Disc herniation and sciatica

Discussion in 'Health & Fitness' started by Richard, Aug 14, 2013.

  1. Richard

    Richard New User

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    Hi all,

    Been suffering now for 10 weeks with lower back issues and going for MRI on Monday.

    Clearly this is frustrating and literally a pain in the a** with the sciatica. Physio thinks I have a disc herniation which is aggravating the sciatic nerve OR piriformis muscle issues trapping the nerve!!

    Popping all kinds of meds to get me through the day and night prescribed by my doctor.

    I have had steroid injections for a previous disc herniation but this is not the same disc nor symptoms, but I am now in absolute agony, severe lack of sleep and zero court time ( I'm struggling to even walk at the mo).

    Anyone else had same/similar problems and what was your diagnosis, treatment and recovery time?

    Thanks in advance.
     
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  2. Say Chi Sin Lo

    Say Chi Sin Lo Legend

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    I have had 2 random episodes of sciatica. Both times, I was out for at least 2 months. For me, the most agonizing part was "change". I bet you know what I mean too. If I'm already up and walking, let me continue to walk. If I'm sitting already, let me continue to sit. Getting up, and sitting down were AGONIZING.

    I've taken precaution since the latest flare up to strength my core and lower back. My PT suggested I loosen up my hamstrings and calves as well.
     
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  3. Richard

    Richard New User

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    I'm struggling to walk or sit, which is becoming a bit of a problem at work as I'm constantly up and own.

    I'm literally bent over to the left hand side as I over compensate for the pain in my right cheek and leg.

    Stupidly I searched for surgery on the Internet and this does not appeal at all BUT I cannot go on as I am, and in the early hours of zero sleep, I will do anything to get relief!
     
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  4. El Diablo

    El Diablo Hall of Fame

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    Given the severity of the pain it wouldn't be surprising if this came to surgery, though you will certainly do physical therapy first to see if that can help. When I had this 10 years ago my doctor first asked me "have you had any incontinence or impotence," so be very careful about not pushing yourself to do anything resembling exercise right now.
     
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  5. RogueFLIP

    RogueFLIP Semi-Pro

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    I feel for you, and I wish you a speedy recovery. Had an episode of piriformis syndrome some years back. Was doing some very light barbell curls and felt my R piriformis just "grab". Very sore, didn't pay much attention to it. I think the downfall was going to the batting cages that night with friends. All that rotation and the next morning my whole right leg was burning. Then came the numbness of the whole leg. The worst was this random intermittant electric shocks up into my lower back that would totally freeze me.

    Sitting was killer, standing was a joke, changing positions was hazardous, walking was ugly, driving was a nightmare (45' commute each way). But at least I could sleep.

    I'm a physical therapist, and it's pretty sad when you're in worse shape than some of your patients.
    What was also pretty sad was doing the things that I was taught that was supposed to "help" didn't do a damn thing. Ultrasound, electrical stim, massage, mobilization, exercise, stretching, accupunture, myofascial release, Mckenzie this and that protocol....you name it, I had access to it, I tried it, no effect.

    Never bothered to go to a doctor or get any imaging done bc what were they going to tell me that I didn't have an idea about? And no way was I getting surgery.

    2 months of no change...getting treated by someone everyday.....:(

    My recovery was a little unorthodox I will say....started dating my physical therapist :) Went to a club one night...little bopping up and down and I noticed that my piriformis kinda relaxed a little which relieved my symptoms quite a bit.....interesting.....and a few days later after other "activities" :twisted: my piriformis totally relaxed and NOW it seems that stretching and exercise had some noticeable effect on reducing my symptoms. And before the 3rd month I was back on the court.
     
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  6. RogueFLIP

    RogueFLIP Semi-Pro

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    Few years later, I had a reoccurence after rehabbing a sprained left ankle.

    But time around, I was a little bit more aware of my body and in tune with what my body was telling me.

