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Herniated Disc


VinRLX

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I somehow screwed up my lower back in June and haven't been able to ski since. MRI showed bulging disc L/4, herniated disc L/5, and S/1 (sciatica?). Other info includes degenerative disc disease and facet sclerosis. A microdiscectomy is an option, though I am not choosing to pursue it at this time. Have been doing the PT thing for seven or eight weeks now and am improving but not recovered. Steroid/cortisone injection may be the next step if necessary, although, as I understand it, this would reduce inflammation of the nerve and reduce pain, but not curatively heal the disc problem.

Will you please share with me any experiences or knowledge of this type of injury? I am specifically interested in finding out the probability of returning to skiing.

The good part of the summer has been enjoying the amenities that the new boat has to offer and watching the ski partners improve through the slalom course we installed last year. Other than that. . .well, it's been kinda rough.

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Hey Jack, I had a herniated disk and a bulging disc in my neck about 10 years ago. The surgeon tried to make an appointment for surgury for the next week, but I opted for 3 months of PT, (cervical traction) and got better enough to avoid it. I still have some neck pain, but it's not bad enough to go back and see him. I alter my sleeping habits and take Advil.

About 7 years ago I had 2 bulging discs in my lower back and a bone spur. Not only did I have a bad case of sciatica, I couldn't sit or lay down. Three months of PT, (just exercises), and I got better. My back has never felt so good.

Try everything before you go under the knife. Prednisone worked great for my neck, but did nothing for my pack. If you can find the position to take all the pressure off your back and get in that position as often as possible it may help. The best advice I got was that the best way to cure a disc problem is to nurse it for a long time.

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I had problems with a herniated disc and took a year off, went to chiropractor and phys. therapy, nothing helped. After 2 years of various healing methods, I got 2 shots in the spine. That was 2 years ago now. Worked great for me.

I'm still kind of weary about butt sliding and deep water barefoot starts, but have done them a half dozen times this year and haven't had any negative effects. I kept off my butt last summer and did a lot of barefooting (with a kick-off ski), skiing and surfing.

Does your sciatica flare up if you ski? My sciatica didn't get worse from skiing, so I kept doing it the first summer. My sciatica would stop hurting when I was skiing.

When the next summer came around, and I had been doing PT and Chiro and stretching with no results, I took the summer off. At the end of the summer 2006 I got the shots.

Edited by JasonK
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Okay, I may be a little biased about this, but here goes: just about everybody

has an abnormal MRI! Surgery is a last option. Epidural steroids often help,

and a series of three is reasonable and perhaps even necessary before your

insurance will pony up for the microdiscectomy.

The surgery itself is pretty straightforward, and typically short, maybe 30

minutes of actual surgery time and the rest is anesthesia and prep time.

They'll take out the portion of protruding disc that is putting pressure on

the cord or nerve root. You'll feel better almost immediately. Structurally,

your back will be stable. Two friends of mine have had the procedure

and both have skied behind my boat afterwards (I think their neurosurgeon

told them to hold off for 3 months).

My brother, on the other hand, decided to put off the surgery even though

two different surgeons recommended it. Within 3 months, he was completely

asymptomatic. That was over 2 years ago. The difference was that, while

my brother had radiating pain, he didn't have any muscle weakness or foot drop

or numbness. Both of my friends who had the procedure had one or more of these

symptoms. So, I'm not suggesting that you will absolutely get better if you don't

have the procedure, but you may very well get better without it, especially since

it sounds like you're getting better anyway.

My brother is not a skier, but he is a biker (as in bicycle), and he's back to full

activity. Both of my friends are back to full activity, though they both, on

occasion, complain of back tightness or minor pain.

As we get older, the intervertebral discs change. They become more firm

and more brittle. If you've already had one herniate (bulge or have a portion

break off), just realize that they are all in pretty much a similar condition and

any one of them could bulge and cause symptoms at some point. Most don't.

If I were you, I'd wait until my symptoms had completely resolved, start

an exercise program concentrating on core conditioning, and plan on enjoying

next summer skiing to my hearts content. YMMV.

