Discectomy - After the Operation

[Mia Devis]

If you and your familly have only sought the help of GP's, surgeon's etc then maybe you should should seek the help of a good osteopath, there you may find an alternative opinion........more in line with what your intuition is telling you.?

 

[dashhound_91]

I did try a osteopath once and swore never to go again!

Back in 1995 when I had my first episode of sciatica I had a very unsympathetic boss who insisted that I sorted it out ASAP. So I made an appoinment to see an osteopath. Prior to seeing this osteopath I only had sciatica without any pins and needles or numbness. However after 2 sessions with this osteopath my pain increased and I also started to develop pins and needles. When I told him this his facial expression said it all. Obviously I didn't see him anymore!

Just my opinion but when it comes to treating prolapsed discs the only remedy is either wait until this heals itself or surgery. I haven't found any alternative methods helpful and I also think physiotherapy is a waste of time. I believe physiotherapists are only helpful when the cause of your pain in your back is muscular rather than prolapsed discs. Obviously getting the right diagnosis helps. Both the Osteopath and a physiotherapist said to me that I didn't have a problem with my discs and yet an MRI scan 2 months later revealed disc prolapsed at L4/L5, L5/S1. If they can't get the diagnosis right then they are unlikely to help you!

 

[M N]

I'm sorry you've had a bad experience of osteopathy.

Misdiagnosis is a risk in any field, medicine tends to suffer form it particularly badly, because it is a system that is very intolerant of error. Small and easily missed details can turn a life-saving treatment into something deadly. That said, I would never say one bad experience of doctors should put one off doctors.

However, what this highlights is the importance of finding the right PRACTITIONER. I often say it is the vision of the theraPIST that matters, and not the certificates they hold.

Good luck

 

[Barbiee?]

I'm amazed that an osteopath could tell you it wan't a disc problem without having an MRI first

 

[Gipsy]

Hi ogothorpe, I was very releived to read your posts regarding otheopath and physio treatment. I tried both options when my disc prolapsed 3 years ago, as my hip had moved out of line the head physio told me the disc had come out and gave me exercises to push it back again. I couldn't describe the amount of pain I suffered...for 9 months! I blame my own stupidity for the length of time it went on but the physio told me I would stay like that for life if I didn't continue. My one visit to an osteopath was slightly beneficial, she was able to diagnose a disc prolapse plus an inflamed sacro illead joint, thanks physio. I think the osteopath eased the problem but I was unable to afford any more sessions. Even so, I don't think she could have solved the problem.

I've now had surgery on my neck and lumbar spine, the lumbar spine has been a problem for a long time and is making life difficult again. I agree that further surgery would be a mistake and hope to get near a consultant to request an epidural for pain relief. It has crossed my mind though, that spinal surgeons only act on the scan results. I don't beleive they have much knowledge about symptoms and outcomes....and this makes it very difficult for the patient to make an informed decision regarding treatment.

Back problems cause total havoc in peoples lives and we have no real support, advice or guidance. I would even say that heatlh professionals find it all very boring and resort to pushing people onto the conveyor belt of surgery as a last resort. If I had some power in government I would make sure back problems are given a higher priority, and that would reduce the amount of people claiming state benefits. I hate it when the government and media throw scorn at people on sickness benefits, as if we all have choice in the matter!

Rambled on again...but does anyone agree that maybe spinal treatment is outdated and poorly informed? And how can a small group of people change anything?

 

[Ren]

Totally agree about the havoc back problems cause. I have always said that the biggest challenge isn't dealing with the pain or numerous operations but how its impacted my life socially i.e friends, girlfriends, family.

Having to live with the stigma attached to back problems is another challenge. Unfortunately their are many dishonest people who use a bad back as an excuse. This makes it very difficult for those who are genuine. Like I said in a previous post when I intially had back problems my boss was very unsympathetic. As he threatened me with the sack I continued working with 2 prolapsed discs for 18months and my job involved being on my feet all day. He even suggested my MRI scan report was false and accused me of typing it out myself.

On a different note today is the day I see my spinal surgeon to get a detailed explanation of my MRI scan. At the moment all I know is the disc at L5/S1 has prolapsed again. Should be interesting to hear why this disc has prolapsed considering I had a fusion at this level!

 

[~21 weeks prego!~]

Hello all, I thought I would continue to follow up with my progress. I know when I was looking for information before I had a L4/L5 disectomy four months ago, it seemed those who had surgery and were feeling great stopped posting.

