Bulging disc and sciatica

[Ered_Lithui]

Reading through the threads, back problems seem to be sadly common here.

The back story (no pun intended): I woke up one morning in mid-March with numbness in my left leg. After six weeks of constant weakness and mild pain, plus lower back pain, a lumbar MRI showed a lateral disc bulge at L5-S1 crushing the nerve root.

I'm finally starting physical therapy for overall lower back pain, but the neurosurgeon I saw thinks that a microdiscectomy is probably the only solution left for the leg pain. To his credit, at our first meeting three months ago he was inclined to wait it out and try less invasive treatments (oral and epidural steroids, which failed). It's been five months with virtually no exercise; even standing up and bending over cause shooting pains.

Even if the sciatica is resolved, my back is a mess, with multiple levels of degeneration, disc bulges and stenosis. I'm only 25; no one has a clue what happened here. I've been told I probably shouldn't run, which is a real disappointment, and that everything else will be gradual and tentative. Lower back pain anecdotes abound, of course, and most of them seem to end with "I just have to live with the pain and limit my activity." Every time I hear this sort of resignation, my heart sinks a little.

Where are the people who've been through this, still have horrible backs and yet remain super-active? This board seems like the right place to find them. I'm hoping some of you can help me out, either with suggestions for what to do next or just encouragement. I know life goes on... but it doesn't always feel like it will these days.

Okay, done whining. Help me, TE; you're my only hope.

[KnottedYet]

"McKenzie" (mechanical diagnosis and therapy) certified or diplomate physical therapist.

They will be able to tell you within 3 visits if physical therapy will help your particular issues. They will not just throw random exercises at you.

http://www.mckenziemdt.org/

[jessmarimba]

I have no words of wisdom or help for you...but this board has been nothing but encouraging for me (check out the Aaargh broken back (http://forums.teamestrogen.com/showthread.php?t=37076) thread). There are a few responses of people who have returned to activity from awful injuries and it helped me a lot. I'm one month into a 6-month hiatus from exercise due to a broken back, and while they have implied that biking and running will be "frowned upon" I don't think I can quit that easily. At least not without something equally fun to replace it! So I'll definitely be supporting you and hoping to learn from you as you sort this all out. And while I support the position of surgery as a last-ditch effort...it's not the end of everything.

Please keep us updated!

[malkin]

*waving hand in air*

1. Listen to Knot, she knows everything.

2. I had an L5 S1 herniation. I don't know any technical terms for the severity of how these things go, but after poo-pooing my complaints for months, when my ex- took a look at my images, he said, " OH MY GOD.."

I saw a doc who thought I might be a good candidate for non-surgical treatment. He encouraged me to work hard in PT by saying, "There are men with knives pounding at the door trying to get to you!"

PT was awful. The whole thing was awful. I had just turned 40 and felt like the warranty had just run out. It took a long, long time. Six months, then twelve months went by, and I'd pick up a milk jug (or a 6 pack) and set myself back, and I couldn't steer a grocery cart without hurting myself, and lots of stuff like that. but the days went by one at a time, and now it is over 10 years and it's good. And I didn't have surgery.

I believe nerve pain to be especially stressful emotionally. Don't be surprised if you feel crazy.

[Ered_Lithui]

Thank you so much for your responses! Jess -- I can't imagine going through a broken back! (And being told not to bike! Fortunately the doc says biking will be fine for me once the leg pain's gone.) I know I'm lucky in the scheme of things.

And thank you, Knot! I just checked, and the PT who read my MRI (and thinks PT could fix the leg pain) is listed on the McKenzie web site -- unfortunately, she lives 100 miles away, and the one I've been referred to is a DPT but isn't McKenzie-certified. I don't know if my insurance would cover visits to a non-referred PT close by. At the very least, I'll see what my PT recommends and try to check with the other one to see if it sounds reasonable.

Malkin, I'm so glad to hear you're doing well now.



2. when my ex- took a look at my images, he said, " OH MY GOD.."

Hah! Yep. I had started to wonder if I was imagining things, and then the MRI came back. I felt vindicated, which helped...a bit.



I had just turned 40 and felt like the warranty had just run out.

And this really resonates with me. I'm really curious -- were you able to ride in the interim? What's killing me right now is that I can't swim, play tennis, bike, or run -- even *walking* up or down slight inclines hurts -- and the lack of exercise has me pretty depressed. It's hard to hear my boyfriend mention his latest casual 80-miler knowing that it's more mileage than I've gotten in six months.

(And also because I'm lusting after a new road bike. You know.)

