Discovered the cause of my back pain - Herniated L4/L5 disc

[DeutschBag]

I did search and read through a lot of the threads that have been posted here. Mainly, I'm wondering how some of you that have had a similar problem are faring these days. I'm referring mainly to the posters in this thread: http://www.tetongravity.com/forums/s...herniated+disc

I just had my MRI today. Here it is:


Although the bulge doesn't look all that bad, it has caused me a tremendous amount of pain and has greatly reduced my mobility. Because of the bulge, I'm also experiencing sciatica, with shooting pains down my left leg, the pins and needles feeling in my lower leg and foot, pain behind my left knee, and muscle weakness. My entire lower back feels like jello, too. The only thing that has helped with the pain has been percocet and muscle relaxers. Oh, yeah, I've had some bad muscle spasms and soreness too.

I've been eating strict Paleo for the past 8 months, have lost 45 lbs in that time, and have been working out regularly. I was doing yoga a couple of times a week, stretching, and doing resistance training using my own body weight (push ups, sit ups, lots of pull ups). For the past 5 weeks, I haven't been able to do much of anything, and it's sucked. Doctors kept telling me to rest and things would get better in a couple of days. They've only gotten worse - a lot worse.

I'll be seeing my GP tomorrow and see what he advises as a next step. It's got me a bit freaked out, though. We are expecting twins at the end of January and it sucks right now that I can't be there for my pregnant wife.

Anyway, I guess I'm just looking for some advice or for someone to tell me it will get better. I can only hope!

[irul&ublo]

Why would you be getting your advice from the GP? A neurosurgeon would be better.

[PB]

It sounds like you might be considering surgery - don't; definitely move on from the GP - I'd recommend a sports med. clinic/physiatrist, and a rigorous PT regimen.

[splat]

Find someone who does ortho bionomy in your area. Quite likely one session will get rid of the sciatica. Then go to a good natural foods store (not whole foods, something more core) and get pure st johns wort oil. Apply it to that area everyday for a year. Worked for me. It's something you are far better curing yourself; unless you want to send some doc's kid to college while you gimp out for the rest of your life. (That's not a certainty, but I've seen it happen to a few friends).

[DeutschBag]

Things are a bit different for me on the medical front. I'm an American living in Germany. My wife works on one of the bases over here so we have access to the medical clinics. I tried to book an appointment with the local German neuro clinic, but they are booked through the end of October. They wouldn't even let me make an appointment yet. The only reason I go to the GP is for real medication. The Germans consider Voltaren (dicloflenac) a 'very strong pain pill'. Although I hate taking narcotics, sometimes it is a necessity just so I can get up to go to the bathroom. That's why I go to my normal GP. I also need him to refer me to a doctor down in Regensburg. It's the only way I can get in to this certain doctor's clinic.

I'm not contemplating surgery at all at this point. I was just curious how people were doing that posted in the other thread since it's been a few years. What worked? What didn't? I will look in to Splat's suggestions and see what I can find. Also, if I did have 2 or 3 or 4 doctors recommend surgery, it's a helluva lot cheaper to get it done over here than it is in the US. I think my first step will be visiting the PT clinic down the road from me. Hopefully that will help alleviate the pain enough that I can deal with it without taking drugs.

thanks for the replies.

[splat]

Maybe find an osteopath or homeopath there. The Germans also invented homeopathy.

[GBB]

I'm doing much better with the exception of a small relapse last spring. Keeping my core strong and stretching are the two things that have really helped me.

Let me know if you have any specific questions.

[::: :::]

While healing up without surgery is laudable (and awesome if it works out), it's not the only thing to consider. In my case, also an L4/L5 herniation, surgery was exactly the right thing. I tried a variety of alternate therapies for over a year and unfortunately none of them worked.

I have been back to normal for 5yrs now since surgery.

Consult a good neurosurgeon who understands your intended level of activity.

And a big +1 to stretching and core work for a healthy back!!!

[cat in january]

I had the same herniation as you although more severe (had foot drop where I could not control my left foot). I ended up having surgery and it worked for me, but it does not work for everyone. I was not aware of the procedure splat had done at the time.

There has been some good advise and I will throw in my two cents-take from it what you want.

At the point you are at, the two things which helped me the most were a regimen of ibuprofen (reduces the swelling) and walking-seemed to loosen the tightness and help improve posture and strength. As soon as you are able, go for a 5 minute walk and then increase it slowly.

As things improve, and they will, become hyper aware of your body posture and work to maintain good body posture, Yoga helped me with this. Tell the yoga teacher you have a bad back and they will help you with the proper way to move.

