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L4/5 S1 Bulge for a 21 yr old

MatthysMMatthys Posts: 8
Hi, I've had varying pain because of a diagnosed disc bulge in the lower back. Now, I realize I should probably see my doctor regarding all medical issues, but I've seen the GP several times and he's simply said (not convinced by the pain levels I'm describing to him) to keep taking basic pain killers and put up with it/work around it.

So, this is what I've been trying to do (and let me tell you its really impacted my normal lifestyle as you can imagine). My routine is basically, I get up and pop 1000mg paracetamol, and 400g ibuprofen. This doesn't keep the pain away entirely, but if I sit right and avoid all movements and positions that would irritate my lower back (and in turn my leg) the pain is manageble (it's a sitting job where I'm able to stand up when I want). Then come lunch time and the pain level has significantly increased, but not to a point where it's going to impact my work performance (don't want to become jobless because of this problem). So I eat lunch and take another 1000mg Para'm and 400 grams ibuprofen. Again, this keeps the pain manageble until the end of the day, at which point I drive home and have to lie down for 15ms minimum for the muscles to relax and the pain to mostly subside.

It was once in a more acute stage where the pain was much mroe severe and throbbed a lot, which I believe was due to high levels of inflammation. Now it appears to have become more mechanical.

My main question is, it feels like the pain is 'changing'. While the pain has in some ways gone from my foot and further back up my leg (used to hurt right down to foot), ever increasingly I've been getting a different 'sharp/shooting' pain reaching only my foot, not even in my leg!. This happens when I'm in 'bad' positions and is quickly resolved by temporarily stretching in the right way.

I know I'm not giving much details as to my problem, but has anyone experienced or heard of this symptom during their sciatica, the sharp/shooting (not even that painful, just.. different) going only to the foot and not the rest of the leg.

I'm really unsure about thsi hole process, and I've only just become reemployed so I havent been able to afford PT's or any sort of medical advice (other than my GP's, who I really don't like as he's telling me 'tough luck deal with it just take supermarket meds the rest of your life'.

At present, if I were to not take pills and sit for a couple of hours, I would be in a lot of pain. If I were to stand up after that period, for abuot 30 seconds I'd get a massive temporary throbbing pain down my leg whcih is at least a 9/10 pain level.

Also, when I get that sharp/shooting pain in my foot from being in an incorrect position, I can crack my lower back 'sideways' by standing sided to the wall, and pushing my hip in towards the wall. When that cracks, I often get a head rush, and feel whoozy for a few seconds.

Any advice/ideas? Highly Appreciated. Sorry this topic isn't well constructed.



  • Welcome to Spine Health :H I'm sorry to hear of your troubles. It can be very frustrating to be experiencing this way and not having a doc validate your pain. The pain is real whether it shows on the MRI or not. I had the same problem when I had my first xray and MRI. The docs were saying it wasn't that bad and I shouldn't be experiencing this pain. I didn't settle for that answer though.

    There are many things you can try but may be limited to if you don't have insurance to cover it. The first step is to have your GP refer you to a neurologist or orthopedic doc if your insurance requires an approval. It sounds like you may have some nerve issues. There are many different kinds of injections, chiropractic treatments, physical therapy, pain management specialists etc. I am not a medical professsional and not able to tell you which one you should consider over the other. I would however from my own personal experience, try all conservative methods before considering surgery.

    Another concern I had when reading your post was the amount of ibuprofen you take. Can't your doc give you an anti-inflammatory or a longer acting pain med or something stronger than ibuprofen? I know that ibuprofen is not good for your stomach if you take high doses and for a long time.

    Sorry for the long response. I hope you find this site helpful. Everyone here is so great and welcoming and full of information as well as support when you need it the most. There is also very helpful descriptions of different treatments, surgeries, diagnosis. You just search whatever you would like to research in the search bar on the spine health site up top.

    Please feel free to pm me anytime with any questions, comments or concerns you may have.

    Again, I would like to say that i am not a medical professional and not able to give you a diagnosis. I am basing my response on personal experience and/or opinions.
  • your description sounds all too familiar. except that i get pain in one spot in my lower leg and nowhere else sometimes. i'm also 21, and i've had this problem for 2 1/2 years now.

    i have found that when i'm having bad days, the best thing that i can do is swim, especially when the pain is more 'mechanical'. even when it hurts at first, if i keep going, things will eventually loosen up and i'll feel much better by the end.
  • Thanks for your reply, it would be good to find someone who's experiencing the same kind of pains I'm experiencing. the pains described in the first post are also accompanied by muscle spasms whem I'm sitting. Small little painless spasms in my buttox and upper back leg.

    I saw a dr in Melbourne for several weeks, but had to lose my job because pain was unbearable for the type of work I did. That guy (A PT who has aided people with sciatica before) was quite helpful and I believe was pointing me in the right direction. However, without money, and no job I started to just rely on the ability to lie down/recline whenever I wanted because I had nothing in particular to do, and I never felt sick from popping any amount of ibuprof/paracetamol (also, I ment mg instead of g in my first post). Lying down is the ONLY relieving position, and swimming also helps, but of course only until I sit/walk again.

