Sciatica / Herniated Discs Really Really Suck

[SociallyChallenged]

I've called around to a bunch of other places and it looks like the average price is $100. The initial appointment is like $130-$150. Ugg... $200 a week for this. $800 a month. That's rent right there. With no guarantee that this isn't just a wild goose chase. But you say that this is readily treatable? Sciatica pain from a bulging/herniated disk is totally treatable? I see to feel like this is going to become a chronic condition for me, and I might as well get used to it. It is not piriformis. Probably a herniation in the L4- L5 or L5- S1.

There are places advertising spinal decompression and active release technique, as well as Graston technique. I don't know what the heck to do.

*guh*

I just want someone to give me a list of exercises to do. There's gotta be a way for me to fix this myself through exercise and stretching, right? All I know at this point are McKenzie stretches and planks. That's it. There must be a ton of people out there with disc herniations impinging on their sciatica around the L4-L5 or L5-S1. Aren't there some standard stretches/exercises that all physical therapists prescribe?

How do you know it's not piriformis? If it hasn't been assessed, it can't be ruled out. I'd really like to tell you that it would 100% help you, but just like everything else, there are people who respond well and people who don't. In addition, there are great PTs and PTs who just get by.

If there were a standard plan for every pathology out there, there wouldnt be a need for PTs. People don't respond well to standard plans - they respond well to individualized care. Stretching and strengthening is only part of the game. Like I said, joint mobilization may be necessary, soft tissue work (that you may or may not be able to do on yourself), postural re-education, movement re-education, etc. Where are you located btw?

 

[the DRIZZLE]

I've called around to a bunch of other places and it looks like the average price is $100. The initial appointment is like $130-$150. Ugg... $200 a week for this. $800 a month. That's rent right there. With no guarantee that this isn't just a wild goose chase. But you say that this is readily treatable? Sciatica pain from a bulging/herniated disk is totally treatable? I see to feel like this is going to become a chronic condition for me, and I might as well get used to it. It is not piriformis. Probably a herniation in the L4- L5 or L5- S1.

There are places advertising spinal decompression and active release technique, as well as Graston technique. I don't know what the heck to do.

*guh*

I just want someone to give me a list of exercises to do. There's gotta be a way for me to fix this myself through exercise and stretching, right? All I know at this point are McKenzie stretches and planks. That's it. There must be a ton of people out there with disc herniations impinging on their sciatica around the L4-L5 or L5-S1. Aren't there some standard stretches/exercises that all physical therapists prescribe?

I would really suck it up and try to at least get evaluated by a better orthopedist. You are a young guy and it would be a shame to have nerve damage that permanently reduces your quality of life for some that could be correctable now. My uncle is semi-crippled because he waited too long to fix a bulging disk that was pressing on a nerve.

 

[Pantlegz]

no way!? you injured yourself seriously doing crossfit!?

this is one of the many reasons why the majority of crossfit is just a piece of shit waste of time. injuring and hurting yourself isnt cool though many crossfitters take pride in it.

http://joshsgarage.typepad.com/Crossfit_White_Papers_--_Timeline.html :biggrin:

 

[fuzzybabybunny]

How do you know it's not piriformis? If it hasn't been assessed, it can't be ruled out. I'd really like to tell you that it would 100% help you, but just like everything else, there are people who respond well and people who don't. In addition, there are great PTs and PTs who just get by.

If there were a standard plan for every pathology out there, there wouldnt be a need for PTs. People don't respond well to standard plans - they respond well to individualized care. Stretching and strengthening is only part of the game. Like I said, joint mobilization may be necessary, soft tissue work (that you may or may not be able to do on yourself), postural re-education, movement re-education, etc. Where are you located btw?

I'm in Mountain View, CA. It's probably both a herniated disk and piriformis, from this: http://www.sciatica101.com/basics/symptoms/distinction-between-piriformis-syndrome-and-sciatica.html

1. While sitting on a chair, straighten your leg parallel to the floor on the side you are experiencing pain. If the pain increases, it is the symptom of true sciatica in which the nerve experiences irritation.

Yup.

2. Sit straight on a chair and pull your knee to the same shoulder and then to another one. If the pain gets worse, you have Piriformis Syndrome.

Yup.

This has been going on for over half a year. Do you think there's permanent damage?

