Bulging disc and sciatica

[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

[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!

[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.

[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...99407143310201

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.