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I understand that nerves can get stretched and irritated during the fusion procedure. Since the pain is different than before surgery, it can't hurt to call your surgeon's office.

I had a one-level ALIF and ended up with CRPS in my left leg, which is almost in remission -- fingers crossed. If you had an ALIF and/or have temperature differences or skin changes, then definitely consult your surgeon or a second opinion. During the ALIF, they use an off-center approach, usually slightly on the left side of the spine. Pain management diagnosed my case of CRPS.
[QUOTE=SweetPeainSF;5024132]I understand that nerves can get stretched and irritated during the fusion procedure. Since the pain is different than before surgery, it can't hurt to call your surgeon's office.

I had a one-level ALIF and ended up with CRPS in my left leg, which is almost in remission -- fingers crossed. If you had an ALIF and/or have temperature differences or skin changes, then definitely consult your surgeon or a second opinion. During the ALIF, they use an off-center approach, usually slightly on the left side of the spine. Pain management diagnosed my case of CRPS.[/QUOTE]

Thank u!! Yes my surgeon knows and I will be going for ct scan to see why the leg hurts.
What type of fusion did you have? Sometimes a person comes away from surgery with a temporary "injury" that is actually caused by the way the person has been placed on the operating table. If you had a posterior incision, sometimes the femoral artery can be damaged and the result is leg pain.

Where on the leg is your pain located?
[QUOTE=teteri66;5024434]What type of fusion did you have? Sometimes a person comes away from surgery with a temporary "injury" that is actually caused by the way the person has been placed on the operating table. If you had a posterior incision, sometimes the femoral artery can be damaged and the result is leg pain.

Where on the leg is your pain located?[/QUOTE]

I did have posterior spinal lumbar fusion at level L4-5 and same level laminectomy. Pain is above knee on left thigh and on left side of thigh then below knee on top and under calf and sometimes foot
I am by no means saying this is what happened to you...but with the type of surgery you had (I had the same PLIF at L4-L5 in 2008) the patient is usually placed on a type of table that breaks away...the bottom third or so of the table falls away so the patient's legs are sort of at a lower level. This opens up the disc space in the spine and makes it easier for the surgeon, but if the patient is not adequately padded, something happens that is similar to when you wake up with an arm or foot that has "fallen asleep." It can cause some injury to the femoral nerve or artery that is almost always temporary, but it can take a long time to completely clear up.

They initially thought that had happened to me after my fusion in 2008. It turned out to be something different, but I did some research on it at the time.

When you have the scan, if they don't find anything, you might ask them about this possibility. It's not something doctors like to admit...that a patient could suffer from poorly placed or inadequate padding, but it does happen.
[QUOTE=teteri66;5024477]I am by no means saying this is what happened to you...but with the type of surgery you had (I had the same PLIF at L4-L5 in 2008) the patient is usually placed on a type of table that breaks away...the bottom third or so of the table falls away so the patient's legs are sort of at a lower level. This opens up the disc space in the spine and makes it easier for the surgeon, but if the patient is not adequately padded, something happens that is similar to when you wake up with an arm or foot that has "fallen asleep." It can cause some injury to the femoral nerve or artery that is almost always temporary, but it can take a long time to completely clear up.

They initially thought that had happened to me after my fusion in 2008. It turned out to be something different, but I did some research on it at the time.

When you have the scan, if they don't find anything, you might ask them about this possibility. It's not something doctors like to admit...that a patient could suffer from poorly placed or inadequate padding, but it does happen.[/QUOTE]
Thx soooo much. Makes sense to me!!!
Be sure to keep walking even if your leg hurts. Distance isn't important. But you should walk short distances, even around your house or apt., as often as you can, without tiring yourself, of course. You want to keep those spinal nerves stretched out so that the scar tissue will not attach to those nerves as it grows and fills in, from about now through around the 12th week post surgery.

