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| TDR post-op pain at 11 days; Nerve? Fluid? Muscle? Normal? | |
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| Tweet Topic Started: 15 Dec 2013, 10:06 AM (537 Views) | |
| eLSSI | 15 Dec 2013, 10:06 AM Post #1 |
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11 days post-op TDR L5/S1. Wasn't too bad for the first 2 or 3 days but for the last week some pretty bad pains in lower back, glutes and backs of legs. I've never had nerve pain but i imagine that is sharp and tingly and follows a very specific line down the legs whereas what I have is more like whole muscle ache in the glutes and also like all of my hamstrings are constantly being overstretched. I've been pretty active, walking and on my feet a fair bit so it's possibly a symptom of doing a little too much than too little, but i feel i'm being sensible with the amount of activity. Maxing out on Ibuprofen, Co-codamol and Gabapentin but only providing some relief. Next stop Dihydrocodeine. Anyone any ideas? Normal? Muscle system adjusting after spine stretched to accommodate a 12mm M6 disc? Nerve? Post-op fluid working its way down the body? Too soon to expect anything better? |
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2 years Lumbar pain. Cessation of sports. Restriction of much other 'normal' activity. Facet joint injections 2012 and 2013, Dr Chris Dare, Spire hospital, Southampton, UK. Interestingly painful Discogram 2013. L5/S1 ADR with M6, Dr Chris Dare, 4 Dec 2013, Wessex Nuffield, Eastleigh, UK. | |
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| ajj1001 | 15 Dec 2013, 12:33 PM Post #2 |
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You've hit on the most probable causes and also add in the anaesthetic clearing your system and leaving you to get on with it! Hang in there, you will be able to properly see how things are at 6 weeks. Feeling how you do is commonly reported by patients early days. Keep doing the physio exercises you've been given and stay mobile, plenty of rest too. |
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Std Meds Gabapentin, MR Tramadol, Paracetemol, Laxatives 2011 Sept PLIF L4 - S1 2010 May Discogram L2/L3 & L3/L4 both looking ok. 2009 May PLG Fusion L5/S1 Charite in situ April Dismissed 2008 Caudal Epidural failed to work 2007 Deterioration L5/S1 Facet arthritis, Loss of disc height. 2004 Returned to Work 2002 Aug - physio March 2 level ADR Charite L4/5, L5/S1 2000 Broadbased disc prolapses L4/5, L5/S1 | |
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| eLSSI | 15 Dec 2013, 01:38 PM Post #3 |
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Thanks. Wish i knew if it was muscle or nerve or what and what to do, e.g. More or less walking? Pelvic tilts into the lumbar pain or not? Stretch these tight aching hamstrings and glutes or not? As a further clue, i crouched down today for a couple of minutes and when i got up i could hardly walk with the burning pressure behind my knees. Not doing that again in a hurry. |
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2 years Lumbar pain. Cessation of sports. Restriction of much other 'normal' activity. Facet joint injections 2012 and 2013, Dr Chris Dare, Spire hospital, Southampton, UK. Interestingly painful Discogram 2013. L5/S1 ADR with M6, Dr Chris Dare, 4 Dec 2013, Wessex Nuffield, Eastleigh, UK. | |
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| cunningtonpaul | 16 Dec 2013, 08:34 AM Post #4 |
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After my fusion, I was advised to avoid NSAIDs (like ibuprofen) as some research indicates they can inhibit bone growth. I'm not sure whether this applies to ADR procedures, but perhaps worth double-checking with your surgeon? |
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Male, 46 years old, Singapore. One episode of acute low back pain in my teens (rugby!). Low back pain episodes on and off since my 20s, manageable through exercise and occasional physio. By August 2012, the pain and stiffness meant I couldn't work or travel, so I began conservative therapy (physio, exercises, aquatherapy). Lack of progress means I'm now considering ADR. MRIs show L5-S1 disc with annular tear but no herniation. | |
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| ajj1001 | 16 Dec 2013, 10:38 AM Post #5 |
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NSAID's generally advised as OK for ADR and not fusion. You need to follow advice from a medical professional as each individual case varies. (No medical advice is given or should be followed from this forum.) I generally think that if its "fizzing" or numb then its probably nerve pain, if its throbbing or tight then its muscle. Just my experience and I can tell what my Gabapentin affects so is most likely nerves. |
