Join Date: Jul 2004
| | Re: Grade 4 annular tear
Have the same thing. Suffered 2 1/2 years with a bulge at L4/L5 that left me with sciatica off and on in right leg, but mostly a deep ache in the hip and buttock, with low back pain, mostly achy, sometimes sharp.
Then this Jan I got leg pain galore when I upped my walking from 3 to 5 miles a day (to lose weight to help back pain) and standing, sitting and walking made it worse. If I lifted just an 8 oz glass of water, I got pain in the spine. All this after losing 40 lbs and walking 7 days a week, eating right, stretching etc. to fix that back. Ridiculous. I was losing the battle. The doctor watched in awe as I did my superwoman effort to win the back war.
Also, this sounds funny, but with that bulge my spine felt tight and it was hard for me to balance or bend. Back felt stiff as a board.
Then had MRI this April revealing no longer a bulge but a lose disk fragment sitting on nerve meaning the disk tore (suspect that did so while ago). Very painful. Only comfortable position was to lay down on side with leg drawn up to chest. Had ice pack glued to me all day. Luckily I don't work so can be at home. Could not ride in car at all. Too painful. Basically disabled. That was January. Still didn't want surgery and doctor didn't want to do it, so held in there.
Was told tear would heal itself with time, and it did get a bit better with acupuncture and rest, slowly, but I couldn't do my walking - too painful. He said these disk fragments will absorb into the body 50% of the time. The tear wouldn't have been a problem except the fragment leaked out and landed on the nerve causing problems.
When doctor found out I'd not been walking for 3 months, he ordered a lumbar shot (cortisone) so I could move and exercise (takes moving to get blood flowing to heal disk) then 5 days later, bam, got drop foot and couldn't lift my leg or lift my toes. Why didn't I go back to doctor earlier? Because other than surgery or a shot there was nothing he offered me.
I had already battled worsening leg pain and my thigh and right toe were numb which worried me but as long as I could lift my toes the doc wasn't concerned.
Had a microdiskectomy one week after getting drop foot (six weeks ago) to remove fragment from nerve as it was pinching it causing the problem. But doctor did not want to do surgery until it got that bad. Surgery is a serious thing and can leave scar tissue causing you more problems like pinched nerves. Was told microdiskectomies help with leg pain but not usually for back pain, though can help some wtih that. It seems to me a crap shoot.
Woke up in hospital able to lift leg and move toes again. No more spine pain and tightness. 6 weeks post op, my leg is less numb as the nerves do their thing, but still have bad sciatic pain in butt. i have arthritis in two disks as well, so this coujld be partly that. Doctor told me today that the butt pain should go away in 3 weeks, or I may have it permanently, in which case, he'd do a disc replacement. Oh joy.
I had a very large annular tear in L4/L5 from top to bottom, so had lifting, sitting, bending restrictions longer than normal after surgery" 6 weeks instead of 4. He removed the disc fragment from the nerve, removed the piece sitting in the opening and removed some more from inside the disk to lessen the chance of more hernating out, so now I'm TERRIFIED of sitting, sneezing, bending - don't want any more disk leaking!
I start physical therapy in two weeks and am walking 1 hour a day with percocet for pain in 30 min sessions. I hope you do not battle this this long. Frankly, I don't know if I'm winning or losing the battle. It's too early to tell after only 6 weeks. My advice is read up on the back, use these forums, ask the doctor questions, try conservative approaches, try to avoid surgery, but if it gets bad, then be open to surgery. And say your prayers. If you get a weak foot, tell the doctor.
I have to say that you can only do what you can but do everything you can. I lost weight, walked, stretched, did acupuncture and gave the tear time to heal, but it didn't work. Doctor said a fragment was sitting in the tear holding it open making it hard to heal. I hope this isn't your case. I don't know what to tell you except do EVERYTHING you can conservatively: lose weight, walk every day, refrain from lifting and bending, use ice etc. I couldn't even stretch at one point because stretching hurt, even simple gentle stretches.
But be aware that if you reach a point where you cannot move around at all due to pain that you need to tell the doctor because being down a long time does not help. At the same time, you have to rest that back to heal the tear. It's a tightrope walk. move to get blood flowing to heal it, but don't make a wrong move or overdo it.
To quote the doctor: WALk WALk WALk! But don't walk too much all at once, but build up distance gradually. I swear that's the only thing he tells me to do for this back is walk. Frankly, knowing what I know now I would follow post surgery instructions to help your tear heal: no sitting at all no bending (keep spine straight), no lifting over 5 lbs, no twisting, rest and walk.
I don't know what a grade 4 annular tear means, but was told these tears normally heal themselves and do not require surgery.
Hope that helps. Good luck!!