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Old 04-14-2010, 11:56 AM   #1
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runagainsoon HB User
L5-S1 herniation, lengthy post

Hello,
Back in December, I started to have pain in my left buttock that i associated with running and weightlifting. I'm not as fit as I used to be, but that's cause I was crazy with it for a few years, so I'm still fit, or was as of December. Anyway, I'm not big, 5'7'' and 130, so weight isn't a problem for me. The pain wasn't bad at first and since i've been a runner for >10 years, just figured it'd go away on it's own.

Six weeks later, it was getting worse. What was some soreness in my buttock started turning into a burning sensation into my hip. I saw a dr. who sent me to a physical therapist for piriformis. While doing the pt, the pain started to work down my leg. First my calf was getting pain, then my ankle. I stopped running 2 weeks in pt, just to make sure i was doing as much i could to rest and fix my body. After 1.5 months of pt, i was worse than when i started, when I was able to touch my toes by bending at the waist quite easily. Now, it's takes some work to tie my shoes. I don't blame the pt, i think the pain's advance was just a coincidence of timing with the pt. I went back to the dr., he realized i was worse than before and he sent me to a orthopedic specialist.

The specialist is supposed to be one of the best guys in the area. I don't doubt that he knows about backs, but his bedside manner, for lack of a better term, needs work. I don't think he even spent 15 minutes with me at the MRI follow-up. The MRI showed what the dr. described as a pea-sized herniation of L5-S1. He said he could operate and mentioned fusion. I declined.

I was considering getting an epidural, but then, i don't know if that will really fix the problem. I have pain constantly, but mostly, it's not horrendous. Sometimes, i think i walk funny because of it, but i mean, i can make a quick jog to the next building and Saturday, i spent the morning shoveling soil for a garden. So, yes, i think about pain. But i'm not really worried about that.

I'm more concerned with how much further this will go. The MRI was a week ago, so about 4 months after the pain started and 2.5 months after it really started to worsen and it showed a small bulge. Is a herniation LIKELY to worsen? I know that it CAN (as in i can also fall down the stairs and break my leg any day), but if i've given up running and biking (for now anyway), will it start to heal on it's own? If it at least stops getting bigger and i were to choose surgery, is a fusion really necessary? Can't the dr. just cut out the bulge? Or will more of the disk extrude to fill the spot formerly occupied by the removed section? Being mostly young, I've read that the material in the disk is still pliable and that messing with it is not suggested and that it might be better for older people, who've had the material sort of solidify, use surgery. But if the surgery is just removal of the bulge, it doesn't seem like it should have as big an impact.

My mind still spins with the fact that i was able to run with the underclassmen in ultimate frisbee and now, i can't even tie my shoes without pain. I'm coming to grips with that fact, but it's not easy.

I know the disk doesn't actually get back to normal, but a couple of people have said that the bulge should shrink or dehydrate(according to specialist), at least reducing the pain i have. Is it possible for a herniation to kind of heal and subside, so that one can do the activities they used to?

 
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Old 04-14-2010, 02:34 PM   #2
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tomsocal2000 HB User
Re: L5-S1 herniation, lengthy post

[QUOTE=runagainsoon;4225633]
I'm more concerned with how much further this will go. The MRI was a week ago, so about 4 months after the pain started and 2.5 months after it really started to worsen and it showed a small bulge. Is a herniation LIKELY to worsen? I know that it CAN (as in i can also fall down the stairs and break my leg any day), but if i've given up running and biking (for now anyway), will it start to heal on it's own? If it at least stops getting bigger and i were to choose surgery, is a fusion really necessary? Can't the dr. just cut out the bulge? Or will more of the disk extrude to fill the spot formerly occupied by the removed section? Being mostly young, I've read that the material in the disk is still pliable and that messing with it is not suggested and that it might be better for older people, who've had the material sort of solidify, use surgery. But if the surgery is just removal of the bulge, it doesn't seem like it should have as big an impact.[/QUOTE]

Ok lengthy post be you and me now so here we go.

First, the bedside manners of the doctor is concerning to me and to suggest fusion at that point is surprising.

