9 Months post L5-S1 ADR: Post surgical radicular pain

[Glendalough Drim]

Dear Fellow Travelers

Post ADR surgery at L5-S1, I continue to marvel at newly found abilities to perform �normal� activities. For three years leading up my August 2004 visit to the Alpha Klinik in Munchen, I lost count of the many daily functions and simple responsibilities that ventured beyond my reach. So many trivial things that I take for granted could be accomplished only by employing unreasonable will power over debilitating pain. Now, I continue to marvel each day at the sheer novelty of driving a car, reading a newspaper or eating a meal without that ubiquitously oppressive yoke of intractably acute suicidal pain that, from 2001-2004, dictated the degree and extent to which I needed to force myself to trudge through another miserable task, day or event.

While four months of surgical recovery was a high price to pay for the freedoms I�m enjoying today, this price was, without a doubt, a worthy bargain relative to my pre-surgical pain and its corresponding future prognosis. Dr. Zeegers will always have my heartfelt respect and appreciation for the skill and talent he employed in giving me a new opportunity at a healthy life.

Right now, I�m far enough beyond the ADR surgery to separate the temporary surgical recovery pain from ongoing trauma. Unfortunately, the proverbial �silver bullet� is relatively unknown to so many of us on this forum. At this point, the most significant pain obstacle I face is sciatica in my right leg, which has become a constant and very real hindrance since ADR surgery. So far I�ve tried lamictal (lamotrigine) to no avail, physical therapy and time & patience. I�m scheduled to have an epidural nerve block in an attempt to quiet the post-surgical leg pain. [note: I�ve experienced right leg sciatica previously from an L4-5 rupture but it was significantly resolved post-laminectomy in 1985. The current leg pain was caused and/or triggered or exacerbated by the ADR surgery at L5-S1]. Needless to say, I want to avoid, if at all possible, any further surgical intervention.

In an ideal world, an occasional epidural might just manage the radicular pain I�m living with now. We�ll see. For those of you who have any ideas, insights or comments about post ADR radicular pain, I�d really appreciate any advice or suggestions you have.

Thanks in advance for any postings or direct emails. I always appreciate this community�s generosity of helpful advice and unique insights.

sl�inte,
�GD" (leahy@sover.net)

--1978 Bi-lateral ruptured disk, L4-5;
--1983 Chemonucleolysis Chymopapaine injection at L4-5 (colossal failure).
--1985 L4-5 Laminectomy:
--1983-1992: Ongoing worsening of L4-5 DDD;
--1985: T9 compression fracture;
--1993 Successful L4-5 fusion at Hosp. for Special Surgery NYC; Resolved majority of L4-5 mechanical & facet pain. Regained most normal function with manageable back pain subsequent to long recovery.
--1994 L2 compression fracture;
--2001 L5-S1 left lateral disc herniation;
--2002 L5-S1 Microdiscectomy: Brief resolution of some left hip pain but low back pain unchanged then worsened dramatically beginning in 2003 as DDD became chronically and progressively acute.
--August 2004: Successful L5-S1 level ADR surgery at Alpha Klinik orthopedic hosp., Munchen Germany;
--2005 Pain at manageable level

[Harrison]

Wow, what a journey. Thx for letting us know where you are and how things are going...I hope the nerve block works wonders.

You've been through so much, I hope each day finds you stronger and healthier!

[Janie]

Hey all
I'm 7/months post/op ADR - charite L5/S1 and I'm experiencing severe nerve pain which is somewhat worst than before surgery
I'am scheduled to have a epidural injection next week & hoping this can reduce some of the pain
I've had numerous injections before surgery with not much success ,but would appreciate any experiences after ADR
Thank you
Best wishes
Janie

[SF_Marcello]

Janie & GD,
What distribution is your pain in?
L5/S1 dermatomal pattern?
Both sides?
All the way down the path of the nerve, or just at some parts (feet only)?
I'm dealing with nerve pain in an L5/S1 dermatomal pattern, mostly in the feet, that is making standing a challenge.
My ADR was 7/04 at L3-4 & L4-5.
Thanks,
Marcello

[Glendalough Drim]

Marcello,

The distribution is L5 (likely) down the back right side of the right leg. It travels through the back right side of the thigh, stops 2-3" above the knee and then continues down the back of the calf on the right side. The pain/numbness stops about 4" above the ankle joint w/no pain going into the foot.

