This article explains some of the potential reasons this may be the case. If those dont do the trick, an epidural steroid injection may also begivento manage the symptoms. One reason for continued pain even after a discectomy could be a misdiagnosis. Your doctor made a 1- to 2-inch cut (incision) in the skin over the spine. For editorial comments and questions, you can reach Dr. Bergin via email. The "no pain, no gain" adage does not apply," Dr. Liu says. At The Spine Center, were dedicated to providing you with high-quality, personalized back and neck care. When the root swells, some return of symptoms can be expected. Thank you for choosing Dr. Corenman as your healthcare provider. The diagnostic process including imaging, nerve conduction studies, musculoskeletal examination coupled with provocation maneuvers, palpation, and the musculoskeletal differential diagnosis of buttock pain is illustrated . These stretches performed too aggressively will piss off the nerve. Was up walking shortly after surgery. You can develop a seroma (a collection of fluid post-operatively) that temporarily will partially compress the nerve after surgery. What should I do, other than physical therapy.. My leg is getting slimmer than the other and I am scared Its been six months already. How to best prepare for it, if there is a way? Book an appointment with our board-certified orthopedists at Comprehensive Spine Institute by calling (727) 300-2537. Now considered the gold standard treatment forremovingherniated lumbar disc tissue, a microdiscectomy procedure is an ultra-precise method that requires only atinyincisioncausing minimal disruption to surrounding healthy tissue. This type of postoperative pain is commonly called failed back surgery syndrome because you've swapped out one type of pain for another. Learn More and Watch Our Video on Microdiscectomy for Herniated Discs. But its still there with the same movements as before but later in the movement. I had a few physical therapy sessions (electrotherapy including tens, magnet therapy and laser therapy) that made things worse almost immediately, but for the last two days I have been doing much better. We offer this Site AS IS and without any warranties. In this case, the source of the pain will continue since the direct cause of the issue was not pinpointed properly. Burning sensations can also be the result of nerve issues in the spine. Even though most lumbar microdiscectomies are done on an outpatient basis, complications could dictate that you remain in the hospital for up to 72 hours. Piriformis syndrome after lumbar spine surgery was defined as persistent or newly developed sciatica after surgery, sciatic notch tenderness and induced sciatica, and positive Freiberg sign. The loss of this pain after surgery is a good indicator that the nerve is relative free of compression. Anyways, this newly developed, post-surgical buttock pain hasnt resolved even after 2 weeks. In general, the postoperative period includes the same patient experiences. "Do what's comfortable. Although symptoms are varied andcanbecome more severe with movement, they typically include: When you are experiencing any of these warning signs onan ongoingbasis,its best toschedule an evaluationwith afellowship-trainedorthopedic surgeon. We have a strong commitment to excellence in diagnosis and treatment of spinal injuries and conditions spanning all age groups. Thank you for your answers and your advice. Epidurals x3, PT 4 mos, some relief, but constant foot pain and numbness continued Microdiscectomy 6/6/03 9/5/03 still have foot pain and numbness but recovered fine from surgery 1/19/04 I am 7 mos post op. my L5 / S1 disc herniation mainly lead to severe left-side buttocks pain when stretching the nerve. Once you start experiencing recurring back pain,your surgeonmustdetermine if the pain is being caused byreherniationor an acute flare-up. IV pain medication is stronger than oral but you obviously can not be on an IV drip outside of the hospital without some prearranged licensed care. A microdiscectomy that does NOT make your pain go away is called Failed Back Surgery Syndrome (FBSS) by The World Health Organization. Also, other tests, such as the slump test and straight leg raise, are positive for pain in the buttock. This is usually done when there is leg or arm pain that radiates from the spine, caused by compression of the nerve. surgery. Any activity (like walking) can stretch the root. My sciatic nerve was crushed and I have been unable to walk and have been in constant agonizing pain for six months. This website is the stand out source for me. I highly recommend Dr. Corenman and the Steadman Clinic. "Patients leave the hospital the same day or the day following the procedure and can begin microdiscectomy recovery immediately.". This compression is most