Learn how to lift using your legs and good body mechanics. Even once the pain goes away you will be vulnerable for a long time. Slowly start building your core-ideally under the direction of a PT.

Congratulations on the weight loss-keep losing weight.

Get off the drugs as soon as you can. They make you feel lousy and get you out of touch with your body.

Congratulations on the twins!

[Meathelmet]

Deutch,was in the same boat 2006.

http://www.tetongravity.com/forums/s...ter?highlight=

http://www.tetongravity.com/forums/s...TR.?highlight=

If you have more questions,feel free to ask! Now in a bit of a hurry...

[mamason3]

I woke up with a herniated disc at the L4-L5 level and severe sciatica down right leg. It started March lst, 2011 and finally has gone away. I went to a back spine specialist. No one knew the cause after all the tests. Given narco and P.T. 3 x wk. Also went for corto-steroid injections into my spine at the injured level to reduce the swelling. Rest, the P.T. and their exercise, injections, and 4 months time finally cured it. I am 65 and very active.

[DeutschBag]

Thank you for the replies, folks. Right now, I'm still in a holding pattern. I do have a neurosurgeon going through my MRI back in the States and am just waiting on a plan of action from him. The great thing is, I found this doctor on a Paleo message board and he is pretty well-renowned. He's giving me a great deal on doing the read and he is in the same frame of mind as me regarding eating Paleo and keeping fit. I was supposed to hear back from him last week but the package I sent was delivered to the wrong address (damn USPS....).

It's been a little over a month since things started going really haywire for me. I'd love to report that things were getting better, but they aren't. I tried a session of PT and then had to lie on a couch for three days afterwards. When it gets really bad, my legs almost feel like they stop working. I've fallen a couple of times as I've taken a step and my leg 'just wasn't there'. Last week, I maybe averaged 2-3 hours of sleep a night. I just couldn't get comfortable and my lower back had a constant and very intense burning feeling. It was a rough week.

I've been doing a few things that do seem to be helping a bit with immediate pain. I picked up some all natural salve at an Apotheke/Pharmacy here that seems to work quite well for letting me go out and move around lightly for a couple of hours. I did ask for St. John's Wort, but haven't been able to find any yet. Also, if things get really painful, I lie down with my back flat and my legs propped up high on two large pillows. That takes a lot of the extra stress off of the injured area. I've also started sleeping this way and feel much better when I wake up each morning. The pain just comes back with full force after being up and moving about for a bit. I also am wearing a good back brace if I plan on being up and standing for more than a few minutes.

Out of sheer desperation a couple of weeks ago, I order the free book (well, 2 bucks shipping) "The 7-day Back Pain Cure" by Jesse Cannone. It's poorly written, repetitive as hell, and has a fairly misleading title, but there are some good nuggets of wisdom in there. I think the idea of inversion therapy might work well for me right now. Just seeing how taking the stress off the injured area helps so much when I have my feet up leads me to believe this might be something worth trying. I need to find a PT clinic around here that has a table I can try. Another thing I may try from the book is 'trigger point therapy' using a little board with balls on it to work knots out of your back. I have them everywhere up and down my back. My aunt, a massage therapist, said my back was a complete mess all the way up through my neck. The book also mentions his 'muscle balance therapy' which I may look in to later.

Bottom line, I'm willing to try anything at this point. When my body is up to it, I do want to try more yoga. I have friends who teach classes that are willing to help me out. Even they say I shouldn't try it right now, though. I have been stretching when I can, though, and I'm happy to report that my abs are still feeling pretty strong. I guess I really notice myself using them more now that I have to balance my body out when my lower spine is feeling like mush.

GBB- glad you're feeling better. I just worry about the recurrence of injury when I'm out skiing or biking or hiking. What a crappy time to have your back go out!

Meathelmet - going to check your links out later this afternoon. AND - thanks for the heads up I need to get healed up so we can meet up in the Alps this winter!

Cat in January - thanks! I have stopped with the narcotics. A couple days of them is okay, but anything more than that sucks. I'm not taking any OTC pills, either. The salve is working much better than the Aleve I normally take and is helping with the swelling much better. It's called 'Kytta-Salve f in case anyone is wondering.

[::: :::]

from a pain mgt perspective, you may also consider acupuncture

[DeutschBag]

There aren't a lot of acupuncturists in my area, and I don't know if I'd trust a German with a lot of sharp needles! I've had acupuncture done a few times while living in Japan. Works great for some thngs, not so good for others. I was told it wouldn't do anything for my current problem, but who knows.

