Herniated Disc - What Helped You?

TripleB

Hall of Fame
After several months of lower back pain an MRI confirmed I have a herniated disc around the L3/L4 region. The doctor said it didn't look horrible but was in the worse place possible. He said operating wasn't a good option now based on where the herniation is, what the operation would entail, and my age (52). He said he could definitely give me shots to help with it but I would think that the shots would just be a temporary fix.

I asked how playing tennis, or even jogging/running, would affect the herniation and he said that the pounding would create a situation where is would take many days for the pain to subside every time I played and prolong the recovery process. As far as a timeline to recovery he said that it would take between six months and a year depending how well I stayed away from situations that aggravated it and the effort I put into stretching.

For those of you who have had a herniated disc, or even lower back pain, what have you found that helped you make it back on the tennis court pain free?

Thank you for any and all help!

TripleB
 

downunder

New User
Specialist assessment and advice would be a good first step (if you have not already done that). Go somewhere that specializes in sports rehabilitation. That might include physiotherapists, doctors, chiropractors, osteopath, etc. Not all doctors regularly work with sports people. You may find that some activities make the problem better rather than worse, while there are some activities you must avoid.
 

Dartagnan64

Legend
Likely the disc is unrelated unless its a fresh herniation. If you had a significant L3/4 disc herniation you'd have hip pain radiating into your thigh. This is why MRI's are generally useless for people with lower back pain and generally not recommended. Rate of false positive findings is very high. Almost everyone over age 50 has disc changes such as bulges and herniations and treatment directed at those things has no correlation with outcome.

And increased activation, core conditioning and stretching and time are the best ways to manage back pain. Imaging if anything is associated with worse outcomes because it promotes catastrophic thinking about what are often very normal human changes.
 

downunder

New User
The suggestions from Dartagnan64 worked for me! I did not want to be too prescriptive with solutions because your problem could be very different to mine (I had lower back pain and disc pressure on my spinal cord causing pain radiating to hips and hamstring). I went through a progressive program of various physical therapy that ended with strengthening exercises for years to come. Fortunately, I live near a clinic that specializes in sports rehabilitation for internationally competitive athletes, through high school athletes, and the general public.
 

TripleB

Hall of Fame
Thank you for your replies and advice!!!

I saw a physical therapist today (for a problem with the knee I had microfracture surgery on back in 2012) and he seemed to think most of my problems can be corrected with increasing my flexibility (especially in my lower body...said the flexibility of my hamstrings was worse than elderly people) and some strengthening (especially around the knee, hip, and calf areas).

He has me on a program that involves stretching at least once a day every day and simple strengthening exercises (so as not to hurt my back worse) once a day for three days a week. I'm also going to try and incorporate some yoga in there as well.

I've been putting off stretching for 52 years now, I guess it's time to start!

Again, I appreciate you replying!

TripleB
 

Crocodile

Hall of Fame
1. Physio twice a week
2. Your own program twice a day authorised by your Physio.
3. Lots of swimming
4. Wear a back supposed when you get tired
5. Be aware of your posture, don't sit for long periods and avoid things that hurt your back and you should come good.
 
How exactly does a disc herniation fix itself ?
Does it just stop bulging and go back into place?
How does PT help in this process?
The disc is bulging so what does PT do to make the disc not bulge anymore.
 

Dartagnan64

Legend
How exactly does a disc herniation fix itself ?
Does it just stop bulging and go back into place?
How does PT help in this process?
The disc is bulging so what does PT do to make the disc not bulge anymore.
The pain from the herniation is usually due to compression of the exiting nerve root. The nerve root will find more room over time and the disc material will dry out and shrink over time giving more room. It doesn’t magically withdraw back into its capsule.

Most low back pain is related to poor back mechanics and not bulging or herniated discs. That’s why physio helps. Physio does nothing for herniated discs other than improve your spine health so discs are under less stress and don’t bulge further.
 
So, if the nerve root finds more room and disc never withdraws, does that mean herniated discs just resolve themselves over time, even if you do nothing?
 

Dartagnan64

Legend
So, if the nerve root finds more room and disc never withdraws, does that mean herniated discs just resolve themselves over time, even if you do nothing?
90% will resolve over time with no treatment at all. The other 10% need surgery. For most pinched nerves due to disc herniation, PT, massage, chiro are pretty useless providing just short term decompression.
 

FRV2

Rookie
I had one of these in my neck. Never really healed itself completely. Or maybe it did and I just aged poorly. My neck also makes a cracking sound when I spin it around now.
 

RogueFLIP

Professional
How exactly does a disc herniation fix itself ?
Does it just stop bulging and go back into place?
How does PT help in this process?
The disc is bulging so what does PT do to make the disc not bulge anymore.
The point of physical therapy is to restore function and help with pain. The actual disc itself will not be the focal point of therapy. Ways of restoring function and reducing pain symptoms will differ from therapist to therapist as they may utilize different "systems" and various methods IE modalities, exercise and movement based rehab, and multiple manual bodywork techniques.

