It can be pretty scary facing surgery especially when it involves the spine. I should know, I have had a neck fusion, a microdiscectomy and two fusions in the lumbar region over the last eleven years.
Every surgery should be approached with care. But it is always a scary endeavor when your neck or back is involved. We all have those well meaning friends who knows someone who knows someone who had “that type” of surgery and they “were never the same.”
Well, if you are reading this post, then I imagine you just didn’t wake up with a stiff back or a crick in your neck and decide to have major surgery. I know for me, surgery is always a last resort.
I literally had an acquaintance say, “Oh, I wouldn’t have that surgery if I were you.” “Oh really, why?” I replied. “Well, surgery is never good.” Hmmm… With such ironclad facts supporting their opinion, I’m surprised I went through with it!
I hope to offer you more than a flippant opinion, considering I have experienced what you are about to experience and I did not take this route lightly.
I will cover a couple of the things I did leading up to surgery and in future posts, will cover the details of each surgery as well as the recovery path I took.
Physical therapy is worth the effort; it may or may not prevent surgery, but your body will improve by being under the care of a skilled physical therapist. I have experienced significant pain relief from physical therapy. Don’t get me wrong, it can hurt really bad at first but it will get better as you stick with the program. A good physical therapist will help you improve in several areas including:
- Stretching was very important for me. When you have an injury, the muscles around than injury tend to tense up to “protect” the area of the injury. In reality, this in itself can cause pain due to muscle spasms and the muscles are not performing their normal, healthy duty of flexing and relaxing. Some of my most severe pain has come from muscle spasms associated with faulty discs. My physical therapy programs always included exercises to help me increase my flexibility before any strength exercises were introduced.
- When I first heard this, I was thinking, hey I’m strong enough. Well, the truth be told, I had some weak muscles I didn’t even know I had. When you have an injury, you involuntarily stop using the muscles that cause that injury to hurt more. Kind of duh–right? Physical therapists can help you isolate the muscles that have atrophied and walk you through exercises to strengthen these muscles, slowly without causing further injury.
- Proper Posture
- This one is a never ending battle with me because I like to slouch in my chair sometimes (okay, most of the time). A physical therapist will show you how to maintain good posture. Do your best to follow this one—even when the physical therapist is not around! The flexibility and strength exercises will really help you here.
I have had multiple versions of these injections in my back and neck, somewhere in the neighborhood of 20 to 25 over the last five years. There are several different kind of injections for pain relief. All of mine were targeted towards relieving nerve pain.
Although I haven’t had overwhelming success with these injections, the times it did help it almost instantly relieved my leg pain due to sciatica. No issues with the procedure itself, they just didn’t always relieve the pain. I still recommend them as an alternative to surgery since they are minimally invasive. This procedure might give you enough relief to continue with a physical therapy program or at the very least, give you a short break from some of the pain.
Since all the procedures have more in common than not, I will describe the basics of an Epidural Steroid Injection (ESI) which takes around 30 minutes or so. They told me to wear loose clothing which I am glad I did so I didn’t have to put on one of the stylish gowns. The injections I had in a hospital setting vs a surgical center differed in that I always had to wear a gown in the hospital.
They had me to lie face down on a x-ray table and asked me to just relax (yeah right, I’m about to have a very long needle shoved into my back with the goal of getting as close to the spinal nerve as possible—no relaxing for me). They pulled my shirt up as far as they could and pulled my shorts and underwear down some.
While someone was placing an IV in my hand, I hear someone else say, “This is going to be cold,” as they start lathering on the iodine. They didn’t lie, it WAS cold! Wow, I’m starting to finally warm back up. “Ahhh, that is cold!” round two has begun. “Well, we don’t want to get an infection, now do we?” the nurse says politely.
“Let me see your armband, please,” says the doctor. “State your full name and birth date.” “What are you here for today?” Everyone else in the room had already gone through this routine, but I play along and tell him the procedure I am having.
They numbed my skin with a local anesthetic to reduce the possibility of pain. All procedures do not include what I call the “good stuff” but most of mine did. I felt a warming sensation in my hand where the IV was as the “good stuff” began to flow in and that’s the last thing I remember until I started waking up in a sitting position.
They say that I was never asleep but I can’t see how I wasn’t. But somehow, I was in a sitting position…hmmm. The procedures where I had the “good stuff” didn’t hurt a bit except for once and I think they partially missed the vein or something—very bad burning. The ones where I didn’t receive the extra juice, hurt quite a bit. The other procedures I had using a similar technique was a facet joint injection and Radiofrequency ablation. The most painful so far was the Radiofrequency ablation.
The actual procedure, which I didn’t remember, is fairly straightforward. The doctor inserted the needle into my back while using a live x-ray for guidance. The needle was positioned in the epidural space. The epidural space is located just outside the dural sac which surrounds the nerve roots. Once the needle is in place, an epidural steroid solution is slowly injected.
That’s about it, they let me go home about 20 minutes after the procedure. You will need someone to drive you home. I usually go home and sleep a while. The injection site is a little sore sometimes, but I usually resumed normal activities the very next day.
God Bless… Danny