Shit! Ruptured disc?

[BigKuba]

They're boring as shit, it's just exercises. I thought they were at least sandwiches...

[skideeppow]

yes super boring as is most of the back excersises.

[Kevo]

I ruptured L5/S1 back in November and confirmed with MRI. I saw two spine docs for consults.

It has been a long road. I did PT for months, then was sidelined in April and May with major surgery for an unrelated issue.

I came back pretty strong with PT and was released to full activity in early July. I gradually returned to biking and hiking and working out.

Things were going great until yesterday when all of the sudden the disk pain returned. It is localized and not running down my leg at the moment, but I am in a lot of pain and I am having trouble walking again.

I'm really not sure of what the future holds at this point. Pain was bad enough last night that I started taking pain pills for my back again for the first time in months.

Mentally I'm in a pretty low spot- I can't do any of the things I want to do. I'm trying to go back to step one of the ruptured disk PT plan but I'm starting to be pretty concerned that there isn't a light at the end of the tunnel.

I've had a series of injuries and health issues dating back to Jan 2023 and I've been fully healthy for only about 3 months out of the past 20.

Anyone have any advice? I'm getting pretty desperate.

[grinch]

Its like that every tine. "Am i done?"
Youre not. Get back on your pt exercises. You remember them. Rest for 3 days before you do get back into pt. Thatll let the muscle tear heal before you start the pt exercises and light stretching. Short walks will straight things out
I used to love scrambles in the mts. Can do that now. The up is no problem the banging on the down is a recipe for disaster. Emtb and ski touring is the best

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[MagnificentUnicorn]

^^ A ruptured disc isn’t a muscle tear that will heal in three days.

Kevo, what did the spine surgeon say? If it’s a small isolated rupture a micro discectomy is pretty minimally invasive surgery. I know several people that have gotten great relief and returned to full activity.


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[grinch]

Im not saying it is. Generally thats the cycle of events that hsppen though. Muscle tear , loss of spinal support/stability, then rupture or just herniation if your "lucky"

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[Kevo]

Thanks guys.

^^ A ruptured disc isn’t a muscle tear that will heal in three days.

Kevo, what did the spine surgeon say? If it’s a small isolated rupture a micro discectomy is pretty minimally invasive surgery. I know several people that have gotten great relief and returned to full activity.


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Spine doc said the location and size of the rupture made a micro discectomy not possible- the rupture is anterior of S1 and he can't access it from a posterior surgical location, and too much plumbing is in the way to access it from the anterior side. I was told fusion was the only possibility and that i should try to avoid that at all costs given my age (I'm in my 30s).

A second opinion confirmed that as well.

[Dantheman]

Are you familiar with Stuart McGill? I listened to him on Attia's podcast and he really seemed to know his shit. I think his website is backfitpro.com

[Self Jupiter]

I ruptured L5/S1 back in November and confirmed with MRI. I saw two spine docs for consults.

It has been a long road. I did PT for months, then was sidelined in April and May with major surgery for an unrelated issue.

I came back pretty strong with PT and was released to full activity in early July. I gradually returned to biking and hiking and working out.

Things were going great until yesterday when all of the sudden the disk pain returned. It is localized and not running down my leg at the moment, but I am in a lot of pain and I am having trouble walking again.

I'm really not sure of what the future holds at this point. Pain was bad enough last night that I started taking pain pills for my back again for the first time in months.

Mentally I'm in a pretty low spot- I can't do any of the things I want to do. I'm trying to go back to step one of the ruptured disk PT plan but I'm starting to be pretty concerned that there isn't a light at the end of the tunnel.

I've had a series of injuries and health issues dating back to Jan 2023 and I've been fully healthy for only about 3 months out of the past 20.

Anyone have any advice? I'm getting pretty desperate.

Vibes, man. It sucks. I hate to say it man but you kind of have to adjust expectations about what you can do in the short, medium and long term and try to get used to it while working toward the long term goal of a sustainable livable maintenance phase that will hopefully involve some of the activities you love. I’m not going to say I haven’t been, or continue to be mentally wrecked about it but I’ve gotten over some of it and I’m stubborn as fuck about shit like this.

Stuff I can’t do anymore:
Carry heavy shit around— I just pay someone to do it
Go running
Hockey
Golf
FUCKING PICKLEBALL!?
Snowboard
Ski moguls any more than I have to just to get around the hill
Wakesports
And on and on

I can still ski sometimes, even half decently and kind of fast on occasion but I’m careful and quit before my body and brain wants to, before it’s too late. I am able to bike most of the year and I get some of my adrenaline fix from fishing which has seemed to help.

ETA I’ve gone to therapy about my issues over the past ~12 years. I’m only 38. It’s really mentally anguishing.