    Sadly, my unorthodox treatment this time around didn't work as much as I tried.:)

    But essentially balancing my body and system, I was able to right the ship in less than 2 weeks.

    And that's my story....:shock:

    Good luck to you.....feel free to ask any questions....
     
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  7. Maui19

    Maui19 Hall of Fame

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    Roughly 90% of all disk herniations will resolve themselves successfully with rest and PT. I've had three, and only one needed surgery and that was because I waited so long to get treatment.

    Last year I had a herniated disc in my back that made it hard to even walk. It was excruciating. For a while I was worried I was going to have trouble walking for the rest of my life. It took about six weeks of treatment and I was back 100%.
     
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  8. Richard

    Richard New User

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    Thanks for the replies all. Seen the consultant today and am scheduled for an MRI in the next couple of days which will determine the course of action. Options seem to be a steroid injection or surgery to take some of the disc away. I know what my preferred choice is!!!!
     
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  9. dolphinsrus

    dolphinsrus New User

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    Hope you recover soon. I suddenly experienced, for the first time in my life, lower back pain. I don't know what caused it. I tried to play tennis but I couldn't run. I had to stop, because the pain was intense. I could barely walk. I stopped working out and playing tennis. I started to swim and that helped a lot. However, I was still in pain and couldn't play tennis. I dont like to take medicines, so I waited for almost three weeks, but my improvement was very slow. I ended up visiting the Dr. He prescribed me Dexamethasone - Cortisone- 150mg a day, for 3 days and 75 mg for two days and Naproxen 1000mg a day for a week. Tomorrow is my last day, but so far, I feel like 90% recovered. To me, resting is the best therapy. Hope this helps.
     
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  10. scotus

    scotus Legend

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    I guess the sort of physical therapy the insurance doesn't cover works the best.
     
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  11. myservenow

    myservenow Semi-Pro

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    I had a bulging disc injury in the early 2000s that took me away from any physical activity for around three years. It was brutal. Forget playing sports, it was all I could do to make it through a normal day.

    I ended up getting an epidural steroid injection around the bulging disc. I had almost immediate relief but it took many months of walking and exercise before (a) I felt like even trying to play sports or (b) could tell that the sciatica was slowly starting to go away.

    That has been since 2002. Since then I occasionally have had the back issues return and overwhelm me for a week or two and then go away. My back will never be the same as it was pre-injury, but there is a certain level of pain and discomfort that I have just learned to accept.

    I can say once the sciatica went away I felt like I could manage the rest of the discomfort.

    Last year I was going off on a family vacation where I was planning to play tennis everyday. The night before the trip, I was rough housing with my two year old and my back went out. After the 7 hour road trip, I could barely take steps. I made it to an urgent care facility and was given pain meds. No joke, I spent the entire vacation week in bed. It was miserable.

    When I made it back home and went in to see an ortho, he actually asked me if I had scoliosis because the muscles in my back were so contorted. He prescribed me some muscle relaxers, which got me into shape enough to see a physical therapist. The PT gave me several exercises which concentrate on keeping my hamstrings loose. I think those exercises have really helped me.

    Finally, I would say that when I first injured my back all those years ago, my wife worked in a rehab facility and was able to "borrow" an ultrasound machine. For about a month, she used it on my lower back a couple times a week. I swear that ultrasound was a huge help and would recommend it to everyone.
     
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  12. Triskadekaphilia

    Triskadekaphilia Rookie

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    Been there done that.

    Developed an L4-5 herniation over past 2 years with episodic back pain, stiffness, and radiation/sciatica.

    Then got an acute rupture of same disc after coughing hard. Felt like a hammer in my back.

    Ironically, tennis never caused the symptoms and could keep playing through most of it with good stretching and care of the core and lower back muscles. With the rupture I had to take a few weeks off.

    Did PT and oral medicines and got back to 100 percent. No surgery and not even any shots. I have built up my para spinal muscles and flexibility, core muscles and thigh muscles. I avoid slouching, sitting for long periods, and use a lumbar support in the car. Have some recurrences of stiffness which tells me to get in my PT regimen more. No more sciatica.