Lately I've been biking, a week ago before I got my sinus infection, I was trying to bike 16 miles a day, last weekend I completed a 32 mile bike ride. The odd thing is, I can bike, but walking at times is a struggle. My lower back seems to tighten some and my hip hangs out to the right making it complicated to adjust center. That's when walking becomes a problem. I really don't have confidence in my GP, but he recommended that it was muscle induced scoliosis, and prescribed a generic brand of Celebrex. Seems to be helping, but there are still times I endure complications when walking. Anyone else went or going through the same symptoms?

 

[U.S.Veteran]

Hi there

Congratulations on doing so much cycling - you are doing well!

As for problems walking, I am in no way qualified in that sphere, but my husband had problems walking too, with his left hip rotated outwards. This meant his leg and feet were getting tired and he'd catch his foot on things. Since he has started wearing MBT 'rocker boots' from here this problem has resolved and he can be on his feet all day without problems - oh, and no more painkillers! In fact if he has to wear his old footwear he really feels the difference. So it might be worth trying. The soles are based on the Maasai footwear - they walk miles each day through the African bush.

Just a thought.

 

[Justice Sahbi]

Without x-ray eyes, this would not be possible. However, there are supposedly clinical indications that should help us work it out. They are not very reliable.

However, osteopathic treatment is often aimed not at the part in trouble, but the surrounding areas and the environment which the disc inhabits. By ensuring that the tissues in question get the nutrition they require and a state of mechanical ease, fewer adverse forces focussed at them, then they do usually recover on their own - that's the theory.

If this approach to treatment is applied, then it shouldn't make things worse, and in practice it is often effective. The reality is that many problems initially diagnosed as a disc on the clinical picture alone can be made worse by treatment, for reasons I can't go into in a single post. For the same reason, many problems do hide their true nature. Then, by the time the patient gets to a scanner, it really is a disc problem.

We could screen everybody by MRI first, but then the costs and waiting times would exclude many people from help, and almost all from early help. Much better, in my view, to be mindful of all possibilities behind the presentation, and then treat the patient in a way that will not make things worse if it is a disc. What that means in practice, of course, could fill up a library.

Nevertheless, the chain of errors involved does not apply specifically to Osteopaths. We see this arising from massage, specific manipulation, prescribed muscle relaxants etc etc. Any profession has the tools to make things either better or worse. What this highlights yet again is going to a practitioner with a good reputation - whatever profession you look into, this is the best you can do.

 

[Bob White]

Hi, Just though I'd post an update. Had L4/L5 discectomy 8 months ago. Still say it's the best thing I've done. Get the odd twinge in my left leg & buttock but that's mainly if I've not been a good girl and done my exercises! I'm still doing all the ones I was given by the physio's plus some extra Pilates ones although I admit I'm not very religious about it! So I think the main thing is to DO YOUR EXERCISES!!!

Scar is now fading fast and i'm doing a lot more than I was before. I even climbed Ben Nevis last week - something I would never have dreamed of doing prior to the op (& not something I'm considering repeating!). It took me a long time but it was worth it & felt like a great achievement after not being able to walk to the shops 8 months ago.

It all takes time to heal & you do feel that sometimes it hasn't worked. I went camping for a week in the Summer which was a bad idea. Leg pain & back pain came back & I thought that I'd slipped a disc again. But the pain eased after a week or so & I'm pretty much back to normal now. Even wearing high heeled shoes!!

Don't rush things & remember that your body has been through a rough time and needs a long time to recover.

Hope everyone is doing well. Take care.

 

[yzzxvkyf]

Well my consultation with my surgeon was certainly interesting. Apparently the fusion I had last year was unsuccessful and because the bone grafts didn't fuse the movement in this area is what caused the disc to prolapse.

Now I assumed this disc prolapse would be resolved by a Discectomy but unfortunately it isn't this straight forward. According to my surgeon if I have another discectomy then chances of further prolapse is very high due to my past history. I said to my surgeon that I was surprised there is any disc left to prolapse after so many operations. His answer surprised me because apparently only during these past 15 years have they discovered that discs actually regenerate in some cases.

My only option according to my surgeon is a spinal fusion but this time using metal work and screws. However he is very reluctant to perform another operation and said their are many risks.

