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Herniated L5/S1 Disc and the aftermath

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I just got my MRI back on Monday and have a moderate L5/S1 disc herniation. After having a postitive response to prednisone - I recieved an epidural yesterday morning and am coming a bit around. Anyone been through this - how did you proceed? PT? Yoga? Where are you now with your climbing? etc etc.

 

It would be great to connect with some folks who have been through this.

 

Thanks. bigdrink.gif

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I had a burst L5/S1 disk that went undiagnosed and a massive bone infection resulted. Half each of my L5 and S1 vertebrae were removed and a piece of a femur was installed in the interstitial space. Another piece of bone from my hip, two steel plates and 8 screws hold it together. It doesn't slow me down nearly as much as my fused right arm, but that's another story.

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Had a herniation down there somewhere low, cant remember, and it was a pain in my ass(literally) for almost an entire year. I had cortizone injections and that helped a little, but I think time was my biggest ally. Time and PT. If I had it over again I would stick with the anti-inflammatory's and PT, but not take the cortizone injections. Take it easy, dont push too hard, and keep positive cause it'll wear on you.

 

It was the most annoying injury I've ever sustained and I take care of my back now, because it is no joke. I was 22 when that shit happened...way too young to be crippled.

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I think it was 3 years ago now that an ortho doc confirmed my self-diagnosed L5/S1 partial/minor herniation. Hurt like a mofo all the time, with lots of fun nerve pain shooting down my leg.

 

I went the very conservative route, with lots of stretching, careful movement for a while, and lots of anti-inflammatory meds (pretty much just ibuprofen, although I tried some of the other stuff like Celebrex, which didn't work too well for me). The doctor hooked me up with a physical therapist, but I never went.

 

After a couple/few months of being fairly miserable, I started getting active again. Strangely, running was one of the few activities that didn't hurt, so I kept doing that in small doses. Then I started adding back in snowshoeing and mild hikes (it's amazing how much work your lower back does on even mild hikes, yet you never really notice it until some condition like this comes along). Within 6 - 9 months, things were feeling quite a bit better, and I basically ramped back up to my usual activities. I'm just a lot more careful now. Sudden movements, lifting heavy loads, etc. all cause me to think about my back first. Every once in a while I'll do something to strain it a bit, and then I start hitting the Advil for a few days, and do a bunch of stretching, and it gets better. Sadly, I expect this to be the pattern for the rest of my life (I'm almost 39 now).

 

The biggest benefit to me comes from the following:

 

1) Stretching, particularly the hamstrings. After doing a bunch of online research, I found someone who recommended hamstring stretching as the closest thing to a miracle cure. I hadn't really been focusing on that, but I started to, and it made a HUGE difference for me. Now, whenever I feel that ache in my back starting to flare up, it seems it's well-correlated to tightness in my hammies.

 

2) Lying/sitting position. When sitting around, reading or whatever, I lie with my back flat on the floor, with my knees up. At night, I usually sleep on my back with a pillow under my knees. If sleeping on my side, the pillow goes between my knees, which reduces some kind of weird angulation in my hips that starts to hurt my back after a while.

 

3) Ibuprofen. But people need to understand that the so-called NSAIDs (non-steroidal anti-inflammatory drugs) such as ibuprofen really only are effective once they build up to a certain level in the blood, AND STAY AT THAT LEVEL FOR SOME TIME. You get very limited effectiveness from taking a dose or two of Advil. You need to take it continuously for at least several days for maximum effectiveness.

 

4) Paying attention and not doing anything stupid to my back. Sadly, I have had to come to grips with not being 20 years old and able to get away with anything physically.

 

Good luck with the rehab. It's no fun, but I think pretty much everyone with a minor herniation who is fairly careful and diligent eventually gets back into their usual activities.

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Be careful with the yoga route. Many instructors are not very "back aware" and are too agressive. I would strongly recommend the Seattle Holistic Center at the Good Shepard Center in Wallingford. They have a 6 week class called "Heal your back". It's taught by Collette, who was a nurse and had some major back problems herself. She is a great instructor. Once you take that class then you can take her open classes. I've found that it has helped my chronic back problems quite a bit.

 

One other word of advice - mix up your exercise routine. Walk, swim, climb, use weights, bike. Don't get too discouraged - it's a temporary thing you can work through. bigdrink.gif

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thanks jim - i forgot about the seattle holistic center - i actually guided her husband a few years ago - thanks.

 

i appreciate the feedback and help - tough to remain patient with the good weather coming round....

