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Leg pain 3 weeks after L4/L5 micro-discectomy (Page 1)

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Hi, I am a 32 year old male and had L4/L5 micro-discectomy done about 3 weeks ago. Prior to surgery, I had been dealing with back pain for about a year. The main orders I was given was to walk a lot and not lift more than 10lbs. Last week I started physical therapy (PT) and have gone twice so far. After the first PT my leg hurt a little that night, but the pain was gone the next day. For the last 2 days, however, I have been having pain in my left leg again. Is this to be expected? Also, my incision is still a little swollen. I would say that apart from not lifting more than 10 lbs, not driving for more than an hour and not going on flights I have been living a pretty normal life for the last 10 days. I am just worried that I may re-herniate the disc. What are the main issues to watch out for? When can patients start lifting more than 10 lbs again? And for how long is it to be expected to have the leg pain without having to go back to see my surgeon? Thanks!
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First Helper Bello
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replied June 11th, 2011
On Reherniation, Micro-discectomy L5/S1
Hi Jerry, I'm about 9 days post-op on my L5/S1 microdiscectomy. Like you, I felt instantly relief of horrible leg pain after the surgery, though about 25% of the pain has returned since then. I've been up walking everyday for about 1/4 mile a few times a day. My surgeon was a highly respected neurosurgeon who has done 3500 of these and he mentioned one thing that I think is germane to both of us:

He said in his 30 year practice he has seen no correlation between any kinds of light to moderate activities (including bending, light lifting, twisting, etc) and a re-herniation! Thus, although he did say that the conventional wisdom is to avoid all of these activities for a few weeks to 4 months, there is no data showing that actually avoiding these makes any difference. According to him, 5-10% of patients experience a reherniation and there are no predictors or what will cause it. One thing he did in my case was to go into the disc and remove any loose fragments that would be likely to reherniate. In doing this, he said the chances of a reherniation decrease from about 25% to less than 10%. You could confirm that your surgeon did this, for your own piece of mind.

My surgeon did warn me that it may take 3-6 months or longer (up to 3 years)to recover from the leg weakness and numbness given the slow recovery rate of 1 inch per month for nerves. Really, it all depends on the degree of compression and damage the nerve root suffered. Others have said sometimes the pain gets worse before it gets better.

For me, I have a suspicion that it took a while for a) the painkillers to wear off after I went cold turkey 3 days post-op, and b) the nerve began to hurt as it began to heal. These are both just suspicions, though.