[KnottedYet]

I just checked, and the PT who read my MRI (and thinks PT could fix the leg pain) is listed on the McKenzie web site -- unfortunately, she lives 100 miles away, and the one I've been referred to is a DPT but isn't McKenzie-certified.

Can you call the McKenzie PT who read your MRI and thinks PT is viable, and ask her if she can recommend someone near you? McKenzie Certs and DIPs are *months* of further study after graduating PT school.

Someone who hasn't done the advanced study isn't going to have a clue. Having them treat you and asking the McKenzie PT to check their work isn't feasible for a couple reasons: For one, the general PT doesn't know MDT in the first place. For two, asking a non-treating PT to check the work of the treating PT is ethically and legally a complete and total no-no!

[berkeley]

Herniated disc here. We should start a club. :)

In addition to McKenzie, also check out the work of Stuart McGill.

http://www.backfitpro.com/

In the end, you have to find something that works for you - everyone is so entirely different when it comes to this. I know people who have done the discectomy will great results, I know some who ended up back in surgery again a few years later.

I've been religiously doing the McKenzie exercises without only short term relief (but at least some relief) but so far no change day in and day out. I just had a cortisone epidural - I'm one of the lucky ones that gets some real relief from that, so I'm hoping it works this time around again.

It does curtail biking at least in the short term - the flexion on the spine is really not what you need right now.

I'm at my year anniversary in dealing with this, so I know how frustrating it is. And whoever said you'll start to feel crazy is totally right. Chronic pain is mentally defeating.

[KnottedYet]

Herniated disc here. We should start a club. :)

It does curtail biking at least in the short term - the flexion on the spine is really not what you need right now.


Flexion is only bad if someone has a posterior disc bulge, and only 60% of back pain is caused by posterior disc bulges.

There is no such thing as "McKenzie exercises" because there is no one single "McKenzie" approach to joint derangement.

One person's corrective motion is another person's re-derangement motion.

Berkeley - if you've been doing something for months with no lasting results, then it is the wrong thing. Whoever gave you those "McKenzie exercises" either didn't know what they were doing, or hasn't heard from you how they are working and been able to modify them to get you the correct motion to push your unique and particular bulge back into place. (I'm assuming you are doing the motion 10 times every 2 hours, avoiding your deranging direction, correcting your posture, engaging your core at all times, and have not progressed)

People aren't cookie-cutter xerox copies of each other, and neither are painful backs, and neither are corrective motions.

[Ered_Lithui]

For two, asking a non-treating PT to check the work of the treating PT is ethically and legally a complete and total no-no!

Duly noted! I'll see if she can recommend someone here.

And Berkeley--a year! Augh! I'm so sorry.

[berkeley]

Flexion is only bad if someone has a posterior disc bulge, and only 60% of back pain is caused by posterior disc bulges.

There is no such thing as "McKenzie exercises" because there is no one single "McKenzie" approach to joint derangement.

One person's corrective motion is another person's re-derangement motion.

Berkeley - if you've been doing something for months with no lasting results, then it is the wrong thing. Whoever gave you those "McKenzie exercises" either didn't know what they were doing, or hasn't heard from you how they are working and been able to modify them to get you the correct motion to push your unique and particular bulge back into place. (I'm assuming you are doing the motion 10 times every 2 hours, avoiding your deranging direction, correcting your posture, engaging your core at all times, and have not progressed)

People aren't cookie-cutter xerox copies of each other, and neither are painful backs, and neither are corrective motions.

I absolutely agree - which is why I said following the McKenzie method has not helped me - it is quite possible that it won't work for all who experience back pain. And the people I've seen have been instrumental in getting me from being completely unable to do anything to at least functional - so I do trust that they know what the're doing. I loved my PT - it's a teaching facility at the local university and I've seen them several times for other issues.

If she has nerve root impingement, I still don't think riding a bike is a good idea. She did say it was lateral and impinging a nerve root to me would mean biking riding would be difficult until she can get it worked out. Not to mention, flexion itself can be very hard on the back - bulging disc or not. Just my two cents there. YMMV.

I have a ruptured/herniated disc - there is no "pushing it back in". Perhaps this is true in the case where the disc is "just" bulging. Following good body mechanics will make it not continue to ooze the good stuff out of the disc, and critical in order to stop the degeneration.

