Healing After L4/5, L5/S1 Laminectomy and Discectomy: It takes time, but there is hope

Healing After L4/5, L5/S1 Laminectomy and Discectomy: It takes time, but there is hope

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independantedge
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Healing After L4/5, L5/S1 Laminectomy and Discectomy: It takes time, but there is hope

I'm writing this because I know that somewhere out there, there is another person who will go through the same experience as me, and I want to reassure them that there is hope of recovery, but that it may take a long time.

Background - At the time, 24 year old male in good shape, ran several times a week and lifted. I fell on my back twice, and bad stuff ensued. Only a few days after falling on my back the second time, I began to go numb in most of the lower part of my right leg and part of my left leg. I had foot drop on the right side, and numbness in my right calf. Most of my pain, which was pretty intense, was on my right side. Diagnosed as L4-L5, L5-S1 herniation with severe spinal stenosis at both levels. Had L4-L5, L5-S1 discectomy and right sided hemilaminectomy about 2 weeks after the accident, in August 2010.

Immediate Post-Op - The feeling didn't come back when I woke up. I had foot drop for about a month and a half after the operation. I found walking or standing for even 10 minutes would send zings down my left side to my shin (as opposed to the right side pre-op). In addition to the left-sided sciatica, I had pretty severe lower left back pain which would come on after 10 or 20 minutes of standing or walking.

Further Post-Op - I started doing PT about a month and a half after the operation. It made me feel much less stiff, but didn't relieve much of the back or leg pain. Stretching my hamstrings, quads, and calfs felt good, but it just didn't seem to be helping. And while the exercises they gave me also felt good, they didn't pay dividends in pain relief. This went on for several months, until January 2011. So basically, from the operation until 5 months later (yes, 5 months), I didn't see a significant drop in pain. Yes, I could walk a bit further and stand a bit longer, but not by much. Standing was the worst. I had to take the bus to work, which entailed standing for about 15 minutes. And that was impossible, absolutely impossible. My lower back and leg began to hurt within a few minutes of standing still. I found that the only way I could manage to get a seat on the bus daily was to walk the opposite way toward the bus so that I could get on at an earlier stop. In retrospect, that was a pretty desperate move. Simultaneously with the PT, I was trying to swim frequently. At first it was just really easy breaststroke, which after a month or two progressed into some really easy freestyle, all in a heated pool. While I was swimming, I felt great, but as soon as I got out of the pool, the pain came on even faster.

Second MRI - Because things were progressing so slowly, I had a post-op MRI done. Everything looked fine except for facet arthropathy at L4, L5, S1. Keep that in mind. No re-herniations, which surprised my doc considering my sciatica.

Post-MRI: My insurance stopped covering PT after January. It made me sad and anxious. I continued doing the exercises they had recommended, and was stretching every single morning (yes, every single morning). I was loose, but not pain free. Around January, I went back to an osteopath I had seen right before my operation. He worked on my back, cracked it, and I felt an enormous release from pain. He had cracked precisely the spot in my lower back which had been hurting. He had released a stuck facet joint, and wow, it felt amazing. It felt so good, it made me laugh as a reflex. This was my first hint that manipulation could help. A few weeks later I started seeing a chiropractor, who told me I had facet syndrome (swollen facets), and that he could help. I went to him once a week for three weeks. While I felt really great right after the manipulations, they didnt have any lasting pain relief past the first few minutes, at least nothing I could really notice. But then, after those three weeks, I found that my lower left back pain had decreased significantly. The leg pain was still there, but by golly, the back was a lot better. That progressed for a while, and by about February or March, I would say I was facet pain free.

But, the leg pain was still there, and because my back pain was gone the leg pain just grew to occupy my mind that much more. I still couldn't stand (10/15 minutes) or walk (one hour) for that long because the leg pain would come on. After a great deal of consultation and thought, I decided that what I was sufferring was probably SI joint inflammation on the left side which irritated a sciatic nerve. I saw 2 more PTs about this, who gave me a bunch of exercises to do. Some of them worked, some of them didn't. Looking back on it, some of the exercises which targeted my hips caused my pain to increase then, but as I kept doing them, the resulting pain went away and my hips got stronger. Right around August 2011, I found that I could stand with minimal pain again. That meant that if I stood still for a while, the leg pain would come on, but it would go away. And it wouldn't be very intense. That was ONE YEAR POST-OP. It's not October, one year two months post-op, and I just went to my first concert since my fall. I stood for a few hours, during which I felt a zing maybe three or four times for a few seconds. That's pretty good, and I hope that I will continue to improve from here.