I would love to hear stories from others on what their leg pain was post op? Are there folks who got worse before they got better? How long did it take to get pain free again and to recover from numbness and weakness. Like you, Jerry, I do have concerns that I could have re-herniated, but perhaps it's just way to soon to know??
Thanks,
Peter (48 y.o., athletic, active, microdiscectomy L5/S1)
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replied November 25th, 2011
in pain
just had a disectomy tues and i am in the worst pain ever. i didnt have much leg pain before it was mainly my back but now my leg is so numb with horrible pain you could put a knife in it and i probably wouldnt know. is this normal?
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replied May 6th, 2013
I am so sorry to here this i had my back surgery twice last year with the first one when i cam home my leg was feeling a bit better after the second on i feel like you do i dont under stand it the surgen is saying he dose not see any thing wrong just tells me walk dont lift any thing heavy an come back in 2 months ann
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replied December 4th, 2011
Hi Peter, I myself had a microdiscectomy at L5-S1 in 2001 due to a severely bulging disc that was encroaching on the nerves like yours. I had improvement over the first 4 weeks post surgery then the pain started getting worse, even worse than before the surgery. I did not re-herniate but I developed scar tissue that is now totally encasing the S1 nerve resulting in 90% damage to that nerve. I tried physical therapy, exercises, yoga, psychotherapy, facet blocks, nerve blocks, and multiple narcotics. I hope that you are doing better than me now. If you have any specific questions, don't hesitate to contact me.
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replied May 24th, 2012
3 weeks post op and a lot of pain
Hi - I know this is old post but I hope you are doing better. I had microdiscectomy/laminotomy 3 weeks ago and I ad incremental relief at first but things ave been getting worse since. I'd say my hip and butt pain is worse than before and the numbness in the calf and leg coming back as well as shooting pain in calf. Discouraging... I am having MRI tomorrow to check for reherniation as p dr it is a precaution . Good luck all
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replied July 28th, 2012
Back pain
Hello my name miguel and had a s1 l5 Lamitomi 3 months ago and now im still the same right leg numbness and my back have to take pain kilers my sourgen took mri and said i was fine but didnt feel fine sow i went to see another dr neorologist spine and he did a mri and saw i have a hernidaded disc on s1 l5 and he told me my best option is to get. A fusion 360 make me wonder what my first dr do than and why he told me i was fine when i wasnt anybody outhere same issue email please any sugestions
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replied May 6th, 2013
I have i had back surgery twice last year in jan an may an nothing changed it is so much wores than befor just because i had a bulging disc an now all i do is take pain meds that do not help an last week i seen the doctor an he said he did not see any thing wrong go see the doctor that helped him do the surgery as she is a nerve specailist this is all i do is go to one doctor to another i should have just delt with the pain in my back an leg
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replied May 6th, 2013
HI i am the same way after have back surgey twice last year it is making me so missable ann
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replied July 19th, 2012
Back pain surgery
I find your post most interesting. I'm 74 years old, have had back pain off and on for years. But in October 2011, I picked up a TV that apparently caused me more problems than I realized. I happened to have an appointment with my rheumatologist a week later, and told him I was having lower back pain. He felt along my back until I said "ouch" and said I was having back muscle spasms due to me probably stretching my muscles too much. He prescribed a muscle relaxant and it help[ed to a point. But in March, the pain was so bad, I went to the emergency room. I was advised to see a neurosurgeon as a CTI scan showed some disk degeneration. I did, and x-rays confirmed I had a serious problem that even minimal invasive surgery for the problem wouldn't help. So I agreed to surgery for lower back lumbar surgery, L3 - L5 laminectomy and fusion (L3 - L5 TLIF). Prior to the surgery, I had severe back pain in the lower back and left leg down to my foot. Sometimes the leg would tingle and then go limp. Then, a few times it just gave away, so I started using a crutch to support myself in case I fell. I was fitted with a back brace prior to the surgery, and wore it at home for a few hours a day to get used to it. I admit, it really helped. After surgery, I no longer had severe back and left leg pain. I still had some tingling and weakness in the leg but I thought it was a normal aftereffect. Two weeks after my surgery, I told the surgeon during my followup, that my left leg had tingling and sometimes weakness to the point of just going dead or complete loss, whereby I fell one time. He said that it might take up to a year for the nerves to get back to where they were before the pinching. So I always take my crutch with me when i leave my house, because if I fall when the leg goes out, I know I will break something. After my last PT session, while waiting for the elevator, I was fine. When the elevator door opened, I took a step forward with my left leg, and it buckled. Had I not had the crutch I would have fallen and probably broke something. Good thing is that I was in a hospital so I would have been treated immediately. I haven't had a total loss of leg function in weeks, but I still take my crutch with me in case. A cane wouldn't help me, as i need to grab something with both hands. My point: if you need the surgery, consider it fully. Make sure it is done with a qualified surgeon. Expect slow healing, but as in my case, relief from terrible pain is possible.
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replied July 19th, 2012
Back pain surgery
I find your post most interesting. I'm 74 years old, have had back pain off and on for years. But in October 2011, I picked up a TV that apparently caused me more problems than I realized. I happened to have an appointment with my rheumatologist a week later, and told him I was having lower back pain. He felt along my back until I said "ouch" and said I was having back muscle spasms due to me probably stretching my muscles too much. He prescribed a muscle relaxant and it help[ed to a point. But in March, the pain was so bad, I went to the emergency room. I was advised to see a neurosurgeon as a CTI scan showed some disk degeneration. I did, and x-rays confirmed I had a serious problem that even minimal invasive surgery for the problem wouldn't help. So I agreed to surgery for lower back lumbar surgery, L3 - L5 laminectomy and fusion (L3 - L5 TLIF). Prior to the surgery, I had severe back pain in the lower back and left leg down to my foot. Sometimes the leg would tingle and then go limp. Then, a few times it just gave away, so I started using a crutch to support myself in case I fell. I was fitted with a back brace prior to the surgery, and wore it at home for a few hours a day to get used to it. I admit, it really helped. After surgery, I no longer had severe back and left leg pain. I still had some tingling and weakness in the leg but I thought it was a normal aftereffect. Two weeks after my surgery, I told the surgeon during my followup, that my left leg had tingling and sometimes weakness to the point of just going dead or complete loss, whereby I fell one time. He said that it might take up to a year for the nerves to get back to where they were before the pinching. So I always take my crutch with me when i leave my house, because if I fall when the leg goes out, I know I will break something. After my last PT session, while waiting for the elevator, I was fine. When the elevator door opened, I took a step forward with my left leg, and it buckled. Had I not had the crutch I would have fallen and probably broke something. Good thing is that I was in a hospital so I would have been treated immediately. I haven't had a total loss of leg function in weeks, but I still take my crutch with me in case. A cane wouldn't help me, as i need to grab something with both hands. My point: if you need the surgery, consider it fully. Make sure it is done with a qualified surgeon. Expect slow healing, but as in my case, relief from terrible pain is possible.
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replied August 10th, 2013
hello, my name is jerry,i had a l5,s1 back surgery the 25th of july,after 2 weeks of surgery iam having pain on left leg,hips, and bottoms,my question is are you guys able to work in these conditions.i am 37 years old.how are you doing it,or you are out of work.if someone in the same condition,let me know please
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replied May 6th, 2013
well i had my back surgery twice last year an the pain is still in my back i can not bend over to pick up any thing like if i was to drop some thing an my left leg is so bad that i fall it just gives out an gose numb what do you think or can you please help me find out why it is like this thank you ann
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replied August 6th, 2011
I am 5 days post hemilaminectomy L4-L5 and discectomy by one of the two most highly regarded surgeons in my area. Immediately following the surgery, I did not have resolution of the pain. Here at day 5 post-op, the pain is as bad as ever. My pain has always been bad R sided radicular pain. I have no idea what to expect, but I had heard many stories from people whose symptoms were immediately resolved following surgery. Everyone is saying "just wait, it'll get better." I'd be lying if I said I wasn't worried. Everything I've tried has failed (which is why I ended up in surgery) so after not feeling immediate relief, I'm afraid this won't work either. Everyday, I keep looking for a positive sign and I see none. I wish there was some way to know how this was going to turn out. So bummed. I wish I could find in the literature someone that says not to worry until day "X" post op. Is it not unusual for the pain to be worse day 5 post op than it was bf surgery?
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User Profile
replied August 6th, 2011
Especially eHealthy
PaininBoston,

