Exchanging one pain for another !

How often does this happen ?

I'm supposed to have a Spinal De-compression soon - but it sounds a serious op., apparently involves shoving my back muscles out of the way to get at my lower spine to enlarge a passage to fix my sciatic nerve's compression by giving it a bit more room.

BUT - it occurs to me that while that may well fix the sciatic nerve it could result in long term pain elsewhere starting in the areas disturbed during the op. - thus exchanging one pain for another.

Anyone comment - possible ? probable ? likely ? hardly ever ? 1 in 10 ? 1 in1000 ? etc.

Dan

12 Replies

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  • Certainly sounds very severe reaction to treating sciatica.?

    I thought spinal decompression involved some sort of stretching. I'd love to have that done for protrusions but can't because of metal construct in spine. Have to have epidural steroid instead. Yuk.!

    Good luck with your op.

  • Hi

    I had a spinal decompression in my thorasic spine three years ago next month. At the time of the surgery I was 60 % paralysed so I had no choice in the surgery, it was that or go paralysed completely.

    The operation was a success and I am not paralysed now at all. BUT since the surgery the pain is so much worse than it ever was before the surgery. Life is still very hard and pain control mys life and activity is very very limited.

    I am not writing this to,put you off your surgery , I'm just writing to tell you that after the surgery life is not easy either .

    I wish you luck and hope it all goes well for you. My advice would be unless you have to have spinal surgery as I did because of going paralysed , then please think long and hard before you do.

  • I had spinal decompression in 2011 it was wonderful for about a year to a year and a half as I had no pain. But it gradually returned to a point worse then before my surgery now. I'm so pleased that I had it done as I was pain free. Just a shame that pain has returned now. So I would advise you to have it as I it really helped even if for a short time it was worth it.

  • I had lumbar spinal decompression surgery in the 1980s (I'm 55 now). My right leg was almost paralysed before the surgery, after it was much better, but sciatica was still troublesome. I had another operation a year later to remove the spinous processes from L1 - S1 to reduce stenosis. This operation weakened my spine considerably. I still get sciatica in my right leg.

  • I had 2 lumbar discs decompressed and part of the bones cut away to release the sciatic nerve 20 years ago. The operation was a great success as I had been unable to walk and another 3 months and I would have been paralysed. The recovery was much longer than I expected and, at first, I had sciatica as the nerves regenerated. (The leg was dead before.) This soon went and, although I am not pain free as I have fibromyalgia I do not have pain from the operation. Very important to do the exercises and , as my consultant said, take the painkillers and keep moving. My operation was a very big one as rarely are 2 discs decompressed at the same time but my spine was in a real mess. As you are only having one done the recovery should be quicker but remember that the sciatic nerve has to heal where it has been rubbed so it's not instant.

    (Decompression involves removing the jelly like substance from inside the disc and leaving it like a washer between the vertebrae. Treating the stenosis involves shaving a little off the vertebrae to make a larger passageway for the sciatic nerve which is being rubbed.)

    Hope this helps.

  • As a veteran of two spinal decompressions, I would say be sure what you are having done and what you are having it done for.

    Spinal decompression is a blanket term used to describe any surgery designed to relieve pressure on something. I had two emergency laminectomies. I couldn't walk or indeed move my feet prior to both surgeries. There was a very clear cause in both cases - a centrally herniated disc that was compressing my spinal cord. I was paralysed to all intents and purposes.

    After the first (lumbar laminectomy) I quickly regained the ability to walk, had massive pain relief and life was good. Then I woke up one morning after a few weeks, and was back to square one.

    This time I had a cervical laminectomy, more severe post-surgery pain, more post-op sciatica, slower recovery mobility wise.

    I am now 9 months after the second op. The sciatic pain has largely gone (for now?) and my mobility is increasing steadily (but slowly).

    Now, I should add that I have also had a series of root ganglion nerve block epidurals and have (through my own desire not to be in constant pain and unable to walk) undertaken an intensive program of physical therapy - and here's the thing, nobody told me to do that. I was lucky that I realised I was never going to walk with no muscles in my lower torso. I asked my surgeon if exercise was a good idea and he said do it, it's going to hurt, but it's really the only chance you have of regaining much mobility. I have been seeing a skilled personal trainer, and it's made so much difference I can't describe to you how important it has been in my recovery.