Edited by srab
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I was in your exact situation a year and a half ago. I did all the things that were mentioned above, pt, shots, chiropractor, traction, you name it. I went as long as i could stand it with out considering the micro. I wish now that i would not have waited so long and lived with the pain and restriction of not doing the things i wanted. I got to where one wrong move would but me down for several days. I started draging my left foot and didnt even know it till my wife asked me about it. I opted to have the surgery and i was pain free almost instantly. The recovery from the surgery took 6 months but it was worth every min. I had the surgery in november of 06 and i feel that i am 100% now. The only thing that i dont do anymore is heavy squats and heavy deadlifts. No need to risk a new injury when i dont really need to be any stronger, just maintain what i have.

One thing to think about is with the shots, your feel better but your are not better! All it does is make you feel like you are not hurt while you are really causing more and more dammage every day.

Good luck with your decision.

Edit: After reading the above post, i agree with the bike riding. I also ride a roadbike and my recovery did not really take off till i started riding again, then it was night and day.

Edited by txwakejunkie
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So, here is what happened to me. I had the exact same thing start with me last year. I have had back problems for years and finally had enough so I went in for an MRI. They tried PT, but didn't that didn't work. Next step was the epidural shots. I had 2 rounds of those. They didn't work for me. My last draw was surgery. My back surgeon could tell I was ready for relief. My legs, back and hips were killing me. When I traveled or sat for an extended period of time, I would get really stiff and hurt so much. I didn't want to have to take pain killers to make it through the day. BTW... I am 31 years old.... So, last November I had surgery. I had spinal fusion and got a cool piece of hardware called a cage. They went in through my stomach. So far, the pain in my legs and hips are gone. My back is still very sore at times, but keep in mind I have to sit alot at work as I am systems engineer. The more mobile you are the better you will feel. I have wake boarded and wake surfed some this year. Nothing big, and doing what my back will let me do. I have realized it is going to take me longer to heal than I am used to. So, for those reasons, the VLX is for sale and gonna get a houseboat for a while. I would be happy to talk anyone more about it and give more details. Honestly, surgery is the last option. Try EVERYTHING ELSE first. Not that I am unhappy, just taking a long time to heal. Surgery has slowed me down, just changed the way I do thing. Hope is all works out....

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The latest numbers I've seen show that most (greater than 90% of people) will have the same long term (greater than 3 years) result from PT that they get from surgery. As others in this thread have echoed, go down the list, one step at a time, and chances are things will return to "normal" in a reasonable amount of time.

Of course there are exceptions to that (such as a foot drop, or extreme pain), but for most people the added risk of surgery, albeit small, doesn't actually net you much improvement in the long run.

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Sorry to hear of your discomfort.....I can relate. Ask your doc about inversion tables. I can't tell you how its help my bulging L4 and c5 documented by MRI. Continued skiing and excercise are key as well! You'll be back think positive!

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Jack, sorry to hear about your back. I do not have any personal experience with this problem but as a physician (ER), I agree with the post by srab. Great information by the way srab (sorry, I don't know if you are a physician or not). I would definitely recommend a second neurosurgical opinion especially if are planning on surgery. Txwakejunkie is correct, the eipdural shots are for pain control and do not help to structurally fix the problem. Not to offend any neurosurgeons, but remember that when you go to a surgical specialist, they will usually recommend surgery as that is what they are trained to do. For your condition, this is usually done after conservative measures (PT, epidural pain shots, anti-inflammatory pain meds )have been unsuccessful in controlling your pain. Prednisone helps but this medications has lots of long term side effects and you do not want to be on it long term.

Enjoy the rest of the season if you can.

Michael

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I had similar problems a few years back. Since I work with doctors, I received alot of input from them. The consensus was, no surgery unless it is your last option. If I remember correctly, I was told that once you have surgery to repair a disc, that area is weaker than it was before, therefore more prone to reinjury.

I did get the shot in the spine and started aggresive PT immediatley. I also started walking ALOT. One of our Docs told me to walk everywhere and everytime I had a spare minute. I practically wore paths in our carpet at work walking around when I was on the phone.... But, it was a slow process, I gradually got better and better and after 2 months I was feeling pretty normal. I did not ski at all that fall, but that next spring I was ready and able to resume my skiing....

Good luck with your recovery.

