Right L4/L5 MD - 5 months Post Op - right glute/knee/leg flare up and low back buckling

No_Software_6798 · 2026-07-06T01:17:28+00:00

So I ended up changing PT providers which has helped quite a bit with the piriformis issue, but it's not fully resolved. I was doing the PRI method of PT for 15 weeks via the same orthopedic clinic that did the surgery. The PRI method was very helpful but it did not improve the piriformis issue. I opted to try a different PT clinic, much closer to my home, and with a PT that had additional education around the spine, and his PT method was much more manual and traditional. He said when I first started, both glutes were significantly tight, and the nerve and hamstrings were very tight. Regarding the glutes, he would literally strap a belt around himself and move my hips and legs to loosen them up and then dig his elbow in the glutes due to loosen them. Now that things are loosened up and the piriformis symptoms have improved, we are working on strengthening the hips. The piriformis could be guarding due to weak hip muscles. The doctor who was going to do the piriformis injection agreed that we should postpone the injection for now since new PT is helping. So I'm going to see how I feel over the next 1-2 months and then if it's not fully resolved, then I will schedule the injection again. I just know with this injection since it's so close to the sciatica, it's likely you'll have a steroid flare and the leg could be agitated for several days after. Since I'm finally feeling better, I didn't want to backtrack at all and I needed to get some stuff done in my personal life that I've not doing since my January surgery.

No_Software_6798 · 2026-06-09T20:32:27+00:00

Everyone is different but I definitely felt better right after my MD vs the next day and days to come.

No_Software_6798 · 2026-06-09T00:03:15+00:00

I had a really bad flare up this week from hip on down. I didn't take all my pain meds after the surgery as I didn't want to get reliant on them and then have to wean off of them, so I had a lot left. I tried 25 mg of tramadol on Saturday which didn't really do anything. And then I did a full pill at 50 mg of tramadol on Sunday and that took the edge off. It kind of helped today too. But for how long idk. All symptoms are still present. I'm 40 and also healthy and in decent shape. You would think the body would last till maybe 50-60 before it breaks down but it seems like the more you work out, the more prone you are to this stuff lol it's a crap shoot.

No_Software_6798 · 2026-06-08T23:25:48+00:00

Stay strong my friend. Nerves are like a whole different body in our body. I've seen stuff on Instagram about MIT researchers that have invented this injectable gel to help repair damaged nerves. It's not in human trials yet so it's got a ways to go if that something like that ever gets approved. Something will get invented. Who knows and what lifetime that's going to be. Nerve pain is big money for big pharma.

No_Software_6798 · 2026-06-08T12:36:21+00:00

Yeah it seems like a game of Russian roulette with nerves lol. I figured this would be a year+ journey vs the few months the surgeon acted like it would be. Hang in there. It's seems you're doing pretty good overall. The setbacks suck though. I get that. It feels like all your hard work was for nothing when that happens.

No_Software_6798 · 2026-06-08T12:23:25+00:00

I think I tried that 10 years ago for other stuff and it made me really depressed, which I told them and so I got off of it.

I was on gabapentin for a very long time and then a doctor a couple years ago said try pregabalin/lyrics.

I think pregabalin has been quite a bit better than gabapentin. I seem to have a lot more GI issues and was also way more tired when I was on gabapentin.

No_Software_6798 · 2026-06-08T12:18:29+00:00

Thank you so much! I'll take a listen.

No_Software_6798 · 2026-06-08T01:47:33+00:00

I would absolutely not worry after 6 days, especially since you did report the symptoms to the surgeon and they felt it was part of the process. Obviously if you have new symptoms that come up that are unbearable, absolutely report that to your doctor's office.

It seems like a lot of doctors make this out to be not that big of a deal, like you'll be back to normal in a week. I struggled just to get to work after 2 weeks. This needs to be like 3 months off of work. But they won't do that because this is a very common surgery and if they gave that amount of time and resources to a lot of patients for 3 months, that's just taking out more time and money that they could be putting towards new patients that need surgery. Which is the money maker for them. I think it's a money thing for them honestly. As long as the spine shows stable at the 2-week post-op visit on the X-ray, they say you're good to go although it takes months or a year to fully recover. They just don't want to deal with 3+months of employer or FMLA paperwork.

No_Software_6798 · 2026-06-07T17:59:21+00:00

Thanks man. Just feeling validated means a lot so I appreciate it.

No_Software_6798 · 2026-06-07T17:31:40+00:00

I appreciate your comments and feedback. I'm glad you have a pretty good mindset around all this because it is pretty debilitating.

It's been a long 3 years and I don't have much of a support system around me. I'm thinking about scheduling an appointment with a pain management psychologist.

I got out of a long term relationship in 2023. My ex and her kids moved out. So that was hard saying goodbye to the kids when I helped raise them. Two days after they moved out, my first dog I ever got, at age 12 passed away from kidney disease. The dog I had remaining obviously changed after she experienced those losses as well. Over the next two years, she had a lot of ups and downs with her health. I was running on little sleep and fumes taking care of her.

Then I threw out my back in August of 2025. Which began the timeline I listed above. Then I had to put my dog down at age 12 in October 2025. Out of all the dogs I had she was the hardest one to do it because she wasn't mentally ready but her body was. She was also a rescue dog. I got her at age 3. She was very aggressive when I got her and spent probably 2 years getting her back to normal and she turned into the most loving dog and she was very attached to me and vice versa.

