Managing Post-Surgery Pain and Numbness from L4-L5 Disc Herniation

There is a herniated disc issue at the L4 and L5 levels?

Hello, three years ago I had a herniated disc at the L4 and L5 levels that was compressing a nerve, causing numbness in my left calf.
Three months ago, the doctor performed surgery to remove the herniated disc.
Although the surgery has been completed and I have gone through the three-month recovery period, I still experience soreness in my lower back and numbness in my left calf.
The doctor has suggested that I undergo traction therapy for my back.
Will this be effective?

Xiao Lin, 20~29 year old female. Ask Date: 2010/06/27

Dr. Ding Xianwei reply Neurosurgery

Hello, regarding your symptoms after surgery.
Since I am not familiar with your specific situation, the following suggestions are for reference only.
Generally speaking, if there is an acute herniated disc with nerve root compression, surgery can be performed for decompression.
However, to achieve better outcomes, it is usually expected to have the surgery within six months to minimize residual symptoms.

In terms of the order of symptom relief, pain is typically the first symptom to improve, while weakness may take longer to resolve.
Sometimes, if muscle atrophy begins, recovery can become more challenging.
As for numbness, it is considered a negative symptom and is the most difficult to recover from.
Negative symptoms indicate that the nerve has already been injured, hence the manifestation of numbness.
In contrast, if pain (a positive symptom) is present during early compression, it tends to prompt more proactive management.
Regarding lower back discomfort, this is a matter of postoperative care.
You should avoid prolonged standing or sitting.
Many doctors may tell you that you can fully return to your previous work after surgery, but this is an incorrect notion.
You must understand that if you previously had no issues with your "original work," then you should not have developed a herniated disc with nerve root compression.
Therefore, some movements in your work must have impacted your spine.
Returning to your previous job could lead to a recurrence of the herniated disc.
It is essential to reconsider all movements involved in your work to avoid unnecessary spinal injuries, which may help prevent further back pain.
As for traction, this is a non-invasive treatment that can be tested initially.
If it leads to symptom improvement, it can be continued; however, if it causes discomfort, it should be stopped immediately.
If you need further understanding, you are welcome to visit our outpatient clinic for assistance.
It is also advisable to understand all potential issues before surgery to prepare adequately.
Additionally, consulting with another expert before the surgery can help achieve better results.

Reply Date: 2010/06/27

More Info

Managing post-surgery pain and numbness after a lumbar disc herniation, particularly at the L4-L5 level, can be challenging. It’s not uncommon for patients to experience residual symptoms such as pain and numbness in the legs even after undergoing surgery. In your case, having had surgery three months ago, it’s understandable that you are still experiencing discomfort in your lower back and left calf.

Understanding Your Symptoms
After surgery for a herniated disc, it is important to recognize that the healing process can take time. The symptoms you are experiencing, such as lower back pain and numbness in the left calf, may be due to several factors:
1. Nerve Healing: Nerves can take a significant amount of time to heal after being compressed. Even after the herniated disc is removed, the nerve may still be recovering from the initial injury.

2. Scar Tissue Formation: Post-surgical scar tissue can develop around the surgical site and may contribute to ongoing pain or discomfort. This is sometimes referred to as post-operative adhesion.

3. Muscle Weakness or Imbalance: After surgery, the muscles surrounding the spine may weaken or become imbalanced due to disuse during recovery. This can lead to pain and discomfort as your body adjusts.

4. Degenerative Changes: If there are other degenerative changes in the spine, such as arthritis or additional disc degeneration, these may also contribute to ongoing symptoms.

Treatment Options
1. Physical Therapy: Engaging in a structured physical therapy program can be beneficial. A physical therapist can provide exercises tailored to strengthen the muscles of the back and legs, improve flexibility, and enhance overall function. They can also teach you proper body mechanics to avoid further injury.

2. Traction Therapy: Your doctor suggested traction therapy, which can be effective for some patients. Traction aims to relieve pressure on the spine and can help alleviate pain. However, its effectiveness varies from person to person. It’s essential to discuss with your healthcare provider whether this is a suitable option for you based on your specific condition.

3. Pain Management: If you are experiencing significant pain, your doctor may recommend medications such as non-steroidal anti-inflammatory drugs (NSAIDs) or other pain relief options. In some cases, nerve pain medications may also be considered.

4. Alternative Therapies: Some patients find relief through alternative therapies such as acupuncture, chiropractic care, or massage therapy. These can be complementary to traditional medical treatments.

5. Monitoring and Follow-Up: Regular follow-up appointments with your surgeon or primary care physician are crucial. They can monitor your progress, assess the effectiveness of your treatment plan, and make adjustments as necessary.

When to Seek Further Evaluation
If your symptoms persist or worsen despite conservative treatment, it may be necessary to undergo further evaluation. This could include imaging studies, such as an MRI, to assess for any complications or new issues that may have arisen since your surgery.

Conclusion
In summary, while it is not uncommon to experience ongoing symptoms after surgery for a herniated disc, there are various treatment options available to help manage your pain and numbness. Engaging in physical therapy, considering traction therapy, and maintaining open communication with your healthcare provider are essential steps in your recovery journey. Remember, healing takes time, and it is important to be patient with your body as it recovers. If you have concerns about your symptoms or treatment options, do not hesitate to reach out to your healthcare provider for further guidance.

Similar Q&A

Post-Surgery Pain and Numbness: Understanding Recovery After Disc Surgery

I was diagnosed with an L5-S1 herniated disc three months ago and underwent minimally invasive surgery a few days ago to remove the herniation. After the surgery, aside from pain at the incision site, I also experienced some numbness. Four days later, during a follow-up visit, I ...

Dr. Lai Zhaokang reply Neurosurgery
Hello, my personal speculation is that when your doctor mentioned the anesthesia losing its effect, they were likely referring to the patient-controlled analgesia (PCA) that was stopped three days post-surgery. Additionally, the symptoms you described could have many potential ca...

Understanding Disc Herniation: Severity, Treatment Options, and Surgery

Hello Doctor, earlier this year I experienced muscle tightness in my back (with a forward protrusion on the right side). During the Lunar New Year, I began to have lower back pain and numbness in my legs (with different sensations). Currently, I am undergoing continuous rehabilit...

Dr. Lai Zhaokang reply Neurosurgery
Hello: 1. The nucleus pulposus at the L5-S1 level can be absorbed, but if left untreated for a long time, it will degenerate, become dehydrated, and harden, making it more difficult to manage later. Additionally, the intervertebral height will gradually decrease, which can lead...

Desperate for Relief: A Young Girl's Struggle with Post-Surgery Pain

Doctor: Hello! I am a 22-year-old girl experiencing weakness. Since undergoing surgery for a herniated disc on April 1st of this year, I feel like my life has turned black and white. Why is that? After the surgery, I have been experiencing significant pain at the surgical site. U...

Dr. Shao Guoning reply Neurosurgery
Hello: In response to your question: Your situation is unfortunate, but such cases are not common. Typically, young women with sciatica are treated conservatively, and surgery is only considered if there is a herniated disc that cannot be managed otherwise. Even after surgery, sc...

Post-Surgery Care for Lumbar Disc Herniation: Managing Pain and Recovery

Hello Dr. Chiu, I would like to ask about my father. He underwent surgery for a herniated disc on September 30, with the affected area between L4 and L5. However, due to the rupture, it has compressed the nerves at L3-L4, causing weakness, numbness, and pain in his left leg. Post...

Dr. Qiu Yushu reply Neurosurgery
Hello: It is recommended that you start physical therapy and reassess your condition after some time. Wishing you good health!