Longer-term recovery after spinal fusion- feeling a bit down

Sorry to bring my spinal fusion up again, but I got some great advice here regarding recovery shortly after I had the surgery, and I now have a question about the longer-term.
It’s a year since the fusion (L3/4, including bone graft) healed and I was allowed back on my MTB. Since then I’ve been regularly riding my road bike and MTB, also done a few time trials, and an Alps MTB trip. The surgery stopped the nerves from being pinched, and also massively helped the pain I always had for the first few hours after getting out of bed. I knew that it wouldn’t free me from all pain, however, I found myself in considerable pain again last autumn and the surgeon suggested that I was over-doing things and needed to take it easy. He said that since I’d had the back injury for 30 years, I shouldn’t expect to recover so quickly.
I find it hard to take it easy, though, and recently did a 60 km MTB marathon, which I completed while gritting my teeth through the pain, and also did a 100-mile road ride last week.
Then I tripped headlong onto a tiled floor on Friday and jarred my back 🙁

I suppose I’m wondering what other people have experienced after spinal fusion, and also whether taking it easy now will help in the long run – but I’m worried that it will be the first step to giving up. At 47 years of age, I was hoping to get another decade of riding out of my back. It’s getting me down a bit, to be honest.

Admirable manning up from this man! I’ve no experience of your condition but alas I do know as we get older injuries take longer to heal and everything gets a bit creaky. You’re doing well above average for your age. Sometimes we have to accept our limitations or do as you are now and use the pain to power you through and just accept you’ll ache like mad when it’s over 🙂

Suggsey…. You mean, ‘Manning up by this Lady!’

No my bad punctuation/phraseology 😆
I was passing on my admiration of her manning up, more than most men could 😆

Hi Vickypea, I’ve not had spinal fusion, but had a double microdiscectomy in mid 2014. The nerve issues have resolved somewhat, but I’ve now got bad facet joint arthritis due to the loss of disc height. Due to the degenerative nature of this, I’ll be having a fusion in the next few years. I’m just waiting for my income protection insurance to kick in before going back to the surgeon and getting the ball rolling.

Anyway, enough about me, it’s you asking the questions here…

Fusion, as I’m sure you know, solves the issues at the disc level that was fused, but transfers some of the stresses onto the adjacent levels. So by overdoing things as you may well be you’re speeding the degeneration of those adjacent levels. It may be these newly degenerative levels that were tweaked by your slip and the mtb marathons etc.

Even though it sounds like you like to push things to the limit (so did I, hence the problems I now have!), it may be a good way to think of it that by not pushing as hard now, you’ll be able to enjoy those same activities for longer, albeit at a lower intensity. Rather be able to get out and do something, than not be able to get out at all.

My topic has slipped away due to lack of interest 🙁
I’d still be grateful to hear other experiences or advice.

Obelix- good luck with your fusion when you have it. I had an MRI recently and the surgeon said that my discs above and below were fine. Think I’m just expecting a bit too much of my back at the moment, though it felt mostly ok on today’s ride.

How about taping the area during rides ? No direct experience, but I can imagine it might work.

Would your bike setup post op need to be different to your prior setup? Maybe its time to re-visit it all, something out of balance before that you adjusted your bike(s) to over time is now corrected or a mal-adjustment that your body adapted to at the time is now a lot more critical?

I had a surgical fusion t8-t12 about 5 years ago with metal work and a spinal cage after a snowboarding incident!

I have to say that I still feel pain most days, some better than others, and if i spend a day on my feet like I did yesterday then it does hurt a lot.

However for riding I find that it does help, in moderation though, long long days can have teh same effect in terms of pain but if i dont ride I seem to suffer as well so like all things it seems to be about balance.

Mine is a bit higher than yours though so I have less issues, i suppose, with load and more with reach, so I ride a shorter bike (not easy these days!).

Oh and ibuprofen is your friend as is a good mattress.

I take mine as it comes as mine was an accident so could have been so much worse.

Not sure this will help but hopefully I at least can relate to the weird sensation of having a bit of your back that no longer moves…

oh and i stook it steady when i got back on my bike, road road only, and that helped(except the bit where i crashed on a slimy road and knocked myself out!).

Think bike fit is important as if I am over stretched it adds to the issue…

Thanks for the suggestions. I’m planning to get a bike fit this month if possible and we’ve just bought a much better mattress which is also helping.

Vickypea.

I had had “flexible” fusion last March. Discectomy on L3/4, L4/5, L5/S1, with packing and elastomer band “fusion” stabilisation. It has taken a lot longer than I thought to get back riding. It’s still in the build up stages. You are doing far more than I am, by a long way.

A bike fit would be a good start for road bike, but be aware, and make doubly sure that the fitter knows exactly what you have had done to your spine. I have spoken to a couple who didn’t understand and thought I was just being lazy when I couldn’t get in to the “correct aero position”. Well sorry mate, my spine doesn’t bend there any more!

As for long days and marathons, it’s probably early days to expect to get through that. If you’re gritting your teeth and riding through pain, then it’s your bodies way of saying “Oi, pack this in”. There’s no reason why you shouldn’t be able to do them in the future, but little steps first.

My surgeon was very blunt about my future. “I can help you live a better life than you were, but I can’t give you a new spine.” I am still taking Amiltriptyline at 25mg to help with the residual nerve pain. My sciatic nerve had been trapped for 18 years, so he wasn’t surprised that was still recovering. It may take a few years, it may never fully recover.

What has helped me massively is yoga and strengthening my deep core muscles.

Hi bigblackshed. I know what you mean about the nerve pain. My femoral nerves on both sides were pinched for years and when they were released by the surgery, the pain down the sides of my thighs was unbelievable – tramadol didn’t touch it, but thankfully it passed after about a week.
I was going to do our club’s 50-mile time trial this weekend but decided not to enter, as I was in a lot of pain when I rode it last year – from even vaguely assuming an aero position for that long! I’m going to stick to 10-mile TTs as I can manage them without wrecking myself!
I’ve been doing Pilates for my core strength. It definitely helps.

I feel a bit more optimistic from your post that my body could still be recovering too. A mate in our cycling club same age as me had a spinal fusion about 3 years ago and he seemed to make a very fast and complete recovery which kind of set the wrong expectations for me.

I have no experience of fusion – I turned it down as an option in my mid-teens, when it was proposed to resolve chronic sciatica.

I do have experience with cycling with back pain though. My guidance would be to build up slowly – in fact very slowly. I would also try other activities to carefully increase core strength e.g. Swimming. Conservatively selected and cautiously undertaken gym work also helped me at the time.

I think the best advice I received from my Physio was to listen to my body. When exercising you should be feeling the work, but you shouldn’t be feeling the pain. You should feel tired afterwards, but not wrecked. If you feel tired, rest. Eat properly but healthy.

I wasn’t in good shape before my op, so it’s not just getting back to where I was pre-op. Still lots of work to do.

You ‘sound’ frustrated with your back so continually push(?). Take it easier. Stop pushing and listen to your body more. On a more minor level-I ruined my shoulder last June. I still haven’t done one press-up on it as it’s been gradually getting better with time. The excessive events may end up biting you long-term leading to even zero biking.

hora, you have hit on the problem. I am frustrated with my back. The thing is, I’ve lived with significant lower back pain for 30 years, from the age of 17 when I first injured it. Through that time I’ve kept myself fit and flexible, and was repeatedly told that was the best thing I could have done to maintain function. I finally have the surgery, and I’m told to take it easy for once, and it’s hard! I have been reasonably sensible and given up running though.