Anyone with more pain after surgery than before?

@timothytulloch - Welcome to Mayo Connect. This a great place to find answers to some of your questions and to share experiences with others.

You ask - Should you delay surgery until you can't move? I made my decisions from a personal risk management perspective (I had full work on L2-5 in May 2023). That is - the risks of "deferred surgery" vs the risks of surgery. This is a challenging decision process as the exact outcomes of either fork can't be known ahead of time!

I was told by docs and friends to defer until I couldn't get out of bed. I never reached that point but I did start experiencing dead-leg symptoms in both legs, sudden on-set, many times a day. I grew concerned about both falling down a flight of stairs and deferring surgery so long that nerves became permanently damaged.

The risks of having the surgery became much more acceptable. Make no mistake - the L2-5 work can create significant challenges during rehab. I managed the surgical risks by having a solid diagnosis based on images from the best equipment made by the best docs. Then I had a wonderful surgeon and went to a top-notch facility.

What are you thinking? Are you planning to keep your currently scheduled surgery?

Hi There
Many thanks for your reply. Seems I should go ahead with the surgery, I am very scared since three people who I know have had horrific experiences-waking up during surgery, death from infections, leaking and extreme pain.
I am wary of being given opiods post surgery but understand this is the only way to cope with the post surgical pain. Your thoughts??
Best
timothy

@timothytulloch Timothy,

I hope I can help ease the fear a bit. I am a cervical spine fusion patient, and I felt awful on pain medication after surgery. It nauseated me, so I tried going without and I did just fine. I accepted that pain would make me tired and I just slept a lot. That was cervical surgery. The pain was not awful, it was just uncomfortable. I just relaxed. The more fearful and stressed you are about pain, the greater the pain and you will feel higher pain levels. If you can come to some kind of acceptance and thinking that you made this choice for the benefits of the procedure, it helps. Think of pain after surgery as healing pain.

Lumbar surgery is different in that most of your body weight is supported there. The weight is 80% on the vertebral bodies and spinal discs, and 20% on the facet joints. A laminectomy would not alter those places. My 80 year old cousin had a laminectomy for stenosis, and took pains medications for a week, and then weaned off them. He was walking right away and feeling better at 2 weeks, and by 6 weeks, had no pain at all and was back to normal. Of course there will be some scar tissue that may get tight, but this surgery gave him back quality of life and he is active and traveling with his wife. A laminectomy is not as invasive as spinal fusion. Sometimes it is done along with a spinal fusion.

You do need a surgeon who you can trust completely who you believe has the right skill level and success rate statistics to handle the problem that you have. You can ask for that information and for how many of this procedure they have done. You can ask what causes complications for this surgery, and if your bone quality is good enough for what is being offered to you. You can also ask about the anesthesia for your concerns. You can ask what helps prevent infections. For example, for my surgery, I was asked to use a pea sized glob of antibiotic ointment inside my nose twice daily the week before surgery to try to prevent staff infections. After surgery, you have to walk and breathe to get the phlegm cleared out or that can become a chest infection. That did happen to me, but it was facilitated by a physical problem I have with breathing and chest tightness that was preventing my lungs from moving enough. Many surgeons give you a packet of antiseptic soap to shower with the day of surgery. (Mine did.)

Also realize that everyone has a different spine problem and a different proposed treatment for the issues. Some are simple and some are complex. A laminectomy and my single level cervical fusion are fairly simple as compared to a big spine surgery for something like scoliosis with a lot of hardware instrumentation and months of recovery. Learn as much as you can about the procedure that is recommended. That can ease your mind a lot and it takes away the fear of the unknown.

Jennifer

Thank you Jennifer.
Currently I am taking a cocktail of gabopin, diclofenac and tylenol so I can still move around delicately. My fear is complications from surgery and something goes wrong. I know life is a risk but by going under the knife, am I taking unnecessary risk when I can still live with this cocktail or will things get worse and, I am causing nerve damage by delaying surgery?
thanks your input
best
timothy

@timothytulloch Timothy, you kind of have to go with your gut feeling on when you feel surgery is the right step to take. Even surgeons cannot tell you exactly when nerve damage will begin. I hope your surgeon explained your imaging to you and showed you the problem area.

