Bulged/Herniated Disc advice?

[sethschmautz]

Bloom can give his two cents when he has the opportunity, but the cortisone injection helped me a ton. I am not back to normal, by any means, but the problem is much better than it has been. I've been riding my bike to and from work (usually about 12 mi per day) and went on a 9 mile hike this weekend. I've been able to do more around the house and the exercises that my wife/PT has given me has made a tremendous amount of difference. I'm back in the gym this week starting up a lifting program that will help to develop the stabilizing muscles, and any extension (lying on your stomach, pushing with your arms creating an arch in your back) seem to help a ton and put you in a position where the disc can move back into the right place (thereby relieving the pain in your leg).

[fallguy]

seth,
everyone's injury is different and every person different. i've seen people have complete relief from pain with one epidural, and i've seen some who have about 1 hour of relief. it's hit and miss. for me i have L4/5 and L5/S1 in the low back and C7/T1 in neck and the epidural worked great for the neck. i also use an inversion table when things get out of whack ($200. at play it again sports). the disc bulge itself will decrease with time, provided you don't reinjure that area. it doesn't go back in place, but the flow of CFS over the bulge will slowly erode it taking presure off the nerve. now the bummer is that disc is the weak link in the chain. on the mark with strenghtening the core muscles. good luck

[GBB]

Sorry, I haven't checked this thread in a while. The cortisone shot helped, but not as much as I had been hoping. However, I have gotten myself into a daily stretching routine that I think (and feel) is helping tremendously. I can now walk long distances with much less pain than I had before.

Every night, I spend about an hour really stretching my back and my lower body. Although the hamstrings are still tight, I feel like I am making progress and very slowly the tension is starting to diminish.

Along with the stretching I'm doing regular core work to strengthen and stabilize the muscles around my back. However, I'm open to new stabilizing exercises that would help. Seth do you mind sharing the program that your wife/PT put you on?

[skideeppow]

Sorry, I haven't checked this thread in a while. The cortisone shot helped, but not as much as I had been hoping. However, I have gotten myself into a daily stretching routine that I think (and feel) is helping tremendously. I can now walk long distances with much less pain than I had before.

Every night, I spend about an hour really stretching my back and my lower body. Although the hamstrings are still tight, I feel like I am making progress and very slowly the tension is starting to diminish.

Along with the stretching I'm doing regular core work to strengthen and stabilize the muscles around my back. However, I'm open to new stabilizing exercises that would help. Seth do you mind sharing the program that your wife/PT put you on?

send me your emial of fax, i can get you my workout early next week. This saved me from back surgery.

[s.p.c]

skideeppow- do you think you can post it? i f'd up my upper back playing soccer. resting and want to be sure i am strong in my core/back etc. before ski season. as well as general back workout.

if it is too long, no worries and i may pm you.

[mntlion]

stand on a physio ball while watching TV, get off for the commercials (8 on / 2 off)

I did that while watching the simpsons for a long time

[GBB]

send me your emial of fax, i can get you my workout early next week. This saved me from back surgery.

pm sent with my e-mail. thanks man.

[Buzzworthy]

Opens door, barely walks in. Man down. Have 2 bulged discs and blew out the lower back. Seeing the doc and chiro, chiro today.

Ouch, again.

[mntlion]

anyone got some DR advice for surgery for canada?
I've got a referral in calgary soon, but looking for other options if surgery is right for me, but the line ups are too long in AB

[sethschmautz]

GBB,

I haven't checked this in a long time either, so no worries. To be completely honest, I've basically stopped my stretching and core workout routine mainly due to busy-ness in other areas of life. I'm intending to get back on it, but thus far, it's been really difficult. I have kept up pedaling my road bike and that hasn't seemed to cause me any grief. I've been able to ride longer and longer and am up to approximately 2 hours on the bike. Hiking is no problem, even for longer hikes.

The exercises that my wife put me on are as follows. FWIW, it really makes a difference what order I do these in, so I'm going to include the order that I find worked/felt the best.