Im going back to the hospital tomorrow to attend a meeting that will involve my surgeon and other orthapaedic surgeons to discuss my case. Apparently this meeting is called a multi disiplinary meeting which surgeons often organise to discuss patients cases.

Have to say I really don't know what to do. I cannot carry on as I am because the pain is really getting me down. However I don't relish the thought of having yet another operation which involves so many risks, especially considering the 4 operations i've already had haven't helped me.

I do have a question which I will also ask tomorrow. If I have L4/L5 fused by metal work then surely this will put extra pressure on the discs above. Now because my discs prolapse so easily surely the risk of this occuring is high. Personally I would prefer the much easier and less painful discectomy. I know by doing so will mean I could suffer further prolapses but at the moment all im bothered about is getting rid of this pain.

 

[Don H]

Hi Orgothorpe,
after you have had the multi disiplinary meeting would it be worth seeking a second oppinion from Dr Martin Knight? (see other threads for opinions on his work).

What ever you decide I wish you the very best outcome.

 

[GolgZZSem]

@ogothorpe
Your fusion was without instrumentation (transpedicular screws and rods)?

With one level instrumentation, there is no evidence that disc above or bellow will degenerate. However, fusion is always last resort.

 

[Jack Oniel]

Now if only we could get the NHS to fund these visits ( £200.00 a consult) or the surgery but so far they say no, so for most of us the cost of the operations are prohibitive at £10,000 plus!

 

[nicky c]

You took the words out of my mouth (or fingers) cascara, how are you doing by the way?

ogothorpe, your dilemma is similar to mine I think, except you've got closer to a consultant than I have. I know my lumbar discectomy has failed, I just don't know how or what can be done about it. Do you have a degenerating spine? They say that's what is happening to mine and that it limits what procedures can be performed. I was given the impression that any surgical procedure will put pressure on the other discs and cause further problems. Like you I'm pretty well fed up with the pain, although it isn't as bad as before the previous discectomy, I can't stand for long, can't carry anything too heavy and struggle walking too far. And I spend too many cold dark nights sitting in the kitchen waiting for pills to work before I can go back to bed. What do you do?

I'm no spring chicken ( bless my heart) but I'm too young to spend the rest of my life in such misery. I've lost my job, am dependent on benefits and am living alone.....what on earth does anyone do in this situation? It certainly isn't part of the grand plan I had for my life. I often wish I had something a bit more dramatically wrong with me....something 'medically and socially acceptable'.

Like I've said before, so much conflicting advice and different opinions its impossible to make an informed decision about anything connected with the spine.

 

[CHiL0Sa]

I certainly agree with everything you have said.

Now according to my surgeon the reason my discs prolapse so easily is probably due to genetics. This is why he wants to perform a fusion with metal work to prevent movement between L4/S1. However i've been told that in doing this will put extra pressure on the discs above and due to my past history im nervous disc prolapses will occur at L3/L2. My personal preference is another open discectomy. I know this will be my 5th operation and I know I could be back to square one in a couple of years. However at the moment im more concerned with the pain im currently experiencing and would prefer the much less risky and less painful open discectomy compared to a fusion. Im also concerned that I might have permanant nerve damage because its been over 3 months since I was last able to move my toes.

As for living with this condition and im similiar to you. I also live on my own which certainly makes life very difficult. For example all i've eaten today is a bowl of porridge because I just cannot stand long enough to prepare anything. I wouldn't be able to even do this if it wasn't for the tramadol and my crutches. Its been 21 yrs that i've suffered problems with my back because it started when I was 18 and im now 39.

You also touched on a subject that often irritates me and that is the stigma attached to back problems. If you break an arm or leg and have this in plaster then your injury is visible. However this isn't the case with spinal problems. However in saying this it doesn't help that their are many dishonest people who use this as an excuse.

Like you I also survive on benefits due to being unable to do my job. However the recent benefit cuts announced by the government have concerned me. Now my family always tell me im being silly worrying about this due to the amount of evidence supporting my spinal problems i.e 4 operations, MRI scans, X Rays, my GP, Consultant etc. However I still get concerned that the genuine cases could suffer. The problem with me is all these years of pain and operations have had an effect on me mentally. I suffer dreadfully from anxiety and depression and although deep down I know im being silly worrying about the benefit cuts I still can't help it.

Hopefully come tomorrow my questions will hopefully be answered but I do agree the conflicting advice certainly doesn't help. I also fully understand where you are coming from when you say about a medical problem thats medically and socially accepted.