You can always use ice if the pain gets bad. I had pain on the top side of my thigh post surgery and the only thing that helped me tolerate it was using ice. In the hospital they had these big bags filled with ice cubes that they would strap to my thigh...and the minute most of it was melted, I rang for more. I think my leg was probably numb from the ice for hours at a time....
[QUOTE=teteri66;5024891]Does it hurt all the time or does the pain get worse when in certain positions and gets better or even goes away in a different position? Are you ever free of this pain?[/QUOTE]

The pain is there all the time. My gut it feels like the nerve pain i had in the other leg before surgery. It is worse when i sit. Right now its in my upper thigh (on top) , below knee on top and left side and in foot and especially toes. Walking was very hard bc i dont feel my whole leg right. This morning i had tingling n numbness in my right foot (used to have that prior to surgery)
I know...but try to maintain a positive attitude. Just have confidence that things will work out ultimately, and just take it day by day. I hope you were told that most people still have "some" pain after lumbar fusion. I can't think of anyone I know who is 100% pain-free almost all the time. I am, except when I do certain things...I still can't vacuum more than one room. And most physical activities like housework or gardening, I'm good for about 2 hours and then it is downhill after that. The difference now (two years post surgery) is that I bounce back after a night's rest. That never happened previously...so that's a big improvement.

Do you have some aqua therapy available to you?
[QUOTE=teteri66;5025250]I know...but try to maintain a positive attitude. Just have confidence that things will work out ultimately, and just take it day by day. I hope you were told that most people still have "some" pain after lumbar fusion. I can't think of anyone I know who is 100% pain-free almost all the time. I am, except when I do certain things...I still can't vacuum more than one room. And most physical activities like housework or gardening, I'm good for about 2 hours and then it is downhill after that. The difference now (two years post surgery) is that I bounce back after a night's rest. That never happened previously...so that's a big improvement.

Do you have some aqua therapy available to you?[/QUOTE]

Thanks. Yes i was told that i would never be 100% pain free but probably like 85%. I am not sure about the aqua therapy. Last night I called dr oncall becausr the leg pain was sooooo bad. I am up now and have pain and will call my dr when he opens. If i have to go to er i will i just want my dr there and last night he wasnt. My pain really feels like nerve pain. Is nerve pain normal to have after fusion in the leg that wasn't bothersome before?
same thing happened to me after my surgery...I had pain in my right thigh/leg...I started taking Neuorontin and that helped some but lyrica really helped and that is what I am taking now at 900/mg daily...mmy surgeon said I had a damaged nerve during the surgery and it may/ maynot ever heal,but the lyrica seems to help alot I never feel it unless I miss a dose....I hope you feel better soon!
[QUOTE=JustSayMo;5025960]Hey Purple Girl,

I've been having left leg pain that started about day 11 post op (L5-S1 Fusion). I spoke to the surgeon's office today, they want me to get a CAT Scan this week to determine what is causing the pain. They said some tingling sensation is to be expected, but not the aching pain I've been experiencing in the full length of the leg. It seems like it is worst at night when I try to sleep and in the morning, but generally gets better as I move around during the day.[/QUOTE]


Omg i just went today for the ct scan and tomorrow to the dr for results. So weird!!! I will pray for us all here that it is just the nerves aggravated from surgery and will subside. please keep me posted and feel better!!!!
JustSayMo ~ I hope you told the surgeon how much you were walking during the first week after surgery. That alone should explain the leg pain.

How far were you walking on a regular basis prior to surgery?

Doctors really need to be more detailed in their instructions. They really do their patients a disservice when they say walk as far as you can. They don't realize they have some patients who will take them literally when they say "walk as much as possible.... " The result is a bunch of seriously annoyed spinal nerves and then the patient spends weeks trying to get them to calm back down. This much walking causes inflammation, irritation of the piriformis muscle, which in turn irritates the sciatic nerve...and so it goes.

What most surgeons also usually neglect to tell their patients the point of walking in the beginning. It is not for aerobic exercise! The reason walking is important is because it stretches out the spinal nerves better than any other exercise. This is important because it keeps scar tissue from attaching to the nerves as it grows and fills in. It is important to take many short walks during the course of 24 hours. Distance and speed are not at all important at this point in recovery. One should be walking on a flat, smooth surface, no inclines.

