Exercises to Help Bulging Disc, Pinched Nerves...

[TripleB]

I started have a little back pain, a lot of left leg pain, and some numbness in my left big toe back in October. The MRI showed, "L2/L3 disc bulge, L3/L4 disc bulge, L4/L5 herniated disc, L3/L4 and L4/L5 impingement of nerve roots, mild to moderate arthropathy." The back pain has disappeared but if I stand/walk more than five minutes, the pain on the side of my lower left leg is unbearable.

They've tried numerous anti-inflammatories and physical therapy, but nothing has helped. So next Monday I go for an "epidural steroid injection, lumbar transforaminal (proc) in the L4 and L5." The injections are going to be done by a former student of mine who is now a doctor. Luckily it's a former student I definitely trust to stick a needle in my back! I understand that the injections are supposed to just temporarily relieve the pain and numbness.

My question is, for anyone who has had similar problems: what specific exercises should I do on a daily basis, after the injection (for the rest of my life), so I can hopefully reduce the risk of these pains/problems from returning in the future?

Physical therapy has me doing four exercises daily, I believe to strengthen my core: glute bridges, brace supine marching w/legs up in air, paloof press with a band, and theraband pulldowns.

I'm looking to do anything and everything I possibly can to try and keep this immobilizing pain from coming back again.

Thank you for any help you can provide!

TripleB

 

[bigR]

There are referred pain patterns from the glute medius and minimus down the leg and knee that can feel like sciatica. Glute strength/mobility would probably help. Banded glute walks to warm up.

Anything you may be able to manage on a single leg for stability will also translate to core mechanics and the best loading possible. Standing on one leg and keeping your spine and stomach stable while you simulate walking on the other leg for 20 reps. 1 slow step, 1 medium, 1 fast relatively. Switch legs. Doing this without holding onto anything would be the goal for 3-4 sets.

I imagine they wouldn’t recommend rotational core work. If you could do so pain free maybe that is an option. Everything you do should be pain free and you will have to be mindful of how things feel days later when incorporating new movements. Good luck!

 

[EggSalad]

I started have a little back pain, a lot of left leg pain, and some numbness in my left big toe back in October. The MRI showed, "L2/L3 disc bulge, L3/L4 disc bulge, L4/L5 herniated disc, L3/L4 and L4/L5 impingement of nerve roots, mild to moderate arthropathy." The back pain has disappeared but if I stand/walk more than five minutes, the pain on the side of my lower left leg is unbearable.

They've tried numerous anti-inflammatories and physical therapy, but nothing has helped. So next Monday I go for an "epidural steroid injection, lumbar transforaminal (proc) in the L4 and L5." The injections are going to be done by a former student of mine who is now a doctor. Luckily it's a former student I definitely trust to stick a needle in my back! I understand that the injections are supposed to just temporarily relieve the pain and numbness.

My question is, for anyone who has had similar problems: what specific exercises should I do on a daily basis, after the injection (for the rest of my life), so I can hopefully reduce the risk of these pains/problems from returning in the future?

Physical therapy has me doing four exercises daily, I believe to strengthen my core: glute bridges, brace supine marching w/legs up in air, paloof press with a band, and theraband pulldowns.

I'm looking to do anything and everything I possibly can to try and keep this immobilizing pain from coming back again.

Thank you for any help you can provide!

TripleB

I am so sorry that you are dealing with this. I herniated my L5/S1 in 2023 and I am all too familiar with the pain and road to recovery.

The bulges at the various levels are most likely normal and age related. The herniated disc at L4/L5 is most likely what is causing the pain by impinging the left sciatic nerve root. The steroid injection should help relieve pain and give your body time to heal without being in horrible discomfort. Make sure it’s a guided injection; I’m sure it is.

As for exercises, I would be very cautious in what you do right now as you don’t want to make the herniation worse. No exercise that involves bending over (think touch your toes), twisting at the core, or lifting.

Glute bridges, cow cat, super man are all things you can do now that will help. Sciatic nerve glides might also help but given that the nerve is inflamed from impingement, it may actually not feel good.

At this point, you are going to need the herniation to rescede or absorb into your body so that the nerve root is freed up. Until that happens, the pain will persist.