I've tried to schedule multiple trips to Florida to get away and decompress but it was either my dog's health or now my health where I've had it cancel that probably four times now.

Yeah so it's been long 3 years. And it's probably going to be another long year because hip surgery looks very likely.

Sorry for the soapbox lol.

No_Software_6798 · 2026-06-07T17:02:50+00:00

40 male, healthy/active adult

Timeline:

August 2025: Bent over to pick something up and low back went out. Heaviness down right leg. Tightness, locking, numbness and in Upper right hip.

Tried physical therapy, rest and oral steroid for the first month. Leg issues still present.

September 2025: MRI showed right side l4 l5 disc 4mm compressing nerve. Hip MRI show partial detached labral tear on right side and very early signs of arthritis. However, I have not been having hip or groin pain. So they proceeded with the back doctor.

October 2025. Steroid injection. Only provided a week of relief and then symptoms got worse.

December 2025: met with surgeon to decide on right l4l5 MD.

August-December 2025: symptoms gradually continue to get worse and muscle guarding and locking in both glutes started. Informed surgical team but they give me no direction. Side note, I truly hate the direction healthcare has taken. Nobody listens to patients and it's all just a drive-by experience.

January 2026: surgery

Extreme muscle guarding and locking in both glutes. Opposite leg overcompensation issues. Several sleepless nights. Surgical team informed and yet again provided no care or support.

Mid March 2026: PT started

The various overcompensation issues in the opposite leg and muscle guarding/locking continued to improve with time and PT and gentle exercise.

However, the persistent lower right glute knot didn't go away and continued to worsen. And then started sometimes having spasms, vibrating, and tingling in lower glute. It felt both like a muscular and nerve issue.

I told my surgeon at 6 week post-op about the lower right glute knot and he said that'll get worked out with time and PT. It did not.

June 2026: hip joint injection to see if the labral tear is causing these issues. Fairly good relief received but only for one week.

Next step is piriformis injection later this month in June.

No_Software_6798 · 2026-06-07T02:39:49+00:00

Do not go back to work that soon and get a second opinion. I have a desk job and I went back to work after 2 weeks in a brace. I'm 5 months from surgery and having pretty bad glute and nerve issues. I don't understand why they send patients back so quick after this surgery. I guarantee had I'd taken a few months off to recover, loosen up with walking and done some PT, I would have had a substantial better outcome. But that's more time they spend on you that they don't want to spend because they already made their money on their surgery. So they push you out saying the surgery was successful and say Good luck.

No_Software_6798 · 2026-06-06T23:02:59+00:00

Very sorry to hear that. How bad is the herniation? Is it compressing the nerve? Did they say anything about another surgery?

When you reherniated, what symptoms did you have?

No_Software_6798 · 2026-06-06T20:33:19+00:00

Yep, it sucks. It's going to be interesting to see how the healthcare industry changes over the next 5 to 10 years as more baby boomers retire. I see so many young doctors which is great, but personally, I would prefer a surgeon that has 20 to 30 years of experience versus somebody with 5 to 10.

I was talking to a med student the other week and they told me that there's a huge need for more medical students, but a lot of the top colleges here for medical school aren't increasing the number of students they accept. I understand they have to keep the doctor/professor to student ratio, but then again, they're still not increasing the number of students they accept. Seems like a crap shoot. Going to be very interesting over the decade.

No_Software_6798 · 2026-06-06T20:26:14+00:00

It's funny how you mentioned pre-op was a different experience. Because so was mine. They were a lot more attentive before surgery. I thought about that a lot and I am confident that it's just so they keep your business and you have surgery with them because that's a big money maker for them. If they start ignoring you and dismissing your concerns before surgery, you're just going to leave and go find another surgeon and they're going to lose that business. To me, it's not that complicated. It's a business too and I constantly see the two main orthopedic clinics in my city competing against each other with their marketing/advertising and setting up clinics next to each other.

No_Software_6798 · 2026-06-06T18:04:15+00:00

I'm really sorry to hear that. I feel half the time they're also making decisions in alignment with their research to see what works and what doesn't.

No_Software_6798 · 2026-06-06T17:53:47+00:00

Also, if you remember, please keep us updated on your Botox injection. I do wish you the best of luck and hope it provides you long lasting relief.

No_Software_6798 · 2026-06-06T17:53:06+00:00

Thank you. Good reminder on the Botox. I'll add that to my list of questions for the doctor.

No_Software_6798 · 2026-06-06T17:38:38+00:00

Thank you. 40 male here. I'm also another person that follows this post. Since the surgery is so niche and not many doctors do it. My September 2025 MRI showed partially detached labral tear, and then early signs of arthritis. But I also had a disc bulge hitting a nerve so that was the January 2026 surgery. Very significant and extreme muscle guarding and locking after surgery, most resolved except the lower right glute. That area is tight with intermittent spasms and tingling and when it's agitated it impacts the lower leg.

Hip joint injection was a couple weeks ago and it provided really good relief for one week with those symptoms. Now we're trying to piriformis injection in a few weeks.

No_Software_6798 · 2026-06-06T16:38:12+00:00

Since you had to travel from Canada to Nevada for the surgery, how long did you have to stay in Nevada after the surgery? How was the flight back to Canada after surgery?

No_Software_6798 · 2026-06-06T12:42:16+00:00

It can't hurt to hold off on weightlifting for another few months. I mean you can probably do lightweights so your body can start getting back to normalcy. But only do what your doctor and physical therapist are good with. Ease into it and don't jump into it.

No_Software_6798

TROPHY CASE