1. Lie on your back with knees bent at about 90 degrees with your feet flat on the floor. Flex stomach muscles, rotate pelvis downward so that spinal cord is as flat on ground as possible. Hold for 10 seconds, then release. Do 2 sets of 10 on this exercise.

2. Stay in the same position, flex stomach muscles as in 1. above flattening spine (esp. lower back) against floor, rotating pelvis downward. Lift both feet off of floor with knees bent (we'll call this position 1). Keep left leg in this position, and slowly extend right leg to straight. Keep right heel within 1-2" of ground as you extend your leg, but don't let it touch. When your leg is completely straight (we'll call this position 2), bring right leg back toward your body, keeping heel low, until you are back in position 1. Now, keep the right leg bent (but elevated) in position 1 and extend your left leg out to straight keeping heel low until it is completely extended (position 3). Return to position 1. This (everything above) is one rep. Do 2 sets of 10 reps.

3. Get on your hands and knees: thighs at 90 degree angles to your torso. Extend your right arm and left leg away from one another until they extend straight in line with your back, then return to the floor (sort of looks like a 1/2 superman). Do a set of 10, then switch to your left arm and right leg. Do another set of ten. Do two sets of 10 on each side.

4. Flip over onto your stomach and lay flat with your hands in a pushup position. Keeping your pelvis and legs flat on the floor, push your upper body up away from floor with your hands, bending at the lower back. Hold yourself up away from the floor for a count of 10, then lower yourself back down onto the floor. Do one set of 10.

5. Lying flat on your face put your hands behind your head. Lift your feet off of the ground an inch or two. Do small (3 inches or so) back extensions lifting your feet and chest off of the ground using your back muscles. Do two sets of 10. (note: I can't actually put my hands behind my head in this position so I put them behind my ears)

6. Flip back over onto your back with your knees bent at around 90 degrees and your feet flat on the floor. Lift your pelvis off of the ground until your upper body and thighs are in a straight line (sort of thrusting your pelvis upward. Hold for a count of 10, then set your pelvis back on the ground. Repeat for 10 reps.

7. Lie on your back and straighten your legs. Bring one of your legs to your chest, and wrap your arms around your thigh, hugging it to your chest. Try to straighten your leg while keeping your thigh close to your chest. Make sure that you are pulling your toes toward your knee to make it harder. Count to 20. Then, with your leg still stretching, push your toes away from your knee, then pull back toward your knee (this is one rep). Do 10 reps, then switch legs. Alternate for a total of 4 stretches (right, left, right, left) and 40 of the calf reps (right, left, right, left). The stretch is obviously good for your hamstrings and the reps sort of make a flossing motion with your sciatic nerve.

I hope I explained those well enough. Just writing about them makes me want to get back on them. One other thing that seemed to help a lot was using a ball at my desk at work. I need to reinflate it and start using it again. I really think that core is the key, even though I'm doing a terrible job of prioritizing core exercises.

If you have any other questions, feel free to PM me.

Seth

[mntlion]

how long did recovery take from surgery? Looks like I'll be going "under the knife" and physio thinks I'll be 80% in 10 days, and 100% in 6-12 weeks.

[sethschmautz]

Mntlion,

I'm not sure if you're addressing me or just the collective, but I opted not to have surgery. My Doctor suggested that after 12 months, the results were the same between surgery and not having surgery if you took care of yourself. If you could wait it out for a year, you'd be at the same place as you would be 12 months after having surgery. Another friend who had the surgery, however, said that the problem was completely gone when he woke up. No more sciatica, no more back pain. My wife said something to the effect that you aren't supposed to lift anything over 5 lbs for 2 month or so, but if you can handle that, might be a good option. Keep us posted. It might still be something in my future, so I'd benefit greatly from hearing your experience.

