The most commonly searched term on this blog is “pain after discectomy”. So I’ve decided I would dedicate a post to this topic based on my personal experience and some recently published articles and videos. This is by no means an exhaustive search for all that ails us after a discectomy, but I’ll do my best to provide relevant information that can answer the most common concerns regarding the types of pain some of us experience after undergoing this procedure, and possible treatments.
A discectomy is the surgical removal of the whole or part of an intervertebral disc that is often pressing on a nerve root or the spinal cord. The procedure is most often performed by a qualified orthopaedic surgeon or neurosurgeon.
One of the most common issues after surgery is inflammation especially at the incision point. Even minimally invasive, arthroscopic surgery will irritate some tissues and nerves and during this process inflammation can persist. Most physicians will suggest over-the-counter medication to control and reduce inflammation. I was sore for about a week and as you can see here, there was still a bit of puffiness around the 1″ incision.
Epidural Fibrosis (Scar Tissue):
Sometimes after a discectomy, scar tissue forms near the nerve root and can cause extreme burning or nerve pain even if the surgery was successful in relieving the initial pain. This type of postoperative pain is commonly called failed back surgery syndrome because you’ve swapped out one type of pain for another.
As Spine Health points out “Scar tissue formation is part of the normal healing process after a spine surgery. While scar tissue can be a cause of back pain or leg pain, in and of itself the scar tissue is rarely painful since the tissue contains no nerve endings. Scar tissue is generally thought to be the potential cause of the patient’s pain if it binds the lumbar nerve root with fibrous adhesions.”
After my last surgery (discectomy at L4/L5), I experienced some tingling and general numbness in the areas where my Sciatic pain was the most intense (bottom tibia/ankle and toes). Months later a EMG revealed that I had permenent nerve damage caused not by the surgery but by the constant ‘zapping’ of the Sciatic nerve, pre-surgery. Those who have had Sciatica know the feeling of this type of excruciating nerve pain which most likely deadened some areas on my leg and foot. Here’s several accounts of other patients going through similar foot/leg numbness.
Aches / Spasms:
Post L4/L5 discectomy, as the nerves began to heal I had a mild ache in my leg around the site of the sciatic nerve shocks. I was told by my surgeon that this wasn’t uncommon and was caused by the nerve trying to repair itself. Massage therapy can help with the aches as muscles can sometimes tighten from being inactive and without any type of stretching may lead to issues such as piroformis syndrome.
Current research suggest that there is a 2-18% chance of re-herniation dependent upon the size of disc defect as well as other factors such as disc height, pre-surgery. It is most likely to occur in the first few weeks after surgery, and it’s strongly discouraged to lift anything heavier than 3-5 pounds during this period. As this research concludes, there are no hard and set rules that make it more likely for re-herniation, however my personal suggestion would be to not strain yourself within the first 2-3 weeks and when ease into a work schedule rather than full-time duties with no easing in preparation. Post surgery is also a good time to re-examine your sitting posture and to explore other options for working at a desk.
As always, consult a doctor if you are experiencing discomfort and take care.