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Std Meds Gabapentin, MR Tramadol, Paracetemol, Laxatives 2011 Sept PLIF L4 - S1 2010 May Discogram L2/L3 & L3/L4 both looking ok. 2009 May PLG Fusion L5/S1 Charite in situ April Dismissed 2008 Caudal Epidural failed to work 2007 Deterioration L5/S1 Facet arthritis, Loss of disc height. 2004 Returned to Work 2002 Aug - physio March 2 level ADR Charite L4/5, L5/S1 2000 Broadbased disc prolapses L4/5, L5/S1 | |
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| eLSSI | 16 Dec 2013, 10:48 AM Post #6 |
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To me it feels like muscle or fluid. I bend my knees and then when i try to straighten them i get such a searing pain that i cant stand up for a minute or two. Thats in addition to the lower back still throbbing away at me. I dont think the Gabapentin is doing anything but i'm covering all bases. Dihydrocodeine helping quite a bit. Still no idea if i should be stretching into these tight muscles or not and if i should be doing my pelvic tilts throgh the tightness in my lumbar region and even into the pain a little. |
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2 years Lumbar pain. Cessation of sports. Restriction of much other 'normal' activity. Facet joint injections 2012 and 2013, Dr Chris Dare, Spire hospital, Southampton, UK. Interestingly painful Discogram 2013. L5/S1 ADR with M6, Dr Chris Dare, 4 Dec 2013, Wessex Nuffield, Eastleigh, UK. | |
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| ajj1001 | 16 Dec 2013, 04:35 PM Post #7 |
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Sounds like a phone call to hospital physios for guidance might be in order. Its still very early days to be doing anything major. |
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Std Meds Gabapentin, MR Tramadol, Paracetemol, Laxatives 2011 Sept PLIF L4 - S1 2010 May Discogram L2/L3 & L3/L4 both looking ok. 2009 May PLG Fusion L5/S1 Charite in situ April Dismissed 2008 Caudal Epidural failed to work 2007 Deterioration L5/S1 Facet arthritis, Loss of disc height. 2004 Returned to Work 2002 Aug - physio March 2 level ADR Charite L4/5, L5/S1 2000 Broadbased disc prolapses L4/5, L5/S1 | |
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| Alastair | 17 Dec 2013, 10:06 AM Post #8 |
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It's extremely early days and pains down the legs are to be expected, however if you got any queries I would ring back to the hospital for guidance Physio at 6 weeks should help with stretches Best, Alastair
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Founder of this board 24th February 2007 Slow and Steady Wins This Race Over 23 Years experience and research into spine surgery and over 2500 surgeries discussed and recorded ADR L5/S1 Surgery with Dr Zeegers 26th July 2002 in Munich 8 facet joint ablations 28 – 8 – 12 with Dr Baranidharan and Jake Timothy in Leeds Diagnosed Forestiers disease Your Best Asset Is Your Health I live in West Yorkshire aged 81 now Knowledge is power | |
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| sarahp | 17 Dec 2013, 05:18 PM Post #9 |
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Hello eLSSIE, My thoughts are with you, there is nothing more stressful than beng where you are post operatively, once the surgical pain lessons it makes us explore how we are feeling, and it takes a great deal of time for things to settle. Ive had 4 big surgeries and countless injections and everytime I would always get to about 4 weeks and really worry about the pain that was left, and there is always pain left to begin with. Its not been long since your surgery and our spines really dont like being messed around with, its a huge and traumatic experience having anything cut open and hardwear inserted. Be gentle on yourself, walk and exercise but do it very gently and with care, rest when you need to. Your body will do its own healing, it just takes time, the hardest thing is keeping our brains patient, its all such a worry isnt it but trust in your bodies strength and keep your mind busy with distractions that you enjoy. My thoughts are with you, but Im sure that in 6 weeks from now you will be feeling very different both mentally and physically. warmes wishes sarah x |
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2005 D Prolapse L3-4 L4-5 congenital L5- S1 fusion 2006 Nerve Blocks 2006 Decompression surgery L4-5 2008 Positive Discogram 2008 Anterior fusion L4-5 & Adr L3-4 2008 bilateral nerve block injections 2009 Facet joint injections + 2009 Further fusion of L4-5, posterial facet fusion. 2013 Facet spacer inserted. Overloaded facets and nerve pain increase due to irritation ++ Awaiting Scs Trial. | |
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| Joannelloyd19 | 17 Dec 2013, 05:23 PM Post #10 |
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Hi elSSi, I have just looked back through my posts and exactly 11 days after my L5/s1 lumbar disc replacement I had the same leg pains as you are describing. If you look through my old posts, I think it was 17/12/12 that I wrote it. I think the Dr said it was nerve pain with things starting to knit back together. I asked a lot of questions when I had mine done (1 year and 11 days ago!) it might help you to read through my questions and the answers I was given. I am fine now so hope this helps, Take care and don't overdo it Jo
