Herniated Disc Questions

[foxbird]

Hey there, folks! I've read a few of the forum posts here, and a number of you have some good input on matters like this. Hopefully SociallyChallenged is paying attention as well, as he seems to have some experience in helping people deal with this situation. That said, I'll take advice from anyone who wants to share it with me.

Let me start at the beginning and give you a little background. I can fill in more details if you need them. I'm a 33 year old male. About 3 years ago I managed to injure myself playing tennis. Lunged sideways for a ball, and had a shooting pain down my right leg. Walking 5 or 6 steps and the pain would shoot down it again. If I concentrated, I could unclench muscles and walk again. I stayed off it for a day or two, and then begin about a 2-3 week recovery, ending with no lingering issues.

A year later, I was sitting on the couch, leaned forward to get up, and bam, same thing. I applied the same treatment and things got better. No issues again.

Now, October of 2013, it recurred, this time while leaning over the sink. Felt nauseas, laid down for a moment, and when I get up, it was back. Applying the same idea as before, I waited a few weeks and it started to go away. Alas, about when it was getting better, it came back.

So, having figured it was more than just a simple issue that would work itself out, I went to see a chiropractor. He did a number of adjustments up and down my spine between mid October and December. After which, he said I was good to go and that all future adjustments would be 'maintenance' visits. I still had some occasional pain in the saddle area, occasional twinges in the right testicle, and the odd 'ghost' feeling in my right leg. Nothing really painful, just obnoxious. He said I would always have degenerative pain, and to get used to it. I didn't believe that was true.

So, I went to see a spine specialist. He prescribed some PT which I started the following day. Two days after that, I felt really nauseas and my neck hurt. I felt miserable, so asked the doctor about it. They gave me some anti-inflammatories and said to go to my general doc to make sure it wasn't a stomach issue. I went to visit them, and it wasn't.

I did get a referral to an orthopedic spine doctor who ordered some MRI's. The neck seemed to be fine, likely the result of a sprain or strain of some kind. That seems to be getting better. The devastating news was that I had a L4/L5 disc herniation. Picture below, that shows right of center spine (I have the rest of the images if it helps).

It's not really bothering me to the point of pain, it just is mildly distracting and the ghost feeling is a little scary. There's some small discomfort laying down with my back angled upward, but again, it's not awful. Just annoying.

My orthopedic doctor seems to be leaning toward a microdiscectomy, but I'm not sure I really need one since the pain is so minor. But, on the other hand, I don't want to wait 2 years to find out I'll need it anyway, but because I waited so long it's unlikely to help.

So, my questions to you folks are this: What are my conservative treatment options? I'm already seeing a PT guy, but I'd like to make sure he's got me on the right track to deal with this. I'm considering asking him about traction to see if that would help the disc reduce some. I'm also considering talking to a Chiro that specializes in Cox technique as well, and see if that might help. I understand both are a form of decompression therapy, but I'm willing to look elsewhere too. My insurance covers up to 25 chiro visits a year at 10% copay. So the cost isn't too high, so long as the treatment doesn't take more than 25 visits. PT, seems to have no limit.

I'm pretty flexible in what work I can miss to go to PT sessions, and I'm willing to do 4-5 sets of exercises a day (at home) as well as anything I can to avoid surgery. Even though it's a minimally invasive sort of thing, the 3-6 month recovery time sounds awful, never mind the 2 weeks of post-surgery pain.

That leaves me wondering if I have any further options to help this go away. I'd love to hear some advice, since this is all still very new to me. It's got me a little scared, depressed, and a whole host of other emotions I almost never express.

And lastly, about when should I consider surgery an option? Some people say 'It's never an option unless the pain impacts your life significantly'. I'm not there right now, but I obviously don't want to wait until it won't help any either.

My current plan is to hit as much PT, exercise, stretching, and conservative treatment as possible between now and around may. If the symptoms aren't gone by then, perhaps surgery would be an option. I'm not sure if that seems reasonable or not, given the minor impact of the issue, but as I said I'm concerned about long term damage.

Thanks for any advice you can provide. It's very much appreciated.

 

[SP33Demon]

I'm not an expert so not sure on your severity. I had a similar incident happen 2-3 years ago and did about 2 months of Chiro treatment (laying down on the wave roller machine, stim, manual massage + stretching to the area with a roller by the chiro, ice when I got home) and it healed. It was so painful that it would take 5 minutes to roll out of bed (literally), and 5-10 minutes to get into my car. I couldn't change my socks or wash my feet for at least the first 3 weeks of chiro treatments.

After the 2 months of treatment, I then got an inversion table (Teeter Hangups brand) and use it around 3 times a week and the back has never even remotely given me a problem. For reference, I also strengthened my core significantly since then and now compete in powerlifting (abs, lower back muscles) which means heavy squatting and deadlifting.