ETA again my issues began with L5-S1 herniation and fluid/height loss and that took ~2-3 years to heal up and I was in my mid 20s at the time. Now I have similar issues at L4-L5 and the primary cause of my pain comes from the interaction with the discs and arthritis in the facet joint area. Probably getting a medial branch neurotomy done later this month— my nerves are gonna get scorched either way so might as well see if I get some relief.

On the positive side I’m the most stoked dude on the mountain when I put all the PT and lifestyle changes together and get to ski powder. But my days of skiing any conditions or tons and tons of days are likely over. I’ve come to terms with that.

[Self Jupiter]

Are you familiar with Stuart McGill? I listened to him on Attia's podcast and he really seemed to know his shit. I think his website is backfitpro.com

Good stuff for when you’re not acutely wrecked.

I bet Kevo goes hard on the PT. Some people don’t, which blows my mind, but I’m going to assume they haven’t been hit as hard as we have.

Those moments that you lose your walking gait leave you feeling completely helpless. To be honest I’m still not used to it no matter how many times it’s happened to me.

Anyone reading this feel free to PM me. I have a little IRL support group going. We have what I would call pretty serious issues and have gone through the gamut of trying to physically rehab it.

[yeahman]

Vibes Kevo.

[Djongo Unchained]

Kevo- -

Have you seen Dr. Hills at St. Johns?

He's supposed to be a real ace in the back surgery arena around here...

[MagnificentUnicorn]

Thanks guys.



Spine doc said the location and size of the rupture made a micro discectomy not possible- the rupture is anterior of S1 and he can't access it from a posterior surgical location, and too much plumbing is in the way to access it from the anterior side. I was told fusion was the only possibility and that i should try to avoid that at all costs given my age (I'm in my 30s).

A second opinion confirmed that as well.

Ah that sucks. Do you have a spondylolisthesis at L5-S1? I would listen to the advice about avoiding a fusion for as long as you can. We have so many serial fusion patients, it’s really a no win situation.


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[goldenboy]

Sorry Kevo. Have you tried any alternative medicine or therapies? It doesn't sound like you have a lot of good options since you can't get surgery. Maybe something works. Just a thought, and I'm not even a big believer in that type of thing overall.

[Self Jupiter]

Have you gotten an injection? Sometimes they’re the only thing that can get me moving again, unfortunately.

[grinch]

Vibes, man. It sucks. I hate to say it man but you kind of have to adjust expectations about what you can do in the short, medium and long term and try to get used to it while working toward the long term goal of a sustainable livable maintenance phase that will hopefully involve some of the activities you love. I’m not going to say I haven’t been, or continue to be mentally wrecked about it but I’ve gotten over some of it and I’m stubborn as fuck about shit like this.

Stuff I can’t do anymore:
Carry heavy shit around— I just pay someone to do it
Go running
Hockey
Golf
FUCKING PICKLEBALL!?
Snowboard
Ski moguls any more than I have to just to get around the hill
Wakesports
And on and on

I can still ski sometimes, even half decently and kind of fast on occasion but I’m careful and quit before my body and brain wants to, before it’s too late. I am able to bike most of the year and I get some of my adrenaline fix from fishing which has seemed to help.

ETA I’ve gone to therapy about my issues over the past ~12 years. I’m only 38. It’s really mentally anguishing.

ETA again my issues began with L5-S1 herniation and fluid/height loss and that took ~2-3 years to heal up and I was in my mid 20s at the time. Now I have similar issues at L4-L5 and the primary cause of my pain comes from the interaction with the discs and arthritis in the facet joint area. Probably getting a medial branch neurotomy done later this month— my nerves are gonna get scorched either way so might as well see if I get some relief.

On the positive side I’m the most stoked dude on the mountain when I put all the PT and lifestyle changes together and get to ski powder. But my days of skiing any conditions or tons and tons of days are likely over. I’ve come to terms with that.

Very similar injury here. S1 to l5. I was 2 yrs old when i compressed the s1 l5. Later herniated yhe l3/4.At almost 58 ive had 20 extra yrs dealing with it. I've learned what i can and cant do and what works to do what i want to do. In a lot of ways its gotten better despite the deteriation.
-Pt and stretching for 2 yrs without going into spasm
- now just stretch daily , warm up if skiing or biking
- pt if i overdue it(after 2l3 day rest), although i'm continually improving my ability to not overdue it and not needing a 4-6 week pt sesh
- i can now ski 100days/year if i build thru the year not overdoeing it and stretching before(injury prevention), building speed and dynamics thru the day with cruisy starts and stretching after for recovery. I do a few 40-50k vert feet days each year but thats not until after januaryish and im sure ive built to it, and its pow of course
- biking is emtb because i can always warm up riding anything and warm up into pushing harder.
- work i can shovel all day if needed. Heavy object lifting i say a hard no 99% of the time. Like anything posture is key and flex the core doing anything

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[Kevo]

Thanks very much, everyone. I really appreciate all of your replies.

