# How Kenji, a Seattle warehouse operations manager, cured his sciatica seven years after a failed discectomy.

_Seven years. An L4-L5 microdiscectomy in August 2019 the surgeon called successful. Three epidural steroid injections. Four years of gabapentin. Nerve blocks, trigger point injections, a second opinion, a pain clinic. About $6,800 out of pocket on top of everything workers comp paid for. And a right leg he was hiding from his team of 140 associates for six peak seasons in a row._

**From injury to pain-free:** 7 years → 10 months

_No. 21 · 14 min read · Story edited by Tauri Urbanik_

_Kenji · age 42 · Sciatica · Seattle, Washington · Warehouse operations manager_

_Composite story, drawn from documented chronic sciatica recovery cases._

## In short

Kenji is a 42-year-old Japanese-American warehouse operations manager in Seattle. He injured his back at work in 2018, had a microdiscectomy in 2019, and still had leg pain for five more years. Then he found a different framework. Ten months later, pain-free. A 2013 NEJM study showed MRI findings don't predict recovery after sciatica surgery.

*Source: [el Barzouhi et al., 2013, NEJM](https://pubmed.ncbi.nlm.nih.gov/23484826/)*

## Before

### Seven years of a right leg that would not trust him, a surgery his surgeon called successful, and six peak seasons he refused to miss.

Kenji was 35. October 2018. Peak season was starting at the fulfillment center in Kent, the facility he'd walked into as a part-time college kid 14 years earlier and never left. His team was outbound shipping. 75,000 units a night. Three weeks into peak, at 2 a.m. on a Tuesday, he was covering the pallet-break-down station for an injured associate. A customer-return pallet had been loaded wrong. He lifted a dense box off the top layer with his back rounded and his legs wrong. Something gave. He finished the shift.

He woke up the next day at noon with pain down the entire back of his right leg. Sharp, electric, hip to calf. Could not put weight on his right foot. Called out. Saw his primary care doctor on day three. The doctor said probably a disc issue, ibuprofen, rest, come back in a week if it's not better. Day ten he couldn't sit for more than 15 minutes. Drove to work on a pillow and walked the floor with a limp he tried to hide. Reported the injury to HR on day 12. Workers comp initially denied the claim because he hadn't reported it same-shift. He appealed. Six weeks in the worst pain of his life. Eventually approved.

The November 2018 MRI called it an L4-L5 disc herniation, right paracentral, moderate, with nerve root displacement. The radiologist wrote that the findings likely explained his symptoms. Kenji still has that line circled on a printout. Eighteen weeks of physical therapy improved things 30 percent and then plateaued. His PT was kind and competent. The plateau was not his PT's fault. Two epidural steroid injections at a Kent pain clinic. The first gave him three days of dramatic relief. The second, about ten percent. Gone by week four. In June 2019 the orthopedic surgeon told him he'd failed conservative care. Microdiscectomy at L4-L5. 85 to 90 percent success rate. Back on the floor in four to six weeks.

August 2019. Ninety-minute outpatient procedure at a hospital in Renton. Woke up with no leg pain for the first time in ten months. He cried in the car on the ride home. That was the first time. At week 12 he told his GM he was back to full duty. Believed it. Six weeks after that, walking the floor on a Saturday evening shift, he felt the same electric jolt down his right leg. Subtle at first. By Monday morning it was a 5 out of 10 baseline again. The January 2020 MRI was clean. Post-surgical changes at L4-L5, minor residual disc material, scar tissue, no recurrent herniation. The surgeon said technically the surgery was successful. Kenji did not know what to do with that sentence. He still doesn't fully.

