Possible femoral nerve damage after disc replacement surgery

by Chris
(Houston tx)

Possible femoral nerve damage after disc replacement surgery

After total disc replacement in my lower back (L3-L4) I believe, I was still in hospital recovery, when I experienced an extremely painful burning sensation in my lower abdomen near the end of my incision. It was extremely painful to the touch. I was heavily sedated and also had the push button morphine drip that I could give myself a shot every ten minutes if needed for pain.

I was discharged the following day and the pain had subsided some and/or lost amidst all the other pains that come with the surgery. Incision pain, back pain, etc.

During the week at home after surgery I noticed that I have pain/numbness in my groin, inner thigh and front of thigh. I don't know what it's from. Possible damage to a nerve, a nerve that was compressed then relieved after procedure or injury from my catheter . My surgeon says it might be a muscle tear and has no idea how I got it. I know this isn't the case. I remember the branding iron type pain when I was laying in my hospital bed and now almost two weeks after surgery my incision and back pain are getting better but my pain and numbness in my groin and inner and front thigh still remains the same.

Any answers would be greatly appreciated.

Dear Mr Smith
You make no mention of what leg pain you may, or may not, have had pre-surgery. This groin and inner/ anterior thigh pain is presumably new, reading between the lines.

And yes, it is the distribution of the Femoral nerve ... I find it surprising that you had such major surgery with no pain in this very region. That is the indication for major lumbar surgery: Unrelenting leg pain despite conservative treatment.

Look, you went into this surgery knowing it wouldn't be a walk in the park. It never is. Give time a chance. Be careful, follow your surgeon's instructions, tell him about your leg pain, and wait a few weeks before any rash decisions.

The things to look out for are a sensory change in the leg, remembering you may have had such changes pre-surgery. Take a pin and prick your leg. Is there a difference right vs left?

More important, is there progressive weakness of the quadriceps muscle, the big muscle in the front of the thigh. Is it beginning "to give" when walking, especially on stairs? Are you getting little tremors called fasciculations in the muscle?

These may be of a temporary nature and simply a warning to be very careful for the next six to eight weeks, or yes, they could be signs that the Femoral nerve was damaged/ bruised in the surgery.

I have no particular advice, that's not my role, but you might like to ask if these Slipped disc rules might be pertinent to your case. After all, the responsibilty lies with him that you recover completely. YOUR responsibility is to be careful, follow your surgeon's instructions and give time and nature a chance.

IF you notice progressive sensory and motor changes (weakness at the knee) then you MUST bring it to the attention of the surgeon, and expect a cogent answer.

But meantime, be careful, you've had major spinal surgery and this isn't the time for "playing silly buggers!" Be sensible, follow your doctor's advice and above all use your own common sense.

Incidently, cold hot therapy is the best pain killer.


Best wishes, and I hope you end up with a good result. Let us know in a month's time how you are getting on.

Dr B


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Interesting challenges of the day

1. Mr S is a 76 year old man with neck pain of some 9 months duration. Luckily, most of the discomfort is upper cervical which is only rarely arthritic; his lower cervical spine is a degenerative mess that I've left alone. After seven treatments his pain and stiffness is 50 percent better, and he's happy in the circumstances. He can sleep through the night now and that makes a huge difference.

2. Mr P is 32 year old man with very severe lower back pain radiating to the big toe which is 30 percent numb. He had an episode three weeks ago, took anti inflammatories and was soon better as is typical of the medial disc herniation. But before it healed, after a trivia it came roaring back, much worse. The characteristic crossed sign was evident; sitting in a chair, straightening the right leg provoked severe left back pain and tingling in the leg. He's doing well.

3. Severe lower back pain is scary; just ask Mrs P. Just watching her get out of the car I she was in trouble; she had a slipped disc at L4 making her lean towards the opposite side; luckily she had no pain in the leg. Despite family pressure that this was far too severe for a chiropractor, she persevered. Within five days she was standing upright, and after two weeks almost painfree. 

Despite a hectic job, she wisely took my advice and stayed home for what I call exercising bed rest.

4. Mr S has had lower back, groin and back of thigh and calf pain for fourth months.

He has a pincer deformity in the hip causing the stabs in the groin, and a degenerative facet causing the sciatica. Both are responding well to chiropractic and he's well pleased; sixty five percent better after three treatments.

5. Mr T is a wise man; he's taken a warning TIA seriously and has lost 15 pounds, and has at least as much again to lose. A change to a low starch diet and half hour daily walk has made the difference; but the walking is making his foot and back miserable. The expensive orthotic is hopeless; luckily his hips and back are fine, but he needs a simple heel lift.

6. I too have had serious lower back issues, luckily fixed by my own chiropractor; so I too have to do my exercises, take care when lifting supers full of honey, gardening and using the chainsaw. Regaining the function of your spine is just as important as the pain.

7. My own granddaughter, only 7 is hypermobile giving her pelvic, knee and ankle issues. Xrays show a mildly dysplastic hip. Years ago we would have called it growing pains. She too regularly needs chiropractic care and luckily responds well. Increased range of motion is more difficult than too stiff in my opinion. Our care is for kids too.

8. This 65 year old lady is a serious gardener; every day she is bending, lifting and digging for 2 to 3 hours a day. It regularly catches her in the sacroiliac joint, so she has a treatment once a month that sorts it out. She does her lower back exercises faithfully.

9. This 88 year old lady is an inspiration; every day she is busy in the community. With a nasty scoliosis she manages very well with a chiropractic adjustment every six weeks and exercises faithfully done.  

10. Mr X is a 71 year old retired man who wants to continue with maintenance care every six to eight weeks; he had suffered from two years of lower back pain when he first came a year ago. He has no discomfort now after 8 chiropractic treatments, but is aware that danger lurks.

11. Mrs C has been having severe headaches, and taking a lot of analgesics. It's a non complicated upper cervical facet syndrome, and she's doing well.

12. Mr D is a 38 old year man with chronic shoulder pain after a rotator cuff tear playing cricket. It responded well to treatment, but he knows he must do his exercises every day; for two years he couldn't sleep on that shoulder.

13. Mr D, a 71 year old man, has a severe ache in the shoulder and midback since working above his head. Trapped nerve tests are negative but he has advanced degenerative joints of Luschka; after just two treatments he is 50 percent better. Can we reach 90?

And so the day goes; chiropractors shouldn't be treating the elderly most medical sites state but that's so much bunkum.



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