I want to give people the advice that I wish I had heard from someone, so here it is (sorry for the length):

1. Diagnosis. If you have symptoms like mine (leg pain on the opposite side post-op, lower left back pain, and notoriously tight hips in my case), suggest to your medical professional of choice that it might be SI joint pain. The SI joint can cause sciatica, or so they tell me. Strengthen your hips and stretch them, don't ignore them.

2. When you go to PT, ask them about stretching with a towel under your back. I did piriformis stretches on my back for four months without realizing that the entire time, I was flexing (curving) my lower back so that I could get the stretch. This was bad for my discs, and made the stretch less effective. It probably also made by SI symptoms much worse. Solution: fold a towel, put it under your back right below your belly button. This forces your back to extend (as if you were standing very straight), and then the stretch works much better. DISCLAIMER: I'm not a medical professional, this is not meant as medical advice, but rather as something to ask your own medical professional about. It worked for me, it may be terrible for you, I don't know. But please do ask. I learned the technique at yoga, and I have to say that the towel probably had the single greatest impact on improving my flexibility of anything I did. It is so effective, you would not believe it.

3. This is a mental battle you are about to undertake in your recovery. Talk to people, let friends know you need help. The good ones will reach out and talk to you. Honestly, consider springing for a therapist once in a while. I didn't have one, but I wish I did. Remember that you will have many, many dark days. Keep a blog about them, so that when you get to the next, you can look back at the last and witness your progress. I kept an excel spreadsheet of how my back pain was daily, including detailed comments, 0-10 rating of pain, and logs of activities (walking/swimming/biking) I did that day.

4. Chiropractic/Osteopathic Medicine: These helped me a lot. They may/may not help you. They may make you even worse, I don't know. But ask someone about them, like your surgeon. If you get the thumbs up, give it a try. I would say wait a few months post-op before you go, because manipulation is pretty dangerous if you haven't healed enough.

5. If you have SI pain, do the bird-dog exercise. Do it every morning. Seriously. I started doing it again every morning about 9 months post-op, and felt a pretty significant difference a week after I started doing it. I learned about it at PT 3 months post-op and did it on/off for a while, but it really only had an impact once I did it every day. I do 30 reps on each side. You should be fatigued by the end. Make sure you have good form, don't twist your back.

6. Swimming. Once I figured out how to strengthen my hips during swimming, I felt like I derived much more benefit. I realized my kicking was really weak, so I started using a kickboard. It was nearly impossible to do a single length because my hips were so weak. Now it's not, my hips feel stronger, and I have less back pain. The first few times I used a kickboard, it hurt quite a lot after I got out of the pool. But then, it started going down. If things hurt, don't be deterred, but BE CAREFUL. You have to know when to push yourself and when to bow out.

7. If you take ibuprofen, take it consistently for a week. Don't take it when you're in pain, take it constantly. I did 400 mg 3 times a day.

8. Spend your newfound time (no longer spent going out) learning how to do something. I wrote a story. It was incredibly cathartic, and looking back on it, I never would have been able to write the way I did if I wasn't going through so much.

9. Keep a detailed log of your progress. I made an excel spreadsheet where each day I entered pain level on a 1-10 scale, how much I walked, swam, biked, and then a comments section where I left details on how long it took pain to come on, exactly where the pain is, etc. You may not realize it now, but pain is impossible to recall retrospectively. You may think the pain is unforgettable, but after a month, you won't remember whether that pain on the outside of your knee just below the kneecap is new, or whether it is actually just some old thing you've always had. Write stuff down. Keep a blog too. On the especially dark days during flareups, take a look at it. Use Excel to make a plot of pain vs. time. Know what you'll find? There is probably a steady downtrend, but interspersed are little peaks of pain where your flareups happened. Get it in your head that flareups are transient and that you'll get past them.

10. In the beginning, keep your back warm. I always wore an extra layer and spent 20 bucks on a heating pad. Great idea. After a while, you'll probably find that you won't need the heating pad. It took me a while (maybe 8 or 9 months) to get to that point though.

11. Do planks for your abs. They are so good for you. If you hurt your back, your abs aren't strong enough. I had strong abs. But they weren't strong enough. So strengthen them. Shoot for 3x a week. Enough said.

12. This is the last thing. STOP LOOKING AT FORUMS LIKE THIS ONE. When I was bedridden for two months, I was a hawk on sites like this. Believe me, they only bring you down. Stop looking for people in situations similar to your own. Most of the stories you read are not representative of your own recovery. How did I learn to stop reading sites like this one? I came across a story about a man who was in absolutely perpetual, constant pain for the last five years. No position would relieve his pain. He wrote three pages about it. I'm sure he wasn't lying. But that isn't me, and it probably isn't you. When I read that story, I knew reading this stuff was absolutely ridiculous. Let this be the last post you read.

