Dealing with Hysterectomy Pain!

Question From Sue:

I developed back problems from week 3 and these have now become sciatic. I am 8 weeks post op I have been seeing a physio for the last 3 weeks and am on diclofenac 50 mgx3. The amitrip will help the nerve pain but not do anything for the inflammation that you are likely to have.

Did you by any chance have a laproscopic op rather than an abdominal one? My problems have been caused by being in stirrups for three hours. I have nerve inflammation and lower back (can't remember where but have been told!) inflammation.

The pain is not unbearable but pretty constant. I have been given exercises and told to walk or swim every day (but not breaststroke). The physio has been really good. Any chance you can advise me?

Hi Sue,

Sorry to hear about your problem. I had a total hyst and ovaries removed in September. About 6 days after the op I developed severe pain in wound (felt worse than childbirth!) and was readmitted to hosp. Home now and had several flare ups, whilst each is bad they are get less in intensity. My doc diagnosed subcutaneous nerve entrapment- basically when my abdominal wound was opened up it damaged the nerves and this is what leads to my flare-ups of pain. Like you I was put on amitript. Because low doses of it help the pain- to reassure you after a few days of feeling drowsy my body adjusted and I wouldn’t know that I am taking it now (so will get better). My doc also gave me an injection of steroid into the nerve on my abdomen- I know this has worked because if I now get a flare up of the pain, it comes in that path below my wound. He told me sometimes the nerve is bruised and so gets better or other people need the injection again 3 months later- guess I will just have to wait and see! Can appreciate how hard it is I thought at 7 weeks I would be much more back to normal but know it will just take a bit longer.

Hope this helps. Take care,

Jan-X x

---------------------------------

Ok lets start at the beginning!

Hysterectomy is a surgical procedure implied on women in order to remove partially or totally removal of women reproductive system. This surgical operation can be done through vaginal hysterectomy, or a laparoscopic hysterectomy, or through abdominal hysterectomy. As this operation is done to remove a partial removal of organ as well as removal of the whole reproductive system of a particular patient, different kinds of hysterectomy removes different parts of the reproductive system.

Needless to mention that hysterectomy is recommended on a patient when some kinds of abnormal physical conditions are observed by the physicians related to reproductive organs like, fibroids, heavy bleeding at the time of menstruation, endometriosis, prolapses, ovarian cancer, or incase of post natal complications of the nursing mother are observed and that problem demands surgical intervention.

Hysterectomy itself is a major and difficult kind of surgery and it needs mastery over the situation that decides the best process or the best way by which the operation needs to be done. In case of abdominal hysterectomy, the requirement of extensive observation of the reproductive system is required or there is some anomaly in the uterus or in cases where the patient had never been a mother before.

Vaginal hysterectomy is done to remove the uterus from the vaginal opening and it is done in the situation when due to some reason removal of uterus becomes necessary for steady life of the patient. The operation is done through a incision in the upper part of vagina.

Like all laparoscopic surgeries, laparoscopic hysterectomy is done by making some incisions in the abdomen; a laparoscope is inserted in the side of the abdominal cavity to view the organs internally and accordingly decision is taken to make more incisions to accommodate the operation process.

The recovery period in post-hysterectomy differs from one process to another and it requires 2-5 days stay in hospital after the operation. Vaginal hysterectomy heals faster than abdominal hysterectomy; and in case of abdominal hysterectomy, it takes like eight weeks before going back to normal shape of life.

Side effects of hysterectomy includes irritation cased by nausea, pain in the abdomen, vaginal discharge or in some cases bleeding from vagina are observed.

Sciatica is characterised by pain in the lower back and gluteal region. This pain can radiate down one or both legs into the thigh, calf, ankle and foot. Genuine sciatica occurs when pain travels below the knee.
Sciatic pain results when the base of the spine is compressed or when injury or pressure has compressed the spinal roots of the sciatic nerve. The sciatic nerve systems are located in the lumbar and the sacral regions of the spine. Sciatic pain or sciatica can be described as sharp, dull, burning, tingly, numb, continuous or intermittent and usually only affects one side of the body. It can radiate the entire length of the nerve, in some cases all the way down to the toes.

How is it treated?

