Post hemi-laminectomy nerve pain has increased.

Hi All, I'm only five weeks post laminotomy. The first week and a half was good, but now every day is different. Yesterday, the eclipse day I walked alot and it felt great, then wham! today my legs are twitching and my pelvis feels uneven. I'm having worries that something went wrong in the surgery. I'm trying to get a telehealth appointment with the Surgeon. I really miss being able to exercise, getting fat now from not being able to do any exercise. Any words of reassurance ?

@annie1 The pelvis can easily go out of alignment, and because muscles connect it to the spine, it can generate some pain and possible sciatic pain. I've had this happen to me, and my physical therapist showed me some exercises to level the pelvis. It can relieve the symptoms immediately. This tends to happen from sitting too much and the hip flexors get tight. Stretching them out and mashing out the tightness helps. You can lay face down on a small ball (like a tennis ball) placed just inside the hip bones. When mine gets tight, it pulls the hip forward, and this gets it back where it should be.

Also when you hit that 5th to 6th week after surgery, the incision is finishing healing and the scar tissue starts to get tight. That can create pain. A physical therapist can help if your surgeon advises it. My PT does myofascial release to stretch out the scar tissue. It helps. All surgery creates scar tissue, so this is a common effect.

Jennifer

@annie1 - Good advice from Jennifer. My thoughts are that "just" five weeks post is very early to expect to much in your recovery. As frustrating as it can be - often the best recovery strategy is time-related and can't be hurried. Look for ways to occupy yourself other than vigorous activity, until you feel up to it. Manage food intake as I found food was a great way to pass the time...but with the obvious negative side effect of weight gain.

Listen to your body. Don't over stress it while much of your body's energy is being funneled to healing. I actually learned how to be patient! No one in my family thought that possible...

I found that physical therapy after back surgery is very helpful and never increased my pain. In fact, it relieved my pain. Your muscles need to be strengthened again to help support your spine and hip structure. You say you miss exercising and PT would be the best way to begin to get some of that exercise. I always started PT within two weeks of my surgery. You may feel stiff and/or sore a day or two after your PT session but it isn't long lasting.
Heat packs or a heating pad can be used to relieve your pain. Limit your sitting to no more than about 45 minutes at a time and then get up and walk, if only to get the mail or a drink of water. You should be up on your feet for at least 15 minutes each time if you can tolerate it. Also your chair needs to support your spine. A recliner or easy chair are not good choices. Your goal right now is good posture whether you are standing or sitting. The healing process takes several months and each month will be better than the last. You took the biggest step when you decided to have your surgery. Look at yourself as a partner in your recovery, not just as the patient who is trying to recover.

Thanks for the advice. I have started PT, but have only had 1 session so far. As I think I mentioned in my post, one issue that has gotten better, but has certainly not resolved is pain and spasms around my tailbone and sacrum area. Unfortunately the one session of PT that I had really seemed to flare that up. I was scheduled to have a caudal injection in that area, but my insurance denied it. I feel like I am going to be stuck with this pain. I did have an MRI of my sacrum and tailbone. The surgeon read it and said most things looked ok, but there were some degenerative changes in my SI joints, so he wants me to get an SI injection.

I don’t know if that will help or if insurance will even cover it.

I feel like I am going to be stuck with this pain forever.

I think the injections can help but I never had much luck with them. I never had more than a few days of pain relief. I suspect the help they offer depends upon how significant your degenerative changes are. If they aren't very significant than the injections might help.
I found that if I did more exercises than I was asked to do during PT it would cause flare-ups a day or two after my session. Pay attention to how you feel while doing your physical therapy. I you are feeling stressed, stop or let your therapist know. They might be able to do some changes that will help you.
Did the insurance company explain their reason for denying the injection? You could have the request resubmitted or appeal the denial and ask for the diagnosis codes that were the reason for the denial. Your doctor's office could have used incorrect diagnosis codes when requesting the injection. I know you are probably feeling hopeless when it comes to pain relief. Don't give into that feeling. There is hope; you might need to try some other approaches. I did a lot of walking in a local pool with warm water (about 82 degrees). That will help strengthen the muscles around your lower spine and in the pelvic area. I would walk for 1/2 hour, do some other water exercises and then sit in a hot tub for about 10 minutes. Check with hotels near you to see if they rent out time in their pool. The heat will help your muscles relax and will give you some pain relief in the process.
With a degenerative spine, you will probably always have some level of pain, but you can learn to help control it. You just have to allow yourself time to discover what works for you.

Not all physical therapist are created equal. Think about trying another therapist or office if yours in not helping after a reasonable amount of time.

Thanks everyone for all the advice and thoughts. I am hoping to get either the SI injections or the caudal injection. I actually feel like I could benefit from both of them. If I could get the pain around my sacrum and tailbone to settle down, I think PT would be much more successful for me. Luckily I do have a good Physical Therapist. I have had other back surgeries and surgery on both of my shoulders. I completely trust her and don’t hesitate to speak my mind to her. I am scheduled for another PT session on Tuesday, so we will develop a plan. I am discouraged that no matter what I do or don’t do, the tailbone pain never goes away. Somedays it seems tolerable and I feel like I have turned a corner and then the next day it is right back to being debilitating. I know I will get back to some semblance of normal one day, it just seems way off in the future right now.

I appreciate everyone’s input!