As an aside, probably the most frustrating thing for me in dealing with this has been when people think it's just a matter of doing X and then everything will be all better - if only it was that easy. :) Eight months of physical therapy, seeing multiple people in the practice (one who is McKenzie certified), and every other alternative method short of surgery.... I'm much better, but not anywhere near 100%. It is a hard thing to deal with, mentally. :)

I do appreciate the insight everyone has given me over the year, but just because yoga/inversion table/acupunture/this exercise/that exercise/surgery helped someone, doesn't mean that it will help everyone. It's a very difficult thing in all of this - knowing what advice to follow, what to do, who to listen to, etc..... even beyond the should I have surgery or not? big question, there are a lot of little questions that bog you down.

[KnottedYet]

A herniation (which is a bulge) can be pushed back into place.

A rupture (torn annulus) cannot. A rupture with fragmentation is a surgical candidate. A rupture with leakage is painful as all heck because the disc goo is caustic. Those leaking discs are obvious to the clinician, and they also respond mechanically. If you move one way, it leaks more. If you move another way, the tear is pinched shut and the leak stops.

Folks with tears don't have much fun because they have to spend about 3 days pretty much in one position (the one that pinches the tear shut). It's not a matter of just repeating a motion over and over agan, it's more like holding a cut shut and waiting for it to clot. They have to take 3 days off work and have help at home for 3 days.

Flexion is not inherently bad. McKenzie MDT uses flexion all the time. Some bulges require some flexion to go back into place. (anteriors and often laterals) Some posterior bulges with lateral components get WORSE with any extension. There are no blanket rules because every herniation is unique and the forces every person's body experience are unique.

After the derangement is resolved for a week, the back needs to return to full range of motion in both flexion and extension every day or the repair will never remodel into something tough and elastic, and will likely bust loose again. Flexion is important, and not inherently evil.

Berkeley, I'm sorry you've had such a rough time. Is it possible for you to go back to PT and see only one therapist for continuity of care? I would (of course) recommend you see the cert. MDT. Did the cert. get to see you often enough that they could tell if you had a responding direction? Did you try the 3 days in the responding position? Of course, if it's already been 8 months you've only got about 4 more before it spontaneously resolves anyway. (ruptures have a natural history of about a year)

Ered - I'm sorry to have hijacked your thread. When I was talking about flexion not necessarily being a bad thing I was NOT suggesting you leap onto your bike and go for a ride, I was only talking about the direction of spinal motion and its effect on disc pressures. I was also not suggesting you bend over and do potato-pickers...

[malkin]

... were you able to ride in the interim?...


I wasn't cycling at the time, but I could barely sit, so cycling wouldn't likely have been comfortable.

In PT they had me walk on a treadmill, in a harness to partially unweight me. The harness was designed for a person about 3 times my weight, so they had to pad me up with pillows for it to get a hold of me.

I also walked in the pool, which was funny because the ancient arthritis patients could zoom along and I couldn't figure out even how to do it. After pool walking, they'd have me hang out in the deep end of the pool with weights on my ankles and a life jacket for flotation. That felt great--except for when there was too much weight or not enough flotation and I'd sink.

I can laugh about this now. Even at the time, sinking in the PT pool was kind of funny.

Hang in there.

[jessmarimba]

I've heard so much great stuff about pool walking that I'm asking today if I can try.

Ered - I know how you feel about so much time not exercising. It's absolutely frustrating! I just bought a wii to keep myself busy - I'll play ya in wii tennis (or something I'm equally bad at) if you want company :)

[badger]

Yikes, sorry to hear of your problems at such a young age!!

sorry to hijack, but Knot, would you say that McKenzie would help someone like me with a twist in C1 by 7 degrees? I get a slew of problems due to it, namely migraines, and things are made worse by the fact I have mild scoliosis that makes my right hip higher than my left. I've done PT before and nothing's really come of it so I've resorted to chiropractic, which has helped, but I'm afraid I'm dependent on adjustments and want to be a bit more proactive in helping myself rather than going to him when my headaches get bad. Lately I'm getting numbness down my hip/thigh as well...

There are a couple of McKenzie certified clinics near me. I don't want to waste their time or mine if it's something they're not specified to do. Thanks in advance!!

[KnottedYet]

Yikes, sorry to hear of your problems at such a young age!!

sorry to hijack, but Knot, would you say that McKenzie would help someone like me with a twist in C1 by 7 degrees? I get a slew of problems due to it, namely migraines, and things are made worse by the fact I have mild scoliosis that makes my right hip higher than my left. I've done PT before and nothing's really come of it so I've resorted to chiropractic, which has helped, but I'm afraid I'm dependent on adjustments and want to be a bit more proactive in helping myself rather than going to him when my headaches get bad. Lately I'm getting numbness down my hip/thigh as well...