For reference, I'm also in my mid 30's. I work in IT so my spine gets compressed a lot from just sitting, so the inversion table has been an amazing decompression tool to get my spinal fluid moving and healthy.

 

[foxbird]

For reference, I'm also in my mid 30's. I work in IT so my spine gets compressed a lot from just sitting, so the inversion table has been an amazing decompression tool to get my spinal fluid moving and healthy.

I also work in IT as well, so there is a lot of sitting. I've been making myself get up and stretch every so often to help work out the kinks.

Out of curiosity, did you ever have an MRI or get your problem diagnosed? Since I have, I know have a herniated disc. I'm not sure if knowing makes it any better. I suspect that if I didn't know what was going on, surgery wouldn't even be on the table. But, now that I know, it seems much more realistic.

I'll ask my PT guy about traction, since that's essentially what the inversion table does. If a few bouts of that at his office seem to help, perhaps getting a table would be worth it. Do you still use it frequently, or did you stop using it for the most part once the problems went away? I feel like I am -almost- at 100%, but these pesky little things keep popping in an out.

Thanks again for taking the time to reply!

 

[IHateMyJob2004]

If you are worried, get a second opinion from another professional.

 

[SP33Demon]

I also work in IT as well, so there is a lot of sitting. I've been making myself get up and stretch every so often to help work out the kinks.

Out of curiosity, did you ever have an MRI or get your problem diagnosed? Since I have, I know have a herniated disc. I'm not sure if knowing makes it any better. I suspect that if I didn't know what was going on, surgery wouldn't even be on the table. But, now that I know, it seems much more realistic.

I'll ask my PT guy about traction, since that's essentially what the inversion table does. If a few bouts of that at his office seem to help, perhaps getting a table would be worth it. Do you still use it frequently, or did you stop using it for the most part once the problems went away? I feel like I am -almost- at 100%, but these pesky little things keep popping in an out.

Thanks again for taking the time to reply!

I never got an MRI, I was going off the tests the chiro gave me and he made the diagnosis. It definitely felt like bone on bone grinding with some amazing pain where even the most minute movement would hurt. However, mine may not have been as bad as yours because I didn't pinch the nerve; I didn't have the pain in the leg like you had (the chiro tested for that). It was local pain but around the L4/L5. I was playing football on the beach and jumped and came down hard on the sand with both feet and that popped it. Also, I have a larger upperbody than lower so my spine has to support more than the average person. BTW, I voluntarily stopped after 8 weeks because I felt back to normal. The chiro wanted me to keep going for another couple of months but I started using the inversion table and then icing, and it felt great. Then I started doing planks to strengthen my abs gently and things have been great since.

The inversion table has been a godsend for a couple reasons: I never had any back problems remotely since getting it. I still use it 4 times a week on powerlifting days because the major power movements (bench, squat, deadlift) all compress the spine significantly. I do couple minutes at 45deg and then invert for another 3 minutes to full 90. Then I'll do a couple of swings to "pump" the spinal fluid by expanding/contracting the spine. This is done by starting upright at 45deg, then going to zero, and then going negative 45deg and swinging back up to upright 45deg. This should help flexibility a little since I read that spinal fluid may not get the proper circulation/nutrients to your discs if you're always compressed (maybe SocChallenged can comment on this). In any case, if you don't do it violently then it should be helping improve spinal circulation and flexibility.

One last thing to note: I do use a latex foam mattress which also helps stretch out my back at night. On a normal spring bed with mattress cover, it would sink in an inch and wreak havoc on my back and sleep. One bad thing about the latex mattress was that when I had the herniated disc, it was hellacious because you need to compress the spine (not stretch it out!). That's why it took so long to get through the pain when I was hurt in bed. However, for healthy backs I'd recommend getting memory or latex foam.

 

[Instan00dles]

I have been dealing with 2 herniated discs, L4/L5 and L5/S1 for the past 10 months and my life has been complete hell. The L5/S1 was a central herniation with significant thecal sac compression which resulted with pain in both legs, mainly the left thou. Have been doing PT for the past 10 months and everything has just seemed to settle and not get much worse but I am a fry cry from getting better.

When it first happened I was walking in walmart, moved wrong and fell into a display case. My girlfriend had to practically carry me to the car as I could hardly move my leg without pain I didnt think was possible. Got a cat scan and an MRI fairly quickly and referred to an orthopedic surgeon but in Halifax the wait time was 14 months. Between many mornings not being able to get out of bed or off the floor it has been a crappy year.

I have done so much physio, a program specifically tailored to back and core strength and the only thing that has "helped" is taking 1800mg of gabapentine every day. I am now to the point where I can walk without to much of a limp but get stabbing pain in my left and right butt checks.