Keep in mind that it is much easier to keep from causing a nerve flare than it is to calm it back down once it has occurred. Another thing surgeons love to say is "If it hurts, don't do it." This advice is meaningless. You only find out it was "too much" after you have done it and are now suffering as a result.

I think you'll find that your scan will be fine. It is fairly normal to have some residual pain after fusion. Fusion is an assault on the body. If you ever talk to someone who is awake in the operating room,(in other words, someone watching or participating in the surgery, not the patient) they will tell you how much force is involved in wedging the cage in between the vertebrae, drilling the bone, sawing the bone where necessary, etc.

It is often necessary to tug on a nerve in order to free it up. If a nerve has been compressed for some time, it can take a long time for it to recover. I'm talking months, even a year or longer. I am two years out from my last fusion and the nerves in my feet are still changing....some surgeons will tell you the nerve will only heal for a year. If it isn't regenerated by then, the damage will be permanent. I personally do not believe that because of my personal experience.

Good luck with your scan. And, try to take it a bit easier with your walking. Remember that rest is every bit as important to your recovery.
Hi guys,

I am in the UK and had L4/5 TLIF on May 9th this year after damaging a disc coughing. I walked into hospital that morning perfectly normally, an aching back my only symptom.

On waking from the op, I had the same shooting pains described by many in my groin and thigh in my right leg. Over the last couple of months the shooting type pain has stopped, however I am in constant pain, a really constant ache, in right buttock, hip, groin and right down my leg to ankle. Worse during the night and first thing on a morning. I have to use sticks to walk and have a constant limp.

I have done as requested and walked as often as possible, not massive distances but sufficient to keep the nerves stretching, and find that even after small walks, the limp I have becomes more pronounced and I get extremely tired.

I have had a CT scan which showed a cortical breach on one side, however doctors say its the opposite side to pain so not the cause and its only minimal breach. I have also had a MRI scan and according to doctors, fusion has worked well and surgery was a complete success, and say they do not know what the pain I have is.

I feel like they seem to think its an imaginary pain and shouldnt be there, as it has nothing to do with surgery, but I am reading so many similar stories online, now that I am checking online, that it HAS to be something to do with the surgery, and cannot be a huge coincidence that it began on May 9th.
justSayMo ~ Don't be too surprised if the surgeon just tells you to walk as much as possible. My experience after having seen a number of spine surgeons is that they mainly know about the surgical experience as it relates to what they are doing. They aren't much interested in muscles, soft tissue, the fascia, or topics like movement, posture, mechanics, etc. For a long time, up until fairly recently, they didn't even think issues with the sacroiliac joints had anything to do with back pain. It wasn't a part of their "domain." Don't be surprised if your surgeon just tells you that you should be walking as much as possible. He is speaking from his perspective.

Yes, if every patient responded optimally, he should walk as much as possible. But if the patient is having nerve pain, this is not the best advice. If you talk with someone who works with movement issues, trains endurance athletes, or a really top-notch physical therapist, you soon realize that surgeons are just about the last person that's good at giving advice on how to go about preparing the whole body for movement.

Another issue is that most surgeons do not like to go into much description about the surgery itself. I had an interesting experience with my last fusion. The surgeon definitely downplayed what he found when he opened me up. When I began PT several months later, I was able to learn in much more detail exactly what had been wrong and what measures the surgeon had to take to correct the problems and resolve my pain issues. My Pt has worked with my surgeon exclusively for 18 years. He also teaches at the university level in the Physical Therapy department. He had two students interning with him -- our first days were all at the same time...so they were around the whole time I was undergoing my therapy. We all became very comfortable with one another, and because he knew how interested I was in learning everything I possible could about my "issues," he never hesitated to say something about my surgery to the students, in front of me. I must say, some of it was shocking...but you do quickly learn that spine surgery is a traumatic assault on the body. It is a high-class carpentry project involving the same tools that are used by carpenters -- hammers, saws and drills. You get a feel for how much brute force it can take to wedge a cage into a small space, and how hard they have to work to cut out scar tissue that may be binding a nerve, or how hard they tug to free up nerves. I came away thinking it is a wonder that any spinal procedure turns out well!!