There are a couple of McKenzie certified clinics near me. I don't want to waste their time or mine if it's something they're not specified to do. Thanks in advance!!

MDT is all about getting your own movements to correct your body. (doing your own chiropractic, as it were) The body has a wealth of corrective motions and is constantly correcting itself without you being aware of it. MDT gets you to do some focused repetitive concious movements to correct a particularly sticky bit. They are the same motions your body would normally use anyway, just with more oomph.

An MDT therapist will know within 3 visits if self-management is going to work or not, so don't fear you will waste anyone's time. (and yes, you can be taught to correct your own rotations)

[badger]

I made an appointment for tomorrow!

[nscrbug]

While I don't know if I could call myself "super-active", I do consider myself to be quite active...and my back is a mess, too. I don't have a herniation...I have a grade 2 spondylolisthesis at my L5/S1 level. In laymen's terms, my L5 vertebra has slipped forward and off of my S1 vertebra. The "grades" are used to distinguish the severity of the slippage...so at grade 2, I have a 50% or more slippage. I've had this condition for nearly all of my adult life. My lower back gets stiff and the pain is mostly chronic. The doctors I have seen all agree that surgery (a fusion and laminectomy) is the only solution...but offer no guarantees for being pain-free afterwards. I've had bouts of sciatica, too. My MRI showed severe bilateral foraminal stenosis, degenerative disc disease, degenerative facet joints, and a severe narrowing of disc space, and bilateral spondylolysis. I've been told not to run, but I still do...I'm slow and keep my distances to < 4 miles. I refuse to be told that I can't do something...just makes me want to do it, even more! I also swim, and workout at the gym doing cardio and strength training 5-6 days a week. In addition to my cycling, of course...which is roughly 200 miles a week (when the weather is good).

I can't really offer any suggestions, since I'm not exactly a "good" patient by going against doctor's orders. Exercising and staying active is what helps me deal with my chronic back pain. On the rare days that I don't do any exercise, my back feels 10x worse!!! I stretch a LOT, and also have an inversion table at home that I use daily. The inversion table was particularly helpful in curing my sciatica...but YMMV. I was told by a PT, that I should NOT do any type of back extension because it can cause my slippage to advance more. But you know what...I still do them, because if I don't...I feel "unbalanced"...like those muscles aren't getting worked if I skip it. I'm to the point now, where I know my pain pretty well and know what my limits are.

I hope you are able to remedy your back issues soon and get back to doing the activities you enjoy.

Linda

[DrBadger]

I am going to jump in here with a slightly different perspective. I understand, and fully support, trying to do the PT and non-surgical route if at all possible. Obviously, if you can get relief that way it is the best solution.

However, it doesn't always work, and the surgical options aren't as bad as some people would lead you to believe.

I had my first disc herniation (L4/L5) at the age of 22... slipped on an un-plowed road on my way to a physics final. That time I could sit, but not stand at all with out excruciating pain. Finally had the MRI in April, and the doc was amazed that I was still functioning and finishing my senior year in college. I had done PT for a while right after the pain started, but nothing helped. Finally, in May I had a microdiscectimy. There was immediate relief. 3 months later I was cleared to start doing things again (rollerblading, biking, etc.) I wasn't super active at the time, but became so in the years following. After my first back surgery I went backpacking, hiking, running, rollerblading, started biking (road, and now mountain as well), all without any problems at all. My back would get a little tight at times if I over did it, or my weight got up and my core strength decreased, but nothing too bad.

Then almost exactly 1 year ago I had a bike accident and re-herniated the same disc (L4/L5)... I was 30, so 8 1/2 years later. we tried PT and cortisone injections, and while the injections helped a little (made it so I could function and not be in tears all day, and I have a high pain threshold), surgery was once again in the cards. I had a revision micro-discectimy by a new surgeon (ortho this time), and again, immediate relief. The recovery from this surgery was a lot faster than the first, probably in part due to me being in better shape overall, but also I think from a really good surgeon. 2 months later I was cleared to start getting back to things again. I walked a 5 k 1.5 months after my surgery, ran my first one at 2.5 months, road all over southern Africa 4 months after surgery, and now, at 8 months have done a duathlon, and have a triathlon this weekend... 1 week shy of the 1 year mark for the accident.

So, what I am trying to say, is that, yes, if possible avoid surgery. But, if you can't control the pain, surgery can be an amazing thing. And at least from the herniated disc perspective, once it is healed you can get back to all the things you did before. The only thing I was told to not do until 6 months after surgery is downhill ski.... but that isn't much of a problem here in Texas :-)

Good luck, I know how horrible this can be! Once you get the pain under control (even a little bit) try getting back in the pool... that felt really good for me since it took a lot of the pressure off my disc.

