Bulging/slightly herniated L5/S1 (Disc)

[hubris]

I did a search and found a few good threads on this. Just wanting to hear some more discussion or updates from anybody that is/was going through this.

 

I have a bulging/slight hernation of my L5/S1. It happened about 8 months ago (I actually suffered from this for about 6 years but in a much smaller degree). I was able to get it back in decent condition in about 3 months, in which the first month I experienced mind numbing pain! It lasted about 3 months and I suffered a setback due to sitting too much studying. I was not able to get it back to where it was when I re-habbed it the first time.

 

I recently had a problem at work, and have had to take more time off. Lots of sciatic pain. I was told that just to see a neurosurgeon (I live in Canada) would be 1 year on the wait list. I got to talk with the assistant who told me there is no way they would operate on me anyway (I am 30, and do not suffer any of the debilitating symptoms that require surgery). I have started acupuncture, along with my regular PT, and am scheduled to see a retired Neuro who administers nerve blocks (ESI).

 

Hiking (and climbing) don't seem to hurt my back that much, especially if I can take a few days off after.

 

Anyone have any advice, or can share their experience with this?

 

A tad frustrated at this point!

[layton]

go to a chiropractor, they are your BEST bet for this case.

ask around, and try to find one with a flexion/distraction table!!!

 

(i see you are canadian, a chiro may be harder to find....still seek one out)

[gslater]

I probably had some of the posts in the other threads you found. Same basic issue here, although it hasn't been as bad lately as it was 5 years ago. Still something I worry about all the time. I wonder when I'm going to be out in the middle of nowhere on a 3 or 4 day trip, and then have some major, excruciating damage occur to my disk.

 

What was your rehab methodology in the past? What helped/hurt the most? I'm always curious to find what works for other people. For me, it's mostly about stretching (ESPECIALLY hamstrings), keeping abs strong, and managing weight. Couldn't get into the chiro thing. Really would like to avoid surgery.

[hubris]

To be honest, both of my setbacks have occurred when I stopped doing daily stretching/core strength exercises. That I guess has to be a part of me daily routine for a long time. I use the traction bed at physio (Mike, is this what you mean by "flexion/distraction table"?), and have a group of exercises that I do. Acupuncture has helped a little, but I am more interested in combating the issue, not the symptoms.

 

gslater, are you affected by hiking/climbing?

 

Mike I have heard that Chiro's and discs can be a sketchy combination....but this comes from my GP who told me my problem was a "pulled muscle" about 4 years ago.

 

I have also been told that the disc (nucleus pulpous?) will eventually "dry up".

[gslater]

Whenever I feel mine start to ache a bit, I can usually correlate it with a break in the regular stretching routine. That's the main connection to hiking/climbing for me; if those things cause me to get sore or tight, and then afterwards I don't stretch, I'll start to feel my back getting sore in a day or two.

 

Fortunately, the sciatic nerve pain has been almost completely gone for a couple of years. The only time I feel nerve pain now is if I take a misstep or do something that causes a jolt to the spine. Then it's momentary and very sharp. The trip out after climbing Sloan last summer just about killed me, because there are about 400 trees across the trail, and after a while, every single drop back onto the trail started to hurt.

 

I don't know if the disc will really "dry up", although I can't imagine that's a good thing, since you'll then have no cushioning whatsoever. I read plenty of stuff that says the disc protrusion, if not disturbed too badly, will eventually recede back into where it belongs, and I kind of think that's what happened with mine. Which means I'm constantly aware of the risk of it getting forced out again. If/when that happens, I'm sure I'll know it from the nerve pain.

[layton]

Your GP is plain wrong.

Also, what happens isn't that the disc "dries up". It is re-absorbed, and sometimes "goes back in" depending on the severity of the herniation.

I can't belive folks who will trust going to a PT over a chiropractor when chiropractors have so much more training on this issue especially.

do whatever you want (sorry i don't have time to type more)

[hubris]

gslater, I too am a little worried about "missteps". What can you do? My work involves me climbing over deadfall/slamming through ugly terrain for 9 hours a day.....might be part of it.

 

Mike, I appreciate the suggestion, and have to admit I don't have a lot of info on what chiro's can do for discs. I am going to seek out that route now. Like I say, I have read a lot of conflicting info regarding chiro's and disc problems. At this point (it feels like it is getting better) I am just worried about "flaring" it back up.

[billcoe]

Your GP is plain wrong.

Also, what happens isn't that the disc "dries up". It is re-absorbed, and sometimes "goes back in" depending on the severity of the herniation.

