Wednesday, April 17, 2024

L4 L5 Bulging Disc Surgery Recovery

The Most Common L4 L5 Pain Symptoms

Day 6 after L4/L5 Microdiscectomy Lumbar Back Surgery for Slipped Herniated Disc

Disc problems are one of todays most frequent back issues, and they can also be among the most painful. Thats especially true of the L4-L5 disc area, as it can create additional, painful symptoms that can interrupt your life and have you running to the doctor. Not sure if what youre suffering through is an L4-L5 slipped disc problem or something else? Here are three telltale signs to look out for.

Can A Bulging Disc Heal Without Surgery

In short, the answer is absolutely YES. We think that the actual statistic for how many disc bulges recovery naturally, if the body is optimised for a short bulging disc recovery time, is 90% of people recovering within 12 weeks.

Unfortunately, this is not always the case, and some people remain in pain past the 12 week mark.

If this sounds like you, make sure you are doing everything you can to optimise your body for a recovery from sciatica.

When a person recovers from a bulging disc, the body is able to clear any debris from the injured area through clever cells in the blood stream. The inner disc material is able to return to the nucleus within the disc over time. The annulus then knits back together, allowing the disc to return to a healthy state. This is all dependent on the person suffering from the injury managing to avoid any aggravating activities in their day to day life.

It is worth noting that, during the healing process, the disc is quite vulnerable to a re-injury for up to 6 weeks. However, this sense of vulnerability can remain for quite some time after. A large part of the reason for this is due to subconscious fear of a re-injury.

The fear of re-injury can actually directly increase your bulging disc recovery time. I talk more about what this is and how to beat it HERE.

Reasons For Failed Back Surgery And Pain After Surgery

Spine surgery is basically able to accomplish only two things:

  • Stabilize a painful joint.
  • Unfortunately, back surgery or spine surgery cannot literally cut out a patients pain. It is only able to change anatomy, and an anatomical lesion that is a probable cause of back pain must be identified prior to rather than after back surgery or spine surgery.

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    What Happens After Surgery

    You will awaken in the postoperative recovery area. Blood pressure, heart rate, and respiration will be monitored. Any pain will be addressed. Once awake, you can begin gentle movement . Most patients can go home the same day. Other patients can be released from the hospital in 1 to 2 days. Be sure to have someone at home to help you for the first 24 to 48 hours.

    Follow the surgeonâs home care instructions for 2 weeks after surgery or until your follow-up appointment. In general, you can expect:


    • Avoid bending or twisting your back.
    • Don’t lift anything heavier than 5 pounds.
    • No strenuous activity including yard work, housework, and sex.
    • Dont drive the first 2-3 days or while taking pain medicines or muscle relaxers. If your pain is well controlled, you can drive.
    • Dont drink alcohol. It thins the blood and increases the risk of bleeding. Also, dont mix alcohol with pain medicines.

    Incision Care


    • Take pain medicines as directed by your surgeon. Reduce the amount and frequency as your pain subsides. If you dont need the pain medicine, dont take it.
    • Narcotics can cause constipation. Drink lots of water and eat high-fiber foods. Stool softeners and laxatives can help move the bowels. Colace, Senokot, Dulcolax and Miralax are over-the-counter options.


    When to Call Your Doctor

    What Happens Before Surgery

    Lumbar Disc Herniation with Surgical Laminectomy and Discectomy ...

    In the doctors office, you will sign consent and other forms so that the surgeon knows your medical history . Discuss all medications you are taking with your health care provider. Presurgical tests may need to be done several days before surgery. Consult your primary care physician about stopping certain medications and ensure you are cleared for surgery.

    Continue taking the medications your surgeon recommends. Stop taking all non-steroidal anti-inflammatory medicines and blood thinners 7 days before surgery. Stop using nicotine and drinking alcohol 1 week before and 2 weeks after surgery to avoid bleeding and healing problems.

    You may be asked to wash your skin with Hibiclens or Dial soap before surgery. It kills bacteria and reduces surgical site infections.