So, my mom just got over to Germany for a 3 week visit. Yesterday was our first day out and about, a fairly relaxing day by most standards. By 4 pm, I could hardly move or walk. Now, I'm up at 4am because I haven't been able to sleep all night. She wants to go see castles and quaint towns on her trip. I need to figure out a way to convince her that windmills are cooler than castles and that Amsterdam is in fact a very quaint town. Holy shit this sucks.

[HankScorpio]

My girlfriend has a similar injury. In April of this year skiing at Stowe she did the same thing to her back and ended up in the hospital for 4 days it was so bad.

Its been an uphill battle trying to get her better. We're on a second doctor, who's a spine specialist. She's been giving her cordozone (sp?) shots for temporary relief and she insists that it will heal on its own. She says surgery isn't necessary. I'm convinced she's making $ off these shots and doesn't want to pass her off to another doctor. After every shot she asks the doctor, "So what's the next step?" and every answer from the doctor is, "Let's see how the shot works."

She does low impact exercise to help it (spin classes, yoga, walking). The doctor said to not rest for more than 2 days. Movement is the best way to help it heal. She also gets massages which seem to help quite a bit.

I've heard acupuncture works wonders for ruptured discs, that may the next step.

We've both learned that back injuries are frustrating and there isn't a guaranteed cure. I spoken to people that have had surgery to fix ruptured discs and some said it worked and others say the pain just came back.

Good luck man.

[::: :::]

vtsession, hopefully, your GF isn't getting more than 3 cortisone shots in a year. from my doctor experiences, there was an end to the cortisone therapy; each shot should be worth two or three weeks of relief. it will either work or not; it shouldn't be extended for months.

[HankScorpio]

vtsession, hopefully, your GF isn't getting more than 3 cortisone shots in a year. from my doctor experiences, there was an end to the cortisone therapy; each shot should be worth two or three weeks of relief. it will either work or not; it shouldn't be extended for months.

She just got her third shot since April, so that was the the last one. We're still not pleased with the doctor bull shitting her to just wait to see if the shots work. Time to find a new doctor.

[DeutschBag]

Update - Things have gone from bad to worse. I woke up yesterday and couldn't move. The pain was amazing. The only reason I even got 4 hours of sleep was because I finally took a Unisom at 3am to knock me out. Numbness from my buttocks through my entire left leg down to my little toe, the one next to that, and the inside of my foot by my big toe (Yeah, all those nerves running down the leg). I absolutely cannot get comfortable no matter what I do. The pain behind my knee has been almost unbearable as well.

I've tried 3+ months of the conservative approach, and things are just getting worse. After sitting down and talking with my wife, we came to the realization that I've had these back problems for far, far longer than I had thought. It's just while I was battling gout, knee surgeries, and a severely broken jaw over the last 7-8 years, the back pain played second fiddle and I never tried to take care of it - until now.

I just saw my doc and had a consultation with a neurosurgeon and we all decided I'd try the conservative approach for at least a year. And then I wake up two days later and can't walk. If shit like this keeps happening, though, how can I do anything except lie here in pain? Oh, and those twin daughters? Only 2.5 months until they are here.

Seriously contemplating surgery at this point. Tell me if my thinking is wrong here:

- I've been eating Paleo/Primal since last Feb and eating healthier than 99% of Americans before that. My body's inflammation is in check (had my CRP levels tested recently - new results come back in a few days). I'm way ahead of the curve in this regard compared to most other back pain sufferers.
- I know more than the average Joe regarding sports physiology, exercise mechanics, etc.... meaning, I know how not to hurt myself while exercising. I know proper bending and lifting techniques, etc.....
- I've been active my whole life. Even when hurt, just by simply walking for 10 minutes, I'm getting more exercise and rehab than your average Wal-Mart shopping, 64oz Big Gulp slurping, fat-ass tv watching pile of diabetic shit that many Americans have become. (I also have a shitty disposition right now, so bare with me).
- I'm a pretty good judge of pain. Had some experience there. This is pretty bad. It's not as bad as a bad gout attack, but it's pretty f'in bad pain.

I guess I'm just trying to illustrate that I know what the conservative approach is all about, and I've done it, probably better than most people - and it's not working.

Thoughts?

[::: :::]

now that i'm thinking about it again, i had my surgery about 2 mos prior to my son being born. the good news: you can still recover in time to help hold little 8 pound bundles of joy; you'll need about a month min...bad news: you need to be scheduled soon and will need the cutting doc to review everything with you prior

the recovery will continue beyond that month of course, but basic function will be there

is there not a solid military neuro in euroland that can help you out?

good luck!