Those with lower back pain have historically been prescribed bed rest in order to offer relief for aching bones and joints. Research in recent years has suggested that bed rest alone will not offer relief for those suffering from nerve pain such as sciatica. Staying active may be more beneficial for those who suffer from back pain. Not to say that you should be running marathons! Activity means being up and mobile for periods of time that are not enough to cause further pain and aggravation to your back. Some physicians may prescribe specific exercises, or some may simply suggest walking.

A recent Dutch study followed 183 patients with sciatica. Half of these were counselled to follow a regimen of bed rest with breaks only for bathing and using the toilet. The other half were instructed to remain active as usual. The patient’s symptoms were evaluated after two weeks and again after twelve weeks. Whether they had rested or not, the patients symptoms in the two groups were consistent. Two thirds reported improvement and both groups recorded similar numbers of days off work and subsequent surgeries.

Pain relief
Pain is best treated with a non-steroidal anti-inflammatory such as ibuprofen or codeine (in acute cases).
In some cases cortisone like drug may be injected into the epidural space surrounding the spinal column. This procedure is similar to the epidural used during childbirth. A course of this type of treatment may offer temporary relief, but does not address the root of the problem.

Sciatica Relief Exercises

You may do all of these exercises after 3-4 weeks.

• Piriformis stretch: Lying on your back with both knees bent, rest the ankle of
your injured leg over the knee of your uninjured leg. Grasp the thigh of your uninjured leg and pull that knee toward your chest.
You will feel a stretch along the buttocks and possibly along the outside of your hip on the injured
side.

Hold this for 15 to 30 seconds. Repeat 3 times.

• Standing hamstring stretch: Place the heel of your leg on a stool about 15
inches high. Keep your knee straight. Lean forward, bending at the hips until you
feel a mild stretch in the back of your thigh.

• Make sure you do not roll your shoulders and bend at the waist when doing this
or you will stretch your lower back instead. Hold the stretch for 15 to 30 seconds.
Repeat 3 times.

• Hip abduction (with elastic tubing): Stand sideways near a doorway with your
uninjured side closest to the door. Tie elastic tubing around the ankle on your
injured side. Knot the other end of the tubing and close the knot in the door.
Extend your leg out to the side, keeping your knee straight. Return to the starting
position. Do 3 sets of 10.

To challenge yourself, move farther away from the door.

• Partial curl: Lie on your back with your knees bent and your feet flat on the floor.
Tighten your stomach muscles and flatten your back against the floor. Tuck your
chin to your chest. With your hands stretched out in front of you, curl your upper
body forward until your shoulders clear the floor.
Hold this position for 3 seconds.
Don't hold your breath. It helps to breathe out as you lift your shoulders up.
Relax. Repeat 10 times. Build to 3 sets of 10. To challenge yourself, clasp your
hands behind your head and keep your elbows out to the side.

• Prone hip extension (bent leg): Lie on your stomach with a pillow underneath
your hips. Bend your injured knee, tighten up your buttocks muscles , and lift
your leg off the floor about 6 inches. Keep your knee straight. Hold for 5 seconds.
Then lower your leg and relax. Do 3 sets of 10.

Repeat this exercise for the other leg.
• Quadriped Arm/Leg Raises: Get down on your hands and knees. Tighten your
abdominal muscles to stiffen your spine. While keeping your abdominals tight,
raise one arm and the opposite leg away from you. Hold this position for 5
seconds. Lower your arm and leg slowly and alternate sides. Do this 10 times on
each side.

As you recover increase your activity gradually every day, when you feel capable and aren't in pain. Completely normal activities can be resumed within 4 to 6 weeks or sooner if the procedure was performed vaginally. Drive when you feel capable about 2 weeks after surgery. You can travel further out of town about 3 weeks after surgery, including air travel. Avoid lifting heavy objects (over 10 pounds) for at least 4 weeks. Do not douche or put anything into the vagina for 4 weeks.

You may have intercourse 4 weeks after surgery, or as directed by your health care provider. Light swimming is permitted 2 weeks after surgery in a swimming pool, but avoid vigorous swimming until 4 weeks after surgery. Resume your exercise routine in 4 to 6 weeks, depending on how you feel. Your doctor can tell you when it's best to go back to work. You can usually go back to work in 3 to 6 weeks, depending on the procedure.