I ended up having a Microdiscectomy on mine as the pain was unbearable and the steroid shots and PT stopped working. The surgery was absolutely the right thing to do (in my case) and I’d have no hesitation recommending it.

Feel free to drop my a PM if you want to discuss anything privately. In addition to the intense pain from a nerve/spine injury, it was a very mentally difficult and isolating injury to deal with. I wasn’t able to play tennis so I lost physical excersize and a good part of my social life due to the injury. And unless you’ve had this injury, it’s really hard to understand what someone is going through.

 

[Grafil Injection]

I had seven episodes in the last 15 years of disc bulge / herniation type; varying from 2 weeks pain, to a normal 2-3 months pain necessitating no activities, to 18 months unable to do anything strenuous (the last one 4 years ago). Since then, stretching routines have, touch-wood, prevented any recurrences. Basically, 10 minutes in the morning of gentle stretches, and similar before playing any sports, and calisthenics type exercises to strengthen mainly the core. Good luck.

 

[antony]

I started have a little back pain, a lot of left leg pain, and some numbness in my left big toe back in October. The MRI showed, "L2/L3 disc bulge, L3/L4 disc bulge, L4/L5 herniated disc, L3/L4 and L4/L5 impingement of nerve roots, mild to moderate arthropathy." The back pain has disappeared but if I stand/walk more than five minutes, the pain on the side of my lower left leg is unbearable.

They've tried numerous anti-inflammatories and physical therapy, but nothing has helped. So next Monday I go for an "epidural steroid injection, lumbar transforaminal (proc) in the L4 and L5." The injections are going to be done by a former student of mine who is now a doctor. Luckily it's a former student I definitely trust to stick a needle in my back! I understand that the injections are supposed to just temporarily relieve the pain and numbness.

My question is, for anyone who has had similar problems: what specific exercises should I do on a daily basis, after the injection (for the rest of my life), so I can hopefully reduce the risk of these pains/problems from returning in the future?

Physical therapy has me doing four exercises daily, I believe to strengthen my core: glute bridges, brace supine marching w/legs up in air, paloof press with a band, and theraband pulldowns.

I'm looking to do anything and everything I possibly can to try and keep this immobilizing pain from coming back again.

Thank you for any help you can provide!

TripleB

Ring Dinger?

 

[kayak4water]

I had a lifting accident in 2016. Disc spaces L3-L4 are almost gone. I got lucky. No pain now but … My right foot went numb right after last Xmas. I do a bunch of yoga stretches twice daily—a mix of: Cat-cow, cobra, child’s pose, planks, boat, extended triangle, camel. I resumed kayak and canoe paddling (with some racing) almost three weeks after the accident and still do 1-2x/week during paddling season. I do torso twists and some other stuff on the weight machines 2x/week. Recovery seems to be slow, but steady.
My foot fatigues early, but I can hit groundstrokes, volleys and serves. I got lucky. I go for 60-90 minutes and quit because I can’t stay focused longer than that.

I wish you the best.

 

[TripleB]

I am so sorry that you are dealing with this. I herniated my L5/S1 in 2023 and I am all too familiar with the pain and road to recovery.

The bulges at the various levels are most likely normal and age related. The herniated disc at L4/L5 is most likely what is causing the pain by impinging the left sciatic nerve root. The steroid injection should help relieve pain and give your body time to heal without being in horrible discomfort. Make sure it’s a guided injection; I’m sure it is.

As for exercises, I would be very cautious in what you do right now as you don’t want to make the herniation worse. No exercise that involves bending over (think touch your toes), twisting at the core, or lifting.

Glute bridges, cow cat, super man are all things you can do now that will help. Sciatic nerve glides might also help but given that the nerve is inflamed from impingement, it may actually not feel good.

At this point, you are going to need the herniation to rescede or absorb into your body so that the nerve root is freed up. Until that happens, the pain will persist.

I ended up having a Microdiscectomy on mine as the pain was unbearable and the steroid shots and PT stopped working. The surgery was absolutely the right thing to do (in my case) and I’d have no hesitation recommending it.