Remember, healing your back takes time. Mine isn't done healing yet. Over a year out of my surgery, and I still feel like I am getting better and better. Let that encourage you. Now go and do some planks.

Ouch1987
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Whoa

I'm that "someone with the similar experience" you wrote this for (and I'm sure lots of others will relate as well). You just blew my mind, this post is exactly what I've needed. 24 year old female, same l4/l5 l5/s1 deal, had pain for about 8 months until discectomy/laminectomy 3 months ago.

Surgery was never on my radar, then all of a sudden I had like a week and a half to prepare and no idea what to expect or what recovery would be like. Had the surg, and since then, have been SO down because of the slow recovery. It just started affecting me mentally, especially: simple tasks turning into slow tasks (like picking up something i dropped or shaving my legs or walking uphill), friends/family not being able to relate to understand what I've been facing, no exercise (I'd give ANYTHING to be able to do a workout without worrying about my back), not participating in hmm basically anything i want to (concerts, walking my dog, going out on weekends, running), the lingering pain (sciatic & lower back), the list goes on and on.

So, I felt very isolated. Had a ton of anxiety/ constant worrying if I'd ever get better, which is how i found this forum. It has been SO helpful in many ways, but at the same time, you're so right- I am just not in a place where I should focus too much on other's stories. Lying in bed in pain at night with anxiety can put your thoughts in a bad spot, and I believe I'm in that bad spot.

The way you describe your recovery sounds so on-point with mine. 3 months post-op with definite improvement but still some daily pain, some days are great while some are those days that set your hope back so far that you don't think you'll ever have a good day again (def going to keep a log now). I was ready to give up on PT and say this is it forever and just crawl into a hole. My surgeon, phys therapist, and others have told me it's still early, and I'm (slowly) healing and they're confident I'll continue improving, but it means nothing when I'm standing there and my leg pain is raging because the nerve flared up yet again. Clearly, this is the state I'm in right now.

This post encouraged me, and I hope it helps others that might be going through this. I always get into a rut when I'm sitting at home on weekend nights when all my friends are out, but I love the idea of doing something new. For real. I would love to re-focus some of these feelings. I'm gonna stick it out with PT even though It amazes me that after 2 months they still can only fit me in at the most inconvenient times (am I alone with this?). A few of my friends have been pretty supportive when I've reached out, and I'll make sure I keep working on those relationships.

Thank you. I doubt you'll ever be back to read this, but you just triggered a turning point for how I view my recovery. I'm going to take a more proactive role in it. My back has been my priority these past few months, but there is more to it than rest and reading about my surgery and showing up to PT. I wish I had one of the "had surgery, 1 month later I'm 100% stories," but I don't. My recovery might be slow, but hey, it's getting better slowly but surely, and I'm happy with that. I have a long road ahead of me with this recovery, and even I don't quite see it yet, I have a feeling there's light at the end of this tunnel

brokenbrian
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I'm 3 months out and still

I'm 3 months out and still have some decent days and some really bad days, and still get some sort of leg/sciatic pain every day. Both of your posts help make me feel a little better.

If you read a lot on different message boards it seems more common that people are still in pain after a discectomy and its not as easy of a recovery time as most drs will tell you. But it seems like most people slowly do improve and we have to remember it may take time. It may take a year or more but as long as we stay positive and keep up with PT and walking, we will get there.

robf76
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5 weeks post op

Hi,
I had an endoscopic Foranimotomy/microdiscectomy at Right L4/5 and L5/S1 5 weeks ago. Am a competitive runner - half marathon distances and run for a club and nationals too. Have never had back pain until had a car crash in October 2011 when a van smashed into me whilst stationery. Within a week could barely walk, had never known pain like it. Am in the UK and luckily have medical insurance so had an MRI Scan and saw Consultant within a week.
I do a physically demanding job within Aviation and means I have to stand for most my shift and also lift some weights. The information here is really vague. I was told to do some simple exercises for 2 weeks until see the consultant again. I sa him 10 days post op where he said the op went well..so off you go!!! People been saying should be fine and back to work by week 6..yet I'm week 5 and no way can stand for a whole day - managing a 1mile walk at the moment. Find that all the information takes me to US sites. I've not been told what I'm supposed to do - can i bend, twist, stretch, lift weights etc?? No one really tells me anything..and this is with Private Medical cover!!! Frustration has kicked in, I must admit!!