[TGR420]

Update - Things have gone from bad to worse. I woke up yesterday and couldn't move. The pain was amazing. The only reason I even got 4 hours of sleep was because I finally took a Unisom at 3am to knock me out. Numbness from my buttocks through my entire left leg down to my little toe, the one next to that, and the inside of my foot by my big toe (Yeah, all those nerves running down the leg). I absolutely cannot get comfortable no matter what I do. The pain behind my knee has been almost unbearable as well.

I've tried 3+ months of the conservative approach, and things are just getting worse. After sitting down and talking with my wife, we came to the realization that I've had these back problems for far, far longer than I had thought. It's just while I was battling gout, knee surgeries, and a severely broken jaw over the last 7-8 years, the back pain played second fiddle and I never tried to take care of it - until now.

I just saw my doc and had a consultation with a neurosurgeon and we all decided I'd try the conservative approach for at least a year. And then I wake up two days later and can't walk. If shit like this keeps happening, though, how can I do anything except lie here in pain? Oh, and those twin daughters? Only 2.5 months until they are here.

Seriously contemplating surgery at this point. Tell me if my thinking is wrong here:

- I've been eating Paleo/Primal since last Feb and eating healthier than 99% of Americans before that. My body's inflammation is in check (had my CRP levels tested recently - new results come back in a few days). I'm way ahead of the curve in this regard compared to most other back pain sufferers.
- I know more than the average Joe regarding sports physiology, exercise mechanics, etc.... meaning, I know how not to hurt myself while exercising. I know proper bending and lifting techniques, etc.....
- I've been active my whole life. Even when hurt, just by simply walking for 10 minutes, I'm getting more exercise and rehab than your average Wal-Mart shopping, 64oz Big Gulp slurping, fat-ass tv watching pile of diabetic shit that many Americans have become. (I also have a shitty disposition right now, so bare with me).
- I'm a pretty good judge of pain. Had some experience there. This is pretty bad. It's not as bad as a bad gout attack, but it's pretty f'in bad pain.

I guess I'm just trying to illustrate that I know what the conservative approach is all about, and I've done it, probably better than most people - and it's not working.

Thoughts?

I was diagnosed with a herniated l5 s1 in June . It was been brutal. I have the same shooting down my leg. I started using an inversion table a week ago that a friend leant me. I can honestly say the last week has been the best progress for me. I am far from out of the woods, but going upside down has really helped. I finally feel like I am healing. I will update later. I am also working on core and stretching. Doctors suck and don't seem to know anything in my opinion. Healers are way better.

[DeutschBag]

420 - I tried to order an inversion table a few weeks ago, but was told it couldn't be delivered (after I placed the order). I have tried inverting on a weight bench I have, and it does help a little. Just taking the pressure of off that disc and the nerves does help, but only while inverted. The relief does not last long. Maybe it would be different on a real table, but I'm pretty sure what I'm doing and what an inversion table would do is pretty similar. The mechanics aren't that hard to figure out. I also tried using my Tens unit - that was odd. Every time the thing would shock me, I would feel it all the way through my leg to my toes. Although not altogether unpleasant, it was a bit disconcerting and didn't really help. Even when set on 2 (very, very low), I could feel it. That's not normal. It did help with the tightness in my shoulders, though.

I got my C-Reactive Protein results back today - well below normal. So, systematic inflammation is definitely under control pretty much meaning only one thing - there is a pretty bad injury in my back regardless of how benign it may look on my MRI (although the neurologist who looked at it saw a lot more going on than the average Joe would see).

A bit off topic, but my CRP results have me absolutely convinced that eating Paleo/Primal is how we humans are supposed to eat. I haven't been able to do shit for months, but I've actually gained muscle mass and have leaned down considerably because of my diet. To anyone who has any type of autoimmune disease or is just feeling crappy in general, give it a look.

I've been in contact with OHSU in Portland and more than likely will be flying (heavily drugged flying) back in the next two weeks for surgery. My doctors here in Deutschland say surgery is the best option left for me. Didn't want to hear that, but as Kurt V would say, "so it goes....." Thanks everyone for all of the input and advice. I love this site. Some real good and knowledgeable people on here - Thank you.

[axebiker]

L5-S1 grad here.

I'd love to offer a pile of encouragement, but I'm now in about year 6 of dealing with it.

I know the pain of the feeling of being unable to move...it's awful!! I had the radiating pain you talk about to the point I was literally unable to walk. I sneezed, and it put me to the ground (at work) for almost 45 minutes. I tried Chiro to no avail, tried pain killers and steroids, and a cortisone injection. The cortisone was a miracle for me. I crawled into the doc's office, got the injection, crawled out, got on a plane two days later, and skied The Headwaters at Moonlight Basin the day after that.