    My advice: do not do surgery. Studies are pretty clear that long term outcomes are equivalent or worse when surgery is performed.

    I found books by mckenzie and egoscue were very helpful.

    I just hope I can keep my back healthy for the next 49
    years and keep playing!

    Best of luck
     
    #12
  13. Triskadekaphilia

    Triskadekaphilia Rookie

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    It's amazing how the chronic muscle contracture causes pain.

    In many cases of chronic back pain it's not the disc it's the chronic inflammation and the tense contracted para spinal muscles. When I am particularly stiff I will lie on the floor with one leg elevated and flexed 90 degrees. My lumbar is in a healthy normal curvature.

    It takes a good 10 - 20 minutes but eventually I can feel my para spinal muscles relax and release. At that point the stiffness melts away.
     
    #13
  14. Posture Guy

    Posture Guy Professional

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    Two suggestions:

    1. Get the book "Pain Free" by Pete Egoscue, read the first 3 chapters and then do the exercises for herniated discs. Email me directly with any questions after.

    2. Engage in RogueFLIP's specialized form of physical therapy. Repeatedly. Remember, one doesn't get well without dedicated effort.
     
    #14
  15. Richard

    Richard New User

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    Thanks guys. I know I do have some disc degeneration from a previous back injury for which I had a steroid injection. Worked well for a few years until this episode. I guess it's a case of if the disc has degenerated any further?

    I'm really quite reluctant to have surgery as surely removing partial disc can't be good??

    However, having said that, after 10 weeks of agony and approx 2 hours sleep per night, I get to a place at 1am that I'll do anything to ease it!! Meds are not touching it at the moment.

    My osteo has given me electro / tens machine which does ease the pain for a while, but I find laying on the floor with my legs over the edge of a coffee table at 90 degrees really helps ease it off.

    It's the red hot agony across my right cheek and into my calf that I cannot cope with. No driving, sitting, walking is a real issue, no sleep, can't get out and about with the kids.......I'm really frustrated and p***ed off with it.

    Posture guy - have seen your recommendation of this book and its en route from amazon as I type!
     
    #15
  16. boris becker 1

    boris becker 1 Rookie

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    Had the same issue about 18 months ago. Piece of disk was hitting sciatic nerve...


    Have the doctor prescribe difinacol which is a anti inflammatory. This finally cleared the problem up. Of course the disk is still herniated.

    One surgeon wanted to operate. I said only as a last resort. Physical therapy, steroids etc didn't do a thing. Only this anti inflammatory gave me pain relief.
     
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  17. RogueFLIP

    RogueFLIP Semi-Pro

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    That's because you're shortening the hip flexor muscle in this position. It's short and tight, and when in the 90 degree position its in a position of slack.

    (I talk about muscle bc it's easy to picture and understand, but I'm really referring to the soft tissue).

    This is a generalization of course, but I'd say 99% of the patients I see with low back/sciatica pain have some involvement of the hip flexor which goes unchecked because everyone is looking at the back or hip which logically is the symptomatic area.

    For acute issues, of course treat your syptoms....but when conventional logical treatment doesn't seem to work, then you have to look elsewhere.
     
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  18. Posture Guy

    Posture Guy Professional

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    I agree with RogueFLIP's assessment.

    Here are a couple of more immediate things you can try:

    3 ecises for low back pain: http://www.youtube.com/watch?v=rqNnmC09eUU

    then I would suspect that Supine Groin Progressive would be helpful for you: http://www.youtube.com/watch?v=z7KC-N6N6F8

    The latter takes a chunk of time, but if it's the right thing for you, it's incredibly powerful. It was one of the things that helped me come back from my accident and get to play tennis again. It takes so long because at each level we have to give the tissue time to adapt to the position and release/unwind, and that doesn't happen in 30 seconds. So you're spending 5 minutes (sometimes more) at each level to facilitate this.

