Lower Body Pain: Seeking Relief After Surgery - Rehabilitation

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Lower limb pain


My mother-in-law had surgery on her lower back over six months ago.
Recently, she has been complaining of severe pain in the flesh around her buttocks.
The pain is so intense that it is unbearable.
She visited the surgeon at the 803 clinic, but there was no improvement.
She also consulted a traditional Chinese medicine practitioner, took medication, received acupuncture, and had pain relief injections, but nothing has helped so far.
The pain persists.
She doesn't experience much pain when lying down, but as soon as she stands up, the pain becomes so severe that she can't walk and even feels nauseous.
This is really urgent, so could you please respond as soon as possible? I'm not sure which specialist she should see.

Ai wo de baobei, 20~29 year old female. Ask Date: 2005/03/24

Dr. Zhang Yuzhang reply Rehabilitation


Dear Dr.
Chang Yu-Chang, Director of the Rehabilitation Department at Tainan Hospital, Department of Health, Executive Yuan:
I hope this message finds you well.
I would like to inquire if your mother-in-law has experienced any falls or sprains recently.
How long has she been bedridden post-surgery? What is her current level of activity? I recommend that you take her to the Rehabilitation Department for an evaluation and physical therapy.
If you have any previous X-rays, CT scans, or MRI images, please bring them along for the physician's reference to help identify the underlying issues.

Wishing you good health and a speedy recovery from Tainan Hospital.

Reply Date: 2005/03/24

More Info


I'm sorry to hear about your grandmother's ongoing pain after her surgery. It sounds like a very challenging situation for both her and your family. Lower body pain after surgery can be complex and multifactorial, especially if the pain persists for an extended period, as in your grandmother's case.

First, it's essential to understand that post-surgical pain can arise from various sources. After any surgical procedure, especially those involving the spine or lower body, patients may experience pain due to several reasons, including:
1. Surgical Trauma: The surgery itself can cause trauma to the surrounding tissues, leading to inflammation and pain. This is often temporary but can last longer in some patients.

2. Nerve Damage or Irritation: If nerves were affected during the surgery, it could lead to chronic pain. This might manifest as sharp, shooting pains or a dull ache in the affected area.

3. Scar Tissue Formation: After surgery, scar tissue can form around nerves and muscles, which may lead to pain and discomfort. This is known as post-operative adhesions.

4. Muscle Weakness or Imbalance: Surgery can lead to muscle atrophy or weakness, especially if the patient has been less active during recovery. This can contribute to pain when standing or walking.

5. Underlying Conditions: If your grandmother had pre-existing conditions, such as arthritis or degenerative disc disease, these could also contribute to her pain post-surgery.

Given that your grandmother's pain intensifies when she stands and is accompanied by nausea, it is crucial to seek further medical evaluation. Here are some steps you can consider:
1. Consult a Pain Specialist: A pain management specialist can provide a comprehensive evaluation and may offer treatments such as nerve blocks, medication adjustments, or other interventions to help manage her pain.

2. Physical Therapy: Engaging in a structured physical therapy program can help strengthen the muscles around the affected area, improve mobility, and reduce pain. A physical therapist can tailor a rehabilitation program specific to her needs.

3. Re-evaluation by the Surgeon: If her pain persists, it may be worthwhile to revisit the surgeon who performed the operation. They can assess whether there are any complications or if further imaging studies, like an MRI, are necessary to evaluate the surgical site.

4. Alternative Therapies: Since she has already tried acupuncture and traditional medicine without relief, consider exploring other modalities such as chiropractic care, massage therapy, or even mindfulness and relaxation techniques, which can help manage chronic pain.

5. Medication Review: Ensure that her pain management regimen is appropriate. Sometimes, medications need to be adjusted or changed to provide better relief.

6. Supportive Care: Encourage her to maintain a positive outlook and engage in activities that she enjoys, as mental well-being can significantly impact pain perception.

In conclusion, persistent pain after surgery is not uncommon, but it is essential to address it proactively. A multidisciplinary approach involving her primary care physician, pain specialists, physical therapists, and possibly her surgeon will provide the best chance for relief. Encourage your grandmother to communicate openly about her pain and any new symptoms she experiences, as this information is vital for her healthcare team to provide the best care possible.

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