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symptoms of scar tissue vs. herniation

AnonymousUserAAnonymousUser Posts: 49,321
I've had both an MRI and a ct/myelogram, both showed no recurrent disc herniation. However, the MRI did show some scar tissue at the L5-S1 level - on the S1 nerve root (but not a lot). Does anyone know if symptoms of scar tissue after surgery are similar or the same as other conditions, such as a disc herniation or other spine conditions?

My symptoms seem so odd... walking feels like my nerve is being pulled and stretched on each step, sitting increases pain unless I use a back support, squatting and bending (even with a straight back) hurt, twisting - even a little hurts, bending at the waist of course hurts and arching my back too far hurts. When I say "hurts," I mean sciatic pain.

I'm afraid my doctor's going to think I'm making things up as far as my pain goes, since it is so weird. Literally, the only thing that gets rid of the pain is laying on my stomach or back for at least an hour. Then, the minute I'm up and moving, there it comes again. How can I explain this to my doctor without coming across as a hypochondriac? Any ideas?



  • The fact that the pain goes away when you are laying on your stomach or back shows (at least in part) that your pain is coming from a nerve being compressed. When you lie down, you give your discs a chance to unload. Then when you get back up, even into a sitting position, the discs once again have gravity pushing down.

    Nerve entrapment or compression does not show up well on a MRI. There is a technology available called a MR neurograph that is supposed to image nerves much more clearly, but it is only available at a couple locations, mainly on the West Coast. But, I digress. Just because something doesn't show up on a MRI does not mean you are a hypochondriac...and your pain is not that weird. When you describe it, I would think your surgeon would be able to have a good idea of what you are describing.

    Sometimes you just have to persevere to find what is causing your sciatic pain. Maybe you will need to go to another doctor, or a pain specialist. Perhaps you will need to do your homework and find a physical therapy clinic that is doing innovative work with spinal patients. But, for now, you probably just want to return to your surgeon and carefuly describe what you are feeling. Maybe keep notes for a week or two and take them in with you so you can speak with some authority.

    To answer your question, fibrosis can feel like other back problems, like a herniated disc, or stenosis. The scar tissue may have grown into the foraminal space and is taking up space that the nerve needs to move through. The nerve may kind of hang up depending on how you move. Maybe that's why you feel like it is being stretched....just guessing here.

    Go back to your surgeon and talk to him about your pain. There should be ways to deal with this problem.
  • Thank you for your ideas on this. You mentioned that an MRI doesn't show a herniated disc? Why do you say that? Is it because we are in a lying down position? Last spring, on my MRI, the disc did show up as herniated. Albeit a very small herniation...so small, in fact, that my surgeon said there wasn't much to remove when he went in, except scar tissue from my first surgery 20 years ago. But he removed what he could and for 4 months after surgery I gradually got better. Then, in September, there the pain was again. So, another MRI was ordered, but no herniation this time. And then a ct/myelogram, but no herniation again.

    Can you explain the foraminal space to me? Where is this exactly?

    Thanks again for your thoughts. I see my surgeon tomorrow. I'm excited, but nervous too.

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  • I was commenting on nerves not showing up well on MRIs. But herniated discs do not always show up either. Sometimes it takes a standing MRI to be able to see damage or injury to a disc, a scrunched up nerve, etc.

    There are two foramen, one on either side of each vertebra, and they are basically an open space that the nerves pass through, exiting from the spinal column. In many cases, due to arthritis or various other reasons, bony overgrowths will clog up the opening and will keep the nerve from being able to pass freely. It is just another location where a nerve can get crimped!
  • Wouldn't it be nice if we just didn't have nerves? Then we wouldn't have all these problems with leg pain, etc. If a disc stuck out, who would know the difference? Since the nerves wouldn't be affected. :)

    I will be seeing my surgeon tomorrow. I'll be glad to discuss all this with him and hear what he has to say. He's mentioned wrapping my nerve so it's not affected by scar tissue, if that's the cause. If the pain keeps up, I will probably go that route. Although, I will admit, I'm quite scared. Everyone I know who's had multiple back surgeries just get worse and worse. I hope my story will end differently.

  • I had a ct/myelogram after my fusion but all I was told was that the fusing was coming along okay. Was told no details, and after all this time I still have persistent back and nerve pain. They told me to follow up with pain mgt because nothing else surgically could be done and the fusion did not help me. You can look up scar tissue symptoms/herniation symptoms online and they can give you better info. A lot of us continue to have pain post op and the doctors know better than to think we're hypochondriacs because this happens a lot. They have to investigate and get to the bottom of it. Just because surgery is technically successful doesn't mean we can't be having pain. Other factors play in like degeneration, length of nerve compression, instability caused by the surgery itself, and rate of healing. There can be so many things going on and it's hard to pinpoint the exact cause of the pain.
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