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    Ongoing post-surgical nerve pain
    An_189715 posted:
    I am 3 months recovery from a spinal decompression (foraminotomy and disctectomy) at L4L5 and still have a lot of pain running up and down my leg. I had suffered from intense leg pain 2 years prior to the surgery. I had some releif in the first few weeks after my surgery and tried to slowly resume my regular activities (walk, bike, swim). However the pain returned quite intensely at about 8 weeks and has not seemed to subside since then. My medical team says that the nerve was highly inflamed and needs up to 6 months to a year to calm down. Meanwhile, I go to work (comptuer-related) and come home. I can't seem to feel any improvement. I am not taking much in the way of pain meds. I cannot tolerate the neurontin class of medications and anti-iflammatories dont' work. I try and take the edge off with Tylenol. Yesterday I tried a short 15 minute walk and the pain flared up again. At my post-surgical checkups the neurological tests indicate that things are going well but I cannot seem to shake the pain. My team is not inclined to give me any steroids (shot or medrol pack). I get very concerned that I will not improve and that I am stuck in a very sedentrary life. Have others had this experience after surgery? Does it sound correct that a nerve can be so inflamed that nothing except time will heal it and reduce or vanquish the pain?
    bj1208 responded:
    hi and welcome -

    Neurontin and Lyrica do help with the nerve pain issues - but yes sometimes it can take up to 6 months or longer for nerve roots to heal -

    Pain meds and anti-inflammatory meds do not help these - I have permanent nerve damage in both legs and take neurontin - neurontin does take time to get used to and is a med that has to be slowly increased over a couple of weeks - but once you get thru this you don't notice any effect -

    hope this helps - take care - Joy
    An_189716 replied to bj1208's response:
    Thanks for your reply. I was on increasing dosages of Neurontin for about 2 months before my surgery. It affected my cognitive abiltiies somewhat, increased the frequency of migraines and interfered with quality sleep.
    I can tolerate the present pain if I can think that there is light at the end of the tunnel. I.e. the pain will eventually go away over the next six months to a year. Am I hoping for too much? What caused you to have permanent nerve damage. Was it a result of the surgery? Or had you waited too long to have surgery?
    bj1208 replied to An_189716's response:
    HI - well my disc blew out in 06 and because of changing jobs and insurances' I was going from one pain clinic to another - finally in Dec 07 I was sent to another pain doc to do a discogram and myelogram - I knew they were wanting to do surgery so at this time I resigned from work- went and saw a Neurosurgeon Spine Specialist - fusion surgery of L5-S1 - pressing on the left S1 nerve root - surgery was fine - I fused 100% and my hardware is intact but they could not do anything for the chronic pains or the nerve damage in my left leg. I went to another pain clinic where he refused to do any injections (once he saw my file) and said that they didn't help before surgery and they would not help now (really liked him) so he sent me to a Physiatrist Pain Clinic - they did EMG Nerve Conduction Test and confirmed severe nerve damage in left leg and had mild nerve damage in right leg - this was new to me - I had all my records sent over - and still they refused to do any injections and we discussed the pain pump implant - told them I was not ready for that yet so they put me on controlled medications. After about 7 months I got a call fromt he records dept they had a file with extra records (from all previous doc's etc) asked if I wanted them or to be destroyed - I said I wanted them -

    When I got the copies I started reading them - the very first time I had an MRI the surgeon I saw gave his written report of the findings - I was kinda pissed at what I saw: L5 DISC RUPTURED - SPLINTERED ON BOTH SIDE - LEFT SIDE IMPINGEMENT IS WORSE THAN RIGHT SIDE - THERE IS LARGE PART OF DISC PRESSING ON THE LEFT S1 NERVE ROOT CAUSING NERVE DAMAGE IN LEFT LEG. PART OF DISC (SMALL PART) IS PRESSING ON RIGHT S1 NERVE ROOT CAUSING MINOR NERVE DAMAGE - I took this file into see my pain doc and his PA - (my file was a mile long and knew they didn't see this) so I pointed it out - I was scheduled for an EMG Nerve Conduction Test - it showed Nerve Damage in both legs - left being worse - of course before this they had already taken precautions and had me fitted for a leg brace on left leg and I was walking with a cane to help stabilize me - so this is where I am at now -

    Yes they did wait too long to do surgery - as my pain doc said - and also the 3 spine specialists I have seen in the last year and half - why didn't they do surgery then? they had all the reports showing how bad your disc was - it had ruptured and splintered - so my nerve damage had set in by this time.