Gabapentin at 300 mg three times a day starting April 2020. Moved to 600 TID by fall. Minimal additional benefit. Fourteen pounds of weight gain in six months. Dry mouth, morning grogginess, a slight dulling at work he noticed and did not like. Epidural number three in February 2020 gave him 48 hours. Nothing beyond that. The pandemic came. His facility was essential. He worked through 18 months of peak-level demand without missing a shift. Leg pain escalated to a 6 or 7 baseline during that stretch. A chiropractor his cousin recommended, 10 visits at $65 cash. Acupuncture his mother found, 12 sessions at $85 each, half-hearted attendance. A second spine opinion at Virginia Mason in 2021 that offered him a spinal cord stimulator trial he declined. Selective nerve root blocks at L4 and L5 in the summer and December of 2021. Trigger point injections into the right piriformis in 2022. Gabapentin escalated to 900 TID and tapered back when he noticed he was slower on the floor than he could tolerate. Duloxetine 60 mg added in January 2022. A late-2023 surgeon told him bluntly that another operation would not help him and asked if he had looked into chronic pain rehab. He had not. He re-intaked at the Swedish Pain Rehabilitation Program in early 2024 and declined after intake because the program was 4 weeks full-time and he could not take the time off. That bothered him for months.

He became a manager who walked the floor slowly. His associates noticed. Nobody said anything. A 2022 performance review from his GM noted gently that his presence on the floor had been less consistent. Kenji knew exactly what that meant. About $6,800 out of pocket over seven years on top of what workers comp covered. Over 200 intermittent days of missed work. Six peak seasons worked in chronic pain, in a department that ran from 140 associates in baseline months to closer to 250 in Q4. He did not tell his GM what a full day actually felt like. Other people on his team had it worse. That is the mindset you develop. Whether it is true or not.

A Saturday morning in February 2024. Sayaka was making breakfast at their kitchen table in Rainier Beach. Ren and Yuki were still asleep. Sayaka put down the spatula, came and sat across from him, and said in English, the way she does for hard conversations: 'Kenji. I have something to say. Will you listen without defending?' He said yes. She said: 'When was the last time you laughed at one of Ren's jokes?' He said recently. She said: 'It's been a year. You don't watch Yuki's cross-country races from the finish line anymore, you sit in the car. You don't come to obon, you send your mother a card. Your leg took the rest of you. I have been married to a limp for a year. I'm not complaining. I'm telling you.' He did not speak for a while. Sayaka did not fill the silence. She waited. She is good at waiting. He finally said: 'I didn't know you saw it.' She said: 'I see it. Your mother sees it. Ren sees it. Yuki sees it. We are all watching you disappear. You are very good at pretending nothing is happening. I am tired of pretending with you. What you are doing is not working. It has not worked for seven years. I am not willing to do another seven.' That conversation was the end of something. Kenji did not know what yet.

> "I ran a warehouse with 140 people reporting to me. I could not run my own right leg." — Kenji, Year 7

## The turning point

### A rest stop off I-5 in Federal Way.

The Monday after Sayaka's Saturday conversation, Kenji drove to work on his usual commute. He usually listened to operations podcasts or history. That morning he googled, one-handed at a stoplight, 'podcast about chronic pain.' Tapped on The Way Out. The first episode queued was an interview with Alan Gordon. He listened to 14 episodes that week. On Friday one of them was about sciatica.

The Friday guest was a physical therapist who had recovered from her own post-surgical sciatica. She mentioned a study. El Barzouhi 2013, published in the New England Journal of Medicine, 283 sciatica patients followed for a year. The MRI findings could not distinguish who had recovered from who hadn't. Fifty-three percent of pain-free post-surgical patients still had residual disc abnormalities. Kenji pulled over at a rest stop off I-5 in Federal Way and read the abstract on his phone.

He sat in that parking lot for 20 minutes. He is not a crier. He did not cry. But something shifted that was close to crying, without the release. Three things landed at the same time. The MRI had never been the whole story. His post-surgical scan had been called clean and he had been interpreting that for four years as 'the surgery worked but something mysterious is still wrong with me.' El Barzouhi showed that clean post-surgical MRIs are common in people who still hurt, and residual findings are common in people who don't. The imaging had not been predicting his pain. It had never been predicting his pain.

The second thing. His pain had moved over the years. Started as right L4-L5 distribution. Spread into his right hip, his right glute, occasional right calf, a pressure in his lower back that was not there in 2018. Structural compression does not migrate. Central sensitization does. He had been reading the migration as 'things are getting worse.' It was diagnostic of something else.

The third thing. Boos 1995. A Spine study he read the abstract of in the rest stop. Seventy-six percent of asymptomatic heavy-labor workers had disc herniations on MRI. No pain. Boos had studied workers who did exactly the kind of lifting Kenji did. His 2018 finding was likely something most of his warehouse peers also had. The herniation was real. The story that the herniation caused the pain was not the whole picture.

