Advice needed on nerve inflammation from spinal anesthistic

[maggy]

This is something I've been struggling with since a few days after I got home from the hospital (RTKR - I'm at 31 days post-op) I have pain in my lower back, mostly on the operated side and then it shoots over to my hip and down the outside of the leg to the knee (sciatic nerve). I also have a very uncomfortable feeling in my bladder (not an infection, it's been checked). I've been doing Robin McKenzie's back exercises and use a lumbar roll. No relief.

I can't get an appointment with my OS until next Friday, so yesterday my PT advised me to go emergency at the hospital and get it checked out which I did. They said it's inflammation due to the spinal anesthetic and should resolve itself in about 6 weeks but maybe up to 12.

Other than the very uncomfortable feeling and sciatic pain I have been doing well as far as faithfully doing my exercises and going to PT. The extension ones are the most painful and we've been trying different positions to avoid aggravating the sciatic problem.

I was also part of a pain study of nerve blocks at the hospital so I may or may not have had a sciatic block as well. I think I know which group I was in!

I am taking one percocet 4x day and am now on apo-ketorolac ( a new one for me) 2x per day. Has anyone else experienced complications after the spinal anesthetic?

Sorry for the long post but I'm getting weary of dealing with more than just the knee.

Mag

 

[Jamie]

Oh my, Maggy....I'm so sorry to hear you are having back pain in addition to trying to heal your new knee! No FAIR!!! You were smart to go and have it checked out and I would certainly mention what they found when you talk with your surgeon. Here's hoping this minor setback doesn't last too long!!

 

[JudyS]

Maggie
I have been part of a study for my last 2 surgeries. The study docs have always made themselves very available even after as there has always been some follow up for me. I would definately contact them for advice.
Good Luck
Judy

 

[Josephine]

It's not a long post, honey - not by a long shot!

As for your pain, can you get hold of a TENS machine? That might help some. I know some people do get problems from the spinal.

As for Ketorolac, I found this on a Google search. Hope it helps some.

Ketorolac belongs to the class of medications called nonsteroidal anti-inflammatory drugs (NSAIDs). It is used for the short-term treatment (five to seven days) of moderate to moderately severe acute pain associated with muscle sprains and strains, dental pain, and pain after surgery or giving birth. It works by reducing pain, swelling, and inflammation.

 

[1jt@atime]

Hi Maggy, I never had back pain and sciatica until I had my first knee replacement 16 months ago. I knew right away after surgery that something was wrong with my back and found the sciatic pain to be worse then the knee pain. My pain also went down the leg of the replaced knee and sometimes all the way to the toes.

My spine doctor told me that the knee replacement was not the cause of the back problem but that it simply brought the existing problem to the surface. With the need for multiple joint replacements and a leg length descrepancy, my back is simply out of whack. I incorporated PT for the back in addition to the knee PT and that helped a lot. It took a LONG time to get the pain level manageable. It's still there but I can work with the curent level of pain.

Do you have a spine doctor that you can go see? That might be a good suggestion if the pain does not subside. I've been on this forum for quite a long time and every once in a while, we will see someone with back pain as a result of surgery so don't feel alone. This does happen. Karen

 

[maggy]

Thanks for the support and info everyone. Jo, I'll look into a tens machine. My GP gave me 25 Ketorolac so I hope being on them for 12 days is ok. He said to call him tomorrow so I'll ask him then. Karen, my troubles seem small potatoes next to yours. Hang in there.

I'm seeing my OS this Friday and am hoping that, as I'm into Week 5, things will improve.

Mag

 

[richfriz]

Hi Maggy

I had an epidural for my BTKR 11 weeks ago. The anesthetist had to put it in higher up due to a previous back surgery. At the time he put it in I felt a big jolt like an electric shock. Since the operation the top half of my bum has been numb! My theory is he damaged a nerve when he did it but I could be wrong

My back has also been giving me a bit of trouble but I find Voltaren ( an anti inflammatory) works wonders

Hope you feel better soon
Richard

 

[aussie]

Hi Richard,

I was wondering how you were getting on.