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OK, my experience is like a few of the others. I have herniations in L4-L5 and L5-S1. I went to a neurosurgeon who, unlike described earlier, told me that surgery was the LAST option that we'd explore. I took the round of three steroid shots and they did wonders for my back pain. I felt 18 again! He put me on PT and said to give it some time. I incorporated those exercises into my normal workouts and do them to this day. I also stretch religiously every morning when I get out of bed. My doc told me to take it easy for a year (ski when I felt good enough, but nothing aggressive), then I could get back at it. That was 4 years ago and my back now feels better than it has in ten years. I absolutely do everything he said and don't do anything he said not to do. He even reviewed my workout regimen and removed the exercises that he said were dangerous for my back - just seated dumbell presses, really. He also told me to take two over-the-counter Aleve about an hour before doing strenuous stuff. He said that was the perscription strength and you can take that every twelve hours for short periods - it's hard on your stomach. He also gave me a perscription for Tramadol, which is the baby brother of Vicodin. He said it'd just take the edge off (also just to be taken before strenuous activity). His biggest advice to me was, "Listen to your back. Stop when it tells you to. You'll know better than me when you've done too much." Wow - great advice. I had the foot drag and everything when this started. None of that now. I think alot of people fall short on the PT work and don't get the results. My advice to you is to talk to your doc and your physical therapist and tell them that you want to go back to skiing. If you show them that you'll do the work and listen to them, I bet they'll get you back there.

FYI, I played sand volleyball and skied all summer. I haven't taken ten doses of medication this summer. When I first started with this stuff, I was taking meds ten times a week. There's hope! Clap.gifClap.gif

P.S. My back would have gotten to this point quicker if I hadn't blown my knee out and had knee surgery a couple of years ago. That recovery was actually worse than my back issues, but the limping and lack of ability to work out had a negative impact on my back.

Edited by billb
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Hey Jack,

Sorry to hear about your back. My wife has been suffering a L5/S1 for the last several years. She put off getting a cortizone shot for some time, but finally got them about 5 years ago. Since then, her back has done really well. She also did some PT and went to a Chiropractor using one of those spinal decompression machines. After a few sessions with him she also was doing better. She has gone the last several years without going to a chiropractor etc. and is still able to wakeboard, wakesurf, sky ski, ride jet skis and is now learning kiteboarding.

I think getting the shot was the best thing she did. And like others said, she went to 2 surgeons and neither recommended surgery at this point.

One other thing she does is she bought a special pillow that you put between your legs at night and this really helps in the morning. If she forgets the pillow on trips she says she wakes up with some pain.

Hope it works out for you.

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Bummer about your back, Jack. I've been down this road too. About 15 yrs ago I decided to pull a VW motor & put it on the workbench. Dumb move on my part. Bulging disk in L5 S1, sitting on the sciatic nerve. On a bad day I had pain all the way down both legs to my heels. Spent some days crawling to the bathroom. It sucks.

So I've been to talk to the local docs numerous times, had x-rays & an MRI & never found anything they wanted to operate on. I've done PT for about 6 months & now I just work out on my own to keep my weight down & core strength up.

The guy who really helped me is a fellow SkySkier & neurosurgeon out of the Denver area. His recommendations helped me immensely.

- Hot tub. Apparently the heat increases blood flow & relaxes muscles.

- Wrap your injured area in ice after sitting in the hot tub. This makes your body focus on sending massive amounts of blood to this area. ALWAYS end in ice.

- Naproxen. I didn't care for some of the pain killers being prescribed. This is really just prescription strength Aleve. Worked great without making me blubber like a bowl full of jello.

- TENS Unit. It's an electro-stimulus device about the size of a pack of cigarettes. Runs on AA batteries & goes on your belt, with 2 or 4 electrodes to the injured area. It send pulses to the electrodes & muscles, interfering with the pain signals & causing the muscles to relax. This thing helped a LOTLOTLOT. It's witchcraft, but it worked. I could wear it on the job, avoid the drugs & get thru the day easily. Their available on Ebay for less than $200. Or thru most any physical therapist for a bit more. My insurance actually paid for this.

- Keep your weight down & core strength up. Once your pain free, this will help keep you there.

I've had a couple of light relapses where I would do something crazy & be sore for a day or two. The hot tub, ice & TENS Unit gets me right back on track. I'm 42 yrs old now & ride SkySki exclusively. This year, with good health & a few equipment upgrades, my riding has gotten bigger & more consistent than ever before.

Best of luck with your rehab. It's a tough process but stick to it.

Edited by Bill_AirJunky
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I hate to hear that Jack b/c I have been there..and am still there.