Ellen

[Ered_Lithui]

Hmm. If I had a Wii, I'd take you up on that, Jess.

Thanks for your input, Linda and Ellen. I'm not vehemently opposed to surgery, but it's expensive and I was given a 75% probability of success. The PT I saw yesterday thinks there's a good chance I can fix things without surgery, so we're going to give it a month to see if there's any progress.

Leila

[Ered_Lithui]

Well, 2 1/2 weeks into PT with no overall improvement in the leg. Sometimes (usually mornings) the pain seems lessened, but often (generally afternoons on) it's worse. The back pain does seem better overall, which is in keeping with what the neurosurgeon and PT both expected, so I think the exercises are helping in that regard at least.

Now that I'm looking more seriously at surgery, the naturopath/alignment experts in my acquaintance are telling me vociferously that I'm far too young for surgery, should look at fixing my posture, should walk more and avoid sitting; PT is only one non-surgical option; have I tried [X]?; and so on. There are days when I function more or less normally and think, "this isn't bad enough to merit surgery." And then I realize that I still can't ride or play tennis or hop off a low garden wall, and getting out of bed means grabbing a wall in anticipation of a surge of pain -- and I'm overwhelmed by the ridiculousness of the limitations. I come close to tears trying to justify the surgical option when people suggest yet another alternative. Maybe there is more I should do -- walk in the pool, take ibuprofen religiously, get acupuncture. But at what point is it enough?

Well, that update devolved into a whine-fest. Sorry. :/ Thanks for being so understanding earlier.

[yellow]

I was "too young" too (mid 40s).

You'll know if and when it's time. For me it was a question of continuing to be miserable (after having done everything I could to avoid surgery) or having the opportunity to be able to sleep, move, and sit again with less pain.

I'm a better partner, friend, and employee now. I might get shot down for this, but surgery really wasn't all that bad. PITA, yes, but given the result I'd do it again.

[jessmarimba]

Ered - if the surgery is going to be the most successful option, it's definitely worth considering. It's not as if you're having experimental surgery or they aren't sure what's wrong. And from what I read about a microdiscectomy, it was pretty much the first step in what they had to do for my back after I wrecked - remove a piece of bone that was impinging on the nerves. ta-da, remove the source of the pain!

It sounds like a pretty reasonable cause and effect to me. And while recovering from surgery might suck for a few weeks, it's a lot better than having your quality of life suck for an indefinite amount of time. (plus muscle pain from the surgery is much easier to deal with than nerve pain, for sure)

Not trying to persuade you one way or the other, but you've definitely explored other options - no one is going to accuse you of being scalpel-happy.

Good luck, I hope you're doing better! (And I need to check the other thread to see how your bike search is going, I'm halfway looking for a road bike that I can put up with, too)

[Ered_Lithui]

Thanks, guys. If surgery's the solution, that's fine. I want to get back to the land of the living, and waiting another six months is not an option even if I had the patience. The doctor said the nerve damage may be permanent if I wait too long.

As for the bike search, I'm enlisting my (former mechanic) boyfriend to help me with components once I've been fitted for a frame. Unless I luck out on Craigslist, it'll probably be a building project, so I'll update on that thread as things progress.

[itself]

I had L5 S1 surgery six years ago. I totally blew my disc, had radiculopathy down both legs, and oxycontin would even touch the pain.

Here are some things to consider:

1. Spinal Decompression: You go in for a month of visits and put you in machine that decompresses the discs. 80% success rate

2. Chiropractic: Find a good one. Mine has changed my life. We took a photo of my back two weeks ago and the improvement was incredible. Better spacing.

3. Find a good Physical Therapist: What I found important with physical therapy was to add one exercise at a time, to assure it was not causing further pain. Strengthening the core muscles is very important

4. Dr. Yeung: He is teaching all over the country, and does disc replacements. He is in Arizona. He also put the "X" titatnium piece in for folks with stenosis. This opens up the closed canal. He and his father are quite well know, Dr. Chris and Anthony Yeung.

Hope this helps. Stay positive if you can. I don't think anyone can explain how deep back pain goes. It rips you apart. It's unlike any pain I have every experienced.

Heal well...

Lisa :)

[Ered_Lithui]

I went ahead with the back surgery on Tuesday. The second surgeon confirmed everything the first had said, and was able to schedule me for the surgery less than two weeks after the visit. I'd heard really good things about the second doctor from PTs who have worked with his post-op patients, and was told he's one of the best and that he only does surgery when he thinks it's absolutely necessary. I felt good about the decision going in.