He re-intaked at the Swedish Pain Rehab Program in March 2024. Told his GM he needed 4 weeks off. His GM, to Kenji's surprise, said: 'Take 6 weeks. Take 8. You've been grinding through this for 7 years. Go fix it.' Not dramatic. Not performatively understanding. Just what a good manager who has watched an employee limp through six peak seasons finally says. Kenji learned the central sensitization framework at Swedish. Learned the fear-avoidance cycle. Learned why his leg had been trustable during the one post-surgery month when he was briefly pain-free and rebuilding movement, and why it stopped being trustable when the pain came back and he started protecting again. Completed the 4 weeks. Returned to work. Pain was still there. He understood it differently.

A Tuesday afternoon in May 2024. Walking the floor near the outbound dock. The same area where the original injury had happened in 2018. Talking with an associate named Teresa about a pick-rate issue. He realized mid-sentence his right leg was at a 2 out of 10. He had not checked it in 40 minutes. He had been doing his job. Finished the conversation. Walked to the break room. Drank a cup of water. The leg stayed a 2. Later it dropped to a 1. Driving home on I-5 that evening it was a 0. Not absent. Just quiet. He did not trust it that night. But he noticed it.

### F.I.T. pattern match

- **F — Functional**: His post-surgical MRI in January 2020 was clean. No recurrent herniation. Minor residual disc material and scar tissue, both expected. His 2021 Virginia Mason follow-up MRI was similar. Nothing surgically correctable. El Barzouhi's 2013 NEJM study followed 283 sciatica patients for a year, and MRI findings could not distinguish who had recovered from who hadn't. Fifty-three percent of pain-free post-surgical patients had residual abnormalities. Boos 1995 (Spine) found 76 percent of asymptomatic heavy-labor workers had disc herniations they didn't know about. Whatever was left on Kenji's MRI was unlikely to be the sole reason his leg was still hurting five years after the surgery. _(Strong match)_
- **I — Inconsistent**: Pain moved. Started as right L4-L5 distribution. Over the years it expanded to include right hip, right glute, occasional right calf, a lower-back pressure that was not there in 2018. A compressed nerve does not migrate across territories. Pain was worse during peak season, October through December. Better in February. Worse on Mondays, better on Saturdays. Worse after a tense budget review with his GM, not correlated with whether he had been lifting. Pain did not know what day of the week it was. The nervous system did. _(Strong match)_
- **T — Triggered**: Flared during peak season. Flared during budget reviews. Flared after a tense call with his sister Aiko about their father's health scare that turned out fine. Flared on the weeks leading up to obon every August. Flared the week after Sayaka's Saturday morning conversation, actually peaked that week, then began dropping. Did not particularly flare from lifting or bending, which had been the entire theory for 7 years. The leg had been acting like a barometer for his emotional weather, not a reporter on his physical state. _(Strong match)_

*Where he started (2) at a rest stop off I-5 in Federal Way, and where he landed (7) by the end of his first week reading sciatica research as a patient instead of as a project to solve.*

## Recovery, honestly

### What the ten months actually looked like.

Not a straight line down. In month two his leg flared to a level he had not felt since 2020, three days after his GM handed him an expanded-scope promotion for peak. His first read was regression. It wasn't.

