Thigh pain after L5/S1 fusion

Also if anyone had had the same surgery what has your experience been?

I thank you for the reply currently I do have a Workmen’s Comp. lawyer and my work does not have a medical doctor they have to clear me it feels like the doctor is putting it off on my work to keep me out but my work can’t just keep me out on a pay if the doctor saying I can come back. That is a great idea to get a job description especially with the high level of incidents in the town that I work in. Also my doctor started me in PT this week but never mentioned aqua PT with a 10 pound weight limit of 5 pounds every week ( they have started me off with very light core exercises and have not done any weight yet).

Post Edited (PDTil26) : 3/19/2019 7:25:18 AM (GMT-6)

PTD:
A couple of ideas for you to consider:

1. Sitting
Sitting is not your friend. Sitting places significantly more intra-discal pressure on the lumbar spine than does standing upright or lying supine or sidelying.

It is best to avoid sitting for more than 30-45 minutes at a time. It is helpful to change your position intermittently, sit to stand, and interspersing sitting with periods of standing and walking. Ex. When watching televison, get up and stand at every commercial break. Ex. Work on your computer by standing at a higher kitchen counter or consider purchasing a standing work table (models available on Amazon to see).

Where you have an option, lie down or stand as opposed to sitting for prolonged stretches of time.

Two and Three piece sectional sofas are not ideal surfaces for resting. Sofa cushions create an undulating (up and down) surface that leaves the spine in unstable alignment. When you lie down, choose a level mattress surface. If you have an aging mattress (9 year or older), now would be a good time to consider investing in a new quality bed mattress.

2. Ice. Ice. Ice
Inflammation is a prime contributor to pain and stiffness in the weeks following decompression surgery. Inflammation is a normal and expected process of healing. The key is tempering it’s secondary effects.

Ice will be your best friend. You can use reusable gel packs that you keep on the freezer.
Or you can use bags of frozen petite peas available at the grocery store. Gel packs and bags of petite peas have the benefit of being moldable and comformimg to body contours. Keep the ice in place for 20-30 minutes, using a towel or similar between that pack and your skin.

Use ice frequently during the day/night. Keep one gel pack in the freeze as you use another. Ice is the preferred modality to quell irritated nerve fibers.

3. Walk. Walk.
It be easy to become inactive after any surgery. But gentle walking and graded activity is part of the prescription for recovery.

Bone needs weight bearing forces to solidify the fusion. Standing and walking provide a natural load bearing force on the lumbar spine that will
aide bony fusion. Walking on level surfaces, a walk in the neighborhood, is good. A gentle incline can help stretch the posterior hamstrings and Achilles‘ tendon. Steep up/down terrain should be avoided as well as unstable surfaces (pebbled or rocky trail).

Walking helps mobilize the lower spine and nerve roots by the natural tilting of the pelvis that accompanies taking successive steps. There is a natural rhythm to walking that effectively mobilizes the lower back and pelvis without undue stress. Susie’s recommendation to engage in a swimming pool for walking is a solid
recommendation. The warmth and boyancy of
a pool have inherent benefits.

4. Belly binder
For anyone with a bit too much of adipose tissue carried in the front of the abdomen, wearing a light compressive belly band or lumbo-sacral band can be helpful. You want a stretchy band that gives a compressive “hug.” An abdomen with generous adipose tissue can create a postural imbalance with a top much lordotic curve, which can cause an uptick in pain after decompression surgery. Wearing a maternity-style belly band or stretchy lumbo-sacral band gives an inward compressive “hug” that can promote better postural alignment when up,
standing, and walking. Most people do not
wear these belly bands when sitting or sleeping.

Best wishes in your continued healing.
Karen

They actually went in through the front and the back. They never did anything about the bulging disc in my L4 I’m wondering if it is pressing against the nerve.

I have tried Gabapentin in the past but I stopped it because I found out that it causes memory loss

Can we post pictures on these threads?

We can post pictures here but I have no idea how to do it, lol. Do you have a copy of your written report of your MRI by chance? Reports we can understand somewhat, but to look at CD's we are not experienced enough.

From the sounds of your activities you are not over extending yourself & doing what you should be. One of the things about surgeons or any dr, is they are textbook drs when it comes to these surgeries. Comparing a patient to a textbook is wrong on every level. I don't think drs will ever deviate from this practice, some are much more compassionate than others.

Yes, now a days patients do have to advocate for their healthcare. If we don't we are lost in the shuffle. You are in a situation that is not good. Your light duty release was far too soon to begin with, add in the physical side of your job duties is ridiculous. I am sure the dept will want you back at 100%, otherwise you are a liability to them.

Has the surgeon taken any xrays? You are in a real catch 22 situation with this being a work related injury. I do understand the departments position as well. When do you see the surgeon again? By the way, I suggest you give a copy of your work description to your physical therapist!

PTD:
I would chat with your PT about finding access to a warm therapy pool to enhance your recovery.

A finding of a new lumbar disc herniation with extrusion significant enough to be causing your butt/thigh symptoms, while possible, would be on a lower range of possibilities. It doesn’t sound like you have been overextending in an activity that would precipitate a new and severe herniation.

Inflammation and scar tissue are part of the body’s healing process. Scar tissue may be at the root of your new symptoms, with scar tissue/collagen fibers adhering to a peripheral nerve sheath. Tension on the nerve sheath, as can occur when we move from sit to stand, also places tension tethered scar tissue. The result is referred pain. The bone marrow of the vertebral body, in addition, can remain swollen with a mild degree of effusion for several months.

Gentle movement and mobilization is key. You are still in the period of healing where the formation of scar tissue is an active process. You may feel that you are somewhat “stiffer” now then you were 2-3 weeks ago. Frequent change of position, frequent short distance walks, and a warm pool therapy would all be to your advantage.

Slow and steady. Slow and steady.

Best wishes ahead,
Karen

I hope that you made the physical therapist aware of this. Hopefully the therapist is making notes on you. Have you discussed your job duties with the therapist? What about inquiring about some water therapy? I hope you read what Seashell posted on 3-20. Of course, it's your situation, but if it were me, I would be getting a hold of the surgeon about a short course of a steroid pack, if nothing else talk to your pcp. You have what sounds like a lot of inflammation going on, which happens. Above all, use some ice packs too.

Yes I brought up the water pt and my therapist explained they do not have a pool but if I could find a gym that has a chair to get me in and out he will give me some instructions. I have an appointment with my surgeon and I will be asking about the steroid packs

So I called my doc today and spoke with a PA because my nerve pain has gotten much worse. The sharp pain is shooting all the way to my toes and I can’t take it anymore. She explained that since they put some type of spacer in that it does normally aggravate the nerves around this time and is normal. My next question was why the he’ll wasn’t I made aware of this at my last appointment if this is “normal”. I was prescribed Gabapentin and I have taken it for one day (haven’t seen any results yet but hopefully soon). I just can’t believe how much worse the nerve pain has gotten and I’ve taken so many steps back. I have read that around the 6 month mark the pain begins to subside but everyone is different.