A friend of mine has the same problem and soreness from the epidural, it seems to lessen with time.

Pleased you are doing OK. I guess with what is happening in Victoria we are fortunate to be dealing with numb bums and a sore thigh (in my case), puts it in perspective doesn't it.

Take care

Chris

 

[Judles]

Yes!!!! To all our Aussie friends,,,,,our hearts and prayers are with you as we hear about those devastating fires! G-d bless!!!

 

[aussie]

Thanks so much Judles. Every bit helps!

Chris

 

[maggy]

My thoughts as well are with you Chris. We are just devastated here watching the extent of the fires and the loss of life that has occurred.

Sending all the positive energy we can down there, and hope that this will end soon.
Mag

 

[aussie]

Thanks Mag,

Yes it's absolutely heartbreaking to hear the stories of loss, whole communities..

There has been a bit of cooler weather which has allowed the firies to get in and clean up a few little fires, but there are still a few really hot spots that they doing their best to contain, however they are still a worry.

Then up North we have floods. Boy just can't pick it.

Thanks all for prayers and thoughts.

Chris

 

[Pookerbear]

Thank you for your post, Maggy. I have also been battling sciatic pain since I had my LTKR 10 weeks ago, and the more time passes, the more it is negatively impacting my recovery. I have great ROM, but a horrible, horrible gait when I walk. If I walk w/o a cane, after a very short time the pain in my left butt/hip becomes extreme and I develop a marked limp, "rolling" when I try to walk. With each step of my left foot, I get a sharp, stabbing pain in my butt and down my left hip and leg and I sort of just collapse a little on the left, buckling with the pain in my back and hip. I do Periformis stretches ad nauseum trying to settle the sciatic nerve and see no improvement. Now that I am walking without a cane, I am acutely aware of how quickly my gait deteriorates, literally within a dozen yards. By the end of the day, I look like a caricature of Quasi Moto, lurching down the hallway.

I have a growing fear that having walked "improperly" for so many years due to knee pain and being knock-knee'd, I am not only unable to correct my gait now, but may be pulling my new knee out of alignment to match my old gait! I am also somewhat frustrated by this aspect in physical therapy, when I walk for my therapist and she says I'm doing very well! I'm not! When I concentrate on putting my left foot down "heel/toe" I can feel my foot putting my weight down on the outside of my left foot...not evenly on the entire foot, and when I try to force my foot to land flatly, I get painful cramps in my ankle. Plus I tend to turn my left foot in slightly pidgeon-toed. I've explained to my PT that when I walk longer distances, I can't stop all these things from pitching my body to my left to the point I look like a Weeble (I wobble, but hopefully won't fall down, either).

Today was my worst day yet, and I feel like I'm just ranting, but it is just so frustrating when I think I am getting better, then I walk into my office building and by the time I make it to the elevators I am practically lurching and I'm afraid my "muscle memory" is too strong and will cause some permanent damage by slowly pulling my knee out of alignment to a knock-knee'd position. I know 80% of my extreme limp is due to the pain from my sciatic nerve, but I am out of ideas on how to make it stop. I do endless stretches, walk very slowly to have more control over my gait, sit on endless ice bags, and all to no avail. I am just SO frustrated...

 

[JudyS]

Sorry Pookerbear

I would have a good long talk with my pt about this and if not totally satisfied it is possible for you to change to someone else?
I would also have a good talk with my surgeon. Are the pain meds working at all or perhaps only for your knee.
I am kind of in the same boat after just having back surgery and really needing to get posture and gait under control. I walk knock-kneed now more on the right side. I just had a knee scope/microfracture and thoracic fusion surgery. I want to walk each step correctly to be in proper alignment. It is tough. Lower back pain and sciatic pain were pretty bad today. I will have a good talk with my pt next week.