You state: "I wish I could find in the literature someone that says not to worry until day "X" post op." You will not find it, because it is not out there.

As to whether or not your radicular pain will resolve, depends upon several factors.

Yes, it is true, that many patients will have significant reduction in their radicular pain in the recovery room. However, these patients have a very discrete lesion, pressing upon a single nerve root, indentified by exam and correlated with a study. They usually do not have any other significant problem in the spine, such as DDD, facet joint arthropathy, spondylosis, etc. They have a discrete herniation of the nucleus pulposus, that has not been there for an extended period of time.


If there are any other problems, then the picture becomes more complicated.


If the procedure was done for narrowing of the neural foramina, due to disc bulges or facet joint hypertrophy, without discrete herniations (sequestered or not), then the results are not as predictable.

If there is multilevel involvement, the results are not as good.

If the radiculopathy has been there for an expended period of time (months in some patients, decades in others), then the nerve injury may have progressed to a point that relief of pressure is not enough to reverse the condition of the nerve.

However, it is known that in nerve compression disorders, that the longer the nerve has been compressed (and there is no set time for this to occur, it is different in every patient), the longer it will take to "wake up".

There are essentially three, progressively more severe, types of nerve injuries: neuropraxia, axonotmesis, and neurotmesis. With neuropraxia, by definition, if the nerve wakes up within six months, it is this type of injury. But, usually with neuropraxia, the nerve will start showing some "signs of life" within 4 to 6 weeks, and definitely by 3 months. Electrical testing is therefore, usually, delayed till around 6 weeks after injury or surgery, to see if there is any change in the status of the nerve.



What does all this mean, well, basically, as you know, "everyone is different and reacts to treatment uniquely", but that's beside the point.