    Start with the first video, and feel free to email me with questions.
     
    #18
  19. nkjwlf

    nkjwlf Rookie

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    I have the same issues. Pain killers did not help. Dr. Prescribed my Neurontin. I went from a pain level of 10 to zero. My herniated disc and sciatica may still be there but now I can function and play tennis again.
     
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  20. Posture Guy

    Posture Guy Professional

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    while the drug is chemically repressing the pain signal, I would STRONGLY recommend that you address the reason you have the nerve impingement in the first place. If you don't, and continue to engage in activities that would normally generate pain, the odds are pretty good that this issue will get worse to the point that some very invasive action is required.
     
    #20
  21. El Diablo

    El Diablo Hall of Fame

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    Somebody actually benefits from Neurontin!! Pfizer paid what was then the largest criminal fine in US history, over a billion dollars, for illegally marketing Neurontin for unapproved uses. It's been written widely by exceptionally reputable medical authorities that some of the research for the drug was faked.
     
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  22. RogueFLIP

    RogueFLIP Semi-Pro

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    I agree with PG. While I'm glad you're painfree and playing tennis, the medicine is probably just masking your symptoms. You don't want to be taking meds forever.

    But I will admit, if I was painfree, being a tennis addict and all, of course I'd be playing. So I understand where you're coming from. :twisted:
     
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  23. RogueFLIP

    RogueFLIP Semi-Pro

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    Just a few more thoughts and inputs when I went through my sciatica issues:

    I realized how much of a mental component there is to all this. I'm not saying that it was all in my head....but there was something that was "blocking" my ability to heal myself.

    Perhaps it was some kind of self-defense mechanism of some sort, that I was bracing against the pain and numbness that I wasn't allowing the body to relax in order to heal.

    And that finally, after engaging in coitus (yes, a Sheldon Cooper reference :)), that was finally the trigger to allow my body to relax on a deeper level and finally allow the path to healing.

    I find this a lot with the chronic pain patients I treat. We in the myofascial release community call this "sub-conscious holding pattern", which I won't go into detail as its beyond the scope of this post and thread.

    After I became more aware of this, my subsequent bout of sciatica a few years later was much easier to deal with.
     
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  24. superdave3

    superdave3 Rookie

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    I had sciatica from the L5 disc. I had PT to strengthen the core muscles, but it finally took one back epidural a year and a half ago to get rid of it. I still do my PT at home 2x week, and have not had problems since. I can even drive now for long distances with no problems.
     
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  25. nkjwlf

    nkjwlf Rookie

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    I have been taking the Neurontin for 5 years. I have 3 herniated discs and the orthopedic surgeon didnt know which disc was causing the impingement. I care for my 9 year old son with cerebral palsy who is wheelchair bound. So I cannot be out of commision for months recovering from back surgery while the orthopesic goes eenie meenie miney moe guessing which disc is the problem. I was not able to do anything without massive pain from the sciatica shooting out my left big toe. I do stretching and core exercises daily. Its Neurontin or be an invalid and neflect my son. Ill stick with the Neurontin.
     
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  26. Richard

    Richard New User

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    So, had my results and have L4 & L5 disc issues. There is minimal space for the nerve which is causing my problem. Consultant has recommended steroid injections for both discs prior to any surgery discussions.

    To be honest, I'm relieved in a way that surgery wasn't the only option, it might get to that eventually, but for now I'll take the injections!

    I'm still leaning to the left as I over compensate due to the pain from the sciatic nerve when stood, walking or sitting.

    Posture Guy - book has arrived and I'm doing the exercises, most beneficial seems to be static back and pullovers.

    Thanks all for your comments so far, I'll keep you updated on progress and please, please feel free to share anything more you think will be beneficial to my recovery.
     
    #26
  27. Posture Guy

    Posture Guy Professional

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    Richard, do you feel better putting an arch in your low back, or rounding it? If Static Back feels pretty good, I'm guessing the latter.