 

[Johanna Curtisman]

It may reassure you, ogothorpe, if I tell you I know a couple of people who have had their spine fastened up with metal work...one is a neighbour who is now back at work after 3 years of suffering...so don't think you can completely discount it. Thats why I asked if you had a degerative spine condition, whether it was strong enough to take the strain.

I'm not going to worry about the benefit cuts, my attitude now is 'Whatever!' They wouldn't dare make genuine claimants suffer, and there's enough to worry about anyway. Just concentrate on getting the treatment you need, and eating properly!!!

 

[Skidoo]

Sorry to just fag-end on the conversation. The reason why we have these discussions is that none (or ver few) of these procedures do anything whatsoever about the cause of the problem All they treat is effects, cause remains.

Degeneration, that's a big subject, but remember that if they can't cure you, doctors will keep going until they reach the bit that is 'beyond their control', whether it be genes, age, whatever. Once they can blame the patient then they can finally justify their input so far, or even get a massive research grant. It's not a conspiracy, it's in their training to assume that if anything else could be done the system would do it. All health issues have many contributing factors, some that can be changed, some that can't. Doctors follow the trail to the bit that is unchangeable, that's where Occam's Razor leads.

Why not look at what can be changed? What does that mean? Degeneration in the orthopedic model is thought to be wear and tear, like ball joints in a car. This is not a car, it is living tissue. Think 'general health', and tissue health follows. That's a big subject, of course, but hope it's a start.

The point is, if you think you've tried everything, you haven't!

 

[trouble88]

Well i've returned from the meeting and i've learn't alot more about my condition and how to move forwards.

After the examination it appears i've lost the ankle reflex and they also commented on how cold my legs were. They started speaking in medical terms which I didn't understand and were checking for a pulse in my foot. Im not surprised i've lost the ankle reflex because like i've said it has 3 months since I was able to move my toes.

The next step is they are going to perform an epidural under GA rather than local because I cannot tolerate the pain of an epidural under a local. According to my surgeon this is mainly caused by the sheer amount of scar tissue and the narrowing of the spinal canal. Hopefully this will give me some respite whilst I decide between a discectomy or fusion.

I asked about the risks of a fusion and it appears due to my previous surgeries the main risk is the screws becoming loose and pressing on a nerve. This risk is apparently higher for people like me compared to someone who hasn't had previous surgery.If this happens then further surgery is required.

At the moment I still prefer a discectomy to a fusion. Like I said I want to get rid of this pain by the least invasive surgery possible. This might make me prone to future disc prolapses but I don't think I could stand another fusion as an open discectomy is minor in comparison. I know some people have had spinal fusions which have been hugely successful. However have these people had 4 previous operations or was the fusion their one and only operation. This is why I don't like to make comparisons because its well known that with each successive operation the chances of success reduce.

I might come across as though i've given up. However I just think its now a case of managing my problems rather than curing them. I still think there is a underlying cause to my problems. For example I don't believe the problem with my right hip is just down to bad luck as my GP puts it. Im sorry for being negative but if I tally all my operations (not just for my spine) then its 6 operations since 1996 and over 10 GA during this period. When you consider this number of operations will definitively increase to 8 then you can understand why im fed up. I feel like a boxer in the ring who has taken many knockdowns and fear one more hit will KO me mentally if this makes any sense.

 

[MathHelp]

Hi im new here so i wonder if anyone could give me some advice,i had a microdiscectomy in april this year l5/s1 after years of sciatic pain.My consultant told me he had to dig deep once inside has the bulge was bigger than expected and that i would have refered pain in my back.I didnt get any physio until the middle of august at my local hospital and that was only because i rang in tears on day and told them i could hardly walk or get out of bed because of the pain in my back and left leg,they told me they never recieved a letter from my consultant(i had seen the letter he sent and checked with my doctor to be told she had a copy of the letter).After three weeks of doing exersices at home i went to see a spine physio at the hospital where i had the op to be told i shouldnt be doing those exercise so was given some more. At the moment im 6mth post op in more pain now than before the op,ive constant pain,pins n needles,tingles in my leg day and night and the pain in my foot is terrible also the pain in my back makes me cry.Does anyone else have this or could it be possible the disc has popped again? i would be greatful for any advice as im not sure when im seeing my consultant again