Good Luck to you and you are not alone
Judy

 

[Pookerbear]

Thanks, Judy...I actually feel a little better just reading your post I am unfortunately winding down on my PT schedule with very few visits left. As I have only begun walking unassisted in the last two or three days, this is a somewhat new issue, and I think more problematic than anyone anticipated. The pain meds don't seem to touch the nerve pain, unfortunately - I have had a wide range of pain killers prescribed for the sciatic pain over the last ten weeks, and nothing has really touched it...scary.

I never realized how many factors are actually involved in simply walking a straight line, or how just one or two issues can have such a detrimental influence. I can deal with the knee pain, but am at a loss as to how I can prevent the sciatic pain from making me buckle and roll when I take a step. I will talk with my PT tomorrow. Any suggestions you, or anyone else, has for mitigating sciatic pain would be most welcome!

Thanks for reminding me that I'm not alone with this, Judy...reading your post really did make me feel a whole lot better, and I hope we BOTH have a better day tomorrow!

 

[Josephine]

Pooker, you're in the classic frustration/can't wait to get going mode. But I'd like you to consider this: how many years have you been walking abnormally? If it's even only one, it's expecting rather a lot for your body to adjust back to normal so quickly.

So, as I read your posts, you're feeling that your sciatica is mostly responsible for you inability to correct your gait? Have you tried seeing a chiropractor or getting referred to a pain clinic? Thought of trying a TENS machine?

 

[maggy]

Hi Pookerbear,
I'm so sorry about what you're going through. Do you have any bladder discomfort along with the sciatic pain?

I think my sciatic pain has calmed down a little. Either that or I'm just used to it. I finally get to see my OS today about this issue, I've been waiting for two weeks. Also, my family doctor has ordered a CT scan but I don't have a date yet.

I'm pretty well off the percocet and am just using 500 mg tylenol now because the oxycodone and codeine (from the stronger tylenols) was making me feel weird and I was losing all sense of how I really felt. I have rarely taken drugs in the past so all this medication really throws me off. I may have to take something stronger for physio but I'll see.

I haven't done my exercises for two days because I thought that might help the sciatic nerve settle but I'm really worried about losing my ROM that I've worked so hard to achieve. Now I have a wicked cold so I missed physio for the first time. What next! I know how you feel and how frustrating it can get!

I'l post after I see my OS today.

Mag

 

[Judles]

Pooker,,,,,in your case, it just sounds like you're going to have to let the scatc pain run its course! Isn't it unbelievable how we all seem to have to re learn how to walk properly again (heel toe) after we've been out of alignment? Have you tried hydrotherapy? Anything in a pool should help you feel better! Keep posting!

 

[JudyS]

Pooker

Nerve pain is different to control than the surgical pain. At least that is what I have found. In my neck and lower back I have had steroid injections that have worked wonders for my nerve pain. I knew it was time again in Nov. for lumbar injections, but when my date finally happened (the day after Christmas) my neck was hurting so bad my doc told me to pick which area. So lumbar has just gotten worse and surely not helped by the fusion surgery.

I do believe staying out of pain as much as you can is the key to improving gait. Jo's suggestion of a pain doc sounds like a good plan for you. I know they do injections as well as prescribe meds. I have over the years been on all kinds of nerve pain meds adn I must take high doses to have a little effect. Then I can not function. Right now I am on Cymbalta. I don't really think it does anything.
I after reading my medical records from recent surgery, see my doc said to continue with lidoderm patches on my back. I just got them yesterday , I will see if they have any effect. They are for nerve pain.

If I were you, I would call my doc today. Maybe get another prescription for pt for the sciatic pain and gait. Ask for suggestions for a different pt. Tell him just what you posted. Ask about getting to a pain management doc.

Good Luck with it all and let us know how it goes. Sorry about my rambling
Judy

 

[Josephine]

Your rambling is good stuff, Judy!