I can't belive folks who will trust going to a PT over a chiropractor when chiropractors have so much more training on this issue especially.

do whatever you want (sorry i don't have time to type more)

 

It has been proven that GP's and surgeons really don't know sh*t about backs and necks despite their strong beliefs otherwise. A chiropractor is much better than wandering in the wilderness....in pain. I'd go with Layton on this one, good luck.

[mountainmatt]

First off, sorry man. Back injuries suck and they slow you down for quite a while.

 

I tore three discs in my lower back several years ago when training for Ironman. Following the injury, I had severe sciatica going down my left leg that made it difficult to sleep and sit. I went to PT for several months, after which I was able to run, bike, and swim again. I never had problems climbing once the initial tears healed, however I had to be careful not to strain it by moving quickly (no skiing, or anything else that jerked my back around). The key for me was doing PT and stretching. It was not something that got better overnight, it took several months before I was back to normal. My injury turned out to be related to tight hamstrings, causing me to compensate in my lower back, leading to bulging discs, and finally torn discs. After getting some flexibility back in my hamstrings, I was able to go on as normal. PM me if you want to chat more.

 

I can't belive folks who will trust going to a PT over a chiropractor when chiropractors have so much more training on this issue especially.

 

I think you mean Chiro-QUACK-tor. Don't waste your time and money by going to a chiropractor. They are not medical doctors, they will simply provide you with a really expensive backrub (and no happy ending!) Find yourself a nice PT, and get to work on getting better.

[ericb]

I'm going to stay out of the Chiro/PT debate....I've done both, and think both helped at different times.

 

One thing I did do that helped a ton was bought an inversion table...it's a great way to take pressure off the disks in the low back. You pay $300 once, and no more copays...you can do it in your house, in the morning before work, after you get home, after you go for a run or do something else that pisses off your back.

 

I like that you don't need to take time off of work, and you can fit it into your schedule.

[gslater]

Or, even cheaper than the table, is one of those nifty exercise balls (big size). I've got one that I occasionally flop over (belly down) to stretch out the lower back. I can happily read a magazine in that position for a long time.

[layton]

Hey fuck you asshole. Get some non-biased information before you trash on someone's profession. It's motherfuckers like you that keep me on the defensive everytime I mention what I'm doing. Teasing folks about what they do is one thing, but you are a total fucking asshole.

[mountainmatt]

Get some non-biased information before you trash on someone's profession. It's motherfuckers like you that keep me on the defensive everytime I mention what I'm doing.

 

First off, you do not know if its non-biased information or not. I have delt with a back injury for several years, and I can say (unbiased) that PT helped and Chriropractors were a waste of time. This is my experience, and therefore I relayed the story to someone asking for advice.

 

Teasing folks about what they do is one thing, but you are a total fucking asshole.

 

Secondly, I did not know it was your profession and I might have stepped a little more carefully had I known. For that I appoligize.

 

Third, how about instead of name calling, you actually defend your profession. What makes chiropractors better than PT? Since you are intimately involved in the profession, do a compare and contrast. Who knows, maybe I just had a bad experience?

[hubris]

lol, there is some great info in amongst the flaming here. Mike, my thoughts were that chiro's were mainly beneficial for "manipulation". I did not think a bulging disc fell into this category, but I have set up an appointment (thank god for the wifes ext. medical) with a chiro. I don't see how it could hurt.

 

Matt, eric etc. Some good suggestions here. Much appreciated.

Edited July 26, 2006 by hubris

[ericb]

Good luck...bottom line is I think Chiro, PT or both are effective for people...I don't think there's a right answer. I've often done both at the same time. I've had back issues for many years (disks and vertebral hypermobility), and done Chiro, PT, Cortizone, Yoga, Pilates.....you name it. I've found that core strength (exercises learned in PT) stretching, and an occasional chiro adjustment (1 per month) have kept me from tweaking it as frequently. Find out if it's muscle groups that are pulling you out of whack (hamstrings, hip flexors, etc.) and don't let them stay tight.

 

When my back does tweak and begin to tighten, I head home do repeated cycles of ice and inversion for a couple days and it relaxes. The inversion table for me has been the best way to break the chronic cycle. Major episodes used to last 2 to 5 weeks, now it's 2 to 3 days.

[Matt_Anderson]

Good luck, I had bulging cervical discs, hybermobility in the neck, not enough mobility in the middle back and hypermobility in the lower back. Also a fair amount of the overdevelopment of the upper traps and under development of the lower traps/rotator cuff muscles. It's been a long road but my neck/back/etc seldom holds me back these days.

 

PT is the first place I would go. I would also go to a few PT's and get a few opinions, some are better than others. I'd ask them to look at what is going on throughout your back. One part of the back definitely affects the other. Chiropracty (sp?)has its place, especially for mobilization of undermobile areas, but I've also had bad experiences, including adjustments to a hypermobile neck that aggravated it.

