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  • L5/S1 large herniated disk: no pain, but surgeon still recommends surgery?

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    Old 05-10-2010, 01:34 PM   #1
    mk1979's Avatar
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    mk1979 HB User
    L5/S1 large herniated disk: no pain, but surgeon still recommends surgery?

    Hello everyone,

    first post on this board, hoping for your comments to help make the right decision regarding surgery. I'm 30 years old guy, athletic, no major health issues. A little more than 3 weeks ago my S1/L5 disk ruptured and after seeing a neurosurgeon and a neurologist, based on the MRI and EMG, was recommended for surgery and that it should be done soon-- in the next few weeks. My concern comes from the fact that my pain subsided quickly and was mostly gone after the first 10 days. I still have limitations now (e.g. painful when bending forward) but don't feel in a desperate state and would consider paths alternative to surgery if such exist. The doctor's explanation is that my herniation is very large and there's little chance that it'll get better on its own, but a greater chance that it'll become worse in the future. More details and detailed MRI are below. I would appreciate any feedback.

    Thanks and good luck to everyone going through this.


    It happened abruptly on April 16 while bending forward, after about 2 weeks of on and off slight low back/buttocks pain and muscle tightness as a result of playing pick-up basketball (had not played in years) on April 6. It is very likely that I've had a related earlier childhood injury from skiing/sports since I had sharp pain around L5/S1 at some point as a teenager which then disappeared. Otherwise I've been playing sports actively all my life (skiing, beach volleyball) and have often had lower back pain but it usually subsides in a day.

    MRI (taken April 23):
    MRI report says there's a L5/S1 20 mm large herniation pressing onto the nerve.

    * Pain going down leg started April 18, was given Medrol (steroid) pills April 20, no other medications taken; very painful when walking/sitting, but little pain with icing (several times a day) and laying down.
    * Pain gradually gone by April 26, started walking normally
    * Numbness in left side of foot still persists, but seems better
    * Left calf weaker, but improving: on May 10 can do 15 toe/calf (single leg) raises, up from 5 raises on May 5; other leg can do 50+ raises
    * Still painful to bend forward (beyond 45 degrees from the vertical), when legs kept straight; otherwise can bend legs at the knees OK
    * Able to walk long distances, able to swim, able to travel on plane
    * Still feel the pulling/burning in the leg when straining/twisting, but otherwise very little pain

    Goal: gain full flexibility/strength of motion, return to sports with moderation


    Last edited by moderator2; 05-10-2010 at 05:23 PM. Reason: please do not post pictures - as per the posting policy

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    Old 05-10-2010, 01:37 PM   #2
    Pintail's Avatar
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    Re: L5/S1 large herniated disk: no pain, but surgeon still recommends surgery?

    I wouldnt get surgery until you cant stand the pain anymore !! alot of doctors will cut you just to cut you !!

    You will know when the time is right for surgery !! When it gets bad enough you will be begging for surgery !

    Give it time, the body has a unique way of healing itself, and if you are pain free, I would never risk surgery personally
    2002; Hurt back playing baseball

    2003; L5 S1 microdiscectomy

    2005; Repeat L5 S1 microdiscectomy

    2010; Redo L5 S1 microdiscectomy
    Too young and too scared for fusion at 25...

    Last edited by Pintail; 05-10-2010 at 01:38 PM.

    Old 05-10-2010, 01:46 PM   #3
    Join Date: Apr 2009
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    murr3 HB User
    Re: L5/S1 large herniated disk: no pain, but surgeon still recommends surgery?

    Dear MK,

    according to studies, if you have surgery in 4 months after your first symptoms, then you have chance of long term success. Probably this is why your surgeon recommends surgery, you obviously have problem, and this problem doesn't necessary have to cause pain. Surgeons do not operate pain, they operate your disease.

    Consider minimally-invasive spine surgery.

    Old 07-18-2010, 12:45 PM   #4
    mk1979's Avatar
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    mk1979 HB User
    Re: L5/S1 large herniated disk: no pain, but surgeon still recommends surgery?

    Hi guys,
    thanks for the responses.
    A quick update 3 months post injury -- hopefully useful for other people in my situation:
    Decided to postpone surgery until absolutely necessary. Pain have gradually disappeared and numbness in leg is gone (took almost 2 months). Leg is getting stronger but still weaker than normal, yet good progress -- can do up to 30 calf/toe raises up from 1-2 only after injury.

    What has helped me a lot is swimming three times a week, and doing simple excercises for the back and abs with gradually increasing intensity.
    I tried running but it still doesn't feel right -- got slight pain, and muscle tightness and spasms the next day.

    Although the herniated fragments are still bending the nerve and sometimes I can feel it, my hope is that over time the body will absorb them. If the situation gets worse though I might consider surgery-- just waiting to see how things develop.
    Any feedback is welcome,


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