 

[SociallyChallenged]

I'm in Mountain View, CA. It's probably both a herniated disk and piriformis, from this: http://www.sciatica101.com/basics/symptoms/distinction-between-piriformis-syndrome-and-sciatica.html

1. While sitting on a chair, straighten your leg parallel to the floor on the side you are experiencing pain. If the pain increases, it is the symptom of true sciatica in which the nerve experiences irritation.

Yup.

2. Sit straight on a chair and pull your knee to the same shoulder and then to another one. If the pain gets worse, you have Piriformis Syndrome.

Yup.

This has been going on for over half a year. Do you think there's permanent damage?

Those aren't actual clinical tests so they don't really carry any weight. The first situation is similar to a straight leg raise test, but that isn't specific for anything - it just tells you that the nerve is the symptoms. It doesn't tell you if it's due to impingement at the spine, piriformis, hamstrings, or calves. That requires further evaluation.

The second is a poor attempt at a FAIR test, but it definitely isn't. The FAIR test (flexion, adduction, internal rotation test) is a particular test that must be set up in roughly 60 degrees of hip flexion and stressed passively. Most people can't passive assess themselves. In addition to this, focus adhesions may be present so symptoms may only be present under certain conditions like when the muscle is at a certain length or when it is compressed at a given location.

If you were closer (I'm in SoCal), I'd volunteer to treat you if you came to me. I bet we could get a lot done.

Considering nerve attempts to adapt and regenerate, there could be something called maladaptive neuroplasticity going on, resulting in maladaptive pain. A lot of the time, fixing the mechanical issue can improve symptoms significant, even if things don't return to perfect.

 

[fuzzybabybunny]

Those aren't actual clinical tests so they don't really carry any weight. The first situation is similar to a straight leg raise test, but that isn't specific for anything - it just tells you that the nerve is the symptoms. It doesn't tell you if it's due to impingement at the spine, piriformis, hamstrings, or calves. That requires further evaluation.

The second is a poor attempt at a FAIR test, but it definitely isn't. The FAIR test (flexion, adduction, internal rotation test) is a particular test that must be set up in roughly 60 degrees of hip flexion and stressed passively. Most people can't passive assess themselves. In addition to this, focus adhesions may be present so symptoms may only be present under certain conditions like when the muscle is at a certain length or when it is compressed at a given location.

If you were closer (I'm in SoCal), I'd volunteer to treat you if you came to me. I bet we could get a lot done.

Considering nerve attempts to adapt and regenerate, there could be something called maladaptive neuroplasticity going on, resulting in maladaptive pain. A lot of the time, fixing the mechanical issue can improve symptoms significant, even if things don't return to perfect.

Doh ><

Well, what should I look for in a physical therapist?

BTW, I would like to get an MRI, but "SURPRISE!" my health insurance doesn't cover that either. Diagnostic tests are not covered. Mother fuckers.

 

[TecHNooB]

I recently discovered that my health insurance is awesome.

 

[highland145]

Doh ><

Well, what should I look for in a physical therapist?

BTW, I would like to get an MRI, but "SURPRISE!" my health insurance doesn't cover that either. Diagnostic tests are not covered. Mother fuckers.

WTH do they cover? Lube-less colonoscopy? 🙄

Apply for medicade.

 

[SociallyChallenged]

Doh ><

Well, what should I look for in a physical therapist?

BTW, I would like to get an MRI, but "SURPRISE!" my health insurance doesn't cover that either. Diagnostic tests are not covered. Mother fuckers.

I think the general public is convinced MRIs are the gold standard for everything. They're not though. Functionally, they give a lot of false positives and false negatives. There are many functional assessments that a PT can use to determine if you truly have a disc herniation or not. Regardless of the size of the lesion, we're focused on getting your function back and we'll treat it accordingly.

I think you should have a PT who has a individualized, whole-individual approach. They need to address your goals and help you reach them. In addition, this person needs to spend more than just 10min with you. Honestly, you could call around and see if anybody does pro bono work - literally, just call around. I know it's not the most fun thing to do, but pro bono work is actually expected from PTs within the American PT Association.

 

[SociallyChallenged]

no way!? you injured yourself seriously doing crossfit!?

this is one of the many reasons why the majority of crossfit is just a piece of shit waste of time. injuring and hurting yourself isnt cool though many crossfitters take pride in it.