Carl Oswald
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This is exactly what I needed

This is exactly what I needed to hear... I am 5 months post op and frustrated.. I swim and exercise daily and have gone through 8 weeks of therapy with a pro.. I feel I am on the verge of a breakthrough and have some bright spots of improvement with the numbness and leg weakness and pain very similar to yours...Then I have a setback.. usually when I overdo my workouts, or stand or sit too long in one position.. Depends who you listen too, but the consensus seems to be at least a year for major improvement and the confidence to return to my normal active lifestyle.. And, that being proactive in a proper exercise program, and keeping a positive attitude.. Thanks.

carl

broken77
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Omg finally !!!!! Some

Omg finally !!!!! Some positive posts ! I have been really down lately because I am 6 weeks post op from laminotomy/farminotomy of L4/5 L5/S1 and still have nerve pain. I injured myself at work almost a year ago (law enforcement) and I am not the man I used to be. Haven't had a real work out since now that I had the surgery I was excited to get back to my normal life only to still be in pain. Surgeon says that since it was imprinted for so long it will take time to heal...anyone else hear the same story ?

Doreen2
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8 weeks post op

This thread has really helped me. I am 8 weeks post up l5/s1 and am having such stiffness in my low back and hip pain after surgery. My doctor gave me no restrictions 2 weeks post op and did not think I needed PT. When he said it would take a year for my leg to heal I did not think it meant my low back. I have been really confused.
Thank you all

12/24/13 laminectomy/discetomy of L5

RubyTuesday
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Yes

Yes, thank you for this very encouraging post. I'm 2 months post-op from an L4-L5 fusion (God, it seems longer than 2 months). I think the actual fusion is coming along quite well, but here recently, I've come to think I either have hip bursitis or SI joint issues. My Neurosurgeon told me both before and after surgery that he wouldn't be sending me to PT. Consequently, I have no idea what exercises/stretches I should be doing. Am I okay to do the bird dog?

Anyway, thanks for encouraging me and a lot of other people, although no two recoveries are the same, it still gives us hope.

Synovial cyst removal in 2008. L4-L5 facet joint.
Lumbar fusion at L4-L5 in December 2013. TLIF posterior entry

TexasTrix
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8 weeks post op on L3/L4 and L4/L5 and S1

Did you ask your doctor if this was normal? Or ask him any of the questions you posted here? No one on the forums is a medical professional, therefore we can not answer if this is normal or not, or if it might be causing referred pain.
One thing is concerning, why are you spending the last three years in bed? In most situations , being bed ridden is not helpful, and more often than not causes even more medical problems down the road and leads to breakdown of muscle and loss of strength and stamina.

I'm not in bed. Where is my post?

TexasTrix
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This is weird. I didn't write this but showed up under my post

TexasTrix wrote:
Did you ask your doctor if this was normal? Or ask him any of the questions you posted here? No one on the forums is a medical professional, therefore we can not answer if this is normal or not, or if it might be causing referred pain.
One thing is concerning, why are you spending the last three years in bed? In most situations , being bed ridden is not helpful, and more often than not causes even more medical problems down the road and leads to breakdown of muscle and loss of strength and stamina.

I did not write this post. I am not in bed. Where is my post??

MK1151
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Post laminectomy pain

I feel lessanxious after reading these posts. Thank you all for sharing you experiences.

I suffered with major sciatica (consistent 9+ pain scale) for several months and was basically wheelchair ridden from Dec 2013 onward. Aleve, tylenol, tylenol pm, oxycodone, morphine, etc little help. I would scream in the middle of the night waking my wife - not to mention scare the bejesus out of my kids 13 and 10. I can't overemphasize how horrible this made me feel - now my problem was affecting everyone's state of mind and well-being. Maybe an hour of sleep a night if lucky - every few days i would literally collapse for several hours. I would wheelchair into work/work from home but productivity was maybe 25%.

After several months of the usual conservative measures......
I underwent an L4/L5 bilateral laminectomy/disectomy on 3/18/14. According to the surgeon, the herniation was pretty severe - the initial MRI showed a very constricted spinal column.

No pain 3-4 days after surgery and then sciatica returned along back of left thigh mainly during the evenings (about a 4 level pain during the day and 7-8 at night). I am back on oxycodone and am averaging 2 hrs sleep per night. Also, i feel like im wearing ski boots. Lots of lower leg numbness and it's really hard to flex my ankles and toes. No real progress in the past few week, except i can move my toes a little more. While not in as bad pain as pre-op, my mental state is worse since now i am wondering when does it get better. The only answer i have is "eventually" (maybe, that is).

I'm supposed to be back in the office in two weeks but between the lack of sleep and pain killers i'm in no condition to to do so yet. As the primary breadwinner this is not good.

Been walking and doing light PT exercises as directed - not helping - only making the night pain worse.

Has anyone else experienced these post-op night pains? If so, any helpful ideas?

Thanks and best wishes to all.

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