I still have issues with significant pain from time to time, but try to manage it with NSAIDs, stretching (mainly hamstrings), non-impact exercise, and knowing my limits. It is still shitty, but my neurologist wasn't a proponent of the knife at that age (then 35). I have an inversion table, and while I'd like to think it helps, it's a minor help at best.

I keep getting told that core strength is he key, but the dirty little secret is that I have not been "well enough" to ever really concentrate on core exercise. I'm getting back to he pool soon though, and that should be a good compromise.

I wish all you back gimps the best - it's a brotherhood for sure although one I wish I had never had the opportunity to join. Sucks...if people have never had these issues, they cannot even begin to understand the pain and debilitation of something that seems so "minor".

[::: :::]

if you can get past the voice, you might try this 15min exercise video
http://www.adventure-journal.com/200...with-exercise/

[DeutschBag]

Put this on the sciatica thread, but thought I would post it here too. I'll write more when I'm able to sit up for a longer period of time. Damn stitches in my back itch and the healing pain makes it hard to sit up for too long! But, I feel SO much better after the surgery!
-------------
Just had an emergency surgery to fix my sciatica and horrible lower back pain. Doc said it was my only choice since I could barely walk and no positions were comfortable for me. Couldn't sit, stand, lie down without tremendous pain. Even though my MRI didn't look too bad, when the neurosurgeon got in there, the damage and compression on the L4/L5, L5/S1 nerve roots was quite substantial. Surgeon said the surgery went great and expects a full recovery and a 100% return to action in 8 weeks. Still healing up, but am quite ahead of schedule according to me docs. Gotta thank my diet for that (Paleo). Not saying surgery is the answer for everyone, but I'd been dealing with this for years and no conservative approaches were working. Hope you all can find what works for you.

Also wanted to add that a majority of my lower back pain was being caused by the degenerative disc. Not only did it make my lower back feel like jello with accompanying radiating pain, but it also affected ALL of the muscles in my back and neck. They scooped all of the bad stuff out (there was a lot I guess), then put something in there to reinforce it. They said it went great and will be better and more stable than ever. I can't believe how much better my entire back feels. The muscle are unlocked for the first time in years! I can give more details when I get the letter from the surgeon. My german isn't perfect, so I need to translate it when it gets here.

[bendtheski]

DB,
Glad to hear it went well with the surgery and you're experiencing significant improvement. That was my experience as well, but with so many treatment options, one of the least attractive being surgery, the decision really needs to be left up to the individual.

Funny, mine was done as an emergency procedure too, and at that point I felt as though I had pretty much run out of options. I think I was lucky to have found a good neurosurgeon, and to have followed his advice.

Not sure if you came across it in your quest for knowledge, but I posted this in another thread related to sciatic problems:

In Jan 2003 I herniated my L4-5 disk. Started out with the Chiro who happened to be my roommates brother, and an honest dealer. I had seen him on and off for a few years for occasional muscle spasms and the like. He immediately recognized this as being more serious than anything I had seen him for before.

I was walking with a pronounced limp, had pins and needles, and pain on a 8-9 level after sitting for 15-20 min. The Chiro suggested I go immediately to an orthopedic.

The orthopedic gave me cortizone or similar prescription for a week, and when that didn't provide relief, scheduled an epidural/steroid injection into the affected area. The steroid injection gave me relief for one day, at which time my orthopedic scheduled an MRI.

The MRI revealed a herniated L4-5 disk. By this time it had been approx. 5 weeks since the original injury, caused by a hard, twisting compression while skiing bumps on New Years. The orthopedic referred me to a neourosurgeon and I had surgery the second week in February. Micro-lumbar laminectomy/disectomy.

I experienced immediate relief, and regained a good deal of the strength that was lost due to pressure on the sciatic nerve (S1). Rehab was pretty easy, and I was back to abusing myself on moguls the following December.

I would say that surgery for this type of thing should always be a last option, and there are many other options that may provide significant relief. I had chronic lower back problems leading up to herniating a disk, but herniating a disk is a whole other level of injury/pain/discomfort than simple muscle tears/spasms, and I think I made the right decision opting for surgery.

Ultimately, it was the foot-drop and the MRI that made my mind up for me.

One piece of advice; don't rush getting back to action. I had to move about 6 weeks after surgery and did way more lifting than I should have. It wasn't a major set-back, but probably prolonged my recovery by at least a month.