A lot of people like to rag on CF for some of this stuff. Yes, there are affiliates who don't stress form enough. However, there are some places that are great - they stress form and do not let "performance" ruin that. A lot of the time, it's the individual's fault for not properly researching the movements and pushing too hard, too early.

 

[Sixguns]

I've seen people with L3 to L5 disc herniations who only get a little bit of tingling and numbness. I've seen some with a minor herniation at L5/S1, but be in severe pain. It varies.

That was me. I had a herniation at L5/S1. Started with a chiro, didnt do anything, than they started me on the drugs, a year later PT and more drugs. About a year after that tried the injections which were terrible for me. Another round of PT and drugs but than came down to surgery. I had a lot of the pain in my legs and when they opened me up they found out my spine from L5 up was about 1/2 foward on bottom part of spine and said that that was the cause of my leg pain. I still have some nerve damage from that but nothing to bad.

I felt the same about the drugs in that it isnt fixing anything but just masking it. I also hated having to come off of them after nearly 5 year(that alone did a number on my body). I kind of know what your might be going through from dealing with the same type of pain for so long.

 

[DAPUNISHER]

Cortisone injections can work wonders.

That was my experience. I only had one, and did the PT (which was just electric stimulation, some ultrasound device, and some bone cracker stuff) I was completely pain free in a few months.

 

[SociallyChallenged]

That was my experience. I only had one, and did the PT (which was just electric stimulation, some ultrasound device, and some bone cracker stuff) I was completely pain free in a few months.

Are you sure it was a cortisone shot or an epidural? A lot of the times, orthopedists use epidurals to block the nerve for a few months so people can actually utilize conservative care.

Sigh, it's always depressing when I hear PT like that. Sure, electric stim and ultrasound is good, but a waste of time compared to manual therapies >.< I'm glad it worked for you, but that's a rarity.

 

[Wyndru]

These kind of stories scare the crap out of me for deadlifts. I do them (and squats), but I'm so worried that at some point I'm gonna screw my back up.

 

[SociallyChallenged]

These kind of stories scare the crap out of me for deadlifts. I do them (and squats), but I'm so worried that at some point I'm gonna screw my back up.

Maintain a neutral spine (DO NOT LET YOUR SPINE GO INTO FLEXION) and you will be fine. If you do that, then your only deadlift injuries will be a sprain or strain, which are relatively easy to recover from.

 

[TecHNooB]

Maintain a neutral spine (DO NOT LET YOUR SPINE GO INTO FLEXION) and you will be fine. If you do that, then your only deadlift injuries will be a sprain or strain, which are relatively easy to recover from.

My doctor has yet to tell me what's going on with my MRI. But when I was deadlifting, I had good form. That was before something in my upper right hip gave. Heard 2 pops. Immediately found myself hunched over. Still not sure if it's something in the very bottom right of my spine or some joint/tendon/muscle in the hip. No position improved my sciatica pain. Sleep did, however. Which leads me to believe it's not a herniated disc but a tear somewhere.

 

[the DRIZZLE]

These kind of stories scare the crap out of me for deadlifts. I do them (and squats), but I'm so worried that at some point I'm gonna screw my back up.

SC is right but part of the way you maintain good form is by not being an idiot. Don't take 3 months off then try to pull 225 on the first day back. Do plenty of warm up sets with increasing weight. I like Wendler 5-3-1 because you only go up 10lbs every 4 weeks. That stops you from trying to be a superhero and increase the weight every week.

 

[SociallyChallenged]

My doctor has yet to tell me what's going on with my MRI. But when I was deadlifting, I had good form. That was before something in my upper right hip gave. Heard 2 pops. Immediately found myself hunched over. Still not sure if it's something in the very bottom right of my spine or some joint/tendon/muscle in the hip. No position improved my sciatica pain. Sleep did, however. Which leads me to believe it's not a herniated disc but a tear somewhere.

Right, that's likely not a herniated disc. That's probably a piriformis, hamstring, or glute issue, all of which can result in sciatic nerve symptoms. The neutral spine is important, but so is proper muscle activation. A lot of people are hamstring dominant and therefore overuse them during movements like squats and deadlifts. They'll tear pretty easy in deadlifts if you're not aware of it. The best way to avoid that is to do glute activation exercises, foam roll, and make sure you have proper hamstring length.