It's ironic that this thread came up, as I just had another MRI last Wednesday my 4th in 5 years. I have been dealing with lower back/leg pain/numbness for almost 10 years now. I will be 38 in October.

In a nutshell, I'm frustrated Mad.gif ....

I had a microdiscectomy on L5/S1 a couple years ago after a couple years of pain. Within a month (post-op) I had the same pain across my lower back and down my right leg. My surgeon said I should not have pain, and ordered a post op MRI. He looked it over and said I was fine, and to keep up my daily walking/exercising routine. It got worse as time went on, so I went after a second opinion.

It took me almost 2 months to get in to see another highly regarded surgeon. He looked at the post op MRI and said the SAME disc was herniated again along with some scar tissue from the surgery. He could not believe surgeon #1 said I was "fine". He ordered a discography on 4 levels (I couldn't walk for a few days after that one) which revealed 2 levels of herniation at L4-L5 and L5-S1. My Wife had to drag all 6'7" of me in the house that day, I have never been in so much pain. It was so bad that I had nightmares about it, and I rarely have dreams...let alone nightmares.

As a result of that test, surgeon #2 wanted to fuse L5-S1. By this time I had already had the facet injections (3 total), steroid shots/pills (found out I'm allergic to Prednisone after breaking out in welts all over), and much physical therapy.

I have been taking pain meds for 4 years. When I take them, I can function with limited pain. When I don't, I can barely get out of bed. I have 3 kids to feed, dress, and get to school everyday before I even get to work. I hate that I am dependent on the meds, but I have quite a few people who depend on me.

I'm to the point now that both legs go numb in the evenings, whether I am in my chair, in bed, lying flat, etc. My left thigh feels like I have ants under my skin. I have pain across my lwr back 24/7. My posture is terrible, as a result of years of back pain. It goes down the back of my right leg when I sit too long, stand too long or lay flat on my back.

I have not put on a ski in 5 years, and have never attempted to wakeboard b/c of my back. I can surf until it hurts too bad, then I'm back in the boat. I've had to give up basketball, softball, volleyball, etc....all of which I enjoyed and excelled at for 20 plus years. I can golf if I take it easy, but it takes me a couple days to recover from a round... It sucks.

I won't even get into all the problems I've had with my health insurance, that's another thread :) The surgeons I have seen are all supposedly "The best"...but here I sit no better off than I was at the beginning. I am now seeing yet another surgeon (#3 in 4 years) to see what my options are.

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Let me concur with the ice. I forgot about that. My back really responds to ice. In fact, when I was really in pain, it did so well with ice that I iced it up so well that I burned my back with the ice. I didn't care. The skin pain was nothing compared to the nerve pain.

Also, I learned that with nerve pain you have to get off the inflamed tissue. With muscular pain, you can "fight through it" or "push it." No so with nerve stuff. You have to get off of it.

I also concur with the core strength comments. I will say to NEVER do situps without something supporting your head. I use one of those $50 Ab Roller things. Worth its weight in gold for assuring that I'm not going to ding my back trying to work my abs. I hurt my back early in my rehab doing situps without head support. I'll never do that again.

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I go to the chiropractor and he has made me stronger than I have ever been at age 51. I stroked 38 this morning and ran 3 at 39. Nutrition is a factor. I'm on about 10 supplements, all natural.

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Thank you all for taking the time to reply and relate your experiences. As you all can relate at some level, skiing is a priority activity in my life. In addition to knocking that out, the disc problem has also limited other physical activity--so I can't ride the bike or wax the wife's car as a substitution or distraction. I've been dealing with the whole thing fairly well overall, but sometimes it gets to me far more than I would like. Your replies have been informative and therapeutic--I'm going to print the thread. Thank you again. --Jack

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  • 4 weeks later...

Jack, I have been dealing with a bulging disc for about 12 years now. Most of the time I am 100% and live a active lifestyle between lake activities and my Mtn biking. You will have good days and bad days but avoid the surgery at all cost. I had steroid injections years ago and they worked great. A new treatment is traction applied by a bed that stretches you and if you google DRX9000 you ca find a Dr near you that does it because it works. I have also had great success using the stretches from a book writen by Robin Mckenzie "Treat Your own Back" when I do these on a regualr basis your back will get better. Whatever you do don't just lay around and let the muscle in your low back and midsection go away or it will continue to cause problems.

