How long is recovery after fusion?

[herniated C6-7]

Well, I had a fusion done at C 6-7 on Dec. 14, so it is now 5 weeks later. No bone implant was used. Just a titanium plate with screws plus bone marrow tissue from my pelvis--including stem cells--to promote fusion. Over the last 5 weeksI was told to wear a soft collar 24 hours, 7 days per week, and to keep my head immobilized.

Now I'm told that the collar can come off and I can commence physical therapy in a week or two. Pain at the incision is largely gone.

Other good news is that my old pain triggers are also gone. And I'm down from 6 to 3 pain pills per day.

Bad news is that moving my head still seems to pull on the 3 inch incision and irritate nerves enough that I get chronic muscle spasm and pain in my upper back and head. The head pain, in particular, still leaves me quite fatigued.

My surgeon, James Zucherman, tells me that my body has become used to generating this sort of pain over the past 10 years in response to nerve irritation at C6-7--upper back and head pain were my chief symptomatic complaints prior to surgery--and is now generating like pain in response to different nerve irritation.

Does anyone else have experience with this sort of difficulty? I'm hoping that physical therapy, by loosening me up in the incision area will help. And I'm trying to assume that this too will pass. But day after day of head pain is beginning to wear on my spirits. I'd like to hear about others who faced like difficulties and overcame them, if anyone knows such stories.

[KBear]

Honestly it sounds like you are doing great for 5 weeks post op. I know we all want to be healed yesterday and waiting for the pain free days is hard. I believe what your surgeon is referring to is remembered pain from the nerves. I've heard of it and pretty sure I experienced it post surgery too. It took 9 months before I was able to cut back on pain meds (and this was after I had to go on a post surgery increase of meds) and 12 months for considerable improvement. It was at the 18 month mark that I was medication and pain free. So at 5 weeks to already be on a half dose of meds is really good. Slow and easy wins the race!
Take Care,
Kathy

[Hooch]

I agree, you're doing ok.

Muscle spasm can cause pretty severe pain, when you start pt and can start streching and mobilising that will start to relieve. I'm 5 weeks post op, I've been doing my own walking and pt since I got out of hospital. A week or so ago I started streching, realised my QL muscle was bound up like a vice.. instant reduction in pain.. as your fusion heals you will have little pathology in your neck, so you will be able to maintain streching and mobilisation plus strength without your muscles going into pain spasm again.. become functional.

U are on track and doing well.

[Justin]

Other good news is that my old pain triggers are also gone. And I'm down from 6 to 3 pain pills per day.

Wow! This is fantastic news!

Does anyone else have experience with this sort of difficulty? I'm hoping that physical therapy, by loosening me up in the incision area will help. And I'm trying to assume that this too will pass. But day after day of head pain is beginning to wear on my spirits. I'd like to hear about others who faced like difficulties and overcame them, if anyone knows such stories.

Physical therapy will definitely help. Your body has inherently compensated for the degeneration in your spine over the last 10 years; thus, your biomechanics have been altered in part by the afferent pain signals that your brain has "processed" over the last 10 years. These pain pathways to your brain take time to "cool down" after being up-regulated for so many years.

With good time, you should see progress and your fatigue should get better. Of course, follow-up with your surgeon and rehab team regarding any ongoing concerns you may have.

Good luck!

[herniated C6-7]

Thanks for the information and encouragement. Part of what's bothering me is uncertainty over causation.

My muscle spasms may be from stiffness and weakness in my neck and in the area of the anterior 3 inch incision. In that case I should start physical therapy soon and should also improve soon.

But the pain might also reflect irritation at the interior surgical site which is triggering newish symptoms as well as old pain patterns. Aside from the chronic head pain, which is my most bothersome symptom, I also am getting much briefer and intermittent episodes of sharp pain in my wrist and elbow, usually on the right arm, but sometimes on the left. This pain seems interior in origin. I did have wrist pain before the surgery, but only occasionally. Elbow pain is new.