Second, you can get 3 epidurals and 3 cortizone injections into the disc area over 12 months. I encourage everyone to try PT first, and then injections second, before ever thinking about surgery. I have had the 6 of them and did nothing. My daughter had one epidural and it solved her issues right away. Epidurals are less painful then the direct injections. Not bad at all.

These are my opinions:
1. Yes, it probably will get worse with age but much of that is also the normal progression of our body aging.
[B]2. Yes, it could heal on its own, but I think epidurals and cortizone can be a very good option to assist the healing.[/B]
3. Yes, there is a surgery that is a very small incision to repair the bulging disc but then you lose the disc. Think of the back with discs being shock absorbers. The less discs you have, the more pressure on the other discs to absorb the pressure.

#2 above is my suggestion at this point.
__________________
Tom

09 Re do Fusion L3-L4
08 L Fusion L3-L4
08 Lami L3-L4
04 L Fusion L4-L5
95 Rmv hdwr - prev fusion
93 L fusion L5-S1
91 Lami L5-S1
80 Chymopapain Inj-dissolve disc L5-S1
5 other leg surg

 
Old 04-14-2010, 04:28 PM   #3
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runagainsoon HB User
Re: L5-S1 herniation, lengthy post

tomsocal2000,
Thanks for your reply. When you say it solved your daughter's problems, do you mean it stopped the pain? It didn't fix the disc though, I'm assuming.

[QUOTE]3. Yes, there is a surgery that is a very small incision to repair the bulging disc but then you lose the disc. Think of the back with discs being shock absorbers. The less discs you have, the more pressure on the other discs to absorb the pressure.[/QUOTE]

Doesn't the dr. just take the bulge out? Or does the dr. remove the whole disk? I definitely wouldn't consider taking out what's left, which from my MRI appeared to be a decent amount of material.

best
john

 
Old 04-14-2010, 04:34 PM   #4
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tomsocal2000 HB User
Re: L5-S1 herniation, lengthy post

it stopped the pain and allowed the disc to stop bulging since the inflamation in the area cleared it up.

As for the disc removal, I thought they remove fragment pieces of the disc but I wonder how much that really leaves. I am not clear on this part.
__________________
Tom

09 Re do Fusion L3-L4
08 L Fusion L3-L4
08 Lami L3-L4
04 L Fusion L4-L5
95 Rmv hdwr - prev fusion
93 L fusion L5-S1
91 Lami L5-S1
80 Chymopapain Inj-dissolve disc L5-S1
5 other leg surg

 
Old 04-14-2010, 05:48 PM   #5
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runagainsoon HB User
Re: L5-S1 herniation, lengthy post

Thanks for the explanation of your daughter's experience. I should hope to be so successful. I'll reconsider the shot.

best,
john

 
Old 07-10-2010, 03:23 PM   #6
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bmacbee HB User
Re: L5-S1 herniation, lengthy post

[QUOTE=runagainsoon;4225633]Hello,
Back in December, I started to have pain in my left buttock that i associated with running and weightlifting. I'm not as fit as I used to be, but that's cause I was crazy with it for a few years, so I'm still fit, or was as of December. Anyway, I'm not big, 5'7'' and 130, so weight isn't a problem for me. The pain wasn't bad at first and since i've been a runner for >10 years, just figured it'd go away on it's own.

Six weeks later, it was getting worse. What was some soreness in my buttock started turning into a burning sensation into my hip. I saw a dr. who sent me to a physical therapist for piriformis. While doing the pt, the pain started to work down my leg. First my calf was getting pain, then my ankle. I stopped running 2 weeks in pt, just to make sure i was doing as much i could to rest and fix my body. After 1.5 months of pt, i was worse than when i started, when I was able to touch my toes by bending at the waist quite easily. Now, it's takes some work to tie my shoes. I don't blame the pt, i think the pain's advance was just a coincidence of timing with the pt. I went back to the dr., he realized i was worse than before and he sent me to a orthopedic specialist.

