013 where my screws slipped most of the way out of my L4 vertebra and made the spondylolisthesis even worse than it had been pre-op. I think that having to invade those muscles a second time has made them slower to mend. My surgeon also had to use bigger screws this time! I think we just have to keep walking and be patient. I, too, really start to struggle at the 3/4 mile mark.
  • John KevinJJohn Kevin Posts: 9
    edited 06/13/2015 - 7:56 AM
    Sorry that I've been off line so long. Work is keeping me busy. Since I last posted here, I've had a lot of changes re my lower spine. I STILL am trying to get my medical records (I moved shortly after my procedure), so I am still in search of a specialist for post-op follow up (although I have found a new GP in my new city). I'm at about 11 weeks post surgery.

    I hit my low point about 2 weeks ago. Pain was over-the-top debilitating. My left leg felt like it was exploding. I actually had to miss work a few days, as getting out of bed was almost impossible. I was also waking up screaming in pain every morning at 2:00 -2:30. The percocets were basically useless.

    And then......about a week ago, I started to feel better. A LOT better. I changed nothing in my treatment/ activity. But one morning I noticed the horrific knee and calf pain was distinctly lessened. Starting around three days ago, I went off my prescription painkillers cold turkey. This is the most awake I've felt since a couple of month before the surgery.

    To be sure, things are not perfect. Bending over is still an adventure in pain, as is getting up from a squatting position. Standing still hurts, but walking is more and more achievable (and I am aching to try a short run). My GP did X-rays a couple of days ago, and he said everything looks like it's healing nicely, and the appliance is in good shape (I've literally had nightmares about a broken screw poking out of my back).

    Here a a couple of questions. First, I've been on Percocet (5/325), for two months own and Vicodin (5/300) for a couple of months since before the surgery. Since I've discontinued use, I've noticed I wake up at around 1:00 AM feeling pretty agitated. Do I need to taper my withdrawal from the pain killers? I have plenty left, I could easily take a half pill before bed for a few days....then go to a quarter pill for a while. Good idea?

    Second, my left foot is still horrifically itchy. I'm assuming that this is the sciatic nerve healing. Will it pass? Right now, I'm eyeing a package of 60 grit sandpaper as a short term solution.

    I *>think<* my medical records are finally being sent out, note that this process can be a very, very lengthy one.

    Thanks everyone!
  • John Kevin said:
    This is my first posting here. In late march of this year, I had L5 S1 fusion with a metal support installed (I'm now the proud owner of a piece of titanium). My recovery has been exceptionally slow, to say the least.
    Here's my scenario. I'm a 53 year old male. I'm in good to very good physical shape, prior to this adventure I was a committed runner; I generally ran 2-3 half marathons per year, with the necessary training being done on a weekly basis (20 miles per week, more or less). About 2 years ago I started noticing pain in my left calf. It was worse if I was standing still; walking, running or sitting mitigated the pain nicely. I did what pretty much any guy would do, and ignored it for a year. At that point, it got worse to the point where it hurt walking, running, or standing. Diagnosed as sciatic issues, I began PT and cortisone injection therapy. It continued to get progressively worse, to the point where my doctor decided surgery was the only answer. The MRI indicated a bone spur, a collapsing disk, and a little stenosis that may or may not have been a problem. During surgery, he discovered a lot of arthritis, two grape-sized cysts, and also noted that I actually have 6 lumbar verteba. He cleaned up the arthritis, removed the bone spur and the cysts, and performed a diskectomy along wiith installing the titanium appliance. He informed that he did "nudge" the nerve during surgery, and that I could expect pain for a while.
    Fast forward to today, exactly 7 weeks post procedure. The scar has been healing very nicely, no issues whatsoever. The pain in my leg, however, is still bad. Really bad. I can BARELY walk half of a mile. Pain is on the left side, in the foot, calf, knee region, and left gluteal region. I'm taking percocet (5/325 * 1.5) in the morning and Advil (600mg) in the afternoon, which barely take the edge off the pain.
    Here's my question. Given the extent of the procedure, is this amount of lingering pain normal? Can I expect it to continue for another month or so, and then gradually improve? Added to this scenario is that I had to relocate for my job 4 weeks ago (three states away from my old residence), so it isn't easy to get back with my original surgeon. I am in the process of locating a good Orthopedist, but it isn't easy (my employer moved me from an eastern seaboard city where doctors are pleniful to a small town area).
    Am I "normal?" When, if ever, should I begin PT? And, longer term, when can I think about running again?
    THANKS!
    Except mine is the right side. 6 vertebrae as well. I was 52 now 56. I was never the same but at 7 weeks there's a long way to go. Could take 18 months before the nerves calm down they said. Now mind you I also have all L discs severely torn and ruptured but he only fixed the ddd one that was gone and bones were grinding.
    Give yourself permission to take it easy and allow your body to heal. Otherwise you could do more damage.
    Hang in there.
  • And cold turkey is never a good idea! Take the pills and go two or three days and then cut down repeat as necessary!
  • I did that too about two months after surgery. I had withdrawal for about two weeks and have been good since. I still take 1 Tylenolwith codiene in the morning with a regular tylenol and its not great but gets me to work. I have a desk job and just recently started wearing my back brace at work and it really is helping. Wish I could wake up one day with no back pain. Pushing through and moving forward but I really thought I'd be pain free by now. At least its better than before surgery so I'm staying positive. Spending my Saturday on my back on ice and its heaven. Keep on keeping on ➡
  • Things keep looking up! The difference between where I am now, and where I was two weeks ago, is nothing short of astounding. I'm now walking 2 to 3 miles per day and it feels great. I'm going to try 4 to 5 miles this weekend. There is still pain, but it has changed markedly. I'm speculating that the serious inflammation in/around the sciatic nerve has finally diminished. The pain that I now have is lingering knee, foot, and some stiffness near the incision site. Before, the pain (on the 1-10 scale) in my calf and knee was a solid 9.5. Today, at its worst, it was maybe a 2. I DID need to start taking oxycodone again at night, but only to taper myself off of it (I'm down to a half tablet at 10:00 PM). That stuff is nasty, I hate it and all off its associated side-effects; I'll be thrilled when I can push that bottle waaaaay to the back of my closet.

