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Bulging disc and sciatica

Ered_Lithui2010-12-12 11:38:40 +0000 #1
Reading through the threads, back problems seem to be sadly common here.

The back story (no pun intended): I woke up one morning in mid-March with numbness in my left leg. After six weeks of constant weakness and mild pain, plus lower back pain, a lumbar MRI showed a lateral disc bulge at L5-S1 crushing the nerve root.

I'm finally starting physical therapy for overall lower back pain, but the neurosurgeon I saw thinks that a microdiscectomy is probably the only solution left for the leg pain. To his credit, at our first meeting three months ago he was inclined to wait it out and try less invasive treatments (oral and epidural steroids, which failed). It's been five months with virtually no exercise; even standing up and bending over cause shooting pains.

Even if the sciatica is resolved, my back is a mess, with multiple levels of degeneration, disc bulges and stenosis. I'm only 25; no one has a clue what happened here. I've been told I probably shouldn't run, which is a real disappointment, and that everything else will be gradual and tentative. Lower back pain anecdotes abound, of course, and most of them seem to end with "I just have to live with the pain and limit my activity." Every time I hear this sort of resignation, my heart sinks a little.

Where are the people who've been through this, still have horrible backs and yet remain super-active? This board seems like the right place to find them. I'm hoping some of you can help me out, either with suggestions for what to do next or just encouragement. I know life goes on... but it doesn't always feel like it will these days.

Okay, done whining. Help me, TE; you're my only hope.


KnottedYet2010-12-12 11:53:27 +0000 #2
"McKenzie" (mechanical diagnosis and therapy) certified or diplomate physical therapist.

They will be able to tell you within 3 visits if physical therapy will help your particular issues. They will not just throw random exercises at you.

www.mckenziemdt.org/
jessmarimba2010-12-12 12:10:43 +0000 #3
I have no words of wisdom or help for you...but this board has been nothing but encouraging for me (check out the Aaargh broken back: forums.teamestrogen....owthread.php?t=37076 thread). There are a few responses of people who have returned to activity from awful injuries and it helped me a lot. I'm one month into a 6-month hiatus from exercise due to a broken back, and while they have implied that biking and running will be "frowned upon" I don't think I can quit that easily. At least not without something equally fun to replace it! So I'll definitely be supporting you and hoping to learn from you as you sort this all out. And while I support the position of surgery as a last-ditch effort...it's not the end of everything.

Please keep us updated!
malkin2010-12-12 12:05:35 +0000 #4
*waving hand in air*

1. Listen to Knot, she knows everything.

2. I had an L5 S1 herniation. I don't know any technical terms for the severity of how these things go, but after poo-pooing my complaints for months, when my ex- took a look at my images, he said, " OH MY GOD.."

I saw a doc who thought I might be a good candidate for non-surgical treatment. He encouraged me to work hard in PT by saying, "There are men with knives pounding at the door trying to get to you!"

PT was awful. The whole thing was awful. I had just turned 40 and felt like the warranty had just run out. It took a long, long time. Six months, then twelve months went by, and I'd pick up a milk jug (or a 6 pack) and set myself back, and I couldn't steer a grocery cart without hurting myself, and lots of stuff like that. but the days went by one at a time, and now it is over 10 years and it's good. And I didn't have surgery.

I believe nerve pain to be especially stressful emotionally. Don't be surprised if you feel crazy.
Ered_Lithui2010-12-12 12:58:00 +0000 #5
Thank you so much for your responses! Jess -- I can't imagine going through a broken back! (And being told not to bike! Fortunately the doc says biking will be fine for me once the leg pain's gone.) I know I'm lucky in the scheme of things.

And thank you, Knot! I just checked, and the PT who read my MRI (and thinks PT could fix the leg pain) is listed on the McKenzie web site -- unfortunately, she lives 100 miles away, and the one I've been referred to is a DPT but isn't McKenzie-certified. I don't know if my insurance would cover visits to a non-referred PT close by. At the very least, I'll see what my PT recommends and try to check with the other one to see if it sounds reasonable.

Malkin, I'm so glad to hear you're doing well now.

Quote:

Originally Posted by malkin

2. when my ex- took a look at my images, he said, " OH MY GOD.."

Hah! Yep. I had started to wonder if I was imagining things, and then the MRI came back. I felt vindicated, which helped...a bit.

Quote:

Originally Posted by malkin

I had just turned 40 and felt like the warranty had just run out.

And this really resonates with me. I'm really curious -- were you able to ride in the interim? What's killing me right now is that I can't swim, play tennis, bike, or run -- even *walking* up or down slight inclines hurts -- and the lack of exercise has me pretty depressed. It's hard to hear my boyfriend mention his latest casual 80-miler knowing that it's more mileage than I've gotten in six months.

(And also because I'm lusting after a new road bike. You know.)
KnottedYet2010-12-12 14:08:31 +0000 #6
Quote:

Originally Posted by Ered_Lithui

I just checked, and the PT who read my MRI (and thinks PT could fix the leg pain) is listed on the McKenzie web site -- unfortunately, she lives 100 miles away, and the one I've been referred to is a DPT but isn't McKenzie-certified.

Can you call the McKenzie PT who read your MRI and thinks PT is viable, and ask her if she can recommend someone near you? McKenzie Certs and DIPs are *months* of further study after graduating PT school.

Someone who hasn't done the advanced study isn't going to have a clue. Having them treat you and asking the McKenzie PT to check their work isn't feasible for a couple reasons: For one, the general PT doesn't know MDT in the first place. For two, asking a non-treating PT to check the work of the treating PT is ethically and legally a complete and total no-no!
berkeley2010-12-12 13:14:44 +0000 #7
Herniated disc here. We should start a club.

In addition to McKenzie, also check out the work of Stuart McGill.

www.backfitpro.com/

In the end, you have to find something that works for you - everyone is so entirely different when it comes to this. I know people who have done the discectomy will great results, I know some who ended up back in surgery again a few years later.

I've been religiously doing the McKenzie exercises without only short term relief (but at least some relief) but so far no change day in and day out.

I just had a cortisone epidural - I'm one of the lucky ones that gets some real relief from that, so I'm hoping it works this time around again.

It does curtail biking at least in the short term - the flexion on the spine is really not what you need right now.

I'm at my year anniversary in dealing with this, so I know how frustrating it is.

And whoever said you'll start to feel crazy is totally right.

Chronic pain is mentally defeating.
KnottedYet2010-12-12 13:27:00 +0000 #8
Quote:

Originally Posted by berkeley

Herniated disc here. We should start a club.

It does curtail biking at least in the short term - the flexion on the spine is really not what you need right now.

Flexion is only bad if someone has a posterior disc bulge, and only 60% of back pain is caused by posterior disc bulges.

There is no such thing as "McKenzie exercises" because there is no one single "McKenzie" approach to joint derangement.

One person's corrective motion is another person's re-derangement motion.

Berkeley - if you've been doing something for months with no lasting results, then it is the wrong thing. Whoever gave you those "McKenzie exercises" either didn't know what they were doing, or hasn't heard from you how they are working and been able to modify them to get you the correct motion to push your unique and particular bulge back into place. (I'm assuming you are doing the motion 10 times every 2 hours, avoiding your deranging direction, correcting your posture, engaging your core at all times, and have not progressed)

People aren't cookie-cutter xerox copies of each other, and neither are painful backs, and neither are corrective motions.

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