Shit! Ruptured disc?

[GoBig1776]

I've spent the last few days on the couch as a result of re-injuring my back. I hurt it in late August and thought I had it felt back to normal by the start of ski season. Well, this time I've got pain in my back that radiates all the way down my right leg, my toes tingle and I have pain in my abdomen. I visited my PT on Monday and he seems to think it is a ruptured disc around L4. I can't get in to my doctor until Friday. I'm in my mid thirties and thought until now that I was pretty fit. This shit really humbles a guy. It hurts too much to even take the dog for a walk around the block.

Anyone else have experience with this injury?

[Tuckerman]

I had a procedure late spring to fix a herniated disk.

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[Tuckerman]

BTW I Deadlifted 435# last week for 2 reps.

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[neckdeep]

Anyone else have experience with this injury?

Too much experience. I've had two decompression surgeries. You will have to get an MRI to determine what happened. Tingling and numbness could be a sign that a hernia is causing nerve damage (possibly permanent) so take it seriously. If you are experiencing progressive neural deficit, you are a likely candidate for surgery. I lost quite a bit of leg function the second time this happened to me. It's returning very slowly but after 7 months since surgery, my leg is still too gimpy for me to consider going back to snowboarding. Can't tell if it will ever fully heal, to be honest. Don't let yourself get talked into a fusion; there's estimates that as much as half of all fusion surgeries are unneccessary. The fusion is around five times more profitable for the surgeon and hospital, so be skeptical.

Here's a basic test. Sit upright in a hard chair with your chin tucked down on your chest. Lift the affected leg with your leg straightened. If that sent pain shooting down your leg, it is probably a herniated disc pressing a sciatic nerve root. If the pain seems to go to the big toe, that is the L4-L5 sciatic nerve root. If it goes to the ankle, heel and little toe, that is the S1-L5 root.

[GoBig1776]

Going in to the Doc on Friday and hopefully will get the MRI that should have done in the fall if not for the stupid government shutdown. This injury was sustained while working for the USFS, so they should pay for continued treatment. Everything got fucked up with billing during the shutdown, but my physical therapy was progressing well and I elected to continue the non-invasive treatment.
I was still skiing and working until Sunday, but commuting to the hill and riding on the chairlift caused much pain.

[neckdeep]

Skiing through the pain is not a good idea. You can easily turn a PT manageable hernia into something serious where it hurts so bad that you can't stand without a cane and there is no resting position that gives you any relief for sleeping. I did that twice, so beware, mon frere.

[GoBig1776]

After almost two weeks of couch time, things are getting somewhat better. Doc prescribed a steroid that was supposed to reduce inflammation. I can now walk the dog down to the park and I even went for a short road bike ride yesterday. I still get pain from my back down my leg and numbness in my foot after walking around or standing for a while.
I had an MRI on Thursday and will visit the doc tomorrow for results. It is an early appointment, so I plan on skiing in the afternoon unless the news or pain is dire.
I have not missed more this many days in a row of skiing in ten years, so I'm getting a bit stir crazy.
Wish me Luck!

[HansJob]

BTW I Deadlifted 435# last week for 2 reps.

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Did you have a discectomy or the rounds of epidural injections? I'm on round two of three injections, and have gotten noticeable relief but still have tingling in toes, foot, with occasional heel pain. The VA docs want ya a to go this route first before cutting.

[Rod Ironwood]

Ouch.
I blew L5-S1 disc in June, 2012. I did P.T. narco dope, acupuncture, chiro, ESI (epidural steroid injection) for a year. Docs said leg pain, numbness, weakness, etc. down to foot often ends up with surgery. So, I had a Micro-discectomy in July.

6 months out, all back pain is totally gone, but my left leg still has numbness and a weak sensation...no pain, tho. May or may not be permanent...fingers crossed it's not. I can ski about 80%, but if I hit it too hard, my leg pays the next day.

I agree with Neckdeep about avoiding a fusion. If that is recommended, get a 2nd...and 3rd...opinion. Hope that PT and ESI works, but if not, Micro-discectomy is pretty non-invasive (for surgery), about 80% effective, and you recover quick. I was walking to the end of the block and back the very next day.

Good Luck with it no matter how you get it resolved. Back pain sucks.