The specialist is supposed to be one of the best guys in the area. I don't doubt that he knows about backs, but his bedside manner, for lack of a better term, needs work. I don't think he even spent 15 minutes with me at the MRI follow-up. The MRI showed what the dr. described as a pea-sized herniation of L5-S1. He said he could operate and mentioned fusion. I declined.

I was considering getting an epidural, but then, i don't know if that will really fix the problem. I have pain constantly, but mostly, it's not horrendous. Sometimes, i think i walk funny because of it, but i mean, i can make a quick jog to the next building and Saturday, i spent the morning shoveling soil for a garden. So, yes, i think about pain. But i'm not really worried about that.

I'm more concerned with how much further this will go. The MRI was a week ago, so about 4 months after the pain started and 2.5 months after it really started to worsen and it showed a small bulge. Is a herniation LIKELY to worsen? I know that it CAN (as in i can also fall down the stairs and break my leg any day), but if i've given up running and biking (for now anyway), will it start to heal on it's own? If it at least stops getting bigger and i were to choose surgery, is a fusion really necessary? Can't the dr. just cut out the bulge? Or will more of the disk extrude to fill the spot formerly occupied by the removed section? Being mostly young, I've read that the material in the disk is still pliable and that messing with it is not suggested and that it might be better for older people, who've had the material sort of solidify, use surgery. But if the surgery is just removal of the bulge, it doesn't seem like it should have as big an impact.

My mind still spins with the fact that i was able to run with the underclassmen in ultimate frisbee and now, i can't even tie my shoes without pain. I'm coming to grips with that fact, but it's not easy.

I know the disk doesn't actually get back to normal, but a couple of people have said that the bulge should shrink or dehydrate(according to specialist), at least reducing the pain i have. Is it possible for a herniation to kind of heal and subside, so that one can do the activities they used to?[/QUOTE]

I hope you at least try to get some chiropractic advice first..
I have had this surgery back in 1989..full fusion with a laminectomy.

I have such stiffness after a few hours of walking or working in the yard.I hear that the surgury today is less invasive, mine cut me right thru my waist muscles and I think that is took me almost a month to walk again. My legs feel like logs after a day in the yard and I cant get up out of the chair.

you also need to rest...stretch..low impact things only...its the weight of our own torsos that creates so much pressure on the spine. I was a machinist back then thinking I could just lift things like heavy metal vises and parts..but our backs are not equipped for that,and I didnt have that great of a core strength..

perhaps hanging from your feet, one of those elevation boards so that gravity can stretch you out...it helps me out when it gets too bad for me.

Surgery is a very last resort..

 
Old 07-17-2010, 02:04 PM   #7
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runagainsoon HB User
Re: L5-S1 herniation, lengthy post

BMacBee,
Thank you for responding. I know I should think of surgery last, but having had the herniation confirmed, going to a physical therapist for 3 months, seeing a massage therapist, going to a chiropractor for adjustments and decompression and still no improvement (no worsening either), conservative treatment doesn't seem to be helping. I'm currently doing forestry research and my daily activites, at times strenuous, are taking a toll on me, but my back is holding up through it. Poison ivy, ticks and chiggers and heat are my main enemies at the moment.

I've read up some on fusions in medical journals and at best the average fusion seems helpful for maybe 10 years. No thanks. That's part of the reason I wanted to ditch the specialist I first saw, since that was the first thing out of his mouth. However, a microdiscectomy doesn't seem out of the question, now that I've attempted other treatments.

By summer's end, I should have time to find a dr. for a 2nd opinion. If that doctor says fusion, I think I will wait a year or two, cross my fingers during that time for a miracle and see another.

 
Old 07-17-2010, 05:40 PM   #8
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glassladymn HB User
Re: L5-S1 herniation, lengthy post

I lived with pain off and on for 13 years before going ahead and getting surgery.......You can gett better without surgury but you have to slow down and be carefull with what you do in your day to day duties......and try every un surgical method before you go under the knife!! My therory is do everything possible before even thinking of surgury......I realized I needed surgury because I was loosing strength in my right leg, and I was unable to sit longer than an hour at a time..... many people can live with a herniated disc but you just have to moddify your life a bit... best of luck

 
Old 05-21-2011, 02:03 PM   #9
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Join Date: Apr 2010
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runagainsoon HB User
Re: L5-S1 herniation, lengthy post

Hi,

(Very) lengthy post II

I had a microdiscectomy 8 days ago. I'm feeling a lot better right now. As others have noted, i was able to walk pain free right after the surgery. I don't want to get my hopes up, but right now, i've plenty to be cautiously optimistic about. I'm really not trying to push my limits, but i've already unintentionally made some movements and been in some positions that i couldn't do without pain before the surgery.