I had spinal cord compression in my neck. I had symptoms going on for about 3 years prior to surgery. My case was confusing to surgeons, so 5 of them passed on helping me. I had been keeping records and drawing body diagrams describing my pain and dating them, so I knew how fast it was progressing. I also saw the area of bone spurs double in 9 months time on separate MRIs.

I was working with a physical therapist at the time, and she would work on the muscle spasms in my neck to get it realigned, and use a device for neuro-stimulation to block pain signals. That helped for about a week. I had good feedback because she was seeing me twice a week for a long time.

I experienced intermittent symptoms for awhile in that I walked normally and my bladder functioned correctly when my neck vertebrae were properly aligned (except for the collapsed level), and when muscle spasms shifted my neck, essentially it made the spinal canal smaller and brought on symptoms related to spinal cord compression, the inability to walk without a limp, and my bladder emptying only halfway, and I had to work to get the rest to empty. I knew this was related to contact with the spinal cord because it improved temporarily every time my therapist worked on me. It did progress to where I had pain all the time and I could alter it a bit by changing body or neck position, but couldn't eliminate it. If I bent my neck forward, I sent a big electric shock down my body because the bone spurs where compressing the spinal cord when I did that. I was also loosing muscle in my arms and the back of my shoulders. I got a lot back after surgery, but not all of it that I had before the spine problems. I consider that to be a bit of nerve damage. Surgeons don't usually pay attention to that level of detail, and the nerves work, it's just that the capacity is a bit lower.

I would have done this surgery sooner if I had the chance. I spent 2 years chasing surgeons who were confused about my symptoms because they didn't understand the pattern of pain that was literally all over my body and how to relate it to the imaging. They have to be so careful to check all the other possible diagnoses that could cause this and they imagined an inflammatory problem instead of a structural one. After the 5th refusal, I found medical case literature like my symptoms because of something I looked up when reading a paper of a Mayo spine surgeon. I contacted him with the literature, and he took my case and operated which gave me back the coordination in my arms. I could have done this surgery a year or 2 earlier and any of the others could have done the same surgery. I am grateful however, that I had the very best of the best in surgeons at Mayo. I also did have a choice that I probably would have not had elsewhere. I asked for no hardware and I agreed to stay in a neck brace for 3 months until it fused. My surgeon did that for me and it was worth it because I don't have to worry about any hardware related complications.

I was also working through a lot of fear, and in facing every surgeon who refused to help, I was also learning to face my fear of them and the surgery itself.

You may want to look at this discussion that is about facing fear of medical procedures.

Just Want to Talk - "How can I defeat my anxiety about medical tests and surgery?"
https://connect.mayoclinic.org/discussion/how-can-i-defeat-my-anxiety-about-medical-tests-and-surgery/

Jennifer

@timothytulloch - It's great you're as open about your feelings as you are. Yes, this type of surgery can cause fear to dominate your thinking.

I would personally spend zero seconds thinking about somehow "waking up during surgery". I just Googled and saw that 1 in a 1,000 surgical procedures have that happen. 0.1%. If the weather report predicted a 0.1% chance of rain...would you cancel your outside plans?

I assume you're having your surgery at a great facility with a great doctor?

I don't tolerate opiods very well and went on Tylenol-only within 48 hours or so post surgery. I managed. Probably you can, too. But that should be a game-time decision. A good facility has many tools and techniques to help you manage any post surgical pain. They are not going to let you lie there in agony or be discharged without a solid pain management strategy in place.

Think positive thoughts. Seriously. Picturing positive outcomes can actually be an imprtant part of your recovery process.

Wishing you the best!

Thank you so much for your encouragement. Good thoughts. Yup having it done at Mayo Mankato
Best
timothy

Thank you so much.

I will be having a Laminectomy/microdiscectomy on L3-L4-L5 on April 19th. This is being done due to my Sciatica. I have suffered for over 10-years with Lumbar spinal stenosis and in November this horrible Sciatica hit me on my (R) side. The pain from the back to the ankle has been horrible. I can't sit, stand or walk without severe pain.
I am concerned wondering how I will feel post-op after the surgery. Will the pain be worse than it is now?

Good morning @denman55. First, good luck with your upcoming lumbar work. I understand your questions about post-op pain and the challenge is there's no exact answer to that question. Every doc, every hospital, every patient, every procedure is enough different that perfect prediction is unlikely.

Listen to the docs, follow orders, and mentally picture a positive outcome!