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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Oh no! I had my four layer fusion revision done on the 17th (front and side) and on my back on the 19th. I am also unable to sleep, I end up flopping from one side to the other. Sleeping in a recliner is so much worse for me. My nerve pain has really increased and gives no relief. This is a really tough operation, I hope we both do better soon!

Best,
Julie

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Hang in there Julie. I’m optimistic and hope it gets better with each passing day. I have my first physical therapy tomorrow and I’ll see what they can do. I’ve always found PT very helpful.

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I had this surgery 16 years ago and yes, nerve pain is the worst. However drilling into your bones for hardware has to contribute to immense pain. None of the pain meds really helped. When I called my surgeon she told me recovery would be 5 weeks. During this time, my daughter was getting married and I didn’t know how I was going to handle it. I got a tens unit, which was a godsend. Wonder if it could be an option temporarily. Exactly 5 weeks later I was able to discontinue home healthcare and resume my life. It’s definitely a test of endurance.

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I have had two spinal fusions the last one on 6/1/23 from S1-T11. My first fusion was anterior posterior S1-L4 with plates, rods, and screws. I was told NOT to take ANY NSAID's hence Celebrex, for the first three months. I am 69 years old and now pain fee. I would try stopping the Celebrex. Your Oxycodone should be enough to manage the pain. TENS is great too (I am a therapist) as is lots of patience. It will take 4-8 months to feel like yourself again. Maybe even a year. Nerves heal slowly. It WILL get better..

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Yes, hang in there, as this too shall pass and hopefully quickly! I am praying for you mlbobcat. On May 31 & June 2, 2023 I had pretty much had the same surgeries as you. An ALIF first, double fusion (L3-4, L5-S1) and a PLIF revision at L4-5. I had my first fusion 13 years ago and totally agree the healing process is slow. The TENS idea could be very helpful. RE: Meds I was taking post-surgery all of the same drugs as you currently are, minus the Celebrex as I was told the NSAIDS could slow up the fusion process. After discussing via the patient portal with my surgical team I started at 3-weeks post op weaning off all of the pain meds (except Tylenol). I found they were delaying my progress since I was so foggy, unable to focus and were limiting my activity (walking) throughout the day. The walking (my surgeon says no PT until the fusion has occurred) is so important to get the healing process going. Therefore, at bedtime, since my activity level was so limited, I did not sleep as well as I should have. Without the meds, I started walking a lot more outside and the really good news is my leg nerve pain has slowly improved and I am now sleeping very well. I also have many pillows in my bed, under my knees when on my back or behind my back when on my side. Prior to bedtime I ice up front & back. Since my brain can focus again I enjoy reading at bedtime and this helps distract my mind from the leg nerve pain. Prayers you can get some good sleep real soon. We're all in this together! I am ever grateful for a significant reduction in my pain and pray that you will find the same soon. We all want to get our lives BACK in control and not vice versa have our backs in control of our lives. Bless you!
"I can do all things through Christ who strengthens me." Phil. 4:13

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I have not had any fusions (🙏) but have severe scoliosis and every thing else you can think of…just had nerve ablation in 6 lower spine places after many years of trying everything else.
But maybe can add that tens is awesome, just wear something with pockets and lots of batteries handy. The other thing I found that an acupuncturist used on me, is a cream called Sombra, can buy online, and really helps the pain in my butt, legs and back. Feels a little burning at first, but then goes to a comfortable heat/cool. No drugs. Lasts several hours and along with lots of pillows is sometimes the only way I can get to sleep. Wash your hands well after use!
I hope you all find ways to to get back to a pain free life!

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Ablation procedure went as expected, first night TOUGH, more burning in butt than pain (?) but figured out the meds, too late, and so many steroids that there was no sleep anyway 🤣 Couple days later, all manageable and told will take couple weeks to have results.
Speaking of meds, I think my tummy got ruined ( that’s another story) for so many years of taking different nsaids/nerve/pain meds, ending with oxy that wasn’t really helping my pain. So I quit about 8-9 months ago. Found a provider
( board certified cardiologist that specializes in functional medicine-different approach) that ultimately rx’d low dose naltrexone. I know that you need the oxy now, and you can’t take low dose while you take oxy, but maybe you will reach a point where you don’t need oxy, but still need some pain management. Might be something to check out-I had never heard of it. Since it’s low dose, could take several weeks or months to become effective. ( low dose is 1.5-4.5 mg; high dose for people coming off of alcohol or oxy is 50-100 mg) I’m hoping to drop down to nothing or 1.5 when I finish healing. Take at night, seems to help with sleeping and no constipation!
Good luck with your healing and pain!!!
🙏🤞🙏

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Time is your friend in terms of recovery and reduction in post-surgical pain. I never found I was able to speed-up my body's healing time-clock. I highly recommend maintaining a diary which will help you track your actual progress since I found I lost track of time as my focus was so day-to-day (maybe more like hour-to-hour). I always felt better as I read an entry a week old and realized I WAS improving...I slept very little for the first few weeks. But gradually, I returned to a more normal sleeping pattern and did so in my own bed. I stopped opioids at three days post and have managed with Tylenol and muscle relaxants. You will progress! Hang in there. I describe the return to normal as "glacial" (or so it seems) and "non-linear" as some days are a step-back. I'm nearly three months post (similar surgery) and really starting to feel better.

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So many helpful responses! Thanks, and I wish you all the best. Here’s my update at day 14 post op. I went to the hospital ER yesterday morning, because I deteriorated to the point of having 72 hours straight of mostly agonizing pain and almost no sleep at all! After 9 hours in the ER, new CT and MRI scans, the surgeon changed my meds. Yesterday I was totally shell shocked, but now the past 14 hours have been a miracle! I had 4 blissful sleeps of 1-3 hours each. I still had some major pain while I was awake, but not as bad.

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I take sleeping pills, complete hysterectomy at 44, no hormones = no sleep. New doctor 10 years ago (for a short time) told me I was addicted to sleeping pills…I told her I was addicted to sleep…God bless your sleep, and may your pain continue to improve quickly! 😘
Ps great advice about the diary to track your improvement

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