    My surgery was 3 years ago and even thou I am disabled now I wouldn't have changed anything -

    well long story short! LOL or short story long! - this is my story - hope it helps - keep us posted - take care - Joy
    Anthony L Cere, PT, DPT, MTC responded:
    Welcome to the support group,

    Sometimes it does take a little time to calm down an inflamed nerve. However, have you tried Physical Therapy prior to or after your surgery? Just talk with your surgeon about trying Physical Therapy. A Physical Therapist can evaluate you to see if you are appropriate for PT - which it sounds like you are. The PT will then develope a PT diagnosis which is not a medical dianosis, rather it is a list of impairments found on the evaluation such as decreased strength etc. The PT will then develope a specific program for you to address those impairments found on the evaluation in order to help restore your function i.e. walking, activities of daily living, work activities, etc. You can go to to learn more about how physical therapy can help and to help find a PT near you. I hope you find this helpful.

    natashagoldberg replied to Anthony L Cere, PT, DPT, MTC's response:
    Thank you for your response. I did try PT about 3 weeks ago but it was clearly too soon after the surgery because my pain increased a lot the next day. My Physican's Assistant wants me to wait until I am pain-free to resume PT. I have been doing much better since my last post a weeka ago but I am still keeping my physical activity to a minimum. I took a short walk around the block yesterday and that felt good and I had no repurcussions. A quick note. I believe that you gave me the wrong URL in your post. I think that the correct one is .
    redeemer53069 responded:
    I had lumbar decompression surgery 4 weeks ago to the day. Prior to surgery I had pain in my left hip/butt that went down my leg, in the left calf and ended at the bottom of my foot. I went to see a Dr. when I experienced tingling in my foot. Surgery was performed and other than the intense pain I felt in the leg two days following surgery, the pain was better about a week later and I was back to work within 5 days of surgery. Unfortunately the pain started to gradually come back to the point where 4 weeks since my surgery I feel like I did before I went in. My Dr. sent me to have another MRI three weeks after surgery which he said showed no recurrance of the disc compression, but scar tissue was fusing to the nerve. He told me to keep taking gabapentin which I wasn't doing and also taking my pain meds. I had problems with the gabapentin and so he switched me to amitriptyline today which I haven't taken yet. He also scheduled me for a steroid injection. Because the pain is getting worse rather than better, I'm very concerned that it won't turn around without something being done, but I'm hoping that I'm wrong. Everything I've read about scar tissue talks about that as a remote possibility, but that it wouldn't appear for 6 to 8 weeks after surgery. I'm wondering if this might be somewhat common and that I just have to be patient or should I take my second MRI that was done post surgery and get a second opinion. It's depressing to have constant pain and not seeming to have made any progress after the surgical procedure. For the record, I'm 43 year old male, work at a desk and was in pretty good health before my pain started. I jogged and exercised regularly. I know I can't do much for another two weeks, but based on my condition I'm afraid to even allow myself to think about exercise until the pain gets better. I guess I just want to know if it's possible that time still has a chance to heal me or should I start looking for other solutions?
    bj1208 replied to redeemer53069's response:
    hi and welcome to the support group -

    first - how was the Gabapentin prescribed? I take it and have been on it for about 3-4 yrs with no problems.

    Gabapentin and Lyrica both help nerve issues in arms/legs and probably the scar tissue fusing to the nerve root.

    Both these meds are to be started on a low dose and gradually increased until a therapeutic dose is reached. when I started on it I was taking 300mg a day for about a week then slowly increased to 300mg twice a day. I now take 3600mg a day (1800 in morning and 1800 at night). this does help my pains I have in my legs as i have permanent nerve damage.

    with your concerns, it may be a good idea to get another opinion just to see what they say. be sure they are either a Orthopedic Spine Specialist or Neurosurgeon Spine Speciaist.