You have to look at your own situation: why was the surgery done, what was the exact cause of the radiculopathy, how long had the nerve symptoms been present, etc?

Five days, though, is way too early to give up on the procedure. It is obviously going to take longer in your case, but, no one can give you an "X" number of days.


You need to speak candidly with your surgeon at your next appointment.

Wishing you the best. Good luck.
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replied August 7th, 2011
Gaelic, thank you so much for the response. What a great, thoughtful and informative response! So I believe I am beginning to see some day to day improvement - albeit small. Based on what you had written, it makes sense why some of my friends would have improved so dramatically so quickly while I lag a bit. I do have just 1 level involved, but there is significant R sided facet hypertrophy, there is some DDD, I do have a discrete herniation of the nucleus pulposus at this level, but the condition has been chronic - about 19 months. So I guess this is why I am not feeling "immediate" and total relief. I now understand why I may take longer to feel "normal". Thanks again for your wonderful input.
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replied November 10th, 2011
Nerve and leg pain 3+ months post surgery (L4/L5 discectomy)
Its been a little over 3 months since my L4/L5 (L) discectomy. I injured my back mid September 2010 and my surgery was performed August 10, 2011. The 11 months prior to the surgery i was in sever pain and could not stand up straight. Also, it was almost impossible to walk for more than 10-15 minutes at a time without crutches or a walker before i had to sit down. Even sitting on anything other than a recliner was extremely painful. I completed about 6 months of physical therapy prior to the surgery with no improvement and I am currently attending PT a few times a week. Unfortunately, I haven't shown any signs of improvement or relief in nerve pain. The pain starts in my lower back and shoots all the way down my left leg ending in my foot. Even the pain in my lower back is still pretty severe. The only improvement I have shown post surgery is I can stand up pretty straight, but it is painful to do so. My surgeons told me that it might be from swelling and fluid build up from the operation but I'm starting to lose hope that it will heal. I'm unable to work because the pain is so severe. Has anyone had a situation close to mine with a positive outcome?
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replied November 10th, 2011
I forgot to mention that Im a 24 year old male ( I was 22 when the injury occurred and 23 when I had the surgery). I'm not sure if age has anything to do with the healing process.
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replied April 9th, 2012
I myself am only not quite 4 months out from surgery (surgery date 12/14/11) i have done the round of PT after surgery. i now have scar tissue around my S1 nerve root..not quite sure how that happened.

btw, i am in my late 30s and i had a ruptured disk in L4L5 with my S1 compressed. so i as well wasnt able to sit or stand let alone walk very well. i had also lost muscle mass in my left leg with my left foot numb and felt like walking on a stone on the bottom of the same foot.