    What I have learned: people on here talk about decompression as if it's one thing, it isn't. Microdiscectomy, laminectomy, and other types of surgery are all described as decompression, so we are comparing different things. A decompression (or any other spinal surgery) is only going to be effective if:

    a) it is the correct procedure, correctly targeted at the cause of the pain / impingement - and is done by a highly competent surgeon. In my case there was a disc (I have DDD) pushing into my spinal cord. Pretty obvious.

    b) your post operative recovery plan is sufficient to enable you to do enough physical exercise to regain all of the muscle strength / mass that you will have lost by not being able to walk properly. In my case I caught sight of myself in the bathroom mirror and realised that I had lost so much muscle it was no wonder I couldn't stand up. In fact you need to not only regain lost muscle but add in lots more to protect the weakened areas of the spine.

    c) you are patient and committed enough to ensure that b) happens. It's now 9 months since my last op, 5 months since my last injection. My surgeon has suggested that I have approximately 2 years of recovery 'window'. I would estimate that I am at 50% of my original ability now, I'm not giving up - ever.

    There are so many horror stories associated with spinal surgery that if I had actually had any other option, I would have taken it first. My choice was paralysed or surgery. My surgeon has admitted that when I first presented he thought I was a candidate for a wheelchair. Being determined to not let that happen is hugely important to your outcome.

    I would have thought even the surgeon potentially doing your op would struggle to give you realistic odds on the chances of complications. Moving muscle to get to any deep structure being operated on is pretty much standard I would have thought. I've had two hips and one knee replaced and both required pretty invasive procedures. It's how you strengthen the damaged muscle afterwards that makes a huge difference to outcomes. Even if it hurts, and it will, separating 'normal' pain from abnormal pain, learning how and when to push through it, and sheer bloody minded determination are all pretty important to the longer term outcome.

    All in my humble opinion, I'm not a doctor. Just a patient.

    Ade

  • This option was offered to me and I refused.... they want to open the hole the sciatic nerve root goes thru instead of trying to decrease thr swelling of the nerve itself... once the swelling is decreased thr pain will go away, sciatica and all... I was back surgery and as a nurse I should have known better worse decision I ever made. I see nothing wrong with using high dose steroids to reduce swelling and only go the surgery 'greed' route if all else fails... also I learned if we give our bodies time they will heal themselves.

  • I have decided to postpone the major surgery in favor of a second facet joint injection/nerve block injection, the kind I had last year for the first time, but got only three months relief therefrom.

    Thoughts/opinions anyone ?

    Dan

  • You know Danmdan, I thought about the steroid injections and would have had one in my back because steroids are really strong anti-inflammatories and can take the swelling down....... I think when the back tries to heal itself it takes a couple months sometimes... most folks get the injection and go back to doing what may have caused the injury 'inflammation' in the first place and when you have DDD 'disc disease' it don't take much to inflame the back again

  • I've not had facet joint injections, despite having facet joint pain, but for me the repetition of nerve block injections was what gave me the ability to move again and do some exercise, which helped more and decreased the pain etc. It started off a cycle of improvement without which I think I'd still be in agony.

    I also had them to try and avoid the need for further surgery. I'm still hoping on that one, but so far so good.

    If the surgeon doesn't think there is any advantage to having prompt surgery then maybe injections are a good thing to try first.

    I would personally rather injections that surgery, but it all depends what's going on to cause the pain I guess.

  • I've gone thru the increasing strength of paracetamol, co-codamol, solpadol, tramadol, morphine - before finally getting some relief from Zomorph, 30 mg every 12 hours ( except action only lasts 8-10 hours)

    I currently take a combination of Zomorph and Tramadol plus Pregabalin - I'm unable to take any NSAIDs

  • Since the above was written, and from about a month back my leg pain has slowly faded away such that I have stopped the 30mg. Zomorph, Tramadol, Lyrica, and Codeine - and have gone back to only the occasional Co-codamol.

    Does this sort of thing happen often - and importantly is it likely to be temporary or will it last ? With the lower doses of opiates my constipation has also diminished. If I tell my GP he will remove much of my pain armoury from my prescription.

    ****************

    I still have the offer of the "L5 nerve root block" injections - do I take it - or postpone ? Could anyone with an answer to this question give it asap as I will otherwise be cancelling the Day-center appointment.

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