    What amazes me the most is that I didn't change ANYTHING, I guess it simply took this long for me to heal. I fully expect to have bad days (or less-good days, depending on your perspective) as the healing process progresses, but this has been a good week. FYI, I hit my 3 months post surgical anniversary next Friday (June 26).

    My doctor was largely on target - he told me I would be hurting for about three months. Then I'd slowly begin to improve, and achieve my "new normal" at about six months. Healing would continue, and I'd be better than I was before the whole sciatic nerve adventure began at about the one year mark. He was pretty darned close on the three month figure, so I'm hoping his clairvoyance holds true regarding the other two, still anticipated, milestones.

  • My recovery continues nicely - percocets have been tapered off, hopefully never to be used again. I'm still suffering, however, from science-fiction levels of itchiness in my left foot. Unreal. As I mentioned above, I experienced a fair amount of numbness in my foot post-surgery. The numbness is gradually fading, only to be replaced by world-class itchiness.

    Has anyone else experienced itching in a formerly numb region? Any tips for relief?
  • christibencchristiben Posts: 121
    edited 06/19/2015 - 2:30 AM
    Ugh - I'm taking all my PTO for back pain. Almost 7 months post surgery and am generally doing well, except that I have a desk job. By the end of the week, I can barely walk. I wonder if there is any non-narcotic pain reliever that will help me? Just letting nature take it's course. Hope I don't get fired. This is a major surgery and recovery is slow. My expectations were unrealistic. Another day of Ice and Soma and Tylenol. It's like the low back muscles around the fusion spasm after a long week of sitting. I get up and walk throughout the day, stretch at night, but still have problems. Good news is that I'm much better than before the surgery. Not quite 100% yet. Maybe more like 60%. I wonder if this is as good as it will get? Grateful for my terrific surgeon, but I think I thought I would be totally pain free. Wrong. Prayers and good wishes to all.
  • My medical records FINALLY made it from Virginia to Arkansas. I have an appointment with my new orthopedist in mid July. Hopefully we can talk about PT and easing back into running.

    My recovery continues to be good - orders of magnitude better than where I was a month ago. I just got home from a 4 mile walk, and I feel great!!!! I'm not gloating (I don't do that), I'm just thrilled that my legs feel sore from use right now, as opposed to blinding sciatic pain.

    So, at least in my case, there IS life after fusion surgery. I feel very, very humbled and fortunate that I've recovered to this extent. I wouldn't have believed that this would have been possible last month.

    I just registered for a 5K in September ;-) Even if I have to walk it, I now have something to look forward to on my slow journey back to normal (or the new normal)

    John
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