It happened Tuesday afternoon, and that evening I had a few glorious hours when my leg felt free of pain and there was much rejoicing. I walked around grasping the IV pole and feeling great. A few hours later the nerve pain in the leg came back, and it has gotten worse over the past three days. This is not unheard of, and it probably has to do with the fact that the post-surgical inflammation at the site of the procedure is compressing the nerve root. But the nerve itself may also have sustained damage that could take a long time to repair. So I could be in pain for a few more days, or a few more months. Or longer. (No! Thinking happy thoughts.)

Getting out of bed is hell; rolling over is the worst part. I feel knives digging into my flesh and at every point I'm scared about ripping stitches or re-herniating the disc with a wrong move. I'm physically incapable of leaning forward to get up; it's such a bizarre sense of helplessness. Once up I can walk about a bit in accordance with the doctor's instructions.

Fortunately, I have my sister in town for a bit. Her presence has been invaluable, both in terms of moral support and physical assistance getting in and out of bed and fetching water. The hospital sent me home with a fantastic water bottle complete with a straw that runs through the lid. I suppose parents of young children must be familiar with the concept, but I'm really impressed. (Maybe it's the drugs talking here.) It makes taking pills while lying down simple and painless.

The neuropathic painkiller was supposed to kick in yesterday and address the leg pain, but so far no luck there. That's my only cause for concern right now. My back *should* hurt -- they took knives and needles to it and hacked away at disc and bone. But it was all done for the sake of the still-uncooperative leg. I'm attempting to be sanguine.

[yellow]

Ered, it's a tough decision to make and sometimes during recovery you will wonder why the hell you did it. I recovered very well (I had a different surgery...but it was still back surgery, with hardware) I think primarily because of two things: (1) I was 100% faithful with my PT--it pissed me off that I had to spend so much time doing it (when the benefits were often not apparent) but I'm stubborn so I kept at it and (2) I did not expect to be 100% free of pain after surgery. Recovery was a PITA, but it really wasn't that bad (certainly not as bad as the Internet would have you believe). It took me probably 6 weeks to recover from what I will call the surgical pain. Otherwise, gradual improvement. I know that I will need to continue maintenance for the rest of my life.

Pick an episode from the last year in which you either melted down form the pain or couldn't do something because of the pain. Remember how that made you feel mentally and physically. And then remember, with emphasis, that it is in the past and that you are moving on.

My episodes were being able to bend over on a whim to pick something up and not being able to put on my shoes without excruciating pain. I still have some pain and occasional numbness in my right leg, but I can now bend over pretty easily and put on shoes without much thought.

Hang in there and be patient with yourself!

[jessmarimba]

It probably doesn't feel like it to you, but you sound like you're doing awesome! While I was physically capable of walking the next day, it was probably 4 days before I was able to stand up from sitting on the edge of the bed and not immediately puke everywhere (sorry tmi).

And I feel you on the rolling over to get up - I could NOT roll to my left side for probably 3 weeks. Too weak or uncoordinated or something, and the incision was just enough in that direction that the pain was much worse. And the drain for the surgery was on that side and I was terrified of accidentally pulling on it. They got aggravated with me in the hospital b/c that would have been a 2 step trip to the bathroom, and instead I had to get off of the other side of the bed and walk around (while sick).

I will keep my fingers crossed that the nerve pain will subside quickly. I imagine (and I'm hoping) that it IS just inflammation, and I doubt that will last too long.

Good luck in your recovery - we're all here for you!

[malkin]

Hang in there!
Pain sucks.

[Ered_Lithui]

I've so far avoided vomiting, for which I am very grateful. The leg pain has been as bad today as its worst extent pre-surgery. Severe enough to make me seize up and lose balance. So I'm being very, very careful because falling now would be very bad indeed. I certainly didn't expect to be pain-free, but the severity and suddenness of the leg pain took me by surprise.

I just consulted the doctor on call, who said, "wow, you're on some really low doses." Apparently I could be taking over twice as much of both drugs as I currently am. That might explain some things. I'm increasing the dose of the neuropathic painkiller a bit to see if it helps the leg.

[DrBadger]

Hang in there! it get's better, but sounds like you are doing quite well already. You are right that the nerve pain can take a while to heal... I still get twinges in my big toe now 8 months later.

Take the pain meds per docs order.....don't try to be a hero...they give them to you for a reason.

As you start feeling up to it, take walks... it is great both for getting out of the house and to keep you active and get mobility back.