**Pain level · Months 0 – 10**

- **Month 0** (level 7/10): Enrolled at Swedish Pain Rehab. Took 6 weeks off for the first time in 14 years. Learned the central sensitization framework for the first time. Did graded exposure to walking, sitting, and lifting. Stopped thinking of his leg as a thing being monitored constantly.
- **Month 1** (level 5/10): Finished the Swedish program. Returned to work on a phased schedule. Started Curable on commute. Pain dropped about 2 points consistently. Started tapering gabapentin with his PCP's approval. Noticed he was sharper on the floor within the first week off the medication.
- **Month 2 · setback ⚠** (level 8/10): Peak-prep planning started in May. His GM handed him a new project: he would be accountable for inbound as well as outbound. Biggest scope increase of his career. Three days after the announcement, his leg flared to a level he had not felt since 2020. He called Sayaka from his office and said: 'I was wrong. This was a fluke. I'm going back to where I was.' Sayaka said: 'Kenji. Listen to yourself. You just got promoted and your leg flared. Do you hear it?' He heard it. Kept doing the Curable work. Told his PCP about the flare. PCP said: 'That's consistent with the pattern. Keep going.' Flare peaked for 4 days. Resolved within 10. Ended up lower than pre-flare baseline.
- **Month 4** (level 2/10): Working full time on the expanded scope. 250 associates. Walking 8 miles a day on the floor. Right leg a 1 or 2 most days. Went to Yuki's regional cross-country qualifier. Stood at the finish line for the first time in three years. Yelled when she crossed.
- **Month 7** (level 1/10): Week 4 of peak season. Biggest peak of his career with the biggest scope. Walked the floor every shift. Department hit its numbers. Right leg a 0 most days, occasional 1 under high stress. He did not catastrophize the 1s. He noticed them and kept going.
- **Month 10** (level 0/10): Took Sayaka and the kids to Japan for 10 days over winter break. Walked through train stations. Climbed the steps at Fushimi Inari in Kyoto. Sat on a tatami floor for dinner in Osaka for 90 minutes without shifting. On the Shinkansen from Kyoto back to Tokyo, Sayaka looked at him and said, in Japanese, okaeri nasai. Welcome home. He understood. He held her hand the rest of the ride.

> **About the M2 spike** — The most important point on this chart. The month two flare after the promotion announcement was not a regression. It was an **extinction burst**: a nervous system that's been running a protective program for seven years turns the volume up one last time when it sees change coming. Kenji did not call the pain clinic. Did not restart the protections. Did not cancel the new scope. The flare peaked in 4 days and the baseline that came out the other side was lower than anything he'd had since 2019.

## What he did differently

### The three things that changed everything.

### He stopped managing his leg as a variable.

For seven years every decision had run through the leg. Stairs or elevator? How long would this meeting last? Was this chair okay? Should he sit during the 1:1 or stand? Every call had a micro-calculation about leg position. He had mentally flagged every chair in the office as good or bad. He had a specific driving posture and a cushion that lived on his seat. He had a sleeping position that took 15 minutes of adjusting every night. The management felt like practicality. It was hypervigilance in the shape of practicality.

After Swedish, he stopped checking. Took the stairs if it was three flights or less. Sat in whatever chair was in the room. Drove without the cushion. Slept however his body fell. Let his leg be a leg.

Every calculation had been sending his nervous system the same signal: this leg is a problem that requires management. When he stopped managing, the signal changed. His brain agreed to take the leg off the daily ops plan because Kenji had. The leg stopped acting like a problem because the system stopped treating it like one.

### He stopped protecting his team by pretending.

Before, he walked the floor slowly but tried to hide the limp. Never missed a shift he could make. Never said 'my leg is bad today.' Covered for associates whose injuries had been less severe than his because admitting he was limited meant admitting something. Took on extra scope partly because it was his job and partly because it proved to himself he could still do it. His team sensed it and did not mention it. The sensing and not mentioning was its own weight on everyone.

After, he told his GM about the condition. Told his direct reports, briefly and without drama, that he was working on a long-standing health issue and had been doing better recently. The information landed without drama. His team opened up more because he had. One of his area managers told him she had chronic migraines she'd been hiding for two years. Another told him the honesty had been noticed.

Performing wellness on top of illness had been exhausting. Carrying a private limp while running a public department had been a full-time second job. Dropping the performance freed up energy that went into both recovery and better management.

### He stopped letting his leg decide who he was to his family.

Before, he had missed Yuki's cross-country meets. Sat in the car, came late, left early. Missed his father's 70th birthday toast at a restaurant in Bellevue because he could not sit through the meal. Sent his mother a card during obon instead of driving to the cemetery. Did not go to Ren's spring jazz band concert in 2023 because the auditorium chairs were bad. Sayaka, quietly, noticed all of it for a year before she said what she said at the kitchen table.

After, he went to every meet of Yuki's fall cross-country season. Stood at the finish line. Drove to Mount View Cemetery in Auburn for obon in August 2024, first visit in four years. His grandmother Obaachan Fumiko was interned at Minidoka as a child. She had built a family in a country that had put her there. She had not complained. Kenji stood at her grave for a long time. He did not say anything out loud. Went to Ren's spring 2025 jazz band concert. Sat through two hours of middle school music on a bad auditorium chair and did not once check his leg.