often the result of a herniated lumbar disc. Dr. Bergin has a special interest in medical research and maintains membership in the Scoliosis Research Society. Thank you for input on this. Fifteen cases were diagnosed as piriformis syndrome. Sometimes this is a temporary condition as the nerve root or roots take time to heal. Should I continue this vigorous swimming program, or should I be more careful and dial it back a notch? As was mentioned earlier, the type of surgical technique used during the initial procedure and type of herniation strongly influence whether or not there will be a recurrence. If that treatment is not effective, depending upon symptom severity, I will order an MRI. I highly recommend Dr. Corenman and the Steadman Clinic. Extend your walking distance gradually; engage in aerobic exercises like riding a stationary bicycle if you have access to one at home or a local fitness center and can do so without pain. A seroma is a fluid-filled pocket at the surgical site that develops after surgery. Jogging isnot recommendedwhen you havedisc herniation. Asa patient,thereare five classicsymptomsto watch for: When experiencingrecurrent discreherniation, a patient might also report pain in a different location, intensity, orrelated tophysical activity. Ususally, movement of the low back reproduces pain in the buttock. The most common is inflammation. The best wayfor them to diagnose the problem isthrough physical examination findings correlated with imaging studies (MRI, CT scan, X-rays, etc.). 1 Leg and Buttock Pain After Spinal Fusion Surgery. This pain is really a "pain in the butt." What would cause movement-releated pain that is otherwise completely gone in some situations (like standing up straight) but another obstacle that is touching / disturbing the nerve? Was able to walk longer, and had almost no pain, except for the incision site stiffness. This is quite normal and should not be cause for alarm. Sleeping properly is highly recommended as it is key to rest and tissue recovery. How long ago did you have your surgery? One possible source of this type of secondary nerve irritation is piriformis syndrome, which refers to issues with a muscle deep within the buttocks called the piriformis muscle. I have been careful with avoiding sitting. PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. Otarbo Home Search Home Search buttock pain after microdiscectomy (2022) June 9, 2022 . The movements you notice that increase symptoms all stretch the nerve root so this would be expected for 4-12 weeks. thank you, I truly appreciate your answer. For example, the incomplete removal of herniated disc material or inadequate closure of a significant gap in the annulus may lead to reherniation. Thus, we know there is a 3-6% risk of a recurrent disc problem happening after lumbar discectomy surgeries. All rights reserved. Now considered the gold standard treatment forremovingherniated lumbar disc tissue, a microdiscectomy procedure is an ultra-precise method that requires only atinyincisioncausing minimal disruption to surrounding healthy tissue. Similarly, a thinned-out and stretched- out annulus place the patient at higher risk for reherniation, along with a wide incision of the annulus during surgery. Yes, a swollen nerve can mimic the same, but less severe pain from the herniated disc. Doc agrees it is probably permanent nerve damage. Most patients are gradually weaned off opioids over a period of 1 to 2 weeks. Obviously, I need to do a fresh MRI with gadolinum to discover whats truly happening. The good news is that many patients have significant pain relief from a microdiscectomy and can quickly return to their normal lives, generally in 4-6 weeks. I found this: faradic current having short pulse duration cannot be used to stimulate dennervated muscles as dennervated muscles require pulses of longer duration for having its effects. If you need spine surgery, consider an Inspired Spine procedure. See Also. The most common is inflammation. Recovery may not take place but read this to understand the type of nerve damage that can occur and how muscles recover from this injury. As fellowship-trained physicians with over, treating spinal conditions, we offer patient recommendations for treatment, including conservative care, non-operativetreatment, and sophisticated, customized surgical solutions. The patient reported pain radiating in multiple trajectories but on clinical assessment had no specific dermatomal distribution. Still, because lower back pain can be the result of other problems apart from a bulging and/or herniated disc, it may persist after the surgery. Based onfollow-upstudies, recurrent lumbar disc herniation only occurs inroughly 10%ofallmicrodiscectomy patients. I, for sure, do not want to have a fusion-I have heard from others what a night-mare that