Please let us know what you learn at your appointment! Hope it goes well.
Flickboroboy ~

Welcome to the board. I would love to know a bit more about the need for surgery. Had you been under care for back problems for a long time? It is not too often that a herniated lumbar disc is considered a medical emergency requiring surgery immediately. And I know that they don't rush into surgery in the UK, so I am surprised you had a fusion

Often the reason for continuing pain after surgery is due to the fact that the "pain generator" was not identified properly and the surgery was not done on the right level, or the surgery did not include enough levels...

It is true that there is often residual nerve pain post surgery, particularly if a nerve has been compressed for a long time. Also just in the surgical process, sometimes a nerve has to be tugged in order to free it up. Nerves are very susceptible to irritation and are easily irritated.

In the US spine patients are told that even if a patient shows bone growth early, it takes a year for the fusion to be completed...and for the bone to set up hard and strong. Prior to that time a surgery would not be considered a success or a failure.
[QUOTE=purplegirl1;5024088]Had 1 level lumbar fusion july 11. Having very bad left leg pain since that wasn't there before. ???[/QUOTE]
Hi my name is Mercy. It has been 5 weeks since my Lumbar fusion, and I too have leg pain and nerve pain in the right leg that I never had before. What I have learned is that from the intense manipulation of the spine during surgery has inflamed other areas of my right leg. The good news is that the pain has decreased with exercise, walking and stretching. After much research and on line reading I am convinced that it will get much better with time. Don't give up. I do still take a lot of pain medication, but I can now walk which I could not do before surgery. Be very careful and rest frequently.
Hi Mercy - thanks for your input and words of encouragement. I'm 3.5 weeks post surgery, and I am encouraged that after several days of intense pain, the left leg pain does seem to be slowly diminishing. It started out with the entire leg, from button, hamstring, all the way down to ankle. The upper leg is feeling better, with the pain mostly in my calf and ankle.

I am continuing to walk daily, although haven't been stretching as I'm concerned about putting strain on my lower back. I'll stay the course, and let everyone know how it progresses.
Hi Mercy - thanks for your input and words of encouragement. I'm 3.5 weeks post surgery, and I am encouraged that after several days of intense pain, the left leg pain does seem to be slowly diminishing. It started out with the entire leg, from button, hamstring, all the way down to ankle. The upper leg is feeling better, with the pain mostly in my calf and ankle.

I am continuing to walk daily, although haven't been stretching as I'm concerned about putting strain on my lower back. I'll stay the course, and let everyone know how it progresses.
[QUOTE=Mercy6;5030319]Hi my name is Mercy. It has been 5 weeks since my Lumbar fusion, and I too have leg pain and nerve pain in the right leg that I never had before. What I have learned is that from the intense manipulation of the spine during surgery has inflamed other areas of my right leg. The good news is that the pain has decreased with exercise, walking and stretching. After much research and on line reading I am convinced that it will get much better with time. Don't give up. I do still take a lot of pain medication, but I can now walk which I could not do before surgery. Be very careful and rest frequently.[/QUOTE]

Thanks but I ended up needing a revision of the surgery where the dr freed up some stenosis etc that. He also needed to fix the hardware as 1 of the screws was not through my bone. So if ur not sure about ur pain then make sure b/c my left leg pain was not normal
Doing my nightly reading on the boards. I have been asking some questions about new pain after surgery. Had laminectomy @ L4/5 five weeks ago tomorrow. Having terrible pain,numbness etc in left leg--all new! Dr gave me Prednisone pack last Tuesday. Also on Neurontin,Norcos and sometimes trying a muscle relaxer. Told me to take it easy and see if Pred. worked. Today I decided to see what I could do and push it a little. Went to 25 yard lap pool and "power walked" for 30 minutes. Then into gym and did 4 very very lite sets of pull downs,rows,seated bench and couple others. Feel better tonight than I have since surgery!! Been icing 20 min per hour. Prednisone is gone so we'll see what tomorrow brings. I am just so damn sick of feeling sick!! Got couple of other maladies to deal with as well. Signed up for PT for Thursday. It is at same Ortho practice as my OS so at least they may be able to have some communication with my surgeon. Good luck!
[QUOTE=JustSayMo;5030327]Hi Mercy - thanks for your input and words of encouragement. I'm 3.5 weeks post surgery, and I am encouraged that after several days of intense pain, the left leg pain does seem to be slowly diminishing. It started out with the entire leg, from button, hamstring, all the way down to ankle. The upper leg is feeling better, with the pain mostly in my calf and ankle.

