It's not my hamstring - I have a herniated disc

[Deborajen]

After several months of stretching and doing PT for what I thought were very painful hamstring spasms or maybe a really tight psoas muscle, I got an MRI done of my back and left hip. The report says I have a large lateral herniation at L5-S1.

I just went back and read a thread about bulging discs from a couple months ago. Somehow, it really blows me away that I have what the doctor said is "a large herniated disc" when the only problems I have are with standing or walking for a few minutes. Granted, the pain is definitely what I'd call EXCRUCIATING, but I'm not debilitated with other activities or movements like so many others described in their posts.

The doctor said it's likely I'll need to have surgery at some point, but if I want to try something more conservative first that would be fine. I've made an appointment with a McKenzie certified physical therapist (there's only one in town) and if that doesn't help I might try an injection. If I need surgery I think I'll be o.k. with that, but conservative is better whenever reasonably possible in my book. The doc did say one thing that kind of bugged me. After he mentioned surgery, I asked if therapy to try to push everything back into alignment was a possibility and he said, "no, that doesn't work." I'm not sure if he meant "period" or just in my case - ? but I went on to ask him if he was familiar with McKenzie method. He said he'd heard of it but didn't know how it was done and didn't know who in town would - so I told him about the PT I'd heard of and he wrote me an order to set it up.

First available opening isn't until Monday after Christmas. I'll be counting the days . . .

[KnottedYet]

After he mentioned surgery, I asked if therapy to try to push everything back into alignment was a possibility and he said, "no, that doesn't work."

Oh, cr@p!
Then what is it I'm doing 8 hours a day, 5 days a week, that makes people with disc herniations completely healed and discharged after an average of 6 visits?

You already found a McKenzie therapist, but here's our website: http://www.mckenziemdt.org/index_us.cfm

[malkin]

Your doc kind of bugs me too.

[KnottedYet]

By the way:

Lateral protrusions do not like spinal extension at the beginning (yoga cobra, standing, walking) so if you see any goodies on "teh intertubes" about how "McKenzie" is all about extension.... IGNORE THEM!

McKenzie is not all about extension, and only 60% of protrusions respond to extension anyway.

Please don't do extensions. They will probably hurt. Nothing that puts your bits and pieces back into their proper position or proper shape should make you feel worse as a result!

Big juicy laterals like side-glides. Your MDT physical therapist will help you figure out what flavor of side-glide your back needs to help shove that darn disc back into its proper shape.

Meanwhile, you can try to ease it up some by lying on your stomach and drawing the sore-side (left) leg up to the side, like a frog-leg. (or a commando-crawl) You can also try to ease it as you wait by putting your sore-side hand on your sore-side hip and pushing your pelvis away sideways (to the right), so you look like a banana.

If neither of these gives you any relief, please don't do them.

The idea is to keep things calm and bearable until your PT can get to you.

Your PT will give you a corrective motion to do 10 times every 2 hours right then at your first visit. It shouldn't take you more than a minute to do each time. He or she will tell you how to evaluate yourself. Really, you end up treating yourself. The PT's job is really to educate you so you can be your own therapist.

[Deborajen]

Thanks for the exercises - I'll give them a try. I've given them a "walk-thru" and think I can do them correctly.--

Thankfully, I've been in a little less pain the last few weeks. I haven't run since June and I really miss that. But I have a gym membership so I'm able to ride a stationary recumbent bike and use the rowing machine so I'm not going completely crazy with inactivity.

[KnottedYet]

The two I described are both resting positions: lying on your stomach with either the sore leg (left) drawn up to the side, or with the entire pelvis shoved off to the right.

Only lie in these resting positions if they give you relief. (you can lie in them as long as you want) If they make you worse, STOP.

Anything that makes you feel worse is trouble, so don't get caught up in any "no pain, no gain" stuff. In this case, pain is NOT something to "work through."

Good luck, and I hope you can stay comfortable until you see your PT!

[Ered_Lithui]

Good luck with your PT! My doctors were similarly skeptical about PT (for this case; not in general), and it didn't ultimately help. I hope you will be luckier! If it does come down to surgery, I'd be happy to share my experience or answer any questions you might have. (My herniation was in the exact same spot, also large and to the left.)

[Deborajen]

Thanks Ered. I'm really hoping the PT will help. I keep thinking that if it's possible for me to knock my own back out of whack, then it ought to be possbile for me to knock it back into place myself, too. I mean, it's certainly not out of the question and worth a try.

So how are you doing with your recovery now? Are things going as you'd hoped/expected?

[Dogmama]

I had/have the exact same thing. PT definitely helped me. Surgery is a last resort, IMO. It may come back in a year or two (mine has) so you do PT again. Big deal!

[Trek420]

The doctor said it's likely I'll need to have surgery at some point, but if I want to try something more conservative first that would be fine.

Is your Dr. the surgeon? I realize modern medicine is an amazing thing and is indicated and the best option many times. But so is the human bodies ability to heal.

The thing I liked most about both the orthopedic surgeon I saw (torn ACL, blown meniscus) and the Podiatrist (broken big toe) is that when I said I wanted to pursue PT, non surgical options first they jumped at the chance.

Both said surgery would be the last option.

OTOH some wait too long for surgery and miss years of activity trying to tough it out. So it all depends on the injury, you and your doctor.

Whatever keeps us moving I guess.

[Ered_Lithui]

So how are you doing with your recovery now? Are things going as you'd hoped/expected?

I'm doing a lot better. Shortly after the surgery, the worst of the shooting pain went away for good. While I'm not yet as pain-free as I or the doctor hoped, the pain is less severe. I even went XC skiing yesterday and survived (in spite of the pain and being totally out of breath from months of inactivity).

I'm keeping my fingers crossed for you!

[Deborajen]

Glad you've made improvement, Ered. I'll bet it felt good to do some XC skiing. I really miss the good workouts, but I've gotta keep looking at the big picture right now.

Trek, I don't think my doctor does back surgery. He mainly works with ankles, knees and shoulders, and he sees general sports medicine which is why he was willing to see me in the first place. He prescribed physical therapy after my first visit when it appeared that I had a hamstring sprain or spasms, but he didn't seem to want to mess with a back problem. He did give me a PT order when I asked, and if I end up having surgery I'm leaning towards going to a neurosurgeon anyway.

I don't want to give up my active lifestyle for too long, but yeah, the human body has an amazing ability to heal. I want to give it every reasonable chance first.

[Deborajen]

Well, a week and a half into PT and things seem to be better. Ironically, I'd been doing better for a few weeks before starting PT. Like taking your car to the mechanic, right? You can have all kinds of trouble but when you're finally there to get it fixed, no problems! I still get some leg pain off and on but it hasn't been anywhere near as bad as it had been. Hardly any tingling. My therapist has me doing side glides plus some extensions. I'm doing them religiously.

Basically, I'm encouraged. It's kind of wierd getting an MRI which shows a big herniation and all of a sudden I start feeling better - THEN I start therapy. When I first started the side glides some of the movements did cause some pain in my leg - then it started getting better as we adjusted the exercises. It's hard to understand and know what to expect, but my PT says to keep at it. I'm certainly not complaining - I'm GLAD to feel better! Putting my mind around this one sure is hard, though.

Cause I'd love to go for a run right now! (But I won't!)