Bottom line, you should never give up control of what others decide to do to your body, ask questions of everybody and you can make good decisions (its not like these people are smarter, they just have more information, and should be able to explain to you why certain decision are the right ones).

 

Ultimately, I'm a big believer that correcting the muscles and how you use them is the best thing you can do to have long term health on your back. This takes effective analysis of what is going on in your back, a dedication to doing the exercises, etc that will correct the problem and going back and re-analyzing it over time.

[valleydude]

I ruptured the L5 in late 2004 after the PDX marathon and had surgery in Jan 2005. I thought it was just muscle spasms which I've had occasionally for 12yrs. The numbness in the left foot, loss of calf muscle control scared the shit out of me so I got it x-ray'd and MRI'd. The neurosurgeon said if I postponed the surgery much longer I could lose bowel and bladder control.

 

Surgery was a lumbar lamenectomy and a successful one. It will definitely take you out of action for a while though.

 

I heard both sides of the chiropractor debate from alot of different people. The only thing that matters is pain relief so do whatever feels good. I never saw a chiro ,I just got back into the gym and began excercizing gradually. I was back in the game about 4 or 5 months after surgery. Now I can do pretty much all of my dangerous hobbies. In fact, jogging and jump rope are the 2 things that are the most painful, but who wants to do those anyway.

 

Most important:

 

see a doctor and get the tests done if you start feeling numbness.

 

continue working your core muscle groups through zero-low-impact movements

 

know when to back off. If you feel pain don't push it. There is a line between being hard and being stupid.

[glassgowkiss]

I did a search and found a few good threads on this. Just wanting to hear some more discussion or updates from anybody that is/was going through this.

 

I have a bulging/slight hernation of my L5/S1. It happened about 8 months ago (I actually suffered from this for about 6 years but in a much smaller degree). I was able to get it back in decent condition in about 3 months, in which the first month I experienced mind numbing pain! It lasted about 3 months and I suffered a setback due to sitting too much studying. I was not able to get it back to where it was when I re-habbed it the first time.

 

I recently had a problem at work, and have had to take more time off. Lots of sciatic pain. I was told that just to see a neurosurgeon (I live in Canada) would be 1 year on the wait list. I got to talk with the assistant who told me there is no way they would operate on me anyway (I am 30, and do not suffer any of the debilitating symptoms that require surgery). I have started acupuncture, along with my regular PT, and am scheduled to see a retired Neuro who administers nerve blocks (ESI).

 

Hiking (and climbing) don't seem to hurt my back that much, especially if I can take a few days off after.

 

Anyone have any advice, or can share their experience with this?

 

A tad frustrated at this point!

the good news is your pain has pretty much nothing to do with your disc. if you have numbness, loss of strength, loss of motor function, loss of body mass- that's the disc issue. do you have any of it? the pain is generated in your soft tissue by the nerve intrapment by the tissue. have your gluteus, iliopsoas quadtrutus lumbarum, rotatores and multifidus muscles worked on and 90% of people will improve in days. check your pm

[layton]

i was only able to vent my frustration with your comment in about <2min of usable computer time. when in doubt, the word fuck and asshole works good enough.

 

glassgowkiss is right on the money. severe motor loss or progessive neuro deficits are of course candidates for surgery and a chiro or PT that claims otherwise is in it all for the $$. But w/o other symptoms the odds of it being a buldging disc (even if it does show on the MRI) causing you pain, is 50/50 since a lot of people w/o any symptoms have had buldging discs show up on an MRI taken for something else.

 

As far as the Chiro/PT debate.

 

1. chiropractors can diagnose, which is huge, since you really should know what you are treating, and MD's typically misdiagnose musculoskeletal problems, or take forever in a trial and error way to diagnose them. This is why chiropractors have the D for doctor in their letters (D.C.).

2. chiropractors are a good conservative doctor to go see first. a chiropractor (since they can diagnose) will be able to tell if the problem needs an immediate referral or not. If not, then why not go see one for a week to a couple months, to see if they can successfully treat your condition? Wouldn't you rather not go under the knife or have to take drugs that usually don't address the problem, only the symptoms? Plus, adjustments are a hell of a lot safer than any sort of drug, and way way safer than surgery.

3. chiropractors don't only adjust the spine or extremities, although that is their nich (probably because it works great on low back pain and low back pain is the number two reason anyone goes to the doctor...number one being a cold..). If yours does only adjust, either that's what you only need (doubtful) or they are lazy and greedy. This is a problem with a person, not a profession. MD's do the same thing...it's called their script pad. Anyway, depending on what state allows what, chiros have a huge arsenal of treatment options that they can use, including every and all PT modalities.

