Sciatic pain following microdiscectomy at L5-S1.

by Joel
(Webb City, MO)

Did your xray look something like this?

Did your xray look something like this?

I have had a fair amount of low back "flare-ups" over the last 20 years (I am 48). Until this year they had always been limited just to the lower back. However, this year I did something that caused an episode that create much more significant issues. Pain down the back of legs, numbness, etc.

After several months of chiropractic care and then physical therapy and epidural injections I had an MRI. Result was a severely "extruded" disc at L5-S1. So a few weeks later I had a bi-lateral microdiscectomy and laminectomy. Surgeon says surgery went great, but there was more "stuff" that had to be done than he expected.

I am now almost 9 weeks post op and still have sciatic and lower back pain. In fact, I have all sorts of symptoms that I didn't have prior to surgery. For instance I have numbness, tingling and pain in my feet. Including burning pain around my ankles. Many days very significant pain down the back and outside of my legs. I have had an epidural injection since the surgery which slightly helped and I have also started physical therapy. Which I know is good for me and making me stronger, but it often flares up my nerve pain.

The surgeon and PA don't seem overly concerned, but admit this is not exactly normal. The explanation I am getting is that the nerve has been compressed for a long time and was also very irritated by the surgery and sometimes it just takes a long, long time to heal and recover. Some people recover very quickly, others it takes a long time.

I am trying to have confidence in this theory and be patient, but it is not easy. Especially since in many ways I feel worse than I did prior to surgery.

Any thoughts? Could all this be caused by the nerve being irritated/damaged and it just needs time to heal?

Thanks for your time.

Hello Joel,
It's not a happy story and I share your concern.

A little question, not really for your benefit, but for the many others who will be reading this page. This site has approaching 40,000 pages read per month. Did any doctor, chiro, physio, PA, physical therapist give you exercises ten or fifteen years ago, that should be done daily, and did you do them?

Chiropractic Help is about helping folk with prevention so that they don't reach your tale of woe.

Firstly decompression surgery is always potentially difficult; and you probably didn't have any option, because pain down both legs (prior to the surgery) means conservative treatment will quite likely not help; certainly not quickly. So, yes, perhaps you just have to be patient.

Do a couple of little tests for me. Sitting in a kitchen chair, ask your spouse to gently raise first one leg, and then the other, parallel to the ground, and then slowly flex your head onto your chest. What happens?

Standing on one leg, raise first your big toe, and then stand on your toes, raising your heel. Repeat with your other leg. Can you do it?

These two will give me a pretty shrewd idea of where you are, and neither will aggravate your condition.

I unfortunately leave in a few hours for a three week break and will unlikely be able to contribute further until after that.

Meantime ask your surgeon if you can start some very gentle exercise; I recommend on your bed every morning before arising.

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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