Questions Around Recurrence after Surgery


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Hello All,

I‘m currently 60 years old and had pilonidal abscess when I was 20. At that time, I had a drainage procedure followed by surgery 6 months later as planned. Since then, I’ve had relatively minor flare ups once every year or two where I get some discomfort while sitting along with some minor draining. In all cases to date, the flare up clears on its own within a week or two. I’ve found that the flare ups sometimes occur when I put on as little as 3-4 lbs of weight and sometimes for no reason I can observe.

4 months ago I sustained a herniated disc in my lower back while training for a mountain climb. I had severe sciatic pain down my leg where I couldn’t stand or sit for 3 straight months. After a couple of cortisone shots didn’t work, I had surgery for the disc 3 weeks ago. Though I’ve recovered quickly from that, (all leg pain gone and already working out again), I‘m going through another pilonidal flare up which I felt for the first time literally on my car ride over to surgery. I have to think that because I went 3 months without sitting, going back to sitting again has somehow irritated the area. Also because I stopped working out for 3 months, I’ve feel I’ve added weight in my upper body…..weight overall similar but have lost muscle in legs.…. which could be source of flare up as well

The pilonidal flare up I’m having now has been going on for three weeks (longer than in the past), feels a bit more significant than in the past (though I only feel it while sitting on a harder surface for a while, with no swelling at all) and have no draining which I think is probably a bad thing as there’s no release for fluid build up that I’ve had in the past.

Given that I’ve been sidelined for 3 months from my disc issue just getting back on my feet now, I really, REALLY don’t want to deal with another recovery period from any treatments for my pilonidal issue for at least a while. I’m ok kicking it down the road and dealing with it later.

So my questions with all that are:

1) assuming antibiotics work for me in temporarily getting rid of flare up, how much time should I expect of relief from antibiotics before issue comes back? What have others experience been with that?

2) if I had a just a drainage procedure, how long before I can sit in an office setting for a full day? Though I had this done 40 years ago, I can’t really remember recovery time for that in detail.

Thanks in advance for any advice and insight.