    If true, I'd strongly suggest you get the wood tower and begin doing Supine Groin Progressive per the link above. Feel free to email me directly with any questions, happy to help.
     
    #27
  28. Richard

    Richard New User

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    Definitely feels better rounding it. Will look into the wood tower, thanks for the advice thus far.
     
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  29. Posture Guy

    Posture Guy Professional

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    yeah, if rounding is creating more space around that nerve, I'd get that tower and start doing supine groin progressive. Feel free to email me once you do and I'll give you some other advice on how to incorporate it.
     
    #29
  30. kevo82

    kevo82 Rookie

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    After 2.5 years since I broke the L4-L5 disc, I can say that I understand every phase of this type of injury...physically and mentally.

    1st of all: DO NOT wait more than 2-3 months after the numbness appears. You will do more harm than good by waiting.
    I waited for 6 months tring every treatment before taking the decision to have surgery and I really regret that.

    2nd of all: do not try "non invasive" surgery...if you decide that you won't heal without surgery, choose micro discectomy, and go to the best doctor possible.

    But the most important thing is to stop believing in all the "wonder makers therapists" and believe only in yourself and agood dr if necessary.
    I was so down mentally, that I was listening to all kind of "terapists", throwing money and trying every treatment available. At least I studied medicine, so I know right away if the "doctor" is selling bull****, or has a clue about the problem.

    You have to understand that the problem is the muscular inbalance, but if the disc is fragmented, no teraphy will ever remove the fragments compresing the nerve root.

    Only after the problem is resolved with surgery, you have to solve the REAL problem, and work the weak muscles, and flex the tight ones.
    In my case, strenghten the buttocks, abdominals, multifidus, quadratus lumborum and lumbars; stretch the femural biceps, adductors, hip flexor, and piriformis.
    If you try that trough pain, you only damage the nerve, and it never heals perfectly, and it does very slow.

    I had surgery 6 months after the pain, and it took me 8 months of rehabitation after the surgery, until I could play without pain...after 1 year, I was 90% recovered, I was playing tennis without any pain, serving with +180, BUT...the nerve was still numb and sore after a training.

    So I decided to have another surgery, to completely remove the pressure from the disc. (the first surgery only removed the migrated fragment, without treating the disc)

    But the second surgery knocked me down and I was worse that before...sometimes I regreted that I took the decision, because the pain wasn't going away as fast as the first time.

    Now I am 7 months after the surgery, and I have no pain, but the numbness is never completely gone, even if it's better than before.
    I played 2 times, but with pain (2hands BH and serve), so I think that I will need at least 6 months more to be 90% again...who knows...

    It helps to lie down, with one leg flexed from hip and knee at 90', also to sleep on the belly, because it accentuates the lumbar lordosis, and relaxes the hip flexor muscles.
    Also it's better to be lean than havy. I've always been muscular but very lean, but the muscular imbalances caused me the problem.

    Try every exercise recomended, but stick only with the ones that you feel that really helps you. I had so many "personalised programs" but only some exercises were good...others were doing more harm than good.

    Also, deep tissue massage it's not allways good. I was feeling perfect after the massage, no pain, no numbness, more flexible...but the high pressure made around the surgery area, was creating local inflamation, and the next day I couldn't stand up straight.
    The only thing that made the inflamation go away (temporarily) was walking.

    Now I made 1 week break, and the pain is gone. I didn't worked the muscles at all during this week, just lied on the floor, so I will resume rehabitation, but without massage.

    The time away from normal activities and knowing that you may never heal completely, it's a real mental challenge...the moral support is very important: the weak relations break, the strong ones become stronger.

    The injury (the only serious one that I ever had), made me understand that I am not indestructible, changed the way I see life, I realised who were my real friends, and made me accept that I will never be 100% the same.

    What doesn't kill you, makes you stronger (mentally)...even if physically I may never be 100%...only GOD knows.
     
    Last edited: Sep 9, 2013
    #30

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