So yes, while most back pain issues do resolve itself with time, it's how much time is the varying factor. Physical therapists can identify abnormalities in posture, Range of Motion (and fluidity of it), strength, gait, compensatory movement patterns, soft tissue restrictions (what I always preach on ;) ) and so on and so on. Identifying and correcting these issues may lead to a quicker recovery time & reduction/elimination of pain and a faster return to the prior level of function.

So while one might just try to wait it out and hope things get better on its own, I prescribe to the "Hope is not a method" doctrine. If something can be done about it, why not try? And as long as you don't try to force anything during the rehab process, you won't injure yourself.
 
I still don't understand what PT does to fix the issue.
If the disc is bulging and pressing on the nerve, what does PT do to reverse that?
 

RogueFLIP

Professional
LIke I said, the actual disc itself will not be the focal point of physical therapy. The goal is not to reverse bulging or herniated discs, the goal is to restore function and reduce pain. How one goes about that will differ from patient to patient depending on how they present and from therapist to therapist depending on their training/experience.

There's been multiple studies of taking people who do not have any back symptoms and giving them an MRI and something like >60% of them had herniated discs, bulging discs, structural abnormalities, etc. Yet they are asymptomatic.
So don't be seduced by the logic of "I have pain somewhere and the MRI shows a bulging disc so that must be the cause."

The good doctor said in Post #8 that most of the time it's not caused by the bulge or herniation.
 

scotus

G.O.A.T.
90% will resolve over time with no treatment at all. The other 10% need surgery. For most pinched nerves due to disc herniation, PT, massage, chiro are pretty useless providing just short term decompression.
Perhaps a large portion of the 90% just gave up on medical solutions and are living with pain? That would include me.
 

FRV2

Rookie
Just aggravated what I believe to be a bulged disc in my lower back when I did a rep of squats with poor form. Ow. I forgot how bothersome this injury is.
 

FRV2

Rookie
Try doing bodyweight squats.
You're too old to be packing on 135 lbs or more
? I'm in my mid 20s. It was an issue with form. I was actually squatting so little weight that my body got away with poor form. Unfortunately my spine(?) was much more fragile. I have a feeling if I pack on more weight, muscle memory would help me use proper form. That is how it has worked out in the past.
 

Tmano

Professional
So I had it twice along with some other bulging disks. Until the first time I had a long period of on off issues with the sciatica nerve.
The fist time was bad, the pain about 7 out of 10 and it was right on the L3 and L4 and it would irradiate down to my ankle and foot skipping the whole leg. I had done everything, physical therapy, acupuncture, traction, nothing helped, then when it actually got worse, all of a sudden the day before the appointment with the surgeon it disappeared. I went anyways but after being checked the surgeon sent me back home and slowly I started playing again.
After about 2 years, and this time the injury was more subtle while playing, actually while over stretching trying to get to a ball with my 2HBH. I started feeling my lower back a little stiff, but I kept playing. After a few days of stiffness I started getting more pain and it would also irradiate down to the side of the calf just above the ankle. After a month I had the MRI and again herniated disk along with bulging disks. This time was not that painful so i could function ok, so I started doing physical therapy again and it helped. This summer after 3 years pretty much I started playing tennis again.
The hernia overtime dries out and slightly retrieve as the bulging retrieve as well. after about a year from the injury I started going to the gym again and started running and doing some light weights, and so I went on and increased till I got much better.
However, what made the difference is that since last winter I REALLY started working on my lower BACK and CORE, a lot and that paid off.
I'm still working out daily, about 30-40 minutes of planks of any kinds for core and back. It's a pain because I don't always want to do it but that's the only think you really need to work on to protect your back. A strong core and lower back/back is essential. I also to be safer switch to a more comfy frame and I play with running shoes. Yes, there are running shoes stable enough that you can use as long as you don't drag your feet. You need to move your feet otherwise you'll spring your ankle.
 

Dartagnan64

Legend
Perhaps a large portion of the 90% just gave up on medical solutions and are living with pain? That would include me.
Good quality studies show that the numbers of people living with pain are identical at one and 2 years in both surgical and non-surgical arms with disc herniation. Surgery affords an earlier relief of symptoms and return of neurologic deficits but at a high rate of complications both early and late.

Many people with chronic neck and back pain. Very little has been shown to be superior to just increasing activity. It is a common problem with no simple solution.

What can you tell us about MS?
How can someone get diagnosed with it, and
then just go about normally for decades after?
Variable expressivity. Not everyone with a pathological disease develops the same symptoms. There are benign forms of MS and more aggressive forms and probably it's not all the same disease. But since we don't know the cause we can't separate the groups. I've seen people paralyzed in a year from MS and others with no symptoms, only MRI findings.

Did you go to medical school in the U.S? Just wondering.
Canada, although I did do Neuro-Oncology specialization in New York. Seen both medical systems and their various flaws.
 
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