I am continuing to walk daily, although haven't been stretching as I'm concerned about putting strain on my lower back. I'll stay the course, and let everyone know how it progresses.[/QUOTE]

I am so glad to read ur feeling better!!!!!
Just read my post back, did sound like I had surgery soon after hurting back but actually damaged the disc in December 2009 when coughing, then hurt it again in August 2010 when putting down a telephone in the office, so waited quite a while before surgery.

Although it was only a couple of days ago I first posted, I am now seeing a few new sysmptoms of pain appearing, almost like, what we call in the UK, growing pains, in the left leg from thigh to ankle and a return of the sharp trapped nerve type pain in the right thigh.

Prescribed a variety of drugs, which may or may not be available in US, but given paracetamol, Tramadol and Gabapentin, for the pain, none of which work, but like others I find it easier to manage during the day, mainly because I think my pain tolerance has risen over the last 3 months.
Teteri. You said "let's see how you feel tomorrow. Especially the next day"
Well,I am in big time pain.Starts at site goes to butt and down leg. Kills me to cough! When I straighten my left leg feel like I M pulling on the nerve. When I stand up from sitting mt heel fires! (on IPad so excuse typing)
I have been talking ti OS nurse. She called today and said OS wants an MRI and a nerve block. --that's an epidural right? I have had 4 This year! Not sure pain guy will give me another.
Anyway, I am sorry I had the surgery. My pain is worse than before surgery.
Wondering what is wrong? Been reading--too early to be scar tissue. Maybe a bone spur? Maybe OS did wrong procedure!
I have had so many things lately including rotator cuff,colon. Re section,heart ablation, ischemic colitis and now bladder cancer that needs chemo. Want some semblance of a life back. At 70 I am not ready to sat "it's over."
I have gotten thru all these things with strong attitude but the back is wearing me out. I feel like I can say things here that I would not tell family and friends.
Sorry to be prophetic! But I still think at least part of your problem is doing too much. From early on in the healing process, I think you got some inflammation going --the sciatic nerve is very inflamed and is causing you all this pain in your leg. Once it becomes inflamed and you are still doing things that irritate it, it is very difficult to get the pain to settle down. I think I told you I ruined one surgery due to a family issue that required me to drive 45 minutes to the hospital and hang out in the emergency room all day...and I had to do this for about 5 days. This was five days after surgery when I wasn't even supposed to be riding in a car.

After the second day, I could just feel that I was becoming inflamed. I called my surgeon. He gave me a Medrol pack and we both kind of figured it wasn't going to be enough.

It wasn't. That nerve never calmed down....What I learned was that even a nerve can develop scar tissue from being repeatedly irritated...and when that happens, not too much can be done about it. It causes the nerve to malfunction. My surgeon drew me a complicated diagram of the whole process...but these very fine little strands of nerve tissue that are trying to make a connection, aren't connecting properly so they just keep mis-firing and the result is a signal the brain interprets as pain.

I don't know if something similar is going on with you...but one thing I have learned is that this type of sciatic pain is not something you work your way through by trying to stretch it out, work it out, and certainly not that old adage, "no pain, no gain." The best way to deal with sciatic issues is to not have a nerve flare to begin with -- so that's why I've been saying not to push, do too much, walk too far, go to the gym, etc.

I would imagine your surgeon wants a diagnostic nerve block which can be done without any steroid. I imagine he is trying to find out which nerve is causing the pain...in hopes that it can help him figure out what is going on.

Keep icing and try to restrict your activities to very moderate walking a couple times a day. Maybe you can get the pain to settle down a little bit.





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