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Pain in the foot after the spine operation - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Very Good Posted in: Brain and Spine
Answered by

General & Family Physician
Practicing since : 2008
Answered : 3387 Questions
User :   I had a discectomy/laminectomy 2 years ago on the l4-l5 level. I have been having cramps in my right calf, pain in my right thigh/knee and pain in the top of my right foot/right ankle for about 4 months now. After having an MRI 3 weeks ago, I learned that l4-l5 re-herniated. I now have a large disc herniation in l4-l5 and a much smaller herniation in l5-s1.
The surgeon who operated two years ago is recommending another discectomy/laminectomy or a fusion of the affected levels. Due to accepting a new work position, I am not able to have the surgery. The new job requires a semi-intensive physical training at a federal law enforcement facility for 5 months. Some of this academy includes running, ground fighting and physical activities of the like.
I do not feel as I did when I needed the first surgery. My pain level is about 2/10 and is controlled w/ IB profen and Lyrica. My right foot is affected the most and feels less stable w/ pain on the top and around the ankle.
I feel as if I am a walking time-bomb. Am I over-reacting? Do people have large herniations that never progress to get worse? Is it safe to have the above sympotms and delay any surgical intervention for 6-8 months?
Doctor :   Hi,
User :   hello
User :   good afternoon doctor
Doctor :   Let me read the qury
Doctor :   very good afternon
User :   did my question make sense?
Doctor :   yes, i get it
Doctor :   and it is called Failed back syndrome
Doctor :   surgery is a must without delay
Doctor :   as it could worsen on time
Doctor :   sometimes in a matter of weeks too
User :   is it possible for 5 months?
Doctor :   i do not think you can give that time , its not safe
Doctor :   the reherniation can worsen
User :   do they ever just stay where they are
User :   not getting further onto the nerve?
Doctor :   its dfficut to say
Doctor :   some donot progress fast
Doctor :   but some do
User :   are physical activities what would worsen the herniation?
User :   or do they just progressively get worse over time?
Doctor :   physical activities are the ones which worsen the condition
User :   would cortisone shots "buy me time?"
Doctor :   no,
Doctor :   if it was inflammation of the nerve yes , cortisone would have helped
User :   inflammation from the herniation?
Doctor :   but here its herniation , mechanical presure here has to be corrected
User :   does the fact that i'm 30 years old change anything?
User :   I respect your position, but this job is contingent on passing this academy.... is there anything i can do besides surgery?
Doctor :   i am sorry, there is none
User :   if the herniation stays put and i can make it thru the 5 months, will this cause permanent damage?
User :   or the possibility of it?
Doctor :   a Lumbosacral Belt may restrict the movements and can reduce the affect to soime extent but not completely reliable
Doctor :   yes permanent damage the common undesirable effect
User :   i know you can't see the MRI, but is it possible that inflammation is causing the symptoms and the herniation is not pressuring the nerve?
Doctor :   and also you have symptoms , its nt a good sign
Doctor :   i agree the fact
Doctor :   a datiled examination with the view on MRI one could be able to tel whether its due to inflammation or pressure effects
User :   understood, i have had these symptoms for about 4-5 months now and continue to live a good "quality of life"... it is this new added physical training that is worrying me....
User :   however, I do get relief from ib profen and ice
User :   i guess that's why i was hoping it was inflammation
User :   and make it thru these 5 months
Doctor :   But you have to take risk
User :   if fact, sometimes i don't even feel any discomfort
Doctor :   then thats more in favor of compression than inflammation
User :   the fact of pain coming and going leads you to believe its compression?
Doctor :   yes,
User :   due to movement?
Doctor :   yes,
User :   i'm guessing putting any type of percentage on finishing this academy would be impossible?
User :   if you were a betting man ;)
Doctor :   Finishing the academy at the cost of what ?
User :   understood
User :   just that i do not have a fall-back profession
User :   or job
Doctor :   a resurgery can help you better
User :   understood
User :   i appreciate your advice
Doctor :   You are welcome
User :   i see my time is nearing an end w/ this conversation
Doctor :   Thanks fr consulting me
User :   have a good day doctor
Doctor :   Wish you the same
Doctor :   and wish you al good health
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