The leg had been making identity decisions that were not its to make. Reclaiming the right to be present reclaimed the identity.

## Where he is now

### Back on the floor.

Kenji has been essentially pain-free since autumn 2024. Not flare-free. Pain-free.

He runs the largest scope he has ever held at the warehouse. 250 associates. Walks 8 to 10 miles a day on the floor during peak. Jog-walks with Yuki on Sundays along the Rainier Beach trail. Drives without the cushion. Sits in meeting chairs without rating them. Took the winter 2024 trip to Japan, first international trip since the injury. Walked the Kyoto temples. Sat on tatami floors for long dinners.

He visits Obaachan at Mount View Cemetery every obon. This is quietly the most important marker for him. The grandmother who was interned at Minidoka as a child, who built a family through silent labor, who did not complain. He has been telling her, without speaking, at the grave: 'Obaachan, I made it through. Thank you for showing me how.'

Tapered off gabapentin over three months. Tapered off duloxetine over four. Does not take pain medication. Laughs at Ren's jokes again. Sometimes tells bad ones back. Ren pretends to be annoyed. His father Hiroshi, after Kenji told him what he had been working on, nodded once and said quietly, 'Good. Your mother has been worried.' That was more than Hiroshi usually says.

'I was the quiet one in my family,' Kenji says. 'My sister is the talker. I have been the stoic one since I was nine years old. I thought stoicism meant carrying things alone. I now think what my grandmother did was different. She carried what she had to carry. She did not take on extra. I had been taking on extra. That was not honoring her. That was a misreading. I am trying to read her better now.'

### Current state

- **Pain-free since:** Autumn 2024
- **Current medications:** None
- **Flare frequency:** ~1 / 8–10 wks
- **Average flare duration:** < 1 day
- **Specialists seen since:** 0
- **Floor miles per peak shift:** ~8–10

## For the reader

### Does Kenji's story sound familiar?

If your sciatica started with a real injury and hasn't resolved years after surgery, if your post-op MRI was called clean and you were told you had 'post-discectomy syndrome,' if you've been managing a private pain through peak seasons at work, there's a good chance your pain follows the same pattern Kenji's did.

[Take the 3-minute assessment](https://painapp.health/assessment)

*No email required. Just a quick pattern check against the F.I.T. criteria.*

## Frequently asked questions

### My MRI shows a disc herniation that matches my leg pain. How can this not be structural?

It may be structural at the beginning. Kenji's original 2018 MRI showed a moderate L4-L5 herniation and explained his acute symptoms at the time. The structural story is often real in the first weeks or months. What changes is what happens when acute becomes chronic. El Barzouhi's 2013 study in the New England Journal of Medicine followed 283 sciatica patients for a year. Post-treatment MRI findings could not distinguish patients with good outcomes from patients with bad outcomes. Fifty-three percent of pain-free post-surgical patients still had residual disc abnormalities. And Boos 1995 (Spine) found that 76 percent of asymptomatic heavy-labor workers have disc herniations on MRI they don't know about. The imaging is part of the story. It is not the whole story.

### I had surgery. My surgeon said it was successful. Why am I still in pain?

This is a common and devastating pattern. Post-discectomy syndrome affects 10 to 40 percent of patients. The surgery often does exactly what it is supposed to do mechanically. The persistent pain that follows is usually not coming from new structural damage. It is coming from a nervous system that learned during the acute pain period to maintain the pattern, and kept maintaining it after the structural cause was addressed. Kenji's post-surgical MRI was clean. His pain came back six weeks after he returned to full duty. That is not a failure of surgery. That is a nervous system continuing a program. Nervous system programs can be unlearned.

### I've done physical therapy for years. Why hasn't it worked?

PT is an excellent intervention for acute sciatica and for many post-surgical patients. Where it struggles is in chronic sciatica where central sensitization is driving ongoing pain. Typical PT protocols don't directly target the central sensitization pattern. That doesn't mean your PT was wrong. It means one piece of the problem was being addressed while a larger piece kept running in the background. Mannion 2007 (European Spine Journal) found that psychosocial variables outpredicted structural variables for post-surgical pain outcomes by about a three-to-one margin. What your nervous system was doing often mattered more than what your disc was doing.