So the head pain might improve with physical therapy. But maybe not. Moving my head is the current pain trigger for the head pain,so when I commence PT and start exercising my neck, a concern I have is that if the pain is interior in origin, the symptoms could get worse instead of better, .

My surgeon advised me to start PT this week or next, and left the choice of week up to me. After 6 weeks of wearing a collar 24/7, I am aching to take the collar off and get started with the PT. On the other hand, it's possible that my symptoms reflect residual interior swelling and irritation, in which case it might be more prudent to wait another week.

Part of what's bothering me is I don't know how to figure this out. I will call and ask the physician assistant at the surgeon's office, but it seems that there's no way anyone can know the answer. A compromise, I suppose, is to start this week, but start slowly and cautiously.

I suppose what's really bothering me the most is the need to reframe my expectations. I was expecting to have only minor symptoms by now. After some 10 years of chronic pain, I had been telling myself the end by now would be in sight.

A tendency to bolster myself with over-optimism is a weakness of mine. But I guess I have to reframe my mindset and ready myself for another potential long haul.

Sorry to go on. And thanks again for the support. Sounds like you were real troopers. I'm going to have try to learn from your examples.

[KBear]

I suppose what's really bothering me the most is the need to reframe my expectations. I was expecting to have only minor symptoms by now. After some 10 years of chronic pain, I had been telling myself the end by now would be in sight.

A tendency to bolster myself with over-optimism is a weakness of mine. But I guess I have to reframe my mindset and ready myself for another potential long haul.

I think we all tell ourselves that we will be the exception and be all better within a couple of months of surgery. Unfortunately most of us are the rule rather than the exception. I was going to be back to the old me in a month, because I was young and had the surgery thing whooped. Boy was I wrong, took 18 months. You are still really early out of surgery and it takes time.

[jss]

I had cervical fusions in 2000 and then again in 2002. I spent one night in the hospital each time and was 80% by the end of one week the first time and managed to walk 40 miles the weekend after the second fusion. I had spasms in my neck and trapezious for three and four months respectively each time. They were severe enough in 2002 that I was ready to go in and have something else removed (maybe due to the aforementioned 40 miles?). My PCP gave me a muscle relaxant (don't recall which one). It was a MIRACLE drug and cured the spasms.

Good luck, Jeff

[herniated C6-7]

It is now some 3 months since my cervical fusion at C6-7. I report that I can now move my head much more than 2 months ago without triggering pain.

But I am still suffering from chronic head pain, apparently from tight muscles in my neck compressing the occipital nerve. Because the physical therapist I was seeing seemed stumped, I changed to a new PT who reports that I still have post-surgical inflammation that he can feel, and neck muscles as stiff as taffy.

Current therapy features massage, ice, and acupuncture, aimed at relaxing the tight muscles and reducing the inflammation. I am also gently pushing a beach ball against the wall with my head, pushing forwards, backwards, and sideways left and right, 6 sets of 6 repetitions per day, to strengthen the neck.

I still have some concern that something more might be going on--I get mild transient symptoms in my wrist as I do the beach ball exercise--but overall my symptoms seem moderate enough that tight muscles are probably sufficient explanation.

Did anyone out there in the spine patient community have success in getting relief from tight neck muscles through a particular treatment? I welcome treatment ideas and suggestions. I am hoping that my current course of treatment will work eventually, but thus far progress, though real, has been slow.

[Katie]

I am using a wonderful chiropractor who works simply on the tight ligaments, tendons and muscles in my neck and lower back. He uses pressure on trigger points where it hurts the most, pushing until the knot releases. I'm going every week or two as I'm doing way too much detail work with my art and computer, putting strain where I shouldn't.

I remember feeling so frustrated a few weeks/months out after surgery, as I was limited in what I was allowed to do, and still had enough nagging pain to doubt the success. (I'm a worrywart and not a patient patient ) Yes, it was about 80% gone, but like you, I wanted it to be 100%. I think the uncertainty and anxiety with wanting to get on with life made everything seem much worse than it was.

It truly was the hardest period of my recovery, even harder than immediately post-op, so I so understand what you are going through right now. Hang in there. It will be so much better than what you were going through before surgery.