    Morning of surgery

    • Dont eat or drink after midnight before surgery . You may take permitted medicines with a small sip of water.
    • Shower using antibacterial soap. Dress in freshly washed, loose-fitting clothing.
    • Wear flat-heeled shoes with closed backs.
    • Remove make-up, hairpins, contacts, body piercings, nail polish, etc.
    • Leave all valuables and jewelry at home.
    • Bring a list of medications with dosages and the times of day usually taken.
    • Bring a list of allergies to medication or foods.

    Arrive at the hospital 2 hours before your scheduled surgery time to complete the necessary paperwork and pre-procedure work-ups. An anesthesiologist will talk with you and explain the effects of anesthesia and its risks.

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    Technical Problems After Lumbar Decompression Surgery

    Three potential technical problems that cause the pain after surgery to continue include:

    • Missed fragment is still pinching the nerve
    • The back surgery operation was done at the wrong level of the spine
    • Dissection of the nerve root may cause further trauma.

    Nerve damage during a discectomy or a lumbar decompression is very uncommon, but has been reported in about 1 in 1,000 cases. When it does occur during back surgeries, a permanent neurological deficit with new weakness in a muscle group is possible, and a postoperative EMG can be helpful to see if there has been nerve damage and if there is any reinnervation after the back surgery.

    At times, decompressing a nerve root through back surgery will cause it to become more inflamed and lead to more pain temporarily until the inflammation subsides.

    How To Decide If The Time Is Right For Bulging Disc Surgery

    Any type of surgery is a big step, and the decision to move forward is best made with the guidance of at least one trusted surgeon . For general educational purposes, USA Spine Care offers the following examples of situations in which surgical bulging disc treatment may be an appropriate next step to consider:

    • Several months of nonsurgical treatment, such as lifestyle changes, nonsteroidal anti-inflammatory drugs , heat and ice applications and physical therapy have not produced meaningful symptom relief.
    • Unmanageable pain or progressive leg muscle weakness is interfering with daily activities.
    • Balance or coordination issues are causing walking difficulties and limiting mobility.
    • A rare neurological complication known as cauda equina syndrome, which can cause bladder and bowel incontinence, has developed .

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    Lumbar Microdiscectomy Recovery Time

    Most lumbar microdiscectomy patients are able to go home from the hospital a few hours after the surgery. The traditional approach to recovering from lumbar microdiscectomy has been to limit bending, lifting, or twisting for a minimum of 6 weeks in order to prevent the disc from herniating again.

    While many doctors restrict too much activity for the first 6 weeks, limited research suggests that restricting activities for 2 weeks following lumbar microdiscectomy may be sufficient for many patients.1

    • Driving and light activities can typically be resumed after about 2 weeks.
    • Routine activities, such as work, school, and/or hobbies may be resumed within 6 weeks.
    • Strenuous labor or contact sports may be recommenced after 12 weeks or longer.

    Pain and fatigue are typically severe during the first few days after a lumbar microdiscectomy. During the initial days at home, it is important for someone to be there to help with basics, such as cooking and household chores. If the patient lives alone, having a friend, relative, or hired aide to stay close can be of considerable help.

    What Percentage Of Back Surgeries Fail

    Recovery after Endoscopic Spine Surgery for L4-L5 Slipped Disc and Sciatica

    The American Society of Anesthesiologists estimates that 20 to 40% of back surgeries fail. Patients having repeated back surgeries have a much higher chance of failure. One study found only 30% of second back surgeries are successful. The number decreases for third and fourth back surgeries, with a 15% and 5% success rate, respectively.

    Unfortunately, failed back surgery is common enough that it has received classification as a medical condition. Failed back surgery syndrome occurs when a patient experiences continued pain in the back, neck or limbs following a surgery meant to reduce pain.

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    When To Talk To Your Doctor

    Microdiscectomy is a minimally invasive procedure with an outstanding track record for relieving pain. While most people who experience sciatica will not require surgery, if all other treatments fail, a microdiscectomy may be warranted.

    Your doctor will review your unique circumstances and determine if the procedure is right for you. If youre a candidate, you should discuss the risks and benefits of the surgery with your doctor.

