Bulging disc and sciatica

[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.