The radicular pain I now have in the right leg follows the same route as the radicular pain I felt when I ruptured L4-5 back in the late 70s - early 80s. I also had radicular pain when I ruptured L5-S1 in 2001, however, it was on the left side/leg.

slainte
"GD"

[Janie]

Marcello
My nerve pain is apparently consistant with L5/S1
My right leg is numb from lower buttocks to toes, but mostly the right side although R/foot is numb completely and I'm constantly kicking it or tripping on the right foot when walking ,the foot also claws
I have burning sensations in both feet but much worst in the right
The nerve pain shoots down the R/leg constantly in a sharp,shock like sensation
I have cramping sensations in the right leg and both leg muscles are so tight
I stretch many times daily,but within a short time the muscles tense up again (worst in calf & ankle)
I work 4-5hrs / 3x week -in a job which is mostly standing and this does increase the pain,but good for the head
Let you know how the needle goes next Friday
Ps I did have nerve pain & numbness prior to ADR surgery

Best wishes
Janie

[Wayne]

sl�inte:

It's good to hear that the quality of your life has improved substantially since your ADR. Based on what you've written, I presume you feel better now than you did 7 months ago.

You don't mention your physical therapy routine which I have learned may be a permanent part of my daily life in order to maintain control over the tightness in my legs which can result in symptoms similar to those of yours except mine are associated with the left leg.

I took up Pilates after being introduced to it in at the Alpha Klinik and have gradually narrowed down my routine to daily hamstring stretches which continues to keep me free from any discomfort. If not done, the discomfort in my left leg returns to remind me of my condition. I haven't had any pain medication since about 4 weeks post-op and have been very active physically both at work and doing things around the house. Having just returned from a Hawaiian vacation I did some strenuous body surfing in waves that ranged from 10 to 12 feet, with several poundings resulting in a great deal twisting and turning. However, I seemed to have come through it with not much more than normal muscle soreness. I�m sure my doctor and others here wouldn�t recommend that kind of physical activity to post-op ADR patients and I�m unable to distinguish what is or is not a �high� risk activity as it relates to what I should or should not be doing. I don�t want to re-injure myself, but at the same time, don�t want the quality of my life to be reduced to walking and sitting (actually an acceptable trade off from the life I lived for a year pre-op). The only symptom that continues to be worrisome is that my feet are very dry and chapped. I�ve been told that this is nerve damage related, but haven�t read much about it here.

It's so difficult to make any fair comparisons between patients in this particular area of medical science. However, from purely an antidotal point of view, we can share ideas and experiences to help one another out.

Please post what you are doing in the area of PT, so that we can have a greater understanding of your post-op activity.

Good luck,

[Janie]

Hey wayne
So very glad for you your surgery was so successful
I have had improvement with the back pain ,but as far as the nerve pain it is now worst than before ADR surgery ,so no my quality in life is not greatly improved
I'm taking just as much pain medication as I was before surgery,which I hate
I sway between regret and hope constantly
I have continued work before and after ADR P/T & this is still very much a struggle and increases the nerve pain & back aches,but simply you need money to pay the bills
My gym work is all strenghtening and core stability very similar to Pilates 2xweek and I walk when the pain makes it bearable and stretch many times daily to help relieve the cramps and tightening muscles
I so wanted a great result like you and still hope maybe in time it will be

Best wishes
Janie

[Wayne]

Janie:

Thanks for you story and I'm so very sorry that yours is not a happy one. I'm going to start another thread on PT just to see what kind of responses ensue. Hope to see your posts there.

[Glendalough Drim]

Janie,

My epidural was rescheduled due to an infection. My good friends over at Pain Management Incorporated want me to go through a course of antibiotics before they poke needles into my spine. (Probably a good idea) I�m rescheduled for the 6th and will let you know what happens.

Sl�inte,
Kevin �GD� Leahy
leahy@sover.net

--1978 Bi-lateral ruptured disk, L4-5;
--1983 Chemonucleolysis Chymopapaine injection at L4-5 (colossal failure).
--1985 L4-5 Laminectomy:
--1983-1992: Ongoing worsening of L4-5 DDD;
--1985: T9 compression fracture;
--1993 Successful L4-5 fusion at Hosp. for Special Surgery NYC; Resolved majority of L4-5 mechanical & facet pain. Regained most normal function with manageable back pain subsequent to long recovery.
--1994 L2 compression fracture;
--2001 L5-S1 left lateral disc herniation;
--2002 L5-S1 Microdiscectomy: Brief resolution of some left hip pain but low back pain unchanged then worsened dramatically beginning in 2003 as DDD became chronically and progressively acute.
--August 2004: Successful L5-S1 level ADR surgery at Alpha Klinik orthopedic hosp., Munchen Germany;
--2005 Pain at manageable level