    Physical Therapy After Bulging Disc Surgery

    For some patients, physical therapy may be recommended during the recovery period to help increase the pain and symptom relief. Other patients may receive a guide for at-home activities and stretches to do to increase the spines strength and flexibility. Regardless of the activity you are advised to perform during your recovery period, you should always listen to your body in order to prevent overworking and injuring your muscles.

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    Rebound Pain After Surgery

    Surgeons writing in December 2021 in the journal Orthopedic Surgery expressed concern with the phenomena of rebound pain after percutaneous endoscopic lumbar discectomy. Here is what they wrote:

    After percutaneous endoscopic lumbar discectomy, most patients with lumbar disc herniation experience relief from the typical symptoms of low back and leg pain. However, for a small number of patients, these symptoms are relieved immediately after surgery but aggravated soon after, and then relieved after short-term full rest or conservative treatment. The aim of the study was to demonstrate this short-term recurrent phenomenon, termed rebound pain.

    To assess this problem the surgeons of this study examined post-surgical patients with and without rebound pain. What they found was typical feature was pain that usually began within one month after surgery and lasted for less than one month. The symptoms were mainly leg pain with or without low back pain. The range of pain was equal to or less than that before surgery. The symptoms were relieved after conservative treatment. Although rebound pain with multiple characteristics and a short duration had no significant effect on long-term postoperative efficacy, its high incidence often caused unnecessary concern in both patients and doctors. As a result, careful differentiation of rebound pain from other postoperative complications is needed.

    Factors That May Slow Down Recovery

    Pin on Disc Prolapse: Slipped Bulged Disc

    Lumbar microdiscectomy surgery is less likely to be successful due to delayed healing caused by one or more of these factors:

    • Too much activity, such as lifting heavy items or pushing through fatigue, may lead to increased pain or reinjury that requires additional treatment.
    • Not caring for the incision site during the early recovery period and engaging in restricted activities, such as swimming or taking a bath, could cause the incision site to become infected.
    • Staying sedentary and not walking enough can cause muscles to weaken further and prolong pain and stiffness following the surgery. Staying too sedentary may also contribute to problems with digestion, sleep, and/or mood. Most surgeons recommend taking short walks during the first few days following microdiscectomy surgery, then gradually build up from there.

      See Return to Exercise After Microdiscectomy Surgery

    • Not adhering to the medication plan can lead to inadequate pain relief, complications, and delayed recovery. If the prescribed medication is not working or causing side effects, ask the surgeon if there are any other options. It is important to let the surgeon know about all medications and supplements.
    • Having diabetes or other chronic diseases may slow healing and recovery. Limited research suggests that people with diabetes are at an increased risk for complications following this procedure.2

    Other health factors that may slow down recovery time include malnutrition or overall poor health.

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    The Importance Of Seeing A Doctor

    While you might think you know what is causing your back pain after a little research or if you have had a disc bulge in the past, making an appointment to see a leading back doctor is key to getting relief. It could be that the recommended treatment is something other than what you have previously opted for or read about. Most importantly, an L4-L5 disc bulge can lead to prolonged pain and other, more serious conditions like spondylolisthesis if you delay treatment. Spondylolisthesis is a condition in which a vertebra shifts or slips, and can cause significant pain that may require surgery to fix.

    When Is Surgery Required

    Some people with a bulging disc will require surgery if their disc is not healing for a certain reason. The surgeries that are chosen will usually aim to decompress the nerve root that is being compressed by the disc material. Most of the surgeries involve taking away some of the disc or a piece of bone within the spine to allow the affected nerve root to move, glide and send messages more freely. The names of these surgeries include microdiscectomy, lumbar decompression and laminectomy. These surgeries are reserved for people who have seen next to no improvement during a reasonable bulging disc recovery time period. After surgery, recovery time periods can range from 6 to 12 weeks, to longer in more complex cases. However, during these time periods, the amount of activity you are allowed to perform is far more limited than during the average bulging disc recovery time period without surgery.