 

I would like to elaborate more on the specifics of what a chiropractor could and can do for low back pain, especially a disc problem, but i'm outta time.

 

sorry for calling you a motherfucker, i was stuck in Missourri for a few weeks, and needless to say, in a foul mood. The "quack" comment didn't help.

[JayB]

I think it'd be immensely helpful for people like you to give what you do a new name, as there seem to be two types of chiropractors. The subluxation folks, and people who want to practice a more hands-on style of scientific medicine than M.D.'s do. Since you're a smart guy who falls into the latter category, I'd think that your main beef should be with the chiro's who are members of the Cult of Subluxation, and who fail to limit their practice to treating musculoskeletal pain. As long as you work under the same banner as these guys, the Chiropractor = Quack equation is going to plague your existence.

[JayB]

"Inside Chiropractic" might make for some interesting reading for you if you haven't already taken a look at it.

"Inside Chiropractic: A Patient's Guide

Samuel Homola, D.C. (1999)

Chiropractic, which celebrated its centennial in 1995, is a curious mixture of science and pseudoscience, sense and nonsense. Much of it is based on the theory that misaligned spinal bones produce nerve interference that causes disease. Many chiropractors claim that correcting these misalignments ("subluxations") can restore health and that regular spinal adjustments are essential to maintain it.

 

Neither logic nor scientific evidence supports such a belief. Although spinal manipulation can relieve certain types of back pain, neck pain, and other musculoskeletal symptoms, there is no scientific evidence that it can restore or maintain health. As a result of expressing my opinion on this subject, I have been called a chiropractic heretic.

 

The chiropractic profession has little tolerance for dissension. Its nonsense remains unchallenged by its leaders and has not been denounced in its journals. In fact, many chiropractic journals continue to publish articles that attempt to justify subluxation theory. Although progress has been made, the profession still has one foot lightly planted in science and the other firmly rooted in cultism. Without appropriate criticism, the good in chiropractic will never be sifted out, and competent chiropractors will not receive the recognition they deserve.

 

This book denounces the cultism in chiropractic but supports the appropriate use of spinal manipulation and the research efforts required to solidify its scientific basis. If you are contemplating or receiving chiropractic care, it might help protect both your pocketbook and your health.

 

Contents

Chapter 1 My Personal Story

Chapter 2 From Bonesetting to "The Big Idea"

Chapter 3 From Cult to Profession

Chapter 4 The "Subluxation" Issue

Chapter 5 How Good Is Chiropractic Education?

Chapter 6 The ABCs of Back Pain

Chapter 7 Neck and Head Problems

Chapter 8 Questionable Marketing Strategies

Chapter 9 Nutrition Nonsense

Chapter 10 Gadgets and Gimmicks

Chapter 11 A Surfeit of Techniques

Chapter 12 Homeopathy, Chinese Medicine, and Herbs

Chapter 13 What a Rational Chiropractor Can Do for You

Chapter 14 Chiropractic Responses to My Criticisms

Chapter 15 Is Reform Likely? "

[PLC]

On the subject, can anyone recommend a good chiropractor near Redmond / Bellevue?

 

I mean one who isn't going to hard-sell and insist that I need to come in for 4 adjustments a week for the next two years? One who won't insist that he can cure allergies or digestive problems or AIDS?

 

I have chronic lower back pain, resulting primarily from the combination of a sucky desk job and too much basketball, and I want to get a chiropractic adjustment once every couple weeks (insurance will pay) alongside PT and stretching/lifting at home. But, I can't find a chiropractor who doesn't come across as some jackass quack.

 

I want a rational, decent chiropractor who will just adjust my spine and then leave me the hell alone!

[layton]

Unfortunately, Washington seems to be the place where the "Straight" (read: quack) chiropractors go to practice. It's amazing the difference between chiros in Oregon vs. WA

But sorry, no, I don't. I know a VERY good doc in Bellingham.

[spineguy]

I'd like to respectfully disagree. There is a growing number of us Rehab oriented chiro's in WA. The straight inclination stemmed from scope of practice issues, that have since changed quite a bit. For my two cents, I co-manage most patients with MD's and or PT's. That really appears to be where the future is.

[JayB]

Unfortunately, Washington seems to be the place where the "Straight" (read: quack) chiropractors go to practice. It's amazing the difference between chiros in Oregon vs. WA

But sorry, no, I don't. I know a VERY good doc in Bellingham.

 

So how does someone who wanted something like PLC's after differentiate between quack and non-quack? Kind of amazing that the non-quacks tolerate this situation. Is this because you guys are hopelessly outnumbered or what? Seems like non-straight chiros could come up with their own association, board-exams, etc.