5 weeks post op on L5S1 Spinal fusion

[Bella66]

Hi all,

I am just 5 weeks post op from having an L5S1 Spinal Fusion.  Back pain for the most part is tolerable...the worst time I am having is with the horrible pain from my right knee down to the tips of my toes.  Nerve problems apparently.  I went for a Nerve Conduction test last week and was told that the L5 nerve has irritation.  This pain is crazy!  and moves around like nothing I have ever experienced.  Sometimes the top of my foot hurts so bad that I can't even have a sheet touch it and other times I get this weird electrical sensation in the balls of my foot or sometimes in my big toe.  Its nuts! I was on Neurontin but that did nothing so we are now arguing with my insurance  company to pay for Lyrica.  Has anyone had experience with Lyrica?  One last question, I  am unable to keep this problem foot down for any period of time - I have to haveit elevated.  Riding in the car, it sits on the dashboard.....sitting in a chair, it is up onthe chair .  My neuro said that that is not symptomatic to nerve damage.....so what the heck is it?  Anyone else had it??  I think I am just feeling really frustrated at this point of my recovery and feel like I'm going nowhere fast!  Any advise or words of wisdom would be deeply appreciated

[Dr. A. Srivastava]

Hi, Thank you very much for your question Usually, recovery from a fusion procedure takes time (standard is six weeks) and as everyone is different it may vary as well.  Most of the times, one may experience back and leg pain during the recovery period. However, essentially you should avoid prolonged sitting, lifting heavy objects, bending, twisting and excessive exertion for the first three weeks. It is not like that you restrict all activities but you should gradually increase your physical activities over this period. Additionally, common complication of a discectomy is that there is a possibility that another fragment of disc will herniate and may cause similar symptoms. Therefore, endoscopic microdiscectomy is appropriate in some specific situations, and you may check this with your treating neurologist. Hope this helps.

[Katy890]

I'm a retired RN.  Have had fusions from L2-L5 and everywhere in between.  I believe what you are describing is nerve pain since it sound like extreme sensitivity (to bed sheets) and unreal pain (down your lower leg and foot) are two symptoms.  Neurontin and Lyrica won't help.  I've tried both.  The doctor who did the Lyrica investigational research study is one of my doctors in the city where I live.  Lyrica is mainly for Fibromyalgia and is used more for muscular-related or stimulated nerve pain all over one's body.

I had a flare up of pinched nerves this year in both my right knee (before total replacement surgery) and just this past 2 weeks in my L4-L5 fusion space where a recent auto accident has caused the fused area to move 7mm out of kilter.  The only thing I can suggest that you take is a narcotic that is prescribed by your back or pain doctor.  I also have had good results with this type pain by applying very cold ice packs with a pillow case or thin cloth between your skin and the pack.  Leave it on for 15 minutes or so, then off.  Repeat hourly or as needed..

I've been taking 1-2 Tylox every 6 hours or so when the pain is at it's worst.  But you need to taper off any pain medicine after 3-5 days since hopefully, the pinched nerve will be better and so you don't become accustomed to the narcotic [If you do, then the drug won't work later when pain flares up again.] or become constipated.  This drug is one of the very few I can tolerate for pain, but your doctor or pain management specialist may recommend something else similar to this.

And if you don't have a pain management specialist, have your primary care MD refer you to one.  Sometimes cortisone shots can help calm down irritated nerves too.  Again, a specialist should be consulted because they have years of training and experience with cases like yours.  I've also been given Toradol (non-narcotic, anti-inflammatory) shots for severe nerve pain.

It does get better, but in the worst case scenario, your back surgeon or some other  specialist (like the Laser Spine Institute doctors in Orlando, Fl) may have to go in and shave off some of the bony pedicles that are causing the nerve to be trapped and irritated.  The doctors at LSI can do this microscopically without having to open up your whole back incision again.  You are in their facility for about a week and then released to go home.

Hope this helps some and Good Luck.  Let me know.