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Ask Dr. Arun Phophalia Your Own Question

Dr. Arun Phophalia
Dr. Arun Phophalia, Doctor
Category: Medical
Satisfied Customers: 29651
Experience:  MBBS MS. Post doctoral fellowship in Sports Medicine. General surgeon and sports medicine specialist
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I had a microdiscectomy at the L5-S1 level 5.5 weeks ago.

Resolved Question:

I had a microdiscectomy at the L5-S1 level 5.5 weeks ago. Pre-operatively I had symptomatic S1 nerve pain in my left leg, numbness along the left side and sole of my left foot, and the ability to plantar flex was 70% compromised (stand on my toes) left leg. I had the surgery 2 weeks thereafter. My 4 week post-op visit with my NS was very favorable (rated an A-). My ability to plantar flex was 100%, and the numbness on the side and the sole of my left foot was somewhat dimished. I do not have any back pain and the nerve pain in my leg is pretty much absent. I do have intermittent dull nerve pain (1-2/10) that comes and goes in my leg (but mostly absent). I also have this intermittent pain on the ball of my left foot that symptomatically improves, then comes back here and again. My NS claims around 3-4 mos. for a full recovery of these symptoms. First, would you agree? Also, when I have recurrences of leg/foot discomfort, should I decrease my walking and light physical duties?
Submitted: 4 years ago.
Category: Medical
Expert:  Dr. Arun Phophalia replied 4 years ago.

Greetings.

 

I agree with your doctor's assessment. You should be completely asymptomatic in 3-4 months. Your post op results are very good and your residual symptoms should abate in next few weeks.

 

The pain or discomfort is the best guide for the physical activity and exercises (physical therapy). The pain and discomfort are our protective phenomenon and point to those activities which are harmful to the body, if they hurt during or afterward. So take the clues from them. If there is recurrence of the leg/foot discomfort, decreasing the walking and other work is advised.

 

Please feel free for your follow up questions.

 

Dr. Arun

Customer: replied 4 years ago.

Dr. Arun

 

Thank you for your reply, I just need the assurance that the risk of scar tissue tethering... or negatively affecting the S1 nerve would not be increased by decreasing forms of physical activity. My walking routine as been 4-6 miles per day; however, I believe you are right in that I do notice a recurrence of (as I call it) "the nerve getting angry" everytime I engage to expand the boundary of my current regimin. Your thoughts on scar tissue affecting the nerve (i.e. if this (scar tissue tethering/affecting) was happening, would I be experiencing a different, maybe more significant amount of pain) would satisfy my inquiry.

 

Thank you

Expert:  Dr. Arun Phophalia replied 4 years ago.

You are very welcome.

 

Yes, pain and other symptoms, like abnormal sensation, numbness or weakness would have been far significant than what you are experiencing, if the scar tissue was tethering the nerve or nerve roots. Your present symptoms are definitely linked to going beyond your boundaries (physical capacities) and related to over exertion. Intermittent activity than continuous activity may be advised, if you want to keep it to same level (obviously, that too should not give you any kind of discomfort or symptoms).

 

It is pleasure and privilege assisting you.

 

Dr. Arun



Edited by Dr. Arun Phophalia on 2/20/2010 at 5:24 PM EST
Dr. Arun Phophalia, Doctor
Category: Medical
Satisfied Customers: 29651
Experience: MBBS MS. Post doctoral fellowship in Sports Medicine. General surgeon and sports medicine specialist
Dr. Arun Phophalia and 2 other Medical Specialists are ready to help you
Customer: replied 4 years ago.

Dr. Arun

 

Along the lines of scar tissure and the nerve, I was wondering whether or not I can stop taking Naproxen Na for inflammation. Truthfully, I have been taking 500mg 3x/day because I have understood nerve recovery to require a decompression (done - microdisc) and an elimination of inflammation. I have been taking the Naproxen since my surgery on 1/12...so nearly 1.5 mos. I do not need this for pain, I am only taking it as a qualtiy assurance measure to rid any nerve related inflammation. I would only like to stop because I just don't like to take medicine of any kind..not unless I NEED to. Should I begin to wean off of these, or keep continuing them until my intermitten nerve pain ceases once and for all? This dosage was never offered by my NS, I had it on hand with many refills prescribed by my primary care physician for back spasms (before the disc ruptured and surgery).

Expert:  Dr. Arun Phophalia replied 4 years ago.

Hello,

 

Though Naproxen sodium can be stopped cold turkey; I usually advice them to taper them in about a week's time, if it is taken for so long. So take it for twice a day for three-four days and then once a day for three days and stop it. There is no need of taking it.

 

Best,

 

Dr. Arun

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