Post-Surgery Pain and Numbness: Recovery After Disc Surgery

Experiencing pain again four days after spinal 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 started physical therapy, which included lying on the bed to perform lumbar extension and leg stretches.
While doing the lumbar extension, I suddenly felt severe pain and immediately stopped.
Within a day, the pain worsened dramatically, accompanied by numbness, similar to my condition before the surgery.
The doctor explained that it could be due to the anesthesia just wearing off, but does anesthesia really lose its effect four days post-surgery? The doctor also recommended another MRI, and I am hesitant to do anything until I have that done.
The physical therapist suggested leg lifts to prevent nerve adhesion, but I am afraid to attempt those as well.
What could be causing my current condition, and is it still appropriate for me to undergo physical therapy?

Mr. Luo, 50~59 year old female. Ask Date: 2015/11/25

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 causes, such as irritation from blood or clots, a herniated disc, or a recurrence of displacement, among others.
I recommend that you refrain from guessing and allow your surgeon to arrange for an MRI and other examinations.
That should provide you with answers.
Wishing you well, Lai Zhao-Kang.

Reply Date: 2015/11/25

More Info

Post-surgery recovery after a microdiscectomy for a herniated disc, such as your case with L5-S1, can be complex and often involves a range of symptoms, including pain and numbness. It's important to understand that while surgery aims to relieve pressure on the nerves and alleviate pain, the recovery process can sometimes lead to new or recurring symptoms.

Firstly, it's not uncommon to experience pain and numbness after surgery. The surgical site may still be inflamed, and the nerves that were compressed prior to surgery may take time to heal. The presence of numbness can be particularly concerning, as it may indicate that the nerve is still recovering from the previous compression. In some cases, the pain may feel similar to what you experienced before the surgery, especially if there is residual inflammation or if the nerve has not fully healed.

Regarding the sudden increase in pain after performing exercises, this could be attributed to several factors. One possibility is that the movements you attempted during physical therapy may have inadvertently stressed the surgical site or surrounding tissues, leading to increased discomfort. It's also possible that the pain you experienced was a result of muscle spasms or irritation in the area surrounding the surgical site.
As for the anesthetic, while it is true that some effects of anesthesia can linger for a few days, the sudden onset of pain four days post-surgery is more likely related to your physical activity rather than the residual effects of anesthesia. Anesthesia typically wears off within a few hours after surgery, and by the time you were experiencing increased pain, it is unlikely that the anesthetic was still affecting you.

In terms of your current situation, it is crucial to communicate openly with your healthcare providers. If you are hesitant to perform the exercises recommended by your physical therapist due to pain, you should express these concerns. It may be necessary to modify your rehabilitation program to accommodate your current level of discomfort.
Physical therapy is generally beneficial after disc surgery, as it helps to strengthen the muscles around the spine, improve flexibility, and promote healing. However, it is essential to approach it cautiously. If certain movements cause significant pain, they should be avoided until you have further evaluation from your doctor.
An MRI can provide valuable information about the state of your spine post-surgery. It can help identify any complications, such as re-herniation or scar tissue formation that might be pressing on the nerves. Based on the MRI results, your doctor can better tailor your treatment plan.

In summary, while some pain and numbness post-surgery can be expected, significant changes in your symptoms warrant further investigation. It is essential to maintain open communication with your healthcare team, adhere to their recommendations, and not hesitate to seek clarification or adjustments to your treatment plan as needed. Recovery can be a gradual process, and patience, along with appropriate medical guidance, is key to achieving the best outcomes.

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