After speaking with many doctors and surgeons I am a good candidate for surgery as the likely hood of it getting better on its own since it has been so long is very little. Most people will get better and heal completely after 6 months to a year, it just takes time for the disc to reabsorb the material and scar over. Concentrate on proper posture, if you sit at work try to get up and walk around as often as you can, work out core and keep flexible as tight hips and hamstrings put pressure on the low back. I hope everything works out well for you but from everything I was told its a good idea to avoid surgery in all but the extreme cases or ones that do not get much better after 2-4 months. Its always a good idea to get a second opinion if a doctor is rushing for surgery without giving time to heal without it.

 

[KMc]

For those of you with severe conditions who are considering surgery, I can at least give you a sample size of one where it worked out very well. In fact, now 13 years after the surgery, I still wonder why I waited so long to have it done.

I started having the same sciatica problems as the OP in late 99. I had an MRI done and it showed a burst disc at L4/L5. Over the course of the next year and a half, I tried everything - NSAIDs, physical therapy, oral steroids, epidural steroid injections, you name it. Everything worked to varying degrees for a period of time, but there was never any lasting relief.

Finally, I went to a neurosurgeon and had a microdiscectomy procedure performed. It was essentially an outpatient procedure (went in early am, back home in the afternoon) and I had immediate relief from the leg pain and numbness. It left me with a 2 inch incision that was taped closed without sutures, so you can barely even see a scar. I was out of work for maybe a week.

My back is stronger, more flexible and healthier than ever. The only lasting effect is a small area on the outside of my left leg above the knee where the skin is numb to the touch caused by permanent damage to the nerve bundle from being pinched so long.

So, there's lots of treatment options and you really should work your way through them before resorting to surgery, but I wanted to let you know that not all the horror stories about surgery are true.

 

[Instan00dles]

For those of you with severe conditions who are considering surgery, I can at least give you a sample size of one where it worked out very well. In fact, now 13 years after the surgery, I still wonder why I waited so long to have it done.

I started having the same sciatica problems as the OP in late 99. I had an MRI done and it showed a burst disc at L4/L5. Over the course of the next year and a half, I tried everything - NSAIDs, physical therapy, oral steroids, epidural steroid injections, you name it. Everything worked to varying degrees for a period of time, but there was never any lasting relief.

Finally, I went to a neurosurgeon and had a microdiscectomy procedure performed. It was essentially an outpatient procedure (went in early am, back home in the afternoon) and I had immediate relief from the leg pain and numbness. It left me with a 2 inch incision that was taped closed without sutures, so you can barely even see a scar. I was out of work for maybe a week.

My back is stronger, more flexible and healthier than ever. The only lasting effect is a small area on the outside of my left leg above the knee where the skin is numb to the touch caused by permanent damage to the nerve bundle from being pinched so long.

So, there's lots of treatment options and you really should work your way through them before resorting to surgery, but I wanted to let you know that not all the horror stories about surgery are true.

I am going in for a microdiscecotmy in the next month or two and I am wondering how long was your recovery and how was everything in the first few weeks after the surgery?

 

[KMc]

I am going in for a microdiscecotmy in the next month or two and I am wondering how long was your recovery and how was everything in the first few weeks after the surgery?

Relief from the leg pain was instantaneous, which I was so happy about, it pretty much overshadowed anything else. I stayed home from work for about a week (which just happened to be the week of 9/11/01). The only pain was mostly just from the incision area. It was right at the belt line, so I had to wear sweat pants for that first week while I was home.

They had me do a lot of walking during recovery. It was a good month or so before I was feeling "normal", but again, it was mostly just healing of the incision area. Because it was so long ago, your technique might be even less invasive.

 

[Instan00dles]

Relief from the leg pain was instantaneous, which I was so happy about, it pretty much overshadowed anything else. I stayed home from work for about a week (which just happened to be the week of 9/11/01). The only pain was mostly just from the incision area. It was right at the belt line, so I had to wear sweat pants for that first week while I was home.

They had me do a lot of walking during recovery. It was a good month or so before I was feeling "normal", but again, it was mostly just healing of the incision area. Because it was so long ago, your technique might be even less invasive.

Well I am really hoping for the same results, the nerve pain in the leg is terrible and I can't wait for it to be gone.

 

[slag]

Looking for advice in this thread. About 5 years ago I was lifting something wrong and felt a pop in my lower left back. The next day, I couldn't walk straight up and was bent over. Gradually I could stand up straight, but have always had lingering pain in my lower left leg and back. Earlier this spring, on a Tuesday following a weekend of intense back yard work, I couldn't get out of bed. My back was in such pain, I couldn't stand or sit down, only lay on my side. Went in for X rays and they said I had some swelling of something, but that PT would help alleviate the pain and prescribed me some really awesome painkillers. Well, the pain has mostly gone away, unless I'm working in the garage or on my feet all day. Towards the end of the day, I can tell my back is about to give out again. I can feel it coming on, and sure enough, one more two more steps, and I almost fall down. Then it goes away for 5-10 minutes.

Suggestions? I lift weights daily and when its nice outside, run/jog. I have no pain while running or jogging, only if I walk and only towards the end of the day.