 

[stargazr]

My doctor has yet to tell me what's going on with my MRI. But when I was deadlifting, I had good form. That was before something in my upper right hip gave. Heard 2 pops. Immediately found myself hunched over. Still not sure if it's something in the very bottom right of my spine or some joint/tendon/muscle in the hip. No position improved my sciatica pain. Sleep did, however. Which leads me to believe it's not a herniated disc but a tear somewhere.

You know, you can go to the place that did your MRI and get a copy of the reading. It's one - two pages and very technical. But you can google anything you don't understand, and at least get an idea of what's going on.

I try to learn as much as possible about my injury and take an active role in the process - asking the doctors questions, study online etc.

 

[DAPUNISHER]

Are you sure it was a cortisone shot or an epidural? A lot of the times, orthopedists use epidurals to block the nerve for a few months so people can actually utilize conservative care.

Sigh, it's always depressing when I hear PT like that. Sure, electric stim and ultrasound is good, but a waste of time compared to manual therapies >.< I'm glad it worked for you, but that's a rarity.

I should have been more explicit. The shot was actually for sacroiliitis. But, I was told I had a "suspected" herniated lumbar disc that was causing the sciatica. They also had a staff chiropractor adjust? me. I have to say, that after the tweaking, the pain was significantly reduced.

They gave me stretches to do for my hips. And they told me to sleep with a pillow between my knees from now on. As weeks past the pain continued to diminish. So the MRI that would have been the next step became unnecessary.

 

[SociallyChallenged]

I should have been more explicit. The shot was actually for sacroiliitis. But, I was told I had a "suspected" herniated lumbar disc that was causing the sciatica. They also had a staff chiropractor adjust? me. I have to say, that after the tweaking, the pain was significantly reduced.

They gave me stretches to do for my hips. And they told me to sleep with a pillow between my knees from now on. As weeks past the pain continued to diminish. So the MRI that would have been the next step became unnecessary.

Ah, got it. Yeah, the corticosteroid can kinda ooze around and address multiple areas. SI manipulations and mobilizations are pretty helpful for people with true SI pain so it's good to hear it worked for you.

 

[BooToBackProbs!]

Hi Fuzzy and others...
I'm 31 and I've been dealing with sciatica and back pain for a year and a half as well. I have 2 herniations at L4-L5 and L5-S1. I'm not 100% how mine happened, but here's the story:
First off, I'm a lifelong runner, dancer and soccer player. I can remember lower back pain and hip pain since high school days, but who doesn't have that every once and awhile?? I was always able to continue running through any aches b/c it never seemed like this was a major issue. A year and a half ago, I got off of a long flight from Japan to the east coast. I played a soccer game the next day and thought that I pulled a hamstring. I had NO back pain initially, so I continued running lightly and stretching a ton b/c I thought it was just my hamstring. About 2 weeks after the initial incident, I started having pain in my foot...it was at that point that I realized it was not just my hamstring. I saw both a chiropractor and a sports medicine doc within the first 2 weeks of this happening. Chiropractor did some adjustments and sports med doc thought it was Piriformis. The sports med doc referred me to PT and my PT thought piriformis was BS and started treating me for back problems. I had an MRI a couple weeks later to confirm her suspicions, and she was right!! I've been doing the McKenzie prone push-ups since then, and keeping my back extended...constantly. With prone push-ups, the pain will 'centralize' to my lower back...meaning that I can feel the burning in my hamstring/butt move up into my back. Obviously, just doing the prone push-ups does not fix the problem, so here's the whole frustrating part...
1. I have to be in one of 3 positions in order to keep the pain out of my leg. Standing, laying on my stomach or laying on my left side with like 3 pillows between my legs (herniation is on the right side). If I'm sitting, I have to basically sit up SUPER straight and on the edge of the chair. I can't stand being in any cars that have 'bucket' seats. I have to hold myself up straight or pile stuff/rolls behind my back. My knees have to be below my hips at all times. I sit for no more than 2 hrs a day...and it's been a year and a half since this happened.
2. Pain meds (ie tramadol) takes the edge off if I HAVE to be sitting for a long period of time, but what's the point?? The pain is manageable...I can get over that part. This is long term, so why bother getting hooked on those...I'm too young for that.
3. I can swim freestyle only or do machines at the gym that cause absolutely NO flexion of my back. Even some of the ellipticals bring my legs up too high and cause my back to flex. I stopped running. I don't do anything that moves my core except for swimming. I cringe at people doing horrendous things to their body at the gym.
4. I've been doing A TON of core exercises. I can share some if it would help any of you, but I'm sure that you can find them online as well.
5. This sucks. This is chronic and b/c I can get the pain to centralize and I don't have any muscle weakness, surgery is not an option. If someone told me that this amount of pain was the worst it's going to get, then I would go back to running and soccer and doing everything I love to do. I've been working so hard at this, but I'm getting tired and it's harder to take this day by day when I get a flare-up. I can't even sit at a restaurant for an hour without having pain travel into my leg. Grrr. I'm tired of looking like the 'anxious' girl ALL the time. I share all of your frustrations...
Any input from any of you would be greatly appreciated 🙂 I found this forum last night after leaving the gym in tears. I recognize that back problems are not the end of the world, and neither is not being able to work out...but seriously, I would love to be able to just sit down!!!

