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What care should be taken after microdiscectomy?

Saturday, 04 June 2011
Answered by: Dr Mathew Varghese
Head, Department of Orthopaedics, St. Stephens Hospital, New Delhi
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Q. I am a 30 years old male who underwent a microdiscectomy for right side extrusion in L5-S1 two weeks back. The severe pain, which I experienced before the surgery is gone but I still feel numbness in the right foot sometimes. Is it normal? I feel pain sometimes similar to the sciatic pain that I experienced before the surgery. What does it mean? Most of the days, my back feels very stiff and sometimes, I get a lower backache too; similar to a sprain. Is it related to my bed-ridden days (almost 10 days) before the surgery was performed? What care should be taken post-surgery and for how long? Lastly, when can I start driving? Can I ever lift heavy-weights?

A.  It is common to have some persistent numbness after surgery. Usually this settles. Occasionally if there has been complete damage of nerve fibers before surgery, this may persist as a small area of numbness but this area reduces in size by over growth of surrounding nerves.

Sciatic pain does not go immediately but the severity of symptoms settles remarkably. This pain at times gets worse in the 3rd to 6th week of surgery. This may be linked to the resolving oedema (swelling) and recovery of partially damaged nerves this also settles with time.

The back feels stiff because of persistent of muscle spasm. This should also settle. It may or may not be related to your bed rest.

After surgery there is restricted activity for two to three weeks and then you start off with extension exercises for the back. Avoid forward bending exercises at least for 5-6 months. Though there are no hard and fast guidelines for this. Most people would say forward bending is an absolute no. While this may not be completely correct it is best to be guided by your body. Avoid those moments that bring on the pain. Walking is permitted and there is no restriction only caution is - don’t start long distance walking from the second week! Gradually increase your walking over a six week period. Continuous sitting is not advisable and as far as possible, after sitting for 30-40 minutes take a one minute break and sit again.

You can drive right away but again no long distant driving requiring you to sit for more than 40 minutes or so. Take a break of couple of minutes if you need to sit longer. Sit right up, keep your seat closer to the steering, to avoid leaning forward. I am not sure how heavy the weights can be for weight lifting. It will vary from person to person also from the past conditioning of your muscles. Be guided by your body’s response to lifting weight.

A.  It is common to have some persistent numbness after surgery. Usually this settles. Occasionally if there has been complete damage of nerve fibers before surgery, this may persist as a small area of numbness but this area reduces in size by over growth of surrounding nerves.

Sciatic pain does not go immediately but the severity of symptoms settles remarkably. This pain at times gets worse in the 3rd to 6th week of surgery. This may be linked to the resolving oedema (swelling) and recovery of partially damaged nerves this also settles with time.

The back feels stiff because of persistent of muscle spasm. This should also settle. It may or may not be related to your bed rest.

After surgery there is restricted activity for two to three weeks and then you start off with extension exercises for the back. Avoid forward bending exercises at least for 5-6 months. Though there are no hard and fast guidelines for this. Most people would say forward bending is an absolute no. While this may not be completely correct it is best to be guided by your body. Avoid those moments that bring on the pain. Walking is permitted and there is no restriction only caution is - don’t start long distance walking from the second week! Gradually increase your walking over a six week period. Continuous sitting is not advisable and as far as possible, after sitting for 30-40 minutes take a one minute break and sit again.

You can drive right away but again no long distant driving requiring you to sit for more than 40 minutes or so. Take a break of couple of minutes if you need to sit longer. Sit right up, keep your seat closer to the steering, to avoid leaning forward. I am not sure how heavy the weights can be for weight lifting. It will vary from person to person also from the past conditioning of your muscles. Be guided by your body’s response to lifting weight.

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