Bulging disc and sciatica

[KnottedYet]

I had a patient with history of severe back and leg pain and loss of motor function of the leg. Patient had a multi-level fusion and I think also multi-level laminectomies. At 5 weeks post-surgery the patient was pain-free and had returned to commuting by bike to work.

There is hope, hang in there!

(Ered, what post-surgery protocol does your surgeon have you using? The protocol is chosen by the surgeon, not by the PT, cuz the surgeon knows exactly what he did in there and how he wants you rehabbed. The various protocols have exercises and goals and precautions clearly spelled out for every week, so I'm kind of surprised that your PTs seem to be a bit at cross-purposes. Ask them to give you a photocopy of the entire 3-month protocol. It's nice to be able to see all the exercises and goals and the progression at once, rather than just one week at a time as they dole it out. It also lets you over-see the new PT you get who may not be familiar with you. I'm sorry you are frustrated that they ask the same dang questions about your pain every time, but we have to do that to monitor progress and changes. It drives my patients nuts, too!)

[jessmarimba]

I can't speak for Ered, but my surgeon doesn't seem to care what I do. He can't ever remember if I've even started PT yet and last time just told me I could do anything "reasonable" that I wanted. I hope hers is a little more involved!

[Ered_Lithui]

Wow! Your patient's surgery sounds horrifically involved. I'm amazed he recovered so fast! It gives me hope. I appreciate your professional insight.

I've read the same about MRIs showing bulges that produce no symptoms. My MRI did coincide exactly with my symptoms, though. (There were two other asymptomatic bulges as well.) There was also severe stenosis at the same location, which may explain why PT didn't help before surgery. The surgeon went in and carved out a fair amount of bone, in addition to removing the bulge.

As far as I gather, the main concern right now is that another bit of disc may have come out right after the surgery was completed. (He warned me beforehand that the latter was possible, though in his 1,000+ surgeries it has only happened about 2% of the time.)

what post-surgery protocol does your surgeon have you using? The protocol is chosen by the surgeon, not by the PT, cuz the surgeon knows exactly what he did in there and how he wants you rehabbed.

I will ask for more details; the PTs work for the hospital in accordance with the surgeon's directions.

I'm sorry you are frustrated that they ask the same dang questions about your pain every time, but we have to do that to monitor progress and changes. It drives my patients nuts, too!)

I get the need to monitor, but the nature of the questions ("And have you ever had any leg pain?") makes it clear that they don't remember (understandable) but also haven't bothered to even glance at notes from the last session. Urr.

[KnottedYet]

I get the need to monitor, but the nature of the questions ("And have you ever had any leg pain?") makes it clear that they don't remember (understandable) but also haven't bothered to even glance at notes from the last session. Urr.

Whoa, now that just sucks! You have my permission to slap 'em upside the head. Tell 'em it's therapeutic...

[malkin]

I went nuts when they'd ask every day if I'd had any bowel or bladder incontinence---I wanted to scream--DON'T YOU THINK I WOULD HAVE MENTIONED IT???!!!!