### I was injured at work. Isn't the workers comp process supposed to get me back to full function?

Workers comp can pay for the acute medical care you need. Kenji would not have been able to afford his MRI, surgery, or 18 months of PT without it. But the system is designed for mechanical injuries and mechanical recovery. It is not designed for chronic nervous system conditions. If your pain has outlasted the acute injury, more authorized tests and procedures often won't help and can add to the signal that something is ongoing and serious. At some point the path forward is not another claim. It is a different framework entirely.

### How long does it take?

Kenji noticed shifts within weeks of re-engaging with structured rehab and a neuroplastic framework. He considers himself recovered at ten months. Your timeline may be different. Expect an extinction burst somewhere in month two or three, when the nervous system turns the volume up one last time. Kenji had his during an expanded-scope promotion announcement at work. For related spinal pain conditions, brain-based therapy produced 66 percent pain-free or nearly-pain-free outcomes in a JAMA Psychiatry trial (Ashar 2022). Timelines vary. The slope matters more than the speed.

## References

1. el Barzouhi, A., Vleggeert-Lankamp, C. L. A. M., van der Kallen, B. F. W., et al. (2013). Magnetic resonance imaging in follow-up assessment of sciatica. New England Journal of Medicine, 368(11), 999-1007. [link](https://pubmed.ncbi.nlm.nih.gov/23484826/)
2. Boos, N., Rieder, R., Schade, V., et al. (1995). 1995 Volvo Award in clinical sciences. The diagnostic accuracy of magnetic resonance imaging, work perception, and psychosocial factors in identifying symptomatic disc herniations. Spine, 20(24), 2613-2625. [link](https://pubmed.ncbi.nlm.nih.gov/8747239/)
3. Brinjikji, W., Luetmer, P. H., Comstock, B., et al. (2015). Systematic literature review of imaging features of spinal degeneration in asymptomatic populations. AJNR American Journal of Neuroradiology, 36(4), 811-816. [link](https://pubmed.ncbi.nlm.nih.gov/25430861/)
4. Hashmi, J. A., Baliki, M. N., Huang, L., et al. (2013). Shape shifting pain: chronification of back pain shifts brain representation from nociceptive to emotional circuits. Brain, 136(Pt 9), 2751-2768. [link](https://pubmed.ncbi.nlm.nih.gov/23983029/)

## About this story.

Kenji is a composite, drawn from documented chronic sciatica recovery cases including patients with failed microdiscectomy, research on post-surgical persistent pain in sciatica, and recovery narratives from the Pacific Northwest neuroplastic pain community. Details (first name, age, city, occupation, ethnicity, family details, and specific quotes) have been composed to form a single coherent narrative, not to report on one individual. Kenji represents the common presentation of post-surgical sciatica where structural intervention was followed by a period of relief and then recurrent pain without recurrent herniation. The clinical pattern, treatment history, and recovery arc match published outcomes from el Barzouhi 2013 (NEJM, MRI findings did not distinguish post-surgical outcome), Boos 1995 (76 percent of asymptomatic heavy-labor workers have disc herniations on MRI), and the broader literature on psychosocial predictors of post-surgical pain outcomes (Mannion 2007, European Spine Journal).

## A note on medical care.

Painapp does not provide medical advice, diagnosis, or treatment. Pain is real, and so are the conditions that cause it. If you're living with chronic sciatica, especially after a recent injury or surgery, please work with a qualified clinician who can evaluate your specific situation. The approaches described in this story work best alongside medical care, not instead of it. If you develop new weakness in the leg, new loss of bowel or bladder control, numbness in the saddle region, or acute worsening of symptoms, contact your physician or go to an emergency department. Those signs can indicate cauda equina syndrome, which is a surgical emergency and is not what this story is about.

## Editor

**[Tauri Urbanik](https://painapp.health/authors/tauri-urbanik)** edits PainApp's recovery stories. See the [author profile](https://painapp.health/authors/tauri-urbanik) for credentials and method.

Canonical URL: https://painapp.health/chronic-pain-recovery-stories/kenji-cured-sciatica