HomeAnswersNeurologydiscectomyMy buttock pain has not subsided despite physiotherapy. Why?

Can pain and numbness persist even after a discectomy surgery?

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Published At August 29, 2022
Reviewed AtOctober 11, 2023

Patient's Query

Hello doctor,

I am 66 years old. Three months back, I had a left L4-L5 Metrx microdiscectomy. A postoperative complication was STEMI with cardiogenic shock requiring emergency PCI with multiple Vfib arrests. I was given several drugs, that included Heparin, and hospitalized for 20 days.

I have pain and numbness in my left buttock region that is sometimes severe. Also, I occasionally have pain in my thighs and numbness and tingling in my left foot. My surgical scar has healed well, and I do not have back pain. I am able to sit; however, standing and walking cause pain in the buttocks and legs. Also, I have numbness on the top of my right foot and saddle area, and there is no bowel or bladder incontinence. However, there is constipation sometimes. This discomfort has restricted me from doing any activity around the house, and I continue to use my walker at times as well. I have made significant lifestyle changes since my STEMI with diet, fluid restriction, and medications. My current medications include tablet Brilinta 180 mg, tablet Aspirin 81 mg, tablet Lasix 80 mg, tablet Carvedilol 12.5 mg, tablet Spironol 25 mg, tablet Losartan 25 mg, Potassium capsules, and fiber capsules. I have also been taking injection Novolog, 8 to16 units per day. I have been trying to reduce my insulin injections as I am gaining belly weight. My HbA1c is around 9 %. I do not take any medications for pain and have taken Gabapentin capsules.

My neurosurgeon suggested I gradually increase my activity and referred me to physical therapy. However, my buttock and leg pain have not subsided. As a result, I do not do much lifting, bending, or twisting. I understand that these complaints may subside with time; however, the symptoms are frustrating me.

Kindly advise.

Hello,

Welcome to icliniq.com.

I understand your concern.

Ideally, after an L4-L5 matrix microdiscectomy, you should get pain relief. However, there can be limitations to L4-L5 surgery as it is one of the lowest weight-bearing discs of the body. There can still be chances of symptoms despite a successful surgery due to the body mechanics. I suggest you continue physical therapy and graded exercises to improve your quality of life. I also suggest you take capsule Pregabalin 75 mg or capsule Duloxetine 20 mg to 60 mg for neuropathic pain. Consult a specialist doctor, talk to him or her, and start the medicines with their consent. Also, a topical Gabapentin gel will be helpful. Please share your pre-operative and post-operative MRI (magnetic resonance imaging) lumbosacral spine for further advice.

I hope this helps.

Thank you.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Prakashkumar P Bhatt
Dr. Prakashkumar P Bhatt

Neurology

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