Good luck!
Ellen

[itself]

Ered,

You are doing great! Make sure you are taking B complex as this helps nerve damage and with recovery. Be slow and careful with PT...and make sure you get a good one.

I cried when I woke up from my surgery, as the pain was gone and I couldn't believe it. I had weird feelings/tingling in my legs for quite a while, I want to say at least a year. Different for everyone, but DON'T get freaked out. Your body will heal, it really will.

Ice is your friend. I still to this day ice after exercise. And yep, even six years later there is tingling here and there in my foot and legs on and off. Again, I don't get freaked out anymore. My chiropractor made all the difference in my recovery.

[cyanemi]

I did have surgery five years ago. I did not have a choice and a good surgeon will not do surgery unless there is no alternative. I can bike, swim, lift weights, hike, kayak. I really have problems running though. Once I do, back pain starts again. I am not discouraged because I am so thrilled to be able to do everything else and not have any pain

[Ered_Lithui]

It's good to hear your stories, itself and cyanemi! Thanks.

I have most of my mobility back now, and life is a matter of "mustn't do [x]" (where x = bend over, walk fast, reach high, ...) rather than "[x] is physically impossible." I don't need to remind myself, since anything forbidden causes immediate pain, but sometimes it's tempting to squat and reach down to the floor and pick up my glasses rather than wait until someone in the house has a free moment. My leg's quite a bit better and I'm no longer afraid of unpredictable jolts of pain sending me to the floor.

Best of all is being able to roll over in bed without feeling like I'm about to die.

I went to watch a cyclocross race today -- my first big outing. I'd really hoped to race this year, but watching was still enjoyable. Being out in fresh air is such a welcome change from a stuffy bedroom.

[jessmarimba]

I'd been wondering how you were doing. Glad to read your follow-up!

[itself]

After back surgery you make smarter choices. One of mine was to give up those things that caused any pain at all. Running was one of them. I feel so blessed to be able to hike, bike and kayak and lift weights, I don't miss running at all.

Glad to hear you are making progress!!!

[jdubble]

I went to watch a cyclocross race today -- my first big outing. I'd really hoped to race this year, but watching was still enjoyable. Being out in fresh air is such a welcome change from a stuffy bedroom.

i'm amazed you made it out to even watch a cross race so soon after back surgery! and in the rain we had yesterday! you go! :)

hope you feel better and better and are back on a bike before you know it.

[daisylubob]

Ered, how is your recovery going? I have been following this page since you made the thread. Back in winter '10 I put up a similar thread. Just yesterday, I set up an appointment w/ a neurosurgeon. I have gone through 4 rounds of PT (including Mckenzie) w/ water therapy, ultrasound w/ electrical stimulation, massage, traction, more core exercises, walking w/ a harness. I have tried oral Naprosyn, topical Naprosyn, 2 cortisone injections. Still no relief. In fact this past weekend, I woke up and my left leg was totally asleep from top of thigh to toes :eek: The pain ranges from being in my low back, to the left side in my hip, down the outside of the left leg to the calf and foot. There is also left sided weakness with some numbness. And this past weekend the pain was so relentless I ended up taking Vicodin, which I hate doing as it makes me feel all loopy, not to mention the constipation factor :mad: DRs, PTs, chiropractors all keep telling me it can heal in time, but I have not really seen any sort of improvements as far as 'long-term'. Heck 1 pain-free day would be awesome at this point. Hence the desparation of seeing a surgeon who may have to cut. Which I am totally scared about.

[klesko]

My L5 disk bulged for months in 2006. It does not bulge any more as long as I stretch every day and do yoga. When it starts hurting I exercise more. I can start out a bike ride in pain and have trouble lifting and un clipping my left leg and finish feeling great. When my disk bulged I walked and it would hurt really bad for half a mile and then I could walk briskly. The key to my recovery was physical therapy and the realization that exercise is the fix and rest is bad. I have a lot of spinal degeneration too. Hang in there and stick with the physical therapy. My leg still has a numb spot and feels weird sometimes now, but does not hurt and I ride 100 miles a week.

[Ered_Lithui]

I hope you get some relief soon, daisylubob! Your pain pattern sounds exactly like mine. The day my foot went numb was the day I knew I wouldn't put off surgery any more. After all you've tried, I imagine the neurosurgeon will probably recommend surgery too. If you have any questions or concerns about it, feel free to PM me.