[neckdeep]

After almost two weeks of couch time, things are getting somewhat better. Doc prescribed a steroid that was supposed to reduce inflammation. I can now walk the dog down to the park and I even went for a short road bike ride yesterday. I still get pain from my back down my leg and numbness in my foot after walking around or standing for a while.
I had an MRI on Thursday and will visit the doc tomorrow for results. It is an early appointment, so I plan on skiing in the afternoon unless the news or pain is dire.
I have not missed more this many days in a row of skiing in ten years, so I'm getting a bit stir crazy.
Wish me Luck!

It takes an average of 2-4 months for these things to heal up without surgery so going skiing (or heavy lifting) now is a bit premature. Steroids don't heal you but they can mask the inflamation enough for you to get out and hurt yourself some more. The recurrent numbness in your foot is a major red flag warning you to ease up until that stops. I'm telling you, you should fear that numbness more than the pain because after numbness comes paralysis. Remember, a hernia is an open tear in the disc membrane. Trust me on this: the last thing you want to do is tear that sucker open any further. There is always a next season.

[GoBig1776]

Trust me on this: the last thing you want to do is tear that sucker open any further. There is always a next season.

^^Thanks for that.

Just came back from the Doc. MRI clearly shows bad stuff at L5-S1. We scheduled an injection for Wednesday.
Doc did clear me to return to work next week with no lifting >25lb and ok'd me for 1 careful, slow groomer run per day. Until then I guess it's more Netflix and TGR.

[ill-advised strategy]

It's not just skiing/sports you have to think about now.

Be really careful when you sneeze, be careful getting out of bed, careful with sex... You have to re-learn how to live your life without stressing your spine.

Sorry, but this injury is a motherfucker and you have to take it pretty seriously.

[Ted Striker]

Listen to yetiman.

I had a herniated disc. I can't remember the exact location, but it was between C4 and C7. My doc simply said not to do anything that caused pain and don't do any jarring activities, eg. running, skiing, etc. "If it hurts, stop. Do not work through the pain."

[LegoSkier]

On a related note. I've been dealing with a pretty bad sciatica episode since Christmas. There was no injury per se but a general straining of my back loading shit into my car then it got really bad after a half day of skiing on Christmas day (no falls in fact just some groomers). Classic major pain down my right leg and a bit of numbness in my big toe. Had a similar attack 10 years ago that just sort of went away after a month and a half. I went into the doc for this one and he sent me to get x-rays. The results he said only showed some minor issues but he said there were no major issues and that an MRI was not needed (just gave me naproxen and send me on my way). The thing is this guy is older than dirt and is partially retired. Do I trust the guy? I've been told x-rays really don't show shit and you need an MRI to diagnose disc issues.

P.S. Went to a chiro on Friday and he did some thing where he practically yanked my leg off and popped the hip in a way that unlocked my piriformis. Cleared things up a lot but not totally. Still enough pain where I would not walk more than a half mile without pain and still some numbness in big toe.

[neckdeep]

It's not just skiing/sports you have to think about now.

Be really careful when you sneeze, be careful getting out of bed, careful with sex... You have to re-learn how to live your life without stressing your spine.

Sorry, but this injury is a motherfucker and you have to take it pretty seriously.

Too true. I nursed my last hernia for 3 years of riding, hiking, fishing and firewood only to have a catastrophic blowout pitching horseshoes, of all things. I went from feeling solid to total agony in one week without overdoing anything physically. Fucker was just so worn out from years of toughing out the pain that it just fell apart. Toughing out the pain gives you scar tissue and beat up discs. To be honest, I'm just so glad to be walking without a severe limp that I don't know if I even want to risk going back to the board next season. There are much worse things than missing out on some pow days with your friends. Losing nerve function in your leg is one of them.

[neckdeep]

On a related note. I've been dealing with a pretty bad sciatica episode since Christmas. There was no injury per se but a general straining of my back loading shit into my car then it got really bad after a half day of skiing on Christmas day (no falls in fact just some groomers). Classic major pain down my right leg and a bit of numbness in my big toe. Had a similar attack 10 years ago that just sort of went away after a month and a half. I went into the doc for this one and he sent me to get x-rays. The results he said only showed some minor issues but he said there were no major issues and that an MRI was not needed (just gave me naproxen and send me on my way). The thing is this guy is older than dirt and is partially retired. Do I trust the guy? I've been told x-rays really don't show shit and you need an MRI to diagnose disc issues.