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2009 Foraminal Epidural Steroid Injections commenced 2010-present Caudal Epidural and Facet Block Injections (several) 06/12/12 Activ Lumbar Disc Replacement L5/S1 by Mr Shackleford At Warrington Hospital. 31/3/15 - C5/6 ACDF operation - not fused L1/2 disc herniation and C5/6 fusion caused by a fall in June 2014 Bowel and bladder incontinence (waiting to hear if it is nerve damage) and long term depression due to constant pain and disc trouble at the top, middle and bottom of spine. | |
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| eLSSI | 17 Dec 2013, 09:06 PM Post #11 |
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Thanks Jo. Read your post with interest. Mine is in both legs behind both knees and feels more like muscles (or tendons) than nerves. Had the same very painful dull ache in the glutes for a few days and then upper hamstrings and now mainly behind knees - almost as if the swelling is moving south, which i why i was asking about post-op fluid etc. I'm not overly worried about it but knowing what it might be would help me know what to do about it. Stretch into it cos its just muscle tightness? Rest it cos its muscles overworked? Up the Gabapentin cos its nerves? Exercise cos its stiffness (ie more walking)? Ice? Heat? At present dihydrocodeine helps but its a bit strong for my liking - maybe ok for a few days and see where i am. Physio today wasnt much use - just saying that everyone's recovery is different and just to wait. Probably good advice but i'm the kind of person who would like to be told "it's possible the new angle on your lower spine is creating a permanent stretch in muscle x or irritation in nerve y, and the hamstrings just need to adjust so maybe warm them up like this and stretch them like that"! |
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2 years Lumbar pain. Cessation of sports. Restriction of much other 'normal' activity. Facet joint injections 2012 and 2013, Dr Chris Dare, Spire hospital, Southampton, UK. Interestingly painful Discogram 2013. L5/S1 ADR with M6, Dr Chris Dare, 4 Dec 2013, Wessex Nuffield, Eastleigh, UK. | |
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| sarahp | 18 Dec 2013, 12:37 AM Post #12 |
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So sorry to hear that the physio was not productive, I used to dread going post op, its exhausting and painful and you feel as though you are on a tread mill not going very far at all. The nerves and muscles that are supported and fed through your spine will be very 'spikey' to say the very least at the moment, and the movement for the adr to fit where there was hardly any disc place can cause so many problems with muscle spasms in the back and legs, everything has been re-placed and thats no easy thing to recover from, everything is stretched in a way that it probably hasnt been for years, the nerves will be swollen anyway from the prior to the surgery. It takes a long time for it all to settle down, and its a very anxious time. Dont try stretching your muscles too quickly, they are trying to stabalise and find their new positions, how we sit, stand and walk are all changed by surgery hugely, they have alot of settling to do. Im not a Dr and wouldnt give medical advice but try not to go up on the gabapentin too soon, give things a couple more weeks, keep a gently mix of careful movement and rest and see how you go, dont try and move forwards mentally or physically too soon. Ive had my spinal condition for 10 years now, and although people look at me like im talking 'wishy-washy' alot of the time when I mention it but heat is a wonderful thing. I have a large plug in heat pad that I use every day and have done for a long time, its great distraction sensation, it relaxes the muscles and it really does help me alot, I would be lost without it. Heat is also great post operatively for increasing blood flow to the area and helping with healing. My pad was very cheap on ebay. Now Im definitely being wishy washy, and I do understand how hard this all is for you, but what can you do in the day for yourself to keep your mind busy too? do you paint/draw/listen to music/ read? Set aside some time for yourself, it will help with the constant worrying, ive been driven to almost manic panic many times after surgeries and keeping my mind busy helps so very much. Warmest wishes Sarah x My thoughts are with you |
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2005 D Prolapse L3-4 L4-5 congenital L5- S1 fusion 2006 Nerve Blocks 2006 Decompression surgery L4-5 2008 Positive Discogram 2008 Anterior fusion L4-5 & Adr L3-4 2008 bilateral nerve block injections 2009 Facet joint injections + 2009 Further fusion of L4-5, posterial facet fusion. 2013 Facet spacer inserted. Overloaded facets and nerve pain increase due to irritation ++ Awaiting Scs Trial. | |