Seth

[skideeppow]

how long did recovery take from surgery? Looks like I'll be going "under the knife" and physio thinks I'll be 80% in 10 days, and 100% in 6-12 weeks.

when i had my laminectamy, I was six weeks till skiing.
overnight in the hospital, no heavy lifiting for at least a month. I was 30 at the time and was doing rehab with a pt 3-4 days a week and hitting the gym6 days a week. Back on snow in 6 weeks.

I would be really careful about pushing it but those dates seem right. One thing is if you have a reoccurance or failure, it will occur in the next 12-18 months. After that period you are really home free.

good luck!

[mntlion]

Well that part looks good,
I've had the herniation for 2 years now (after large motorbike crash) but no large, huge, symptoms until 2 months ago.
After the crash, 8 months of physio, then yoga 2 times a week, core work class 1 * week, lots of other core work, etc. 2 months ago (so 22 months after crash) light sciatica pain, getting worse to the point now that I can't wiggle my toe. (plus all the other numbness, pain meds, can't walk etc). Now I've had 5 weeks (2-3 times a week) of physio, accupuncture, chyro, massage, rest, pain meds etc), and still getting worse.

[GBB]

Seth, thanks for the workout. If I have any questions about it I'll definitely pm you.

Mtnlion, it's possible that you did something that caused that herniation to "move" and pinch the sciatic nerve. In my case, I had a herniation, the disc calcified around it to protect my spine, and then I did something that caused the disc to pinch my sciatic nerve. Meaning that the disc found a weakness and went to that weak spot.

After this first happened, I had sciatica so bad that I couldn't even sleep. My only relief was sitting in a chair leaning forward opening my spinal column as much as I could. The doctor gave me a cortisone shot that helped a little, but I can still feel pain in my buttocks/hamstring when I walk for long distances.

[mntlion]

I can't think of anything that I did to trigger it. No lifting small houses, no big bike crashes, no wild 3 day sex binges, etc.

I've started to be able to move my big toe again, and less pain. All good things and signs of improving, and not the center of the hurricane

[sethschmautz]

Man, I reread the description above of my exercises and they were really bad. I edited them, so I should have my rights and lefts figured out now. If the original description didn't make a whole lot of sense, this one should. Again, if you need pics, pm me and I'll send some to your e-mail address. I hope you guys get better. This ski season is supposed to be really good, so I hope that I won't be laid up the whole time.

[Woolybeastman]

I aggravated a herniated disc (c6/c7) sometime around Labor Day. C6/C7, from 2 ski seasons ago. 2 crashes, one was a Wyle-E-Coyote pile into a ditch (don't ask) and second was a high speed ragdoll. When I first injured my spine, it was ten tons of opiates and regular PT which consisted of massage, electro zapping my neck and traction. Little emphasis on exercise. But, I recovered in about a month, and another month to get away from the meds... 2 years, no pain. This time, no major insults to the spine, but some heavy lifting, bad posture hunched over a grill all season. This go around, I'm in a different city, and the PT is different. There is more emphasis on core strength. I'm doing most of the exercises Seth posted. They work great. I'm not 100%, but getting close. Only taking 1000mg acetometaphine a day if I need it. Another huge thing for me this time was that my doctor prescribed an anti depressant. Something called the gate control theory, about how the anti depressant filters out much of the pain "noise" being sent to the brain. A happy brain leads to less pain. No major insights here, just thought I'd share my experience. A question, though. If I maintain a healthy body and strong core, how safe am I from re-injuring the same spot? I want to think I can ski as hard as I want, ride my bike as fast as I want, chop down trees, blah blah blah as long as I stay strong.

[sethschmautz]

Wooly,

Sounds good man. I asked a similar question to my wife (who is a PT) and I got this sort of a response. If we maintain good core strength and continue doing exercises and the like to protect your back, it probably will still never be 100%. Because the area was injured before, it is now more susceptible to injury in the future. Through strenghtening and exercise, we might get close to 100%, but it's now the weakest link in the chain and if we stress our bodies to the point of failure, it's probably going to be the place that fails first.

