Nerve Pain after Artificial Disc Replacement (Activ-L, L4/L5)

**dalhousie** · 08-04-2009, 01:18 PM

Hi there,

This is my first post here! I live in the UK. I am just over 3 months post ADR with activ L @ L4/5. I developed nerve pain in my spine at 2 weeks post op for which I take low dose Pregabalin (I previously tried it at a higher dose in 2005 post fusion & it gave me blocked sinuses & severe headaches) & Amitriptyline. When I saw my specialist recently he said the nerve pain may increase once I started back at the gym & it has although I'm not doing much in the gym at the moment. On the days I go to the gym I struggle to get to sleep at night as the pain is very intense. I think I might increase my Amitriptyline to see if this helps. I'm going to 'phone my specialist to see what he advises but I've heard he has holidays due in August.

Have any ADR patients had experience of this? When I took Pregabalin at a higher dose after my fusion the side effect of blocked sinuses was hell

but I came off it after 6 weeks & the pain had gone & problem solved.

Any advise welcome.

Ruth

**Fuzzy** · 08-04-2009, 01:24 PM

Welcome to the forum. You are in the right place!

It takes time to heal. 3 Month is not long at all. Give yourself time and take it easy on the gym. If it hurts then stop. Exercise is important but not overdoing it is also. listen to your body. Healing can go on for a long time. I have noticed improvments in my back over a year after the surgery. I also have Activ-L.

**Justin** · 08-04-2009, 02:50 PM

Hi Ruth,

Welcome to the SPS Forum!

I'm sorry to hear that you are struggling with nerve pain post-surgery.

Many patients, including myself, experience significant nerve pain post-op. This is commonly called "distraction pain." Unfortunately, nerves are very sensitive to any manipulation and stretching, as is seen during artificial disc replacement surgery.

After my 2-level artificial disc replacement surgery, I did not "turn the corner" with distraction pain until 3-3.5 months post-op. Please remember that Spine Patients heal differently based on preoperative trauma, duration of injury, surgical technique / approach, comorbidities, immediate post-operative course, patient age, etc.

Ruth, the good news is that this is "normal" and will pass in good time. Make sure to take things slow and not overdo it at the gym--even though you are feeling better, it takes the human body quite a bit of time to truly heal, especially from such an invasive surgery that utilizes an anterior approach. I was still making improvements up to two years post-op.

Just an FYI, I had to discontinue using pregabalin (Lyrica) in the past due to increased sensitivity to pain.

My advice would be to take things slow and remember that you are still very early post-op--you only get one shot at healing after such a life-changing operation. There's no need to rush things (I'm not implying that you are, just a general statement).

I wish you the very best and please let me know if you need anything.

**Justin** · 08-04-2009, 03:16 PM

Ruth,

I'm not sure if you've seen this yet, but here's a link to --> "Distraction Pain" Explained.

**Dave** · 08-04-2009, 07:07 PM

Ruth,

Just want to say welcome

to this wonderful forum. I had 2-level cervical ADR and had post-op nerve pain for at least 3 months. Hang in there and take things slow and easy. Give yourself time to heal from this major surgery.

**dalhousie** · 08-05-2009, 02:34 PM

Hi Fuzzy, Justin & Dave,

Thanks for the replies. They've reassurred me. I had read on a pain site about neuropathic pain that someone had been left with after spinal surgery & doubts creep into your mind

. I've had it for 3 months now so I'll try to be more patient. I just wish I could tolerate a higher dose of Pregabalin as that gives me good relief. I suppose it may take longer to settle as I'm on such a low dose of it (75 mg).

The specialist who did my surgery is a very experienced & respected ADR surgeon & he said it's more difficult to insert ADR on early DDD (like me) than more advanced DDD. He said with early DDD there isn't as much loss of disc height & the spine hasn't been compressed in that area (as with advanced DDD) so it can be more difficult to get the ADR to settle & fix in place.

Congratulations on your site Justin!

**Justin** · 08-05-2009, 04:27 PM

Originally Posted by Ruth

Congratulations on your site Justin!

Ruth, thank you!

Please keep us posted on your progress, as we do care. We are here to support you every step of the way.

**dalhousie** · 08-10-2009, 01:42 PM

I just thought I'd ask about this to see if anybody could shed any light on it. I've read on a site somewhere (not sure how reputable it was) & I've heard somebody mention it on another forum site that anti-inflammatories can help with nerve pain?

Post op I've been taking them twice a day anyway but I'm not sure if they're giving me any relief on the nerve pain side of things

. I was thinking of maybe dropping one off as I have IBS & they tend to aggravate it & make me bloated which isn't great for maintaining good posture.

Any ideas?

**ajj1001** · 08-10-2009, 05:06 PM

Originally Posted by Ruth

This is my first post here!

Missed it, presume I was recovering from my birthday. Belated extra special

to my best spine buddy. x

**KBear** · 08-10-2009, 08:44 PM

Fuzzy- I have known you all this time and never realized you had the Activ-L. I'm pretty sure you had surgery in Germany, right? Weird how it was invented here, is still in clinical trials here; but has been readily available in Germany for years. That is why I decided to do the clinical trial, since so many in Germany already have it, and are getting it outside of a trial, figured it was proven and safe.

Ruth- I question if my pain is a combination of nerve and muscle pain, from the surgery itself, messing with everything, moving things, stretching things. I am freaking out, because I am almost positive, that I read a study somewhere that showed that people who were not pain free at 3 months post-op, would not heal. In the study, it stated only one person who had pain at 3 months, did not have pain at a year, and that person had injections. Not sure if I just dreamed this up; but I vividly remember reading it. But then again, there are many on here who were not pain free for a year or two and now are pain free. It's easy to get freaked out when you are waiting for healing. The most scary, frightening thing I can think of, is not death, but of being in pain for the rest of my life.... that keeps me up at night.

Not sure about anti-inflammatories for nerve pain; but they do help with muscle pain and inflammation and aggravation from surgery. I tried to get off the narcotics and went on a high dose anti inflammatory; but was in too much pain and had to go back to the narcotics. Be careful taking that and taking narcotics, as it may be too much for your liver and kidneys to handle. Make sure to consult your doctor about anything you take, so they can advise you.