after surgery i was sore in my lower back from the surgery itself...b ut now due to the scar tissue around my S1 the small of my back is where my pain is although i still have numbness in the back of my thigh. i went almost a year before seeing a doctor for my pain. though i had no trauma or accident to cause the rupture. PT didnt really help me...but im not sure if it was just me and my pain or what it was. i did get some muscle mass back in my leg, and now i can stand upright, and walk. just give it time...and make sure you talk to your neurosurgeon. He/She is there to help. i love my neuro and he did help alot..i just now have a new issue to deal with.
hope this helped
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replied November 17th, 2011
I had L5/s1 microdiscetomy one year ago . After the surgery I had relief for my leg pain. But after a couple months the leg pain came back not as intense. But recently I've been having back pain left leg pain as well as left arm pain. I am 18 yrs old and old I was 17 when I had the surgery
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replied November 29th, 2011
day 7 after disectomy and the leg pain is still horrible. what i dont get is i didnt have much leg pain to start with just lower back pain and after surgery its my leg am i going to be able to go back to work?
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replied December 26th, 2011
Herniated disk in back L-3/L-4
I had a herniated sick and had surgery L3-L4. Immediately after the surgery I felt amazing NO pain at all in my legs or my back. 10 days after the surgery I started to have pain in my left leg. Does anyone know if this is normal. They did tell me I might have some tingling but nothing about pain. I did have some hip pain after about 5 days but they said it was becasue of the ay they position your hips during surgery. That pain did go away but the leg pain is what is making me nervous. Does anyone know if this is normal and if it will go away.
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replied January 3rd, 2012
L5\S1 microsectomy
hi i had L5\S1 microsectomy in sep at first the pain seemed to ease a good bit but was very stiff and aching, but in the last few weeks my leg pain has got worse and numbness is still down leg and in foot. can someone tell me if this will go i think im never gona b out of pain with this or not have to take pain killers. Im 32 female this been goin on nearly 2 years
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replied February 19th, 2012
I had the disectomy done 2 weeks ago myself and as soon as I come out and was in recovry the pain was severe down the left leg. It took 4 shots of pain killers and 2 oxycontins to relieve the pain. The pain is still present down the left leg. Sitting hurts bad, standing is bad and laying down at night is terrible for Im not sleeping well at all. Im trying not to lose hope and keep a positive attitude about this and just hope it heals without any more painIm a 42 yr old male and just hope I can get back to work soon. Not doing anything is drivin me bannanas.
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replied October 4th, 2012
Jadsr69, I know it's been a while since your surgery, but how are you doing now? I had my discectomy a little over 2 weeks ago and thank God I'm back at work.(not working very hard right now obviously). Lol. I did go a little crazy at home. Daytime TV is boring. So how are you?
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replied July 9th, 2012
diskectomy L5/S1
just a quick update...i have now had a fusion of the L5/S1 but i still have the numbness in the left thigh and i have spasms in the left calf....but the first surgery did what it was supposed too....i just happened to have lost all the fluid in my disk
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replied October 11th, 2012
It has been 9 days since I've had a lumbar microdiscectomy on my L4/L5. I felt immediate pain relief the minute I stood up after surgery. I've been doing good, but I did a little too much today and the back of my top left thigh was starting to get pain. I'm going to continue to take it easy though. I keep forgetting it hasn't been long since I had back surgery. I guess I'm just so excited to be practically pain free after over a year of non-stop pain! I'm really sorry to hear all these stories of your surgeries not working. Dr. Mango from South Bend Orthopedics is amazing! I'd highly recommend him to anyone! I'll keep everyone updated with my recovery for the next months to come, but as of now, besides me doing a bit too much today, I've had a great success with my surgery! Good luck to all!
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replied November 16th, 2012
I had a L4-L5 Disectomy Nov 16, 2011 and i'm still in pain just saw my ortho and he has scheduled me for surgery again due to the fact that the disc did not heal properly. Be patient if you do not notice any improvement or did notice improvement and started to feel the pain in the same location I wuld go see your surgeon and have him order some test i.e. C/T scan or MRI to see if your problem has returned.
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replied April 10th, 2013
I had my microdiscectomy (L4-L5) on 1st April 2013. Right now it's better than the pre op. But I still have a leg pain and when I start walking the pain increases even gets close to the pain I had before the surgery. I had an immediate relief after the surgery and everything was very fine but after a week the pain started. I have an appointment with my doctor this saturday, I hope everything is fine but I'm very nervous right now!
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replied May 1st, 2013
Surgery!!
Im pretty far down on this post, so who knows if anyone will read it. I had micro disk surgery on L5/S1 to eliviate sciatic nerve pain that was radiating down my right leg. I suffered with this pain for a year, and can say that this was the most significant long term pain I have ever experienced. I was depressed, in constant pain, and unable to do normal daily activities because of my back. I wasnt able to stand for more that 1 minute or so without having to sit. After the surgery, I had instant pain relief! Though the incision was sore and my back a little weak, the pain in my leg was totally gone! Thank GOD (and my surgeon!). I work in orthopaedics with a spine surgeon and he tells me that there has been no correlation between activity levels and reherniation of a disc. Basically, I have no limitatins now. I am about 7 months out from my surgery and I still feel great. The pain in my leg came back for a little as swelling came and went, but once it was gone for good, I havent looked back. I am so happy that chapter in my life is gone. I will forever pray that those suffering with this pain will soon find relief. I couldnt imagine going any longer myself.....
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replied May 13th, 2013
I'm from Singapore and had sciatic pain on my left leg since Sept 2011. Initial PT worked for a while but it got worse in November last year. Pain persisted till I decided to schedule for L5/S1 microdiscectomy in late April this year.