    Scar tissue does grow sometimes faster with some people while others may take a little longer. One problem with scar tissue is, if it can be operated on to remove, that it can re-grow whereas the surgery process to remove it can go on and on - it grows, you have it removed, more grows etc.

    let us know what you find out~~
    ~~ Click on my name or picture and read my story ~~

    Take care ~~ God Bless ~~

    ~~ Joy ~~
    redeemer53069 replied to bj1208's response:
    It took me a while to find my way back here. I forgot to bookmark it. Anyway, I forgot to check the dosage of the Gabapentin, but I was told to take it three times a day. There was no ramping up. The new meds work great for sleeping. It's the first time I've slept the entire night all the way to the alarm going off without waking up. 2nd injection was done in a different location than the first and it actually took 50% of the pain away for the day, but by the time I went to bed the pain was back.

    I guess I'm lucky that Advil takes away almost all of the pain I have, but I don't think it's healthy to take as much as I do for such a long period of time. At least I can escape the pain when I need to. Seeing the surgeon a week from Thanksgiving. We'll see what he says. Definitely going for a second opinion just to cover my bases as the 2nd MRI said there was continued herniation and when I got my shot yesterday the doctor giving the shot was questioning the L4-L5 diagnosis the surgeon worked on and asked me if I was sure the Surgeon didn't tell me L5-S1. Then He said it was probably just a mixup and started in with the shot. Now I'm more confused and a second opinion should clear it up.

    Thanks for the response. I'll let you know what I end up doing. If surgery is the answer then that's the route I'll take.
    LOOKINGFORHOPE responded:
    iam 5yrs post op and the pain is unbelievable i dont know what it is but iam trapped in a life where i have no control, i cannot even get out the bed most the time iam 39yrs old and i feel like iam 99, I hope you can find a good dr, because after you have surgery all pain is supposed to be gone after 1 yr...good luck.
    bj1208 replied to LOOKINGFORHOPE's response:
    hi again Lookingforhope -

    I'm not sure who told you that pain after surgery is supposed to be gone after a year - I've never heard that.

    I too am 5 yrs post op from Anterior Lumbar Fusion L5-S1 and my surgeon said he would be able to fix my disc to make my spine more stable but could not guarantee any reduction in pain - he was hopeful but no guarantee.

    as with any type of spine surgery, it's main course is to stabilize the spine and take pressure of nerve roots - and if there is any damage to nerve roots hopefully they will grow back in a year or longer. but if there is too much nerve damage it can set in permanent.

    You can click on my name or pic and read my story.

    hope this helps - keep us posted~~
    ~~ Click on my name or picture and read my story ~~

    Take care ~~ God Bless ~~

    ~~ Joy ~~
    MarioNgL replied to bj1208's response:
    I too had an injury where surgery was recommended and though the symptoms pointed to a Lumbar issue with pinched sciatic nerve. It turns out it was my very tight piriformis muscle that was the culprit"026 I can now play soccer again.

    Just a thought in case it helps someone.

    bradcrowne responded:
    This is a very common problem ,sometimes spinal chord surgery is accompanied with nervous system disorders a lot for this reason you need to go through modern therapies such as Viscosupplementation , trigger point injections,platelet rich plasma treatment which may heal you up.
    jaclee45 responded:
    bj1208 replied to jaclee45's response:
    Hi Jaclee45 -

    It seems that you are too early in your post op to be doing so much. I wasn't allowed to walk until after my 3rd month post op and this was on a single fusion L5-S1. I was not allowed to do any exercises until I was released from the surgeons' care which was about 7-8 months. Then I was sent to a physical therapist to start out on exercises.

    Also, the amount of Gabapentin you are taking is really not a therapeutic dose. I take 3600mg daily and it does help with the pains - however nothing helps with the numbness as I do have permanent nerve damage in both legs.

    I would back off on walking so much as this could be irritating the nerves in your legs. I was told the best recovery is to rest, rest and more rest and this meant laying in bed, being careful how I got up or by changing positions.

    It may be in your best interest to discuss this with your surgeon.

    Please keep us posted how u are doing and the outcome of the test
    ~~ Click on my name or picture and read my story ~~

    Take care ~~ God Bless ~~

    ~~ Joy ~~

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