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Well if you had pain all the time, it was probably due to the nerve being inpinged all the time, and/or the sheath protecting the nerve is thinner/worn down.

 

As you get older, the sheaths get thinner, and that's why

chronic back pain is more chronic the older you get.

Stretching helps a lot because it helps to loosen out the nerve i.e. giving it relief from stress.

 

Depending on the severity of your condition you would need

to get surgery.

 

I had relatively frequent pain but usually short bursts

ex: I missed the last basment stair = surprise compression =

HOLY MOTHERF#$%^#^#^~!!!!!!! - u get the idea, not pretty

 

So had it taken care of.

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Ruptured the L4-5 last July. Went through Physical Therapy, Yoga, Stretching Exercises, Swiss Ball Exercises, Ibuprofen, Bextra, and Acupuncture. Believe it or not, the acupuncture was the only thing that gave me relief. After four sessions, once a week for four weeks, the pain all but left my right hamstring. It's been a month since my last treatment. I can feel a little bit coming back into the right hamstring. I also tried massage therapy along with the acupuncture with excellent results. Surgery is a very last resort for me. Bicycling has been one exercise that has felt pretty good. Haven't really done any hikes yet. Just gotta try it out and see what happens . My doc said it would take a year at the least to heal.

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thanks everyone - did the surgery route two weeks ago and am doing 100% better - microscopic discectomy (removed the herniated disc material). hiked up cougar this weekend as the first exercise since the surgery and am psyched.

 

looks like i wil be back to cragging and sport climbing by the begining of july...amazing...

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Good to hear. Glad it went well for you; lots of people don't get such rapidly favorable results. I'm trying to avoid ever having to have any surgery, no matter how small, so I guess I'll just keep trundling along with my Advil and stretching and so on, right up until I have complete kidney/liver failure from the Advil...

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Watch out with the advil and other NSAIDS gslater. They will haunt you years down the road. It's pretty sad taking care of someone who has used that stuff for years, is in their early 50s and really suffering from the kidney damage. Talk to your doc about taking the COX-2 inhibitor NSAIDS (VIOXX, Celebrex, etc.) from what I know they are not as hard on your kidneys or liver.

 

Also, think about your diet. Make sure you have a heathly balance (3:1 or greater) of omega-3 vs omega-6 fatty acids. Your body uses the omega-6 f.a.s in the inflammation process. Omega-3's are more involved in anti-inflammation metabolic processes.

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Watch out with the advil and other NSAIDS gslater. They will haunt you years down the road. It's pretty sad taking care of someone who has used that stuff for years, is in their early 50s and really suffering from the kidney damage. Talk to your doc about taking the COX-2 inhibitor NSAIDS (VIOXX, Celebrex, etc.) from what I know they are not as hard on your kidneys or liver.

 

Also, think about your diet. Make sure you have a heathly balance (3:1 or greater) of omega-3 vs omega-6 fatty acids. Your body uses the omega-6 f.a.s in the inflammation process. Omega-3's are more involved in anti-inflammation metabolic processes.

 

Thanks, I do watch that stuff. I'm not on constant Advil or anything like that; since my initial big problems a few years ago, I now just typically hit it for a few days whenever there's a flareup, and that happens maybe once a month or so. I'm rather paranoid about the long-term effects of that stuff.

 

Tried the COX-2 stuff early on in my ailment, and it just didn't seem very effective. My nurse practitioner girlfriend says that those take much longer than the ibuprofen to ramp up to an effective level, so maybe I just didn't give them a long enough shot.

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Glad your surgery was quick, painless and complication free. My doctor told me when I had hurt my back that I was lucky to be on the west coast. I was perplexed. He said that on the east coast they take a whole different approach. He told me that instead of orthoscopic surguries and such, they do crazy invasive procedures. If I hadnt been young and active they would've likely removed the disc and bolted two vertabra together to eliminate the pain! So, be extremely happy you're not in that boat!! haha, glad to here your doing good!

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lost arrow- hope not to burst your bubble. did u ever read a study done by UW on back problems and back surgery. the conclusion of it was that:

1. there is a very little evidence between actual disc hernation and pain. there is a clear evidence between disc hernation and loos of motor function, loss of strength, numbness, atrophy of the muscle or muscle group.

2. over 5 year period there pretty much no pain relief. there is an improvement at first, but the pain returns.

3 the main conclusion of the study was that 90% of back surgries don't even fit criteria for the surgery, hence they can't be sucessful.

 

my advice- do a proper rehab, have the scarr tissue adhesions treated now, stretch, watch your body mechanisc or you'll pay for it later.

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