Are you familiar with Stuart McGill? I listened to him on Attia's podcast and he really seemed to know his shit. I think his website is backfitpro.com

I actually listened to that podcast recently. I'll revisit. Thanks.

Kevo- -

Have you seen Dr. Hills at St. Johns?

He's supposed to be a real ace in the back surgery arena around here...

I have not seen him yet, but I did see someone else within St Johns. I'll add seeing him to my today list.

Sorry Kevo. Have you tried any alternative medicine or therapies? It doesn't sound like you have a lot of good options since you can't get surgery. Maybe something works. Just a thought, and I'm not even a big believer in that type of thing overall.

I have not tried anything besides PT and traditional medicine. PT has redeemed me from many injuries over the years so I have a ton of faith in it.
Are you talking about chiropractor stuff or acupuncture or something else?

Have you gotten an injection? Sometimes they’re the only thing that can get me moving again, unfortunately.

Dexamethasone injections were mentioned by one of the docs. I might seek that out as a way to make it through my upcoming wedding.

[yeahman]

Chiro has helped me manage back pain for 30+ years but it sounds like you are past the point where it would help?

[goldenboy]

Are you talking about chiropractor stuff or acupuncture or something else?

.

All of the above. The chiropractor helps me but I don't have huge back issues and I don't know if it would be too much given your problems. A buddy of mine has a bad back and goes to an osteopath up in Boulder whenever things go bad for him and swears by her. I know people who say rolfing changed their life. Orthobionomy helped my hip problems a fair bit. Acupuncture didn't help but I know it does a lot for some people.

I'm a fan of PT for sure. Just thought it might be worth trying some other things.

[Self Jupiter]

Thanks very much, everyone. I really appreciate all of your replies.

(Snip)
Dexamethasone injections were mentioned by one of the docs. I might seek that out as a way to make it through my upcoming wedding.

You’re welcome man. And I’m sorry to kind of info dump a lot into this thread. But I personally benefitted from eventually getting advice like that from a specialist and it helped me manage my expectations. I had a history of injuries and surgery prior to my back issues but none of them prepared me for it, particularly the psychological part.

I feel like you should consider getting whatever type of injection would get you relief from pain so you can get moving again. Wouldn’t surprise me if you felt significantly better by the time you got off the table. Use the time that the injection is effective to get a bunch more PT in and see how you come out on the other side. If it works schedule another one and you can always cancel it if you don’t need it.

[evasive_MT]

I feel this. I have a ruptured L5-S1 myself. I first injured it at 24 lifting lots, and I had occasional spasms and episodes for years. They seemed muscular and would go away after a week or so. Six years ago I had one that included monster sciatica. A scan showed the rupture and I had a hunk of disk tissue pressing on the nerve. I was referred to a surgeon who was ready to operate (from the anterior), but we agreed to try a steroid run first. That cleared it up, happily.

I had another flare up this spring, and (milder) sciatica came back, so I knew it was the disk, not muscles. I’ve done a round of steroids and am about 1/3 of the way through a program of mechanical decompression. That seems to be helping.

While all this was playing out, my wife and I got COVID and she was diagnosed with stage 4 Hodgkin’s lymphoma. But that’s a story for another thread.

[yeahman]

That sounds rough, evasive, sorry to hear that.

Lifting weights is what fucked up my brother's back. He's had two surgeries and various injections.

[grinch]

Damn that is rough. Hang tough evasive. You got this

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[Self Jupiter]

Damn, evasive. +++vibes

Lifting weights is what fucked up my brother's back. He's had two surgeries and various injections.

Messed mine up pretty good deadlifting back in college and I’ll never know how much that has played into my situation as an adult. It was regrettable either way.

[Ripzalot]

Looks like I got company here- Double disc hernia on May 25th, L4/L5 + L5/S1. Most intense pain of my life. Found an awesome physio/osteo, former physio for the Romainian National Tennis team,. Started physio right away in the first week. 2x per week.. Each time I came back home I lasted a little longer before the pain set in again. From arriving back home in pain again, to 1 hour, to 4 hours, progressively getting better over about 8 weeks until no lingering pain. Bonus points, in only 2 pulls on my neck with a Y strap he solved a lingering neck rotation problem that a Swiss physio couldn't solve in a year. Find a good osteo.

At 10 weeks I went DH biking, no problems. Been 3 times now, keeping it in check, no jumps or rough trails. I'm in flow trail mode now. Starting fitness training this week at a gym (awesome new on site fitness center at my office, really incredible setup) and should be skiing at least the blues when ski season starts.

My physio told me about a spinal decompression table (not approved in Switz) but his physio friend in Romain uses one and says 90% success vs surgery. If i get bad again I think I'll be trying that. 2 weeks in a 5 star spa hotel, physio every other day, relaxing the others, cheaper than treatment here.

Here's that table in use: https://www.instagram.com/p/C-2OThyNM-B/