P.S. Went to a chiro on Friday and he did some thing where he practically yanked my leg off and popped the hip in a way that unlocked my piriformis. Cleared things up a lot but not totally. Still enough pain where I would not walk more than a half mile without pain and still some numbness in big toe.

Chiros are ok for muscle problems. If you actually have an open hernia and the chiro "adjusts" you hard enough to tear open that disc, you'll be shit out of luck when the quack tries to act like it wasn't his fault that you are suddenly in agony and need a $35,000 decompression surgery. You described symptoms of a L4-L5 hernia but your chiro decided fuck an MRI, guessing is good enough for this guy, I'll just give him an adjustment for piriformis syndrome and collect my fee. Caveat emptor. General Mds can't do much for you either besides a referral. Spines are the realm of specialized orthos, neuros and radiologists. Your general practitioner can only tell you numbness in the big toe indicates a L4-L5 hernia. This muscle group holds the foot up to keep it flat when striding. You should be on the lookout for "drop toe" which you will notice as the repeated, accidental stubbing of the tip of the foot. If you get drop toe, go directly to the best spine surgeon you can find because the nerve is pressured enough to cause nerve damage. If the Md did not tell you that then, yes, you should seriously question whether to trust his knowledge. Same for the chiro; if he didn't mention drop toe then he is a quack. A tight piriformis or psaos muscle can aggravate a back problem but there is usually an underlying injury being aggravated. If you have chronic pain without any specific trigger event, yeah, maybe tight muscles are to blame. That's fat person, too much sitting, couch potato back pain fit for the chiro. If you got an injury, stay the fuck away from a chiro.

[::: :::]

It takes an average of 2-4 months for these things to heal up without surgery

That is an optimistic "average" from what i've been told. My understanding is that the discs shrink as you age and through this shrinkage, the back pain will eventually subside due to less impingement on the nerve in the joint. This is one of the reasons surgery is often not suggested immediately: because it will likely go away over time.

But none of us here is willing to waste years of our lives not being active.


I had a microdiscectomy and laminectomy on my L4-L5 back in 2004. It got me back to being active shortly before my son was born (2mos). [full recovery was more like 6mos]

[neckdeep]

That is an optimistic "average" from what i've been told. My understanding is that the discs shrink as you age and through this shrinkage, the back pain will eventually subside due to less impingement on the nerve in the joint. This is one of the reasons surgery is often not suggested immediately: because it will likely go away over time.

But none of us here is willing to waste years of our lives not being active.


I had a microdiscectomy and laminectomy on my L4-L5 back in 2004. It got me back to being active shortly before my son was born (2mos). [full recovery was more like 6mos]

Surgery is not indicated for pain alone. Most episodes of pain resolve themselves. Numbness and tingling, however, are a warning that neural deficit could be next. So, pain plus significant numbness needs to be evaluated differently; i.e., an MRI might be a good investment if you are experiencing more than just pain. Loss of nerve motor function is an indicator for surgery as soon as possible, even without significant pain. Damage to the peripheral part of the nerve root can heal gradually, over a few years. Damage to the root on the cord is permanent. Unless you are Peyton Manning and can afford being flown to an elite foreign clinic to have ground up babies injected into your neck. For the rest of us, tho...take it easy until it stops hurting!

[GoBig1776]

Lots of good discussion here. Never thought I'd get this much.
I will heed the advice about not trying to work through the pain and make it worse, but the real hard thing for me to wrap my head around now is what I do for work.
I've built myself a pretty cool seasonal lifestyle, firefighting for the USFS in the summer and ski patrolling in the winter. I've dedicated pretty much my whole adult life to trying to become decent enough at both jobs to consider it a career. In essence, ski patrolling and firefighting are just manual labor. I can go back to the ski hill soon as a dispatcher and I'm willing to write off this season, but what about down the line? I've been doing some serious thinking about finding new lines of work.
Anybody still do manual labor after this injury?

[neckdeep]

"The flame that burns twice as bright, burns half as long" - Lao Tzu

[Rod Ironwood]

I don't know about your USFS job, but I would imagine forest firefighting is out with a blown disc. They must have lighter-duty gigs, like dispatching, shuttle driving, or something like that.

I'll second being cautious about you activity, as ESI's and pain meds will make you feel like it's not so bad and that you can do quite a bit. Like has been said, though, that's just due to meds covering up the pain. The injury is still there, and too much strain (even though it doesn't feel like it) will just make it worse.

