Question
Hi my father had allot of pain in his legs but from spinal stenosis but was controlled by pain pills. He went for surgery last week and after the surgery he felt ok but about 4 to 5 days after the surgery he suffers allot more from leg spasms and pain he cant lay on his back or sit then it pains allot. Can you please explain to me what it can be? the doctor says its normal after the operation and that it will get better.

Answer
Dear Sydney,

It doesn't matter what tissue was causing the spinal stenosis (bulging disk, bone, ligament, etc...) because the the surgical correction of the problem will be the same...the removal or cutting back of that tissue to allow for better room around the spinal cord.

After the surgery is complete, even though the tissue has been damaged, your father should have felt pain reduction due to the fact that the spinal cord was not being impinged upon any longer.  However, then the inflammation will set in to heal the area.  This is a normal healing response to tissue damage or trauma...and all surgery creates some trauma and damage.  

The inflammatory response starts the healing process but also promotes increased pain sensation so that a protective effect is achieved.  The pain he feels actually helps to keep him from doing anything that would further damage the healing tissue while proper scar formation is accomplished.  It is normal for surgical patients to have increased pain even for weeks after surgery, but then the pain levels should start to reduce.  

Spasms are also a normal response to injury, trauma or tissue damage.  Again this acts as a protective effect by keeping the injured tissues more at rest while the scar tissue forms.  The main concern I would have is if the pain persists after two weeks without getting any better.  Then you can be at risk for developing chronic pain patterns...however, at that time your father should be able to start some limited rehab protocols such as mild stretching and exercise which will help him to regain function, strengthen the scar formation, and further lessen pain transmission.  I would highly suggest that you speak with your father's doctors about physical therapy and healing.

Hope this helps Sydney.

Respectfully,
Dr. J. Shawn Leatherman
www.suncoasthealthcare.net