MRI update... PT's welcome :)

OK, I got the results back. I was hoping some PT's would jump into the mix here for some advice again as before:p
I have Broad disc bulges at L4-5 and L5-S1 a central disc protusion at L5-S1 and possible musculoligamentuous injury or sprain. I have an appt with a spine DR on friday. They said the do EVERTHING else first before surgery.
I miss my bike and hope I can still bike ride and ride horses again. I was still doing this until last week when my back hurt again and started spasming. Im not spasming now and usally when I will feel better I get back on the bike, but this time I have not, Im waiting to see what the Dr says. This is all Dr. lingo to me anyhow. Anyone have a simpilar term?:eek: You guys are a great support, thanks:D

Sounds like you're going to PT, unless the protrusion is squooshing into nerves. (numbness, weakness, loss of control, intractable pain)

Imagine you have jelly beans with liquid centers between each of the bones in your spine. One of your jelly beans (the one between L4 and L5, the last two bones of your low back) has gotten flattened a bit and is hanging out a little too far, instead of being nicely centered and bouncy between the bones. Another one (the one between L5 and S1, the last bone of your low back and the start of your pelvis) is also flattened and hanging out a bit, but it also looks like the liquidy center of that jelly bean has oozed out some.

Bulges can slurp back into place when the pressure that flattened the jellybeans in the first place is taken away (a lot of that is posture correction and strengthening and rest from aggravating activities until healed). Protrusions can slurp back some or can stay put or can be taken out in surgery.

The tight hip flexors you got from all those sit-ups can aggravate bulgy stuff. (ask your PT about "anterior pelvic tilt" too, please please please.)

Be diligent with your PT exercises, the precautions they give you, the ways they teach you to get up and down from bed and in and out of the car, and the limitations they put you on. (even if they limit your biking!) Limitations are temporary to give you a chance to heal, so try not to "cheat."

Keep us posted!

KnottedYet, your first reply was good! The edited one was just spectacular. Me and my husband both read your response. We understand more clear. Thank you so much. His question is, is this very serious?

I don't know how serious it is, that would depend on how big all the squooshed bits are and what they may be touching or pushing into. (The idea that you feel better after just a week of limited activity make me think it's probably within the realm of PT, but don't quote me on that!)

Most people have disc bulges here and there and now and then, which don't bother them until something else comes along to aggravate the situation. Your DH probably has one or two and doesn't even know it!

Your body can compensate for a zillion things, but along comes the last straw and suddenly you find out about *everything*! Even stuff that might not be causing the pain you feel!

I know every case is different, but reading your description of your MRI results, it was almost exactly the same as my father's MRI results. He completed about 4-5 weeks of PT, and his symptoms have completely resolved. He says that this is the first time he's been pain free for years. So bottom line...PT really helped him. It kept him from needing surgery. I hope the same for you. He'll be 60 in a week and he likes to brag about how long he can hold a plank. :)

I hope your visit with the Dr goes well.

First of all Luna, I agree completely with Knott. As a matter of fact I don't think I can recall a time thus far that I haven't. But that's besides the point.

I do want to add a couple of things.

Quote:

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Originally Posted by Luna

OK, I got the results back. I was hoping some PT's would jump into the mix here for some advice again as before:p
I have Broad disc bulges at L4-5 and L5-S1 a central disc protusion at L5-S1 and possible musculoligamentuous injury or sprain.

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Broad based disc buldges are usually the result of some degradation of the material in the central part of the disc. The oozy bits that Knott referred to. This often occurs weeks, months or years following compression type injuries. Falling on your rear or getting strongly jarred through your sit bones could do this. Usually the fibrous tissue on the outer part of the disc is intact and holding the oozy bits in, just everything is a little more floppy and less stable. Protrusions are a progression of this. Good news is that if they are central and not pressing on the nerves, they are also pretty manageable.

These injuries are very different from a primary, traumatic disc bulge that would require surgery. Conservative treatment should get you back on track (no pun intended).

As mentioned above, core strength and stability exercises are the key. Hip flexibility is also very important. Hamstring flexibility will heavily effect your ability to ride the bike. I agree with Knott on the pelvic tilt issues and would second the need for finding a neutral pelvic and lumbar position and training the muscles to support your body in that position.

Good luck and keep posting questions when you have them.

Quote:

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Originally Posted by Wahine

First of all Luna, I agree completely with Knott. As a matter of fact I don't think I can recall a time thus far that I haven't. But that's besides the point.

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Thread Hijack: Wahine, do you need a PT Asst?;)

Hmmmmmmmm. I'm not the boss and I don't think I would convince the boss to hire. But I'd test the waters if you're serious.

I've gotta be one of the worst people around for starting a thread hijack or going with it. Maybe I was a pirate in a former life.

WOW, there are some super smart, educated people on this board and I am truly blessed. I can not thank you enough for the information you have given me. I am looking forward to getting healthy again and stronger. I just cant wait to get started!! I see the Dr. on friday, I will try and stay sane till then. I feel more at ease now in reading the replys.:p

take it easy and let your back settle down until you see the doc/start PT.

NO SIT UPS!!!!

Think of this time as your quiet calming time for your back. You'll start the work after Friday!

Good luck with your PT Luna, I hope you have good luck with that.

Knotted, I like the analogy of the jelly bean especially as this time of year you can find the pectin jelly beans which are extra squooshy.

