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When does post op pain that disrupts sleep go away? (Lumbar fusion)

Posted by mlbobcat @mlbobcat, Aug 1, 2023

I just had lumbar spinal fusion L4-L5–S1 using ALIF at age 56. The first procedure was through my abdomen and second part 2 days later involved putting in metal rods and screws from 2 incisions on the back. This is after 20 years of constant lower back pain that was mostly intense aching pain in lower back, though I had occasional sciatica too. I managed via pain meds and exercises (bike riding and racing, lots of stretching every day) that were very helpful, and various surgeries/epidural shots etc. that were not. Looking back, I don’t think I was fully “managing” the past 2-3 years, as my work capacity in a desk job declined. Finally, my pain hit a higher level with some sciatica mixed in and suddenly I could not work or enjoy the sports that helped me before. That’s when I finally arranged to get fusion surgery. I’m now 11 days post op, and I’m having periods of intense pain in the lower back and buttocks that keep me from sleeping. Last night I slept one hour. Tonight it’s 4:20 am (lol) and I had maybe 3 hours of sleep so far and my buttocks hurt so much.

How long should it take before there episodes come to an end? What can I do now?

At present, I spend most of my days in a recliner chair mixed in with short walks. I also sleep in the chair. I’m taking oxycodone, Tylenol, Lyrica, Celebrex, Cyclobenzaprine, and some meds for constipation. I’ve tried ice on the back which helps a little.

Any insights would be much appreciated!

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kaceysmom | @kaceysmom | Aug 20 9:36pm
In reply to @choosejoy "I wonder if your doc would consider Gabapentin even though it is somewhat similar to Lyrica?..." + (show)
@choosejoy

I wonder if your doc would consider Gabapentin even though it is somewhat similar to Lyrica? Gabapentin allowed me enough relief to stop the Oxy after my lumbar fusions. Before I tried it, the nerve zaps had me in tears when all I wanted was to sleep. I was on 600 mgs 3x day.
I used ice packs on my back a lot in bed too. That would make me so cold, so I’d counter it with a heating pad on my stomach.
Have you tried any topical meds such as Icy Hot or Biofreeze on your legs and glute?
Sorry for the pain you are going through.

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What have you found icy hot and or Biofreeze to help with.

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sbtheplumber1 | @sbtheplumber1 | Aug 22 2:46am
In reply to @coachdavid "Every spine is different, as is how the nerves 'wake up'. It took me 12+ months..." + (show)
@coachdavid

Every spine is different, as is how the nerves 'wake up'. It took me 12+ months after my L-4-5 & S-1 fusion to be comfortable in bed. Horizontal versus recliner gave my spine relief.

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@coachdavid I feel for ya my surgery was April 17 2023 The nerve pain in my leg is bad I Fell a couple weeks ago from the stingers/zappers in my legs. I’ve been sleeping in my recliner for over 2 months
My tailbone and thigh is tender

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coachdavid | @coachdavid | Aug 22 4:00am

There are no guarantees with spine surgery & it is a complicated organ.

Best of everything with your recovery. ☮️

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dlydailyhope | @dlydailyhope | Aug 22 6:47am
In reply to @kaceysmom "I am also post fusion of L3, L4, L5, and S1, which was done on August..." + (show)
@kaceysmom

I am also post fusion of L3, L4, L5, and S1, which was done on August 5. I am female and 80 years old. I’ve been battling back and leg pain most of my life but mostly the last couple years. For the last year or so I have been on steroid shots and pain meds, nerve blocks, and an RFA. I also tried to physical therapy, dry needling, and acupuncture. My pain was in my lower back and down my right thigh and lower leg. I finally decided to have the surgery which was now 13 days ago. I was in the hospital for 4 days and then to a rehab facility for a week. I am still on Oxycodone, Lyrica, Celebrex, Tylenol, Metaxalone, and Miralax and have been on these drugs for the last year or so. I am having periods of intense pain in my right buttock, my right thigh, knee and lower leg that can bring me to my knees. I am told by the doctor and physical therapists that the nerves are “waking up.” Nerves grow 1 inch a month so they don’t know how long these periods will last – could be many weeks, months, to a year - “Everyone is different.” I would welcome any a serious help/comments. Thank you.

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@kaceysmom
Hi,

I had L3-L5 decompression and fusion with hardware on 8/2/2024 (invasive where they needed to cut through muscle). I am a 55 year old female. It was the most painful surgery I ever had but necessary due to congenital severe spinal stenosis, degenerative disc disease and neurogenic claudication. My quality of life was so poor.

I was on oxycodone, acetaminophen/Tylenol, meloxicam, senna laxative, and gabapentin post surgery. I came off the all of the medication after 10 days/2 weeks. I had to supplement with Metamucil for constipation.

I was in the hospital overnight and was sent home the next day (drainage reduced enough to take the drains out). The first few days were the worst but I am glad I prepared my home and planned to get help prior to surgery (I am a single parent of a teen son with no family). My ex-husband and son have been helping me with my dogs and cats and household chores.

I purchased a bed assist bar for my bed and it has been a life saver to help me roll or reposition myself in bed. I bought grabbers to reach things and pick things up from the floor, use lots of pillows and wedge to prop myself up or put between legs while lying on my side. I purchased something on Amazon to help me with wiping myself since I could not twist/reach, I have grab bars and a chair in my bathtub and used a walker/cane to walk and get around.

I am now about 20 days post op and walking much better without assistance but move slower. The first week was the hardest, the second week got a little better and the 3rd week much improved. I still take Tylenol or Advil as needed and use Salonpas lidocaine pain patches if I bend too much and my sides/back hurt (put it to the side/below my incision). I need to do stairs slowly up/down. Down is not as difficult as going up. I have shooting nerve pain in my back/buttocks and legs when I step up at times. I notice improvements every day and hopeful for much improvement over pre-surgery symptoms. It is noticeable to me that my pain, weakness and numbness of lower back/hips/buttocks/legs and feet post op is better as my surgical pain reduces. My understanding is my spinal cord and nerve roots/nerves that were compressed over 8-10 years will take some time to fully heal.

I can say I am glad I got the surgery and understand I may need more surgery in the future due to my congenital stenosis in cervical/lumbar spine (also had ACDF on C5-C6 in 2022), DDD, and Osteoarthritis. My hope is you feel more relief every day. Be really careful not to bend/twist or lift anything over 10 pounds. If you need to bend, support yourself by holding onto something as you bend/lean/pick something up.

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