 

[fuzzybabybunny]

I just wanted to update this thread. I'm doing much better now, probably about 85% of what I used to be when I was 100% healthy.

BooToBackProbs, this story is unlikely to help you though 🙁

Food poisoning.

My buds and I took a drive down to Mexico to do some spearfishing shortly after making this thread. The drive was about 15 hours and it was killer on my back. When we got to our destination I was worried that all that sitting had undone my chiropractic stuff due to the pain I felt. We spent the next couple of days diving and fishing off a boat, and the pain still sucked. I had a hard time bending over to pick up things at the bottom of the boat, for example.

Then one night we had a party with some crabs and fried chicken. I woke up that night at 3AM and ran outside to puke in the sand. Did this about 3-4 times, once even passing out on the ground. I spent the next 24 hours passed out on my army cot. When I woke up, my sciatica pain was a LOT less. And it stayed that way.

It's been over two months and the pain has gotten even better. I can put on socks without much of a problem. I can sit for 12 hours on a flight with no problem. I can run. I can bend over and almost touch my toes (I can't because my muscles are too tight, not because of the pain).

So yeah. Food poisoning, a ton of puking, and 24hrs of being passed out on a cot seemed to fix 80% of it overnight.

WTF?

 

[purbeast0]

i just want to put something out there...

i have a partially bulging disc in my lumbar that happened squatting improperly like in 2006. i was 24 or 25 at the time it happned. it wasn't until a year later when it got REALLY REALLY bad after a flight that I got it checked out.

as i stated, it turned out being a partially bulging disc. i had some exercises that i could do and what not, but the pain would never fully go away. over the years i started to realize what i can and can't do at the gym, because of my chronic back pain.

over the years it never went away 100%, and i could always do things to aggrivate it big time. one time i was changing my tire and it was nearly unbearable the pain i was going throgh. i had to stop like every 3-4 minutes to let the pain go away.

since then i haven't done free weight squats, deadlifts, or heavy bent over rows because of the pain. if i tried, it would end up making me have back pain for like 1-2 weeks until it died down a bit.

bout 6 months ago i started looking at inversion tables. i found a deal on a teeter hangups on craigslist for $120. it's a $500+ table w/the accessories.

and holy fucking shit ... after about a week of doing it simply 1 or 2 times a day, for 5-10 minutes, my back was SSSSSSSOOOOOOO much better. like better than it had felt in YEARS.

after that week or 2 i stopped doing it regularly. since then i hardly really ever use it, unless i just do something odd to tweak it. like a month ago i was cleaning and literally bending over to open a drawer on a saturday afternoon, and i felt my back go out. that whole week i had to change up my lifting routine on certain days, such as bent over rows or squats, because of the pain. but i also did the inversion table one time a day in the evening.

after the week it was back to normal.

and ever since i got it, i also have been able to do squats fine. i don't go to heavy though, most i really do is 315lbs, but i think i also have a mental block because of my lower back, which i'm trying to get over.

moral of the story is, i would STRONGLY suggest trying an inversion table out if you get a chance. it can literally change your life by relieving the stress. i didn't read the whole thread so you may have already touched on it, but man it helps so much for me.

oh, and i just turned 30 in november and my back now is better than it was through my late 20's.