Post-Surgery Nerve Pain: Persistent Foot Numbness and Back Pain

Q: Post-Surgery Nerve Pain: Persistent Foot Numbness and Back Pain

Hello： Postoperative pain has improved relatively quickly, but the numbness is indeed more difficult to recover from. <br>If you are not satisfied with the answers from your original physician, and while postoperative pain has improved, you still feel residual symptoms of numbnes

Persistent leg numbness and occasional lower back pain after disc rupture surgery?

Hello Doctor,
I would like to ask on behalf of my husband: He underwent minimally invasive surgery for a herniated disc.
Before the surgery, he experienced significant pain and numbness, but after the surgery, he still feels numbness in the soles of his feet.
The doctor mentioned that this is unavoidable and that it would take about six months to improve (he suggested using a heating pad and taking B vitamins).
After six months with no improvement, we returned to the clinic for an X-ray, and the doctor said there was nothing serious.
A year later, with still no improvement, we returned for an MRI, and the doctor again said there was nothing serious, only that nerve repair takes time.

Now, it has been two years since the surgery.
During this time, he has undergone rehabilitation.
Initially, only one foot had numbness, but now both feet are numb, and he frequently experiences pain in his lower back.
He has been limping for the past two years, and when we return to see the original surgeon, he is told that everything is fine and that nerve damage requires time to heal.

I would like to ask you, Doctor, is this normal? Are there any other methods to alleviate the numbness and address the ongoing back pain? What should we do next?
Thank you for your guidance!
Note: Mr.
Chuang is approximately 180 cm tall, weighs 86 kg, is 44 years old, has a history of regular exercise, is healthy, does not smoke or drink, and usually pays attention to his posture.

Zhuang Taitai, 40~49 year old female. Ask Date: 2022/11/07

Dr. Lai Zhaokang reply Neurosurgery

Hello: Postoperative pain has improved relatively quickly, but the numbness is indeed more difficult to recover from.
If you are not satisfied with the answers from your original physician, and while postoperative pain has improved, you still feel residual symptoms of numbness, with one leg feeling like two legs and also experiencing lower back pain, I recommend obtaining copies of your original MRI and X-rays and consulting another specialist for a second opinion.
Best wishes to you.
By Dr.
Lai Chao-Kang, Chief of Spine Surgery, Changhua Hospital.

Reply Date: 2022/11/07

More Info

Post-surgery nerve pain, particularly following spinal surgery such as a microdiscectomy for a herniated disc, can be a complex and frustrating issue for many patients. Your husband's experience of persistent numbness and pain in his feet, as well as lower back pain, is not uncommon. While it is reassuring that imaging studies have shown no significant complications, the ongoing symptoms can be distressing and impact quality of life.

Understanding Nerve Pain and Recovery
After spinal surgery, it is common for patients to experience nerve-related symptoms, including numbness, tingling, and pain. These symptoms can arise from several factors:
1. Nerve Healing: Nerves can take a significant amount of time to heal after being compressed or damaged. The healing process can vary widely among individuals, and while some may see improvement within months, others may take years. The timeline of 6 months to a year for noticeable improvement is often cited, but complete recovery can take longer.

2. Scar Tissue Formation: After surgery, scar tissue can develop around the surgical site. This scar tissue can sometimes cause additional pressure on nerves, leading to persistent symptoms. This phenomenon is known as post-operative adhesions.

3. Chronic Pain Conditions: Some patients may develop chronic pain conditions, such as complex regional pain syndrome (CRPS), which can manifest as persistent pain and sensory changes in the affected limb.

Management Strategies
Given that your husband has been experiencing these symptoms for two years, it may be beneficial to explore a multi-faceted approach to management:
1. Physical Therapy: Continuing with physical therapy is crucial. A physical therapist can provide targeted exercises to strengthen the back and improve flexibility, which may alleviate some of the pain and improve function.

2. Pain Management: If over-the-counter pain medications are insufficient, consulting with a pain management specialist may be beneficial. They can offer treatments such as nerve blocks, epidural steroid injections, or other interventions that may provide relief.

3. Medications: Medications such as gabapentin or pregabalin (Lyrica) can be effective for nerve pain. These medications work by stabilizing electrical activity in the nervous system and can help reduce pain and improve function.

4. Alternative Therapies: Some patients find relief through alternative therapies such as acupuncture, chiropractic care, or massage therapy. These modalities can help manage pain and improve overall well-being.

5. Lifestyle Modifications: Maintaining a healthy weight, as your husband is currently doing, is essential. Weight management can reduce strain on the spine and lower back. Additionally, incorporating low-impact exercises, such as swimming or cycling, can help maintain fitness without exacerbating pain.

6. Heat Therapy: As suggested by the physician, using heat pads can help relax muscles and improve blood flow to the area, potentially alleviating some discomfort.

7. Regular Follow-ups: Continue to monitor symptoms with regular follow-ups with the healthcare provider. If symptoms worsen or new symptoms arise, further evaluation may be necessary.

When to Seek Further Evaluation
If your husband’s symptoms do not improve with conservative management, or if they worsen, it may be worthwhile to seek a second opinion from a neurosurgeon or orthopedic specialist who focuses on spinal disorders. They may consider additional imaging or tests to rule out any underlying issues that may not have been previously identified.

Conclusion
In summary, while it is not uncommon for patients to experience persistent symptoms following spinal surgery, there are various strategies to manage and potentially alleviate these symptoms. A comprehensive approach that includes physical therapy, pain management, and lifestyle modifications can be beneficial. It is essential to remain proactive in seeking care and exploring different treatment options to improve your husband’s quality of life.

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