Post-Surgery Back Pain: Causes and Recovery Tips

Spinal pain

Hello Dr.
Lan, I had a car accident on April 1st of this year.
The other driver hit me from behind, causing me to fall.
The most severe injury was a rupture of the cartilage in my spine, which compressed my nerves and left me unable to walk.
After surgery, I had two screws and an 8-shaped rod placed in my lumbar spine at the L4 and L5 levels.
I have been resting for six months, but since August, I have suddenly experienced increasing pain in the nerves of my back, extending down to the soles of my feet, making it impossible for me to put weight on my legs while walking.
The most painful area is around my coccyx; whether sitting or lying down, it hurts a lot.

I would like to ask Dr.
Lan what I should do.
Why is it that even after surgery on my back, I still experience such pain that prevents me from walking? Should I undergo rehabilitation after the surgery? How long after the surgery can I ride a motorcycle? My job requires me to lift heavy objects; how long should I rest before I can lift heavy items? Also, why am I prescribed muscle relaxants, and what is their purpose? Thank you.

A-Juan, 40~49 year old female. Ask Date: 2015/10/03

Dr. Lan Shengxing reply Neurology

Dear A-Juan, the old injury in your lower back has been treated but is starting to hurt again.
There could be many reasons for this, so it's important to follow up at the hospital.
Regarding rehabilitation and activities after surgery, it's best to consult with the orthopedic or neurosurgeon who performed the operation.
Muscle relaxants are primarily used to alleviate pain caused by muscle stiffness.
Thank you.

Reply Date: 2015/10/03

More Info

Post-surgery back pain, especially after spinal surgery, can be a complex issue influenced by various factors. In your case, having undergone surgery for a herniated disc at the L4-L5 level, it is not uncommon to experience ongoing pain and discomfort even after the procedure. Here’s a comprehensive overview of potential causes for your pain, recovery tips, and the importance of rehabilitation.

Causes of Post-Surgery Pain
1. Nerve Root Irritation: After surgery, the nerves that were compressed may still be irritated or inflamed. This can lead to persistent pain, tingling, or numbness in the legs and feet. The surgical site may also develop scar tissue, which can further irritate the nerves.

2. Postoperative Adhesions: Scar tissue can form around the surgical site, leading to adhesions that may cause pain and restrict movement. This is often referred to as post-operative adhesion syndrome.

3. Muscle Weakness and Imbalance: After a significant surgery, the muscles surrounding the spine may weaken due to disuse. This can lead to instability in the spine and contribute to pain.

4. Psychological Factors: Chronic pain can also be influenced by psychological factors such as anxiety and depression, which can exacerbate the perception of pain.

5. Underlying Conditions: Conditions such as degenerative disc disease or spondylosis may still be present and can contribute to ongoing discomfort.

Recovery Tips
1. Physical Rehabilitation: Engaging in a structured rehabilitation program is crucial. Physical therapy can help strengthen the muscles supporting your spine, improve flexibility, and enhance overall function. It is essential to start rehabilitation as soon as your doctor permits, typically a few weeks post-surgery.

2. Pain Management: Discuss with your physician about pain management strategies. This may include medications such as muscle relaxants, anti-inflammatory drugs, or even nerve pain medications like gabapentin. These medications can help alleviate pain and improve your ability to participate in rehabilitation.

3. Activity Modification: While it’s important to stay active, you should avoid heavy lifting and high-impact activities until your doctor gives you the green light. Gradually increase your activity level as tolerated, focusing on low-impact exercises that promote mobility without straining your back.

4. Ergonomics: Pay attention to your posture and ergonomics, especially if your job involves lifting or prolonged sitting. Use supportive chairs and consider ergonomic tools to minimize strain on your back.

5. Mind-Body Techniques: Techniques such as mindfulness, meditation, and relaxation exercises can help manage pain perception and improve your emotional well-being.

When to Seek Further Help
If your pain persists or worsens, it’s essential to follow up with your healthcare provider. They may recommend imaging studies to assess for any complications, such as recurrent disc herniation or other structural issues.

Conclusion
In summary, while it can be frustrating to experience ongoing pain after surgery, understanding the potential causes and engaging in a comprehensive rehabilitation program can significantly aid in your recovery. It’s crucial to communicate openly with your healthcare team about your symptoms and concerns, as they can provide tailored advice and interventions to help you regain function and reduce pain. Remember, recovery is often a gradual process, and patience is key.

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