Was pain free at the left leg immediately after surgery. Things went fine until now. Experienced some pain in my left glutes and now it's hitting my left thigh and calf. I'm not limping as I did before surgery. I'm not sure whether my activities had caused this to happen although I did not carry my heavy backpack nowadays.

Will be seeing the Dr next week and we'll see how it goes. Just praying that it's not a reherniation Sad
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replied May 21st, 2013
i am a 49 year old male whi si getting a discectamy in the morning..i have also had 3 lamanecatimies. i had immediate releif from the severe excruciating sciatica pain i suffered but then i allways ended up re herniating just by moving furniture,or lifting..after your surgerty you should have no sciatica, especially with a laminectomy....i have been in such severe sciatica pain i felt like i was being burned alive. i would rather be dead. and no pain pill made helps with this severe pain..i just suffered here for 7 months of sciatica. and finally getting a discectomy in the morning..wish me luck...i just want to say how important it is to heal after a surgery..do not lift anything! i have reherniated my disc lifting my small dog..i hate my doctors..
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replied May 26th, 2013
L4-L5 discecetomy, leg pain returned 3 weeks post op.
Hello,
I am sadly only 22 and have under gone this surgery for L4-L5 3 weeks ago now. The surgeon said it was a bad hernia and it took 2 hours in surgery. I have had bad left leg pain from hip to foot for 2 years, with numbness and muscle loss. I was an avid ballet dancer and road cyclist and worked in the hospital as a health care assistant which all together meant I ended up with a bad back and terrible damage that my surgeon said was really rare for my age and I'm the youngest patient he's had for this op. The surgery went well and I woke to no leg pain. I was on crutches for the first 10 days but can now walk well but just slower and I get tired easily. I've been signed off work for 3 months and my surgeon said to find a new career as health care isn't right for my back. The leg pain was horrendous and lead to the surgery decision as I'd tried PT and injections with little hope. But worryingly now after 3 weeks post op my leg pain is returning, it is around 40% pain of what it was before surgery, but I'm worried as my surgeon said not to expect leg pain only back pain from the cut. My scar has now gone lumpy and is more tender. Will this pain go or do you think the surgery wasn't 100% successful? I'm just so upset by this all as I'm 22 years old and I cant do any of the things I love anymore. Please help if you had this problem. I haven't been lifting anything heavy, but I have been walking regularly and doing daily tasks like the washing up and making my bed. I've tried to be as careful as I can be!
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replied June 26th, 2013
L4/5 and L5/S1 discectomy - post surgery worries
I went in for a L4/5 and L5/S1 discectomy 2 weeks ago.
Im 21 and this is my second surgery for the same discs. The first surgery being when I was 14/15 years old in 2005.

When I was in hospital for the 2 days after my surgery the only pain I had was from the incision on my back, but the day after I returned home I have severe pulling in my left buttock and back of left thigh, numbness thought my left calf and what feels like pins in needles in all of my left foot except the big toe. The pain is worse than before I even had the surgery!! Prior to surgery my left foot was only numb on one edge on my foot but this pins and needles feeling is my whole foot except the big toe. The pulling in my left buttock and thigh is defiantly worse than pre surgery!

Is this normal cos I don't remember much from post op when I first had this surgery done and am getting very depressed as I came to back NZ to have this surgery with the same surgeon and would like to return back to Australia soon!

I haven't done much activity other than getting up and walking every hour or so as told my the physio.

Please let me know what I should do or if I shouldn't worry about it.
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replied July 4th, 2013
L4/5 surgery
I'm a 31 year old about to go into microdisectomy surgery for my L4/5 in 4 days and have read your stories - it saddens me that anyone should go through this awful pain. My pain originates from my first (and only) pregnancy, whereby it kicked off with stabbing pains on my right hip in my third trimester and continued on after birth until one day (9months later) I couldn't stand straight. I had numbing, tingling and sciatica on my right leg and trying to enjoy life is so hard with chronic pain as such. I'm booked in with top nuerosurgeon of Melbourne Dr Paul Smith and praying that I will be able to stand straight for my sons first birthday.

I've been fit and a health freak prior to pregnancy so I don't understand how disk buldges just develop? Certainly we are nutrient deficient somewhere for all that weakness? Or is it something like weight of pregnancy that causes that kind of stress on a disk? How is this avoided?

I pray for all of you to heal and get better.
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