The dr said to take it easy for the 1st two weeks. I'm not allowed to drive for now. Pick up exercise after two weeks. I can't ride a bike until 4 weeks and no running until 6 weeks post-op. Six days after surgery, i walked 4 miles and today i walked close to twice that. Based on my prior level of fitness and ability, i'm following dr's orders.

I'm not walking this much every day. I'm spending far more time resting. While i feel good, i'm planning on following his rec's about no riding or running. Since it's been well over a year w/o running, i'm willing to forgo that. Being pain-free is far more important to me. I lived and breathed running before all of this. It sounds like I'm blaming the running. I don't know what to blame, but i don't know if running will help the disc. The dr. said that i've got a 15% chance of reherniation in the first 6 weeks. After that, it drops to 5%. I'm trying to play those numbers to my advantage.

Right now, i'm very relieved to be rid of the pain. I'm still waiting for the wound to heal, so i'm not going crazy with activity, but i can walk without pain. About 2 months ago, the pain was really starting to ramp up and i don't know why. I was walking daily, lifting weights a little once or twice a week, but i'd been doing that for months. If you go back to the first post i started in this thread, i give a little background about my activity level before all this happened. If you don't want to, short story: i was a runner for >10 years, very active, then woke up one day with immense pain on the whole left side of my back which turned into some butt pain in a few days and then sciatic/back pain after a few months. Diagnosed with a herniated disc and i guess i have some degenerative disc going on in that disc.

I was very worried about having surgery done. You hear a lot about the mess-ups. I saw this dr. 2x before deciding on the surgery. Even then, that was over a course of 6 months. A lot of people warn you about surgery. I strongly believe that's a justifiable position to have. Surgery is no guarantee, and there is plenty that can go wrong.

On the other hand, after 18 months, my pain started to intensify and i had no options for relief, so i decided it was the right thing to do. I weighed what i thought were my options and you know how that balanced out. However, there is the flip side as those here will attest to. I know personally of at least one of those.

An acquaintance of acquaintance was airborne military and he ended up with a herniated disc, they think from all of the parachuting. I don't know the guy well and never asked him about his experience, so i don't know how cautious he was about surgery. He got a microdiscectomy done. Something didn't turn out right and he had to go back under the knife. The _2nd_time_ around, he ended up getting a staph infection in the joint or wound or something. He's recovered from the infection, but he's still got some pain. So surgery might have marginally helped, i don't know his whole situation with regards to relief and complications.

To further drag this post out, another point about people's decisions. I know another guy who's got herniations in L4-L5-S1. The first started 20 years ago and the 2nd was a year or two later. He has days where he stays home because of pain. He also can pass a wildland firefighter pack test: 3 miles with 45 lbs on your back in 45 min. I was training for that too, but the surgery changed those plans. This guy has had some tough runs, but he's put up with two herniations for nearly 20 years. He told me that he'll get the surgery done, but so far he hasn't. I'm not sure for his reasons, but then, i'm not sure what type of procedure he's referring to. So, if you're reluctant about surgery and can stomach the days/weeks where you won't feel very good at all, you can get by with it.

The calculus of decision making is very personal. While it's still early, i'm happy with my choice. Hopefully, i'll post again in a month or so, saying everything is great.

Last thing: i made a separate post about what it might cost. I have a crappy student health insurance plan, but it's not that crappy. SO FAR, it's only cost me $1000 for this procedure. I'm sure there will be some kind of adjustment or whatever insurance people like to do, but even if it's another $1000, i'll be happy to pay it. When i have a better idea of what this cost me in total, i'll update that other post.

Best regards,
J

 
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