Practically, it means that I just need to be a little more careful. I've been riding my mountain and road bike a bunch and know when and where I will start to feel it. The more I can avoid this, the more the disc will have a chance to heal and get stronger rather than get a bunch of additional micro injuries. The more that I can allow it to heal, the better it will feel and the more I will be able to push it next time.

I'd love to think that I'm going to ski 100% this winter, but I'm starting to look at this year as being an investment in my athletic future as a whole. If I think about it that way, I'll feel a bit better if I need to quit a little early some days. The time that I'm spending recovering and healing is time that I'll cash in on later when my back back is healed and functions more like it should.

My dad did the same thing when he was 27 (I'm 29). His took a long time to heal (around 7 years in all), but now he says he barely feels it. In those days, the doctors focused on rest instead of activity and I think that is why it took so long. Every once in a while he feels it after a really long bike ride or a lot of lifting, but after it healed, he's been able to go back to doing the things he's always loved. For me, that's a long time, but it's still encouraging to know that it will eventually get better if I'm diligent.

Wow. That was long. Sorry. Hope it helped some.

Seth

[Woolybeastman]

Thanks Seth,
I needed to hear that. I'm still looking forward to this ski season, but am convinced I won't be 100%. "An investment in my athletic future" is a great way to put it. I'm getting up there in age at 38, so I need to focus on preserving a future doing things I love like skiing and riding my mountain bike. My doc was telling me about the increased potential for some degeneration/deformation of the vertebrae around the affected disc that will create some arthritic type pain in the future. So, just gonna keep at the exercises and keep strong.

[skideeppow]

IAnother huge thing for me this time was that my doctor prescribed an anti depressant. Something called the gate control theory, about how the anti depressant filters out much of the pain "noise" being sent to the brain. A happy brain leads to less pain. No major insights here, just thought I'd share my experience. A question, though. .

This is real interesting, what did they prescribe? I heard about this from a number of people, but two of my docs would not prescribe it. Really interesting.

[Woolybeastman]

This is real interesting, what did they prescribe? I heard about this from a number of people, but two of my docs would not prescribe it. Really interesting.

Amitriptylene. I take it before bedtime. It takes a couple of weeks for the full effects to set in. There is no physical indication that its in my system, but after a couple of weeks of taking it, I was definitely taking less and less meds for pain/inflammation. My doc said that if I did not respond to the dose of the amitriptylene, the next step was another dose in the AM, but he would have given me a generic prozac. Hitting the "pain filter" from different angles. I will be taking the anti depressant for a while tough. Not for any underlying depression, but because even though I am doing better, I can still stir up pain by doing different things. So, if I stop with the AD, the pain can come right back, then back to no sleep, etc. etc. I'll take it through to complete or as close to complete recovery as I can get. Maybe your docs don't subscribe to the whole "Gate control" theory. From what I understand, its well documented. There is no addiction or even any recreational side effects, just a wicked sweet tooth for some reason.

[sethschmautz]

Man, I have a well documented sweet tooth without the ADs.

[spanghew]

I've got two herniated discs, above and below L-3. This has pinched a nerve so my right knee has gone numb. I tried taking some Prednozone in a 'burst' that gave me some relief, backed up with flexeril for teh pain and to let me sleep.

That worked for about a week, then I was back to lots of pain and no sleep.

Now I take gabapentin, and it works great: no drowsiness, no pain. I can ride my bike and drive and walk without pain, even do a little work, though any lifting and twisting and pushing hurts (I'm a cabinetmaker so this means I can't do much of anything). Looks like surgery coming up for me: the cortizone might help the pain, the neurosurgeon says, but not the numbness.

I want my knee back: it's starting to snow around here (the shrinking Palisade glacier is what I see out the window).

Good luck to all with back pain . . .

[splat]

www.ortho-bionomy.org

Best thing I've found.
I'll just throw it in here until someone bites and gets a session and reports back.