I'm still waiting for some progress. It seems as though my pain has changed and become a bit duller, but I have to lie down every few hours or suffer the consequences. When I don't, the pain is the same as the worst days pre-surgery (and this is while taking strong painkillers; when I'm late with the neurontin, the pain is severe). Sitting or bending over a table for any length of time make it worse. I'm getting another MRI next week before my 6-week follow-up because it doesn't seem to be getting better. It's really frustrating. I'd hoped to be active by now, but all I'm allowed to do is walk and do a few tailored PT exercises.

But PT is frustrating as well; each week I get asked the same questions and given the same instructions. I understand the need for a new PT to review my symptoms the first time, but once they have it in their notes I wish they wouldn't go (without first consulting notes), "So which leg is it in, and where in the leg?" It's not as though the answer ever changes. Equally tiresome: focusing on the back pain and forgetting entirely that the leg is an issue. The latest PT even had me do an extension stretch before remembering my diagnosis and going, "Oops! You're not supposed to be moving like that yet so soon after surgery."

Which isn't to say the surgery was a mistake, just that the verdict is still out. (And thanks, klesko -- I look forward to being able and allowed to be active, too!)

[KnottedYet]

There was an interesting study done a few years ago where the researchers gathered a bunch of folks who had NO back pain or leg symptoms, and ran 'em through an MRI. http://www.nejm.org/doi/full/10.1056/NEJM199407143310201

25% of them had disc bulges so honkin' gigantic that they were instant candidates for surgery.

But they had no symptoms.

EVERY single day I have patients with classic disc symptoms, yet their MRI show no evil bulges at all, just minor stuff that raises no red flags. I treat them like a disc problem, and their symptoms go away.

It is possible for distribution pattern of symptoms to be more accurate diagnostically for symptom-generator level than MRI.

[KnottedYet]

I had a patient with history of severe back and leg pain and loss of motor function of the leg. Patient had a multi-level fusion and I think also multi-level laminectomies. At 5 weeks post-surgery the patient was pain-free and had returned to commuting by bike to work.

There is hope, hang in there!

(Ered, what post-surgery protocol does your surgeon have you using? The protocol is chosen by the surgeon, not by the PT, cuz the surgeon knows exactly what he did in there and how he wants you rehabbed. The various protocols have exercises and goals and precautions clearly spelled out for every week, so I'm kind of surprised that your PTs seem to be a bit at cross-purposes. Ask them to give you a photocopy of the entire 3-month protocol. It's nice to be able to see all the exercises and goals and the progression at once, rather than just one week at a time as they dole it out. It also lets you over-see the new PT you get who may not be familiar with you. I'm sorry you are frustrated that they ask the same dang questions about your pain every time, but we have to do that to monitor progress and changes. It drives my patients nuts, too!)

[jessmarimba]

I can't speak for Ered, but my surgeon doesn't seem to care what I do. He can't ever remember if I've even started PT yet and last time just told me I could do anything "reasonable" that I wanted. I hope hers is a little more involved!

[Ered_Lithui]

Wow! Your patient's surgery sounds horrifically involved. I'm amazed he recovered so fast! It gives me hope. I appreciate your professional insight.

I've read the same about MRIs showing bulges that produce no symptoms. My MRI did coincide exactly with my symptoms, though. (There were two other asymptomatic bulges as well.) There was also severe stenosis at the same location, which may explain why PT didn't help before surgery. The surgeon went in and carved out a fair amount of bone, in addition to removing the bulge.

As far as I gather, the main concern right now is that another bit of disc may have come out right after the surgery was completed. (He warned me beforehand that the latter was possible, though in his 1,000+ surgeries it has only happened about 2% of the time.)


what post-surgery protocol does your surgeon have you using? The protocol is chosen by the surgeon, not by the PT, cuz the surgeon knows exactly what he did in there and how he wants you rehabbed.
I will ask for more details; the PTs work for the hospital in accordance with the surgeon's directions.


I'm sorry you are frustrated that they ask the same dang questions about your pain every time, but we have to do that to monitor progress and changes. It drives my patients nuts, too!)
I get the need to monitor, but the nature of the questions ("And have you ever had any leg pain?") makes it clear that they don't remember (understandable) but also haven't bothered to even glance at notes from the last session. Urr.

[KnottedYet]

I get the need to monitor, but the nature of the questions ("And have you ever had any leg pain?") makes it clear that they don't remember (understandable) but also haven't bothered to even glance at notes from the last session. Urr.

Whoa, now that just sucks! You have my permission to slap 'em upside the head. Tell 'em it's therapeutic... ;)

[malkin]

I went nuts when they'd ask every day if I'd had any bowel or bladder incontinence---I wanted to scream--DON'T YOU THINK I WOULD HAVE MENTIONED IT???!!!!