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| eLSSI | 18 Dec 2013, 09:00 PM Post #13 |
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Thanks Sarah, You've articulated perfectly what i've been hearing from most people (medical too), which is that these are early days and that the important thing is to wait and see, whilst, as you say, gently blending movement and rest. Neither physio nor doctor seemed that intersted in diagnosing anything, but i kind of understand why now. Could be this could be that, but in any case, wait and see, and don't push too hard. Distraction time is hard to get with young children requiring attention and the unravelling of their carnage, but i will try! Looks like you've been through the mill a fair bit with your history as well. Hope the trend is that things are improving for you. Thanks again for the helpful reply. |
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2 years Lumbar pain. Cessation of sports. Restriction of much other 'normal' activity. Facet joint injections 2012 and 2013, Dr Chris Dare, Spire hospital, Southampton, UK. Interestingly painful Discogram 2013. L5/S1 ADR with M6, Dr Chris Dare, 4 Dec 2013, Wessex Nuffield, Eastleigh, UK. | |
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| sarahp | 20 Dec 2013, 09:50 PM Post #14 |
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Hi again eLLSI, Just a quick check in to see how you are doing? how many days post op are you now and hows it all feeling in there, hows your thoughts? Really isnt easy with children to look after post operatively and my thoughts are with you, how old are they? Are you getting any help with lifting etc. Distraction can be very hard to fit in, and pacing isnt great for people with busy lives or children. I always take myself upstairs to lay down for 30 minutes and listen to a cd of natural noises, seaside, rain forest etc. I imagine myself walking through each picture in my mind, it sounds airy-fairy but its lovely me time and fills my mind with some lovely visuals and I force myself to do it every day. Thinking of you, its such a cliche but with spinal surgery times the healer, however ive never been patient! its a real test of mental indurance as well as physical. warmest wishes x |
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2005 D Prolapse L3-4 L4-5 congenital L5- S1 fusion 2006 Nerve Blocks 2006 Decompression surgery L4-5 2008 Positive Discogram 2008 Anterior fusion L4-5 & Adr L3-4 2008 bilateral nerve block injections 2009 Facet joint injections + 2009 Further fusion of L4-5, posterial facet fusion. 2013 Facet spacer inserted. Overloaded facets and nerve pain increase due to irritation ++ Awaiting Scs Trial. | |
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| eLSSI | 21 Dec 2013, 04:56 PM Post #15 |
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Thanks for the thought. Saw a better physio and aside from general pain around the area of the op (actually just below l5/s1, and pain in the back, nothing to do with the scar or the disruption to organs etc from entering thru the front), she diagnosed sciatic nerve issues. I agree. Basic test was how tight are the hamstrings. Being very sporty pre-back issues i'm reasonably aware of what my hamstrings and glutes should be able to do, even after injury or hard work, but with me lying down, the physio couldnt pull my legs up much beyond 30 deg which is 90 deg short of where i could be! It is getting better as the days go by - i'm 17 days post op now. Trial and error led me to dihydrocodeine as the only way to relieve an episode of the bad pain that can last for 12 hours and moves around (usually downwards) from lower back to glute to hamstring. Happily my GP was ok to give me a bucketload (i saw him at 11am after being up since 1am writhing around in pain so i didnt have to try hard to get the prescription - my situation was fairly obvious!) So now a few exercises, continue the gabapentin (doc - "coming off abruptly may cause issues at present"), maybe some paracetamol and/or ibuprofen for the little niggles, but the main course is dihydrocodeine as and when things get bad. Seems to work. Kids are 9months and 3yo, but i'm pretty mobile and if i'm careful about posture and weight distribution i can pick up the little one ok. In terms of strength, core, scar etc i'm v pleased with progress. Just the nerve to sort out. Maybe its common for the adr site to get irritated and the inflammatory pressure on the sciatic nerve creates the perception of pain lower and lower over the next few hours? |
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2 years Lumbar pain. Cessation of sports. Restriction of much other 'normal' activity. Facet joint injections 2012 and 2013, Dr Chris Dare, Spire hospital, Southampton, UK. Interestingly painful Discogram 2013. L5/S1 ADR with M6, Dr Chris Dare, 4 Dec 2013, Wessex Nuffield, Eastleigh, UK. | |
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