Feel free to drop my a PM if you want to discuss anything privately. In addition to the intense pain from a nerve/spine injury, it was a very mentally difficult and isolating injury to deal with. I wasn’t able to play tennis so I lost physical excersize and a good part of my social life due to the injury. And unless you’ve had this injury, it’s really hard to understand what someone is going through.

Thank you so much for your reply.

I'm currently doing the glute bridges, one legged glute bridges (which seemed to hurt my hip), super man, dead but, plank, leg raises/hold.

The shot in my L4 and L5 offered no relief.

I thought it was strange that the pain is now (didn't start out this way) is the exact same spot on my left leg...excruciating pain if I stand/walk more than 5 minutes. I know the pinched nerve in my back is probably the cause of the leg pain and 100% sure of the numbness in my two left toes, but it just seems to me that the excruciating pain spot never moves. So my back doc agreed to take an x-ray of my leg and he said it didn't look normal but it didn't appear too abnormal. It looks as though one of the bones has a slight thickening right above where my pain is. So I'm having an MRI on my left leg on the 24th.

He said if it turns out to be nothing wrong with my leg, and I can't bear the pain (which I can't if I stand/walk more than 5 minutes), he would do the microdiscectomy surgery. He said it wasn't too involved (hopefully as outpatient), but I shouldn't bend or twist for 6 weeks afterwards. Since I'm a teacher I'm trying to make it to Summer break before having the surgery.

Since I have a couple months to play with, I'm currently going to a chiropractor to see if that might help (back doc said it wouldn't hurt anything) - been to 2 sessions, nothing so far, said it would probably take 5 to 7 before I would feel any difference.

If that doesn't help any, I told my wife I would go to a acupuncturist because it was the solution to her back problems. I figure why not give the chiropractor and acupuncturist a shot while I wait on the time for surgery.

I appreciate all your help and guidance!!!

TripleB

 

[SpinDr.]

I've recovered from this injury a few times. Surprised no one has mentioned the McKenzie program. Emphasis on low back extension exercises, which push extruding disc material back into the spinal column. During my most recent disc injury, I did 80 of these a day. Combine this with a strengthening program for glutes, hamstrings, and core. Do what you can without pain and bank on gradual improvement over the course of a couple to several months. Super simple and effective. Avoid surgery at all costs. I would only have it if you fail 6 months of dedicated PT.

Second time I had this injury, I had a trainwreck MRI, and docs were suggesting disc replacement or spinal fusion. I had already had L5 S1 surgery 6 years earlier. Severe pain down the entire sciatic nerve path and acute low back pain and stiffness. Gave surgeons the middle finger, did a high dose of prednisone, which killed inflammation, and went straight to PT.

PT said bend over slowly, reach down and tell me when you feel pain. We measured. Did 20 Mckenzie pressups, and measured again. I could go into flexion further without pain. Everytime I would do an excercise (squats, dead bugs, Romanian deadlifts, stationary bike) I would immediately follow with McKenzie pressups and then measure flexion tolerance again.

In 3 months I was surfing 8-10 foot OBSF and easing into tennis again.

The exercises you are doing are fine for strengthening low-back support muscles in the intitial recovery phase but they are not healing movements and will do little for longterm injury prevention. Stretching is not a healing movement for low back. It will help with mobility once you are out of the acute phase. Acupuncture can help manage pain and possibly increase blood flow to accelerate healing, but is mostly placebo compared to the medicine of corrective and preventative MOVEMENT and hypertrophy training.

Now I lift weights. Once you are healed, there is no better way to prevent injury and bullet-proof your back. Squats, deadlifts, lunges, overhead presses, resistance core work. Lift iron and get strong.

The body wants to move, as a good friend and sports physio once said to me. The worst thing you can do is take painkillers, sit or lie around all day, spend $$$ on palliative care like chiro and acupuncture) and wait for your scheduled surgery.

For my first injury, my surgeon quoted me a 6 week recovery, and it took me a year. He was one of the best neurosurgeons in the Bay Area. Six weeks out, I felt absolutely broken, though I was told it was safe to tie my shoes. Surgeons know how to do surgery but rarely have any insight into actual recovery. Spinal surgery is GNARLY. They cut through your muscle and connective tissues down to your spinal column -- think about that. Outpatient means nothing except that they will dope you up and send you home same day.