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    Bulging Disc Recovery Time Healing A Bulging Disc Without Surgery In 2022

    When you are suffering from sciatica due to a disc problem, it is absolutely reasonable to ask about bulging disc recovery time, and whether you can heal a bulging disc without surgery or not. The aim of this article is to answer all your questions about recovery from a bulging disc, whether surgery is really needed and what to do to speed up bulging disc recovery time.

    Recovery Process And Timeline

    Right L4-5 Microdiscectomy on Right L4-5 Herniated Disc

    According to the North American Spine Society, people who undergo surgery for a herniated disc earlier rather than later may have a faster recovery time. They may also experience improved long term health.

    Typically, most people can go home 24 hours after a herniated disc operation. Some may even be able to go home the same day.

    Doctors recommend that people recovering from herniated disc surgery avoid the following activities for around 4 weeks:

    • lifting heavy weights

    Some exercises may be beneficial for people who have had herniated disc surgery. However, they should consult their doctor or surgeon before attempting any strenuous activities.

    Sometimes, doctors may suggest rehabilitation therapy after surgery. People who follow a rehabilitation program after herniated disc surgery may achieve a shorter recovery time and improved mobility.

    Discectomies hardly ever result in complications. However, in rare cases, people may experience the following:

    • tears in the spines protective lining
    • injury to the nerve

    In around 5% of people, the problematic disc may rupture again, causing symptoms to recur.

    Herniated disc surgery can be an effective treatment for many people with challenging pain. However, surgeons cannot guarantee that symptoms will disappear after surgery.

    Some people may continue to experience herniated disc pain after the recovery period. In some cases, the pain may worsen over time.

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    Is Spinal Surgery Dangerous

    The answer to the question, Is lower back surgery dangerous? is both yes and no. Every surgical procedure has risks, including spinal surgery. The nature of spinal surgery increases the risk of severe complications compared to other procedures. Spinal surgery happens at and around sensitive areas in the spine and spinal cord. The most significant risks you could face if an error occurs during surgery include paralysis or a spinal infection.

    Despite the possibility of severe complications, the mortality rate for spinal surgeries is low. One study found a mortality rate of 0.13% out of 803,949 lumbar spine surgery patients. The rate of surgical complications is also low, with a 7.6% complication rate in a study of 3,475 patients. Your back surgery may deviate from standard risk levels, depending on your existing health conditions and the type of surgery youre having.

    That Was 2017 This Is 2022 Is The Information Still Outdated Yes

    An October 2020 study citing this research says Clinical practice guidelines provide recommendations for practice, but the proliferation of Clinical practice guidelines issued by multiple organizations in recent years has raised concern about their quality. The aim of this study was to systematically appraise Clinical practice guidelines quality for low back pain interventions.

    The studys outcome: Yes, they are still outdated:

    Conclusions: We found methodological limitations that affect Clinical practice guidelines quality. In our opinion, a universal database is needed in which guidelines can be registered and recommendations dynamically developed through a living systematic reviews approach to ensure that guidelines are based on updated evidence.

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    The Worst Mri Ever I Was Told I Must Get Surgery

    Some patients tell us that they started losing patience with this hit or miss treatment method and that they need surgery. Their doctors sometimes disagree. Others tell us that their doctors have told them that they have a terrible MRI and that they should get online for surgery. Some of these terrible MRI people are the ones who contact us. They want an option other than surgery and one with a realistic chance of providing some type of long-term relief, or enough relief that they can go about their routine daily business without making a game plan in the morning to decide if they need their back brace, anti-inflammatories, or other remedies to get them through the day and into bed at night feeling no worse.

    You may be reading this article convinced you that you have the worst MRI ever, and based on this, you must have surgery. You may be a business owner, a physical laborer, someone on their feet all day, someone sitting in front of a computer all day, or a caregiver. If your pain is so significant, your MRI confirms that you have significant disc degeneration and you have constant, radiating pain into your legs with numb neurologic problems, you cant walk for example, then yes, surgery should be explored and you should follow recommendations from your surgeon. Again, this is not the patient we usually see. We see the patient who despite a terrible MRI, still manages to get along in their daily activities and responsibilities but not without moments of severe pain.

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