procedure is. This article explains some of the potential reasons this may be the case. Our physicians serve as innovators in technology,actively participate in national and international research studies,and are on the forefront of medical knowledge. Dr. Liu also suggests that patients continue the herniated disc surgery recovery process by walking short distances during the first couple weeks after surgery and gradually building endurance until they can walk two to three miles a day. Our physicians serve as innovators in technology, actively participate in national and international research studies, and areatthe forefront of medical knowledge. This review, with the help of a case study, provides a detailed account of the possible biopsychosocial risk factors underlying piriformis muscle syndrome, post discectomy. A microdiscectomy is aminimally invasiveversion of the surgerythatcan be performed on various parts of the spine. An MRI will be able to determine if this is your cause of pain. NSAIDs, acetaminophen, or other medications may be used to continue managing pain after opioids are discontinued. Minimize your risk forreherniationby not smoking, watching your weight, and eating a balanced, back-healthy diet. Standing, walking, swimming wasn't a big issue, however sitting down was . I have nerve issues in the lumbar and my spine doc is in denial - advice? I am extremely grateful for the opportunity to have an answer to my question from you. Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Finding the actual source of your discomfort following an initial microdiscectomy may involve: It Could Be Due to Scar Tissue or Other Possibilities. By 6 weeks post-surgery, most patients discontinue pain medication, however, it is still possible to have painful flare-ups or stiffness that requires medication. Had microdiscectomy L 4/5 on 08/13/09. Although it isnt very large, the incision site will probably be covered with surgical tape strips and will take about 10 to 14 days to heal. This . I had to have at least 2 courses of them to quell nerve irritation post micro-D. In addition to those resulting directly from the surgery itself or a spine injury, these lifestyle choices can increase ones likelihood for reherniation after microdiscectomy: As you can see, patient compliance plays a major role in ensuring ahealthier, more completerecoveryafter undergoing a lumbar microdiscectomy procedure. Most disc herniation occurs in the lumbar spine, causing debilitating pain in your buttocks, thigh, and calf areas and is referred to as sciatica. 1.3 Postoperative inflammation of the nerve root. Although weakness has improved, pain and burning sensation has also reduced, I cannot stil lift my foot from the ankle or make a single twist or movement of my toes.. No dorsiflexion or plantar flexion, MRI results revealed thickened edematuos(10mm) sciatic nerve plexus on the left side with grade 1 muscle edema within the gluteus maximus, sub acute denervation muscle changes in the form of combination of athropy /fatty replacement along the territory of the injured sciatic nerve, During therapy, when The (EMS) machine pads are placed on myL5region using interrupted currents, my muscles contract and my foot is lifted up but when faradic current is set It doesnt contract, what could this mean? In addition to medication, ice packs and/or heat wraps may be used. What causes reherniation after microdiscectomy surgery? Contacted the answering service for my Dr. this a.m. and still no response. The procedure involves a surgeon making small cuts in the patient's back and then, while peering through a lighted endoscope, carefully removing herniated tissue or portions of the offending bone protecting a nerve root. One reason your leg may still hurt after microdiscectomy surgery is because of the way compression can affect nerve roots. If you or a loved one suffer from backor neckpain, call The Spine Center today at(847) 628-8147toschedule a consultation. For full benefit/risk information, please visit. For instance, if a herniated disc was irritating a nerve for a while before your surgery, it could take a few weeks or more for the affected part of the nerve to fully heal and recover. Sciatica is the type of pain that originates in your lower back and typically radiates down one or both of your legs. The information is produced and reviewed by over 200 medical professionals with the goal of providing trusted, uniquely informative information for people with painful health conditions. If you or a loved one suffer from backor neckpain,call The Spine Center today at, once per month - call 847-628-8147 to confirm, Anterior Cervical Discectomy and Fusion (ACDF), Total Disc Arthroplasty & Total Disc Replacement, Non-operative Treatment of Idiopathic Scoliosis, Treatment of Degenerative Spondylolisthesis.