 

[antony]

Will you try it and let us know if it works

 

[TripleB]

In an effort to avoid back surgery this Summer, they're trying to figure out if there may be any other cause for the excruciating leg pain I have on the side of my lower left leg if I stand or walk for more than 5 minutes.

I had an MRI (contrast and no contrast) on my lower left leg on Monday but the results aren't in yet. I also had an ultrasound on both legs yesterday looking to see if there are any veins or arteries that could be causing the pain (had a DVT blood clot back in '19 that gave me excruciating pain behind my knee).

The ultrasound results are back but I have no clue what they mean.

Right leg (that doesn't hurt): "Significant decrease in flow velocity in the external iliac concerning for more proximal disease that is not well visualized." To me it looks like my 'External Iliac' value is extremely low (41.64 cm/s) compared to that value in my left leg (124.22 cm/s).

Left leg (that does hurt): "Significant decrease in flow velocity in the common femoral artery concerning for proximal disease that is not well visualized." To me to it looks like my 'Common Femoral Artery' value is lower (47.61 cm/s) compared to that value in my right leg (59.99cm/s).

Hopefully my back doctor, family doctor, or chiropractor can explain what all of this mean.

Still, my back doesn't hurt a bit, but that one spot, after 5 minutes of standing or walking, makes doing either unbearable!

TripleB

 

[pointbreak]

I started have a little back pain, a lot of left leg pain, and some numbness in my left big toe back in October. The MRI showed, "L2/L3 disc bulge, L3/L4 disc bulge, L4/L5 herniated disc, L3/L4 and L4/L5 impingement of nerve roots, mild to moderate arthropathy." The back pain has disappeared but if I stand/walk more than five minutes, the pain on the side of my lower left leg is unbearable.

They've tried numerous anti-inflammatories and physical therapy, but nothing has helped. So next Monday I go for an "epidural steroid injection, lumbar transforaminal (proc) in the L4 and L5." The injections are going to be done by a former student of mine who is now a doctor. Luckily it's a former student I definitely trust to stick a needle in my back! I understand that the injections are supposed to just temporarily relieve the pain and numbness.

My question is, for anyone who has had similar problems: what specific exercises should I do on a daily basis, after the injection (for the rest of my life), so I can hopefully reduce the risk of these pains/problems from returning in the future?

Physical therapy has me doing four exercises daily, I believe to strengthen my core: glute bridges, brace supine marching w/legs up in air, paloof press with a band, and theraband pulldowns.

I'm looking to do anything and everything I possibly can to try and keep this immobilizing pain from coming back again.

Thank you for any help you can provide!

TripleB

Watch all the info you can find from Stuart Mcgill, he is Nr1 in the world on the topic! Seems you are doing good things, be patient, all will be well=)

 

[pointbreak]

In an effort to avoid back surgery this Summer, they're trying to figure out if there may be any other cause for the excruciating leg pain I have on the side of my lower left leg if I stand or walk for more than 5 minutes.

I had an MRI (contrast and no contrast) on my lower left leg on Monday but the results aren't in yet. I also had an ultrasound on both legs yesterday looking to see if there are any veins or arteries that could be causing the pain (had a DVT blood clot back in '19 that gave me excruciating pain behind my knee).

The ultrasound results are back but I have no clue what they mean.

Right leg (that doesn't hurt): "Significant decrease in flow velocity in the external iliac concerning for more proximal disease that is not well visualized." To me it looks like my 'External Iliac' value is extremely low (41.64 cm/s) compared to that value in my left leg (124.22 cm/s).

Left leg (that does hurt): "Significant decrease in flow velocity in the common femoral artery concerning for proximal disease that is not well visualized." To me to it looks like my 'Common Femoral Artery' value is lower (47.61 cm/s) compared to that value in my right leg (59.99cm/s).

Hopefully my back doctor, family doctor, or chiropractor can explain what all of this mean.

Still, my back doesn't hurt a bit, but that one spot, after 5 minutes of standing or walking, makes doing either unbearable!

TripleB

Sounds like something is pinching a nerve?

 

[antony]

Check out the Steadman Clinic