I hope you can continue NOT to have nerve impingement, NOT fun. I have my bulged/herniated disk at L5-S1 and hope that my surgery takes care of the nerve pain so I can get back on my bike as well. I know what you are going through wanting to get back on the bike. Good luck

Boy, waiting till friday has me coo coo. It is soo hard to lay up. Im not in a whole lot of pain right now, although my neck has been hurting and it was suggested that it was due to my lower back and tension???
My buiness is steady but slwo and this would be the time I would use for biking. Too much rest is not good for this girl.:cool:

Hi Luna!
I know I'm new here..and maybe b/c of that I don't carry much weight yet... but Knott and Wahine are SO on point with what you should concentrate on. I have no doubt you've been in a lot of pain and it IS very disconcerting - esp when all ya wanna do is get back on the bike and ride!

Been there...

My experience with my L4-5 bulge was different than yours and went through a different path, but I want to emphasize the PT aspect of your greatest potential for help with the bulges/pain/strains. What happened to me was that my disc was ripped b/c of a moderate car accident. It was probably already slightly degenerated because of my running and cycling (mostly running!), but I hardly ever had pain before. After it ripped, I tried every kind of therapy (save for accupuncture) and waited 5 yrs off the bike and in pain before saying yes to surgery. It was definitely NOT healing, but getting worse.. 3yrs AFTER my surgery (and still off the bike), I thought all dreams of getting back ON the bike were lost..let alone being pain free.. I was taking dilaudid (of all things) to control the pain - it was that bad. .... I was on my last string of hope.. I didn't want to live like that so I begged for another try at Physical Therapy.
THANK GOD it worked this time. I didn't think anything would - but I really tried and it did work!

I'm a bit long winded - sorry!! I know this is early in your recovery and really.. you can be sure that 95% of back pain sufferers really do not need surgery. Please give PT all you've got...if you've got a great therapist and a good relationship with him/her - you will come back stronger and pain-free.. with tools to help you the rest of your life!

Beware of the knife-happy surgeon (esp if you have good insurance)...sometimes they'll look at an MRI and see bulges or encroachments and immediately suggest surgery. If you've got a good, conservative one...he'll give everything else a chance before resorting to surgery.

I'm pulling for you! Go girl!! :)

P.S. I've been narcotic-free for 19mos!! :) :) :)

I've been there too, and PT helped me. I did it for about 3 months, stretching, and traction (sp??) where they put you in this device with heat. Absolutely great machine :) I think I fell asleep once...

But good luck...know that it does help some people. I haven't had anything come back, and its been about 5 years so far.

thank you!!!!!

I start PT on tuesday. The Dr. did not give me much info. Just its nothing real serious, gave me some celebrex and sent me to PT. He did say that if Im not better in 6 weeks, he would like to put steroid injections in my back:eek: . Heck Im not doing that, I dont even have a hernated disc.

Yay! PT for you!!!

I'm not too keen on steroid injections, but if you don't feel you are improving enough check it out as an option.

Let us know what your PT has you doing! (we'll all critique your PT, hee hee!)

I'm so glad you're going to PT!

Look at a website called laserspineinstitute.com. They do arthroscopic laser surgery on disc and spine problems. Most people are on their feet in 1-2 weeks and back exercising

:D Ok, Ill keep you posted on what the PT has me doing. Look for updates!!:p

Hooray - that sounds promising, Luna! ("nothing real serious")

I bet the PT does the trick. Celebrex was pretty helpful for me too!


IF you do face those ESIs (epidural steriod injections)...don't fret TOO much about the pain w/the procedure. Although they never helped me much, they are different for different people. I just wanted to say that ONLY try it if the doctor is offering sedation with the procedure. I've done it once without (my first time) and I'll just say.. Uhhh.... I never did it without sedation again. Lemme just say that Versed is a WONDERFUL cocktail. LOL

Over my 9yr experience with back trouble, I've had 3 sets in my L4-5 and 2 in my SI joints (hip joints). PT always trumped these shots for me. Still...if you go down that road..there is a chance it can help. I will send some healing good thoughts for you that anti-inflammitories and concentrated PT is all you need!

Keep the faith, Luna!
:)

HI all.
I was put on a traction machine today. I was mostly assesed and then later this week he will give me some exercises. He said my hip was out of alignment a little. He has me doing a yoga stretch that i bend back on my stomach.
More to come.
He was real nice and smart, oh and he stretched my hip flexors.
I was a little ingflamed and iced some and too a celebrex.
I dont like this celebrex though, it has too many warnings.

So far so good Luna!! It's not unusual to be a little inflammed from the assessment day. Now that he's done all his testing he'll get right into treatment the next day and you'll likely not feel so sore afterward.:)

That yoga stretch.... I'm guessing that was a back extension? That IS a good position/stretch... I do that every morning and evening. It looks kinda like the 'cobra pose' (but don't go much above your elbows!).
I also do a great-feeling one that looks like the 'puppy dog' pose (get on hands n knees, then drop/rest your chest to the floor - keeping your sit-bones in the air.., make sure your femur bones are at a right angle to the floor, let gravity put traction on your lumbar spine... great stretch!)

If you read the indications/contraindications (warning labels) on any prescription medication, it can scare ya no matter what it is! Trust me! I've seen many that spooked me too. Pharmacist helped set me straight. I wouldn't worry too much about Celebrex for the short amount of time you'll use it though. If you want...try Aleve instead. (not that I'm a doctor - but one of mine told me once that it is just as good - and cheaper!). Aleve is naproxen sodium - a generic of naprosyn (anti-inflammitory). Good stuff, too! Orrr... good ol ibuprofen.. another good anti-inflam.

Unfortunately, I've had a lot of experience with a myriad of pain medications. And as I said...the really GREAT anti-inflammitory was my PT!

You're on the right track, Luna! :)