Brad

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Jack, I have been dealing with a bulging disc for about 12 years now. Most of the time I am 100% and live a active lifestyle between lake activities and my Mtn biking. You will have good days and bad days but avoid the surgery at all cost. I had steroid injections years ago and they worked great. A new treatment is traction applied by a bed that stretches you and if you google DRX9000 you ca find a Dr near you that does it because it works. I have also had great success using the stretches from a book writen by Robin Mckenzie "Treat Your own Back" when I do these on a regualr basis your back will get better. Whatever you do don't just lay around and let the muscle in your low back and midsection go away or it will continue to cause problems.

Brad

Thanks, Brad. Yeah, I've got the McKenzie book as well, and the PT used methods/exercises from there. I am back to riding my bike, though there is an odd sensation in my low back as I am riding. Not pain, just something telling me it is not 100%. I am no longer having symptomatic pain/sciatica. However, reflex and sense of touch is diminished on left side compared to right. I thought based on the lack of pain that I was on track, but may end up with injections yet. Even without causing pain, if the nerve is still being affected I will need surgery to avoid any long-term problems from this. Big waiting game for me. Tick, tock.

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  • 1 month later...
Any update Jack? Touchin' your toes yet?

YaSir! Although I'm required to do hyperextensions before and after any toe touching. Crazy.gif

My current thoughts are that it took quite awhile to achieve noticeable improvement. This even during/after PT. Once I started back into more normal activities, under controlled circumstances, it was uncomfortable but seemed to accelerate the healing process. Eventually, before my season ended completely, I decided to get up behind the boat and see what happened. Although I would NOT recommend this to anyone, it worked out ok for me. And yes, once the attempt was successful, I was right back out there any chance I got (albeit with caution and letting the handle go if I was in a bad spot).

Now I'm just trying to balance my activities--keep active without over-stressing. There's certainly no sure bet, but I'm hoping to be 100% by Spring.

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I too have the herniated disc problem but mine is in my neck. I went the chiropractor/physical therapy route and so far I am glad I did. The pain at the onset of the injury was very constant and after a while, depressing. I have never been someone that gets depressed but boy I tell you I was in a bad way there for a while. I was given prednisone (sp?) which helped a good deal but you can't take that stuff very long. I had an MRI and a ct scan with dye that confirmed my injury. I saw a spine surgeon and he recommended surgery (big surprise huh? :) ) Anyway I told him I would think about it. I had been seeing a chiropractor all along (in fact he is the one that initially told me he suspected a herniation when I first started having trouble) and he told me to hold off for a while and try physical therapy. We did traction and other stretching, as well as the electrical stimulus. It took a while but I began to see improvement and today, 2 years later, I am doing pretty good and glad that I was able to avoid surgery. I still have neck pain and tingling in my index finger of my left hand once in a blue moon. For me a bad wakeboard fall is when I catch a back edge and get the whiplash effect! But the majority of the problems are gone. I continue to see my chiro....I feel like it will be a lifelong effort on my part to manage the disc but I think it's doable. I would never tell someone not to get surgery...every one is different and some injuries are worse than others, but I would advise to try everything else first and give it some time if possible. It won't get better right away but it will improve if you put the time in. There will always be a surgeon ready to go if you get to that point! That being said I know a neck is different from a back and have no experience (knock on wood) with that. I do wish you luck and want to say hang in there.

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Any update Jack? Touchin' your toes yet?

YaSir! Although I'm required to do hyperextensions before and after any toe touching. Crazy.gif

My current thoughts are that it took quite awhile to achieve noticeable improvement. This even during/after PT. Once I started back into more normal activities, under controlled circumstances, it was uncomfortable but seemed to accelerate the healing process. Eventually, before my season ended completely, I decided to get up behind the boat and see what happened. Although I would NOT recommend this to anyone, it worked out ok for me. And yes, once the attempt was successful, I was right back out there any chance I got (albeit with caution and letting the handle go if I was in a bad spot).

Now I'm just trying to balance my activities--keep active without over-stressing. There's certainly no sure bet, but I'm hoping to be 100% by Spring.

That's awesome Jack! Glad to hear it!

I'm proud to say I have been pain pill free for almost 2 months (after almost 8 years on them). I go in tomorrow morning for more nerve blocks. Things are looking up!!

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