Sciatica following microdiskectomy

  Can you please explain some of the dynamics of nerve healing? I experienced a herniated disk at the level of L-5.  Following a course of rest/anti-inflammatories, an epidural steroid injection with no relief, a microdiskectomy was performed on Friday, 2/5.  The most prevalent symptom of my problem has been severe sciatica - mostly localized to my left foot. Hoping to wake from surgery with immediate relief, I have instead found the pain to be mostly unrelieved in the week since the surgery.  Can you explain some of the dynamics of nerve healing ... what can I expect?  The foot is not as sensitive to touch as it was preceeding hte surgery, but the pains continue.  Is this normal?  Can exercising the foot be beneficial?  Is there anything I can do to ease the pain?

[CCF NSG MD / gsh]

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Dear Karen,
Nerves heal in a specific sequence after surgery such as you had.  Typically the first thing to improve is pain.  This is often realized in the postop unit right after surgery.  Second to get better is strength, if any was present preoperatively.  This typically takes weeks to months to improve.  Last is numbness, which may take many months to improve, if it gets better at all.  Much of the time course for improvement depends on the severity and duration of nerve compression.  For example, the shorter the time period of compression, the quicker the nerve heals.
At times after surgery on a disc the pain is not improved.  This may or may not be an indicator that there is still some disc or other residual stenosis on the nerve.  Often a surgeon will give a patient some time to heal before investigating residual pain further.  If a patient has persistent or worsening pain or other symptoms, another MRI may be warranted.  This should clear things up, if necessary.
Speak to your surgeon about your problems and see what his opinion is at this point.
Good luck.