I'd suggest seeing a PT also. They can make up what they call a "home program" for you of exercises to do at home that will strengthen your core, maintain nerve elasticity in your spine, yet not aggravate your disc injury.

I also agree with staying away from the chiro. I saw an Anesthesiologist for the ESI's and a Neurosurgeon for the surgery.

LegoSkier, to the best of my knowledge, you need an MRI to accurately diagnose disc issues. I don't believe an X-Ray will cut it. I'm not a Doc, tho. I do know the Doc who did my ESI's wouldn't do shit without an MRI...so there's that.

[ill-advised strategy]

Lots of good discussion here. Never thought I'd get this much.
I will heed the advice about not trying to work through the pain and make it worse, but the real hard thing for me to wrap my head around now is what I do for work.
I've built myself a pretty cool seasonal lifestyle, firefighting for the USFS in the summer and ski patrolling in the winter. I've dedicated pretty much my whole adult life to trying to become decent enough at both jobs to consider it a career. In essence, ski patrolling and firefighting are just manual labor. I can go back to the ski hill soon as a dispatcher and I'm willing to write off this season, but what about down the line? I've been doing some serious thinking about finding new lines of work.
Anybody still do manual labor after this injury?

I did 14 fire seasons. IMHO it's undoable with a bad back.

Hang on tight...I pulled the plug in 2008 and life has been dog shit since then. I had that dream life, helitack in the summer, took winters off. Owned a home. It all went away until I was down to nothing. I'm just now finally sort of maybe getting it together again working as a bus driver. It's been a long, hard road reworking everything. Get ready for people to have no idea what wildland firefighters do, get ready for everyone to assume since some structure firefighter they know is obese that you don't need to be in shape to be a firefighter.

Honestly, I wish you the best. It's been extraordinarily difficult for me.

edit: also re: dispatching wildland. I would STRONGLY CAUTION AGAINST THIS. Unless you're desperate. It's the worst job I ever had. It was life-changingly bad.

[neckdeep]

I did 14 fire seasons. IMHO it's undoable with a bad back.

.

I agree. Stoop work with a pulaski and shovel is the sort of repetitive motion wear and tear that will probably lead to recurrent problems and a life of chronic pain. Shovelling dirt or snow, either is a killer on the lower back and should be avoided, if you are thinking for the long term. There are acute spine injuries and then there are chronic problems. Wear and tear tends to beget the chronic issues that lead to degenrative disc disease. On the plus side, degenerative disc disease is a legitmate diagnosis for a med card for weed, if that's your thing. Won't make it any better but you'll care less, I guess. Better than oxy. It only takes about two or three weeks on oxy or hydro before your brain is scrambled to mush and you get withdrawal. I was on oxy for a month and couldn't think my way out of a paper bag.

I had my first decompression 15 years ago and got in around 800 more days of riding afterwards until a DIFFERENT level blew out last may. I also worked, cut my own firewood and rowed a drift boat like there was no tomorrow. Basically, I got away with it for another 15 years. But now, I'm middle-aged with a bum leg and I am a candidate for a three level spinal fusion if it happens again. Yeti makes the case that things can get worse than that. I wouldn't argue that. I'm relatively pain free, so I've got that to be thankful for. So, the answer to your question might be, "where do you want to be in another 15 years." Getting back to snowboarding was really important to me, a decade ago. Right now, I'd trade in my pride for a leg that worked better, kapiche?

[GoBig1776]

Yetiman, Ouch. That's quite a tale of woe. Glad things are finally starting to come back together. I'd raise a beer with you and trade stories if you are ever in Montana.
I've also done 14 seasons with the USFS. From trail crew foreman to Wilderness ranger and horse packer to hotshot to heli-rappel. I thought the heli gig was pretty easy on the body compared to rest.
I had been thinking it was time for a change for a year or so, but the money and excitement is pretty hard to pass up. I'm just having a hard time coming up with alternatives. My education and experience are totally invested in forestry or ski patrol stuff. At least people here in Montana seem to know what wildland firefighters do.
And No, I'm not considering wildland dispatch, but doing ski patrol dispatch till I can get back to full duty. I think I would hate doing it for the USFS, but it is pretty fun at the ski hill.

[GoBig1776]

Between the discussion here, talking to my PT, and several friends and family members in medicine, I decided to go for the injection.
The whole procedure was pretty quick and didn't hurt too bad. I got relief right away. I know I still have a long road of rehab, but at least the pain is drastically reduced.