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Recovery from Discectomy

Dear Dr Licina

Thank you for successfully performing discectomy surgery on my back during April 2000.

The purpose of this letter is to outline post-operative recovery, and to place this in context, I'll outline my personal statistics and fitness level, as well as my pre-operative condition.

Sedentary worker, but fit 50 year old, height 180 cms and weighing 80 kg with weekly exercise program involving 2x1 hr bicycle rides; 2x30 min swims; 5x15 min weights sessions; and walking 2x18 holes of golf. Exercise program had significantly suffered in the 10 weeks leading into the operation on account of sciatic pain. On a scale of one to ten, the constant pain from my buttock down my leg to my ankle, had been up to level eight, and after the scan with the injection of anesthetic into the nerve, up to a level five. Weeks on constant pins and needles in the four smaller toes, and weakness of the foot. Hierarchy of positions for pain relief were lying down, leaning over desk, standing, sitting (worst). A month of taking maximum prescribed doses of pain killers.

My operation took place after lunch, and by 4:30 pm, the physiotherapist had me up and walking, and by 8:30 pm that day I was back at home. On pain killers and suffering mild pain in the area of the surgery to say level three. Relief from the constant leg pain, with only occasional shooting pain up to level 2, particularly to the lower leg and ankle. Pins and needles remain. Slept comfortably for the first time in weeks.

Over the next few days, cutting down on pain killers, able to sit and enjoy a meal, walk around the house, undertake the stretching exercises prescribed by the physiotherapist, and take a ten to twenty minute slow walk around the block. Spent most of the day on a mattress on the floor in the lounge, but generally tired, lacking energy and enthusiasm - couldn't be bothered to read, and TV would need to be good otherwise I would fall asleep.

During the second week, I started back at work for from two to four hours per day, not so much because I felt like it, but because I needed to complete some key tasks otherwise the business would suffer over the next year. I found concentration difficult, and that I suffered head ache the following day after trying to do too much. I felt depressed because I didn't feel as if I was getting better and still needed to take pain killers on account of the level two shooting pain in the leg. And constant pins and needles to the little toes remained. Walking times increasing to twenty minutes and continuing with the stretching exercises, still walking with a slight 'drop foot' limp. Returned to the swimming pool, and was amazed at my lack of condition - managed only 200 meters day one, and struggled to swim 600 meters two days later. I associate the swimming (improvement in blood circulation) with the gradual re-gaining of feeling in my little toes, as the first instance occurred the night of my second swim, and that was a real psychological pick me up for the end of the second week. Pain in the back from surgery all but gone.

The third week was a case of small incremental improvement. Further cuts to pain killers, shooting pain in leg less frequent and less severe, pins and needles absent then returning, working a little longer, but still getting sick the day after overdoing it, generally feeling down and lacking in energy: needed to sleep in the afternoon after working in the morning. Increased swimming to 1200 meters and walking to up to one hour, with no adverse after effects from swimming, whereas at times the walking and standing for long periods contributed to the feeling of overdoing things.

Four weeks was like magic. My energy, enthusiasm and zest for life returned. Returned to work full time, not because I had to, but because I wanted to. Completely off pain killers, no pain in the leg with only occasional and weak pins and needles to the foot. Leg still relatively weak, but improving. Continued stretching exercises, swimming, walking, started jogging short distances, rode my bicycle for twenty minutes, and played 5 holes of golf. Towards the end of the week, flew to Perth and back: feeling good again, but still lacking strength and stamina.

At seven weeks, affected leg is still not quite as strong as the good leg, but still improving. Able to walk with only minor hint of a limp. Back to my former exercise program, save for the weights. Playing one round of golf per week, yet to play to my golf handicap, but hitting the ball well. Back to working a 50 hour week.

I hope the above is useful to your future patients to understand the post-operative recovery, and in particular, knowing that even though the relief from pain is immediate and almost complete, it takes four weeks before one starts to feel really good about oneself again. My advice to someone having a discectomy is to plan to take four weeks off work if at all possible: my state of mind was not conducive to effective decision making and efficient work practices during this period.

Kind regards