    I've started working again and I think my best chances are seeing that PT again. I'll make another apointment. It's just a 3 hr trip up and 3hr trip back. Local PT's feel useless/unfamilair with my issue and think because I'm young they can throw a massage my way, tell me to stretch in ways that hurt and laeve me walking out feeling fairly good but not having done anything for the longer term.

    Ugh... you guys shouldn't have to put up with my ranting.. just that.. with all our medical advances .. noone can help me work my body to heal/remove this pain.

    I think it's best I make the appointments again now that I can afford to, and just ask questions.. as I feel a little shy to do so. being informed is probably more important than anything.
  • i also have twitching sometimes, but luckily, none lately. mine has always been in my lower leg. Lately it's just been back and left leg pain and left leg and foot numbness and tingling.

    pt is the only thing that has really helped me so far (even pain meds don't do anything for me), but it took going through 5 different pts to find one that could help. currently, i do ~1-1 1/2 hrs pt every day on my own. Learning as much as i could about what's going on with me has also been really helpful. i think i have a better understanding of everything than any MD i've seen. so if you have found a pt that knows what they are doing, that's probably your best bet of getting better.

    as for swimming--i have found if i swim everyday, it does help after i get out of the water. if i go more than a day or two without getting in, i can feel everything tightening back up.

    good luck!
  • I posted something similar in another thread, but I believe it may be useful to you.

    Now, before I give you the juicy details, just to share a bit about my self, I have DDD running down from L3 to L5, a bulging disc at L2 and L3, a herniated disc at L4 with moderate nerve impingement, a really impressive herniation/rupture whatever you wanna call it really, with obvious impingement on L5-S1.Oh and I'm only 19--and just a year ago I was an All-State Wrestler, All-County Football Player, and Track athlete with scholarships to several universities for all three sports--to say the least I was very active. However, I was also quite smart in that I happened to receive a full academic scholarship as well, which is the path I chose to take.

    My Sciatica began mid-August of 2008, and it was very mild, and one day it went to hell. After doing a little exercising I began feeling a sharp pain down my glute at 7-8/10 scale. A couple of days went by, and I had a mix of pain, numbness, and weakness beginning in my right glute shooting down to my calve, and the outside of my foot. This lasted for a couple of weeks, and at first all the specialists I went to insisted that I get surgery immediately because because the disc herniation I had was to big for my body to break down the old fashioned way, and it had caused too much damage already. However, when I finally decided to talk to my brother, who happens to be a fairly renowned physical therapist overseas, he convinced me not to. Now, several months since that week where I could not walk and all I could do was really just like flat on my stomach, I can jog, swim, and sprint, although I avoid it because the concussive forces of your foot hitting the ground is very bad for our spine. Anyway, I can finally sit for about an hour or two before I feel it necessary to stand. I've even started going back to the gym, and can do just about everything using very light weights. I don't bend down--ever, and avoid working out my legs, (can't really squat, do lunges, deadlifts, and etc). I still can't really bend down. Anyway, still a huge improvement--one better than most I've spoken to. I attribute this to diligent work ethic and following proper technique.

    What I've learned is that the most tested and proven conservative form of treatment for disc herniations and radiculopathy is the the McKenzie technique for Sciatica. It usually involves a lot of back extensions when referring to disc herniations causing radiculopathy. A little googling, and even searching it on You Tube will help you familiarize yourself with it. Here's a quick link illustrating some of the McKenzie excercises. http://www.lasportsandspine.com/pdfs/McK-1-05-1.pdf

    I would highly recommend you see a McKenzie certified specialist. They come in all shapes and sizes. Some doctors are McKenzie certified, some chiropractors, and on the whole, many physical therapists are certified. I realize without the proper insurance, it can be very difficult to do this, so I'll fill you in on what I did.

    My McKenzie certified physical therapist prescribed a lot of back extensions. The reason is, with disc herniations, when you bend down your vertebrae squeeze down on one side and push the disc out. Think about it, when you bend down that is usually when you feel that pain shoot down your leg. The reason this happens is because the disc is being pressed on and pushed out causing it to pinch the nerve. However, when you do back extensions the vertebrae is pushed down on the other side pushing the disc back in. I was told to do them every day--just about every second of the day I could. The reason is that the more back extensions you do, the more disc nucleus is pushed back in--you should especially do several back extensions after you have bent down, again because you have pushed the disc nucleus out a bit and you want to push it back in. The more extensions you do, without irritating the sciatica the better. Please note that with some cases of sciatica back extensions will actually make it worse. If this is you, where doing back extensions irritates your sciatica, of course do not do them! Again, try finding a McKenzie Certified specialist for a more individualized approach.

    One thing I've seen with most people with our problem is that we only seek treatment for symptoms and not for what caused the symptoms it in the first place. The annulus holding our discs in are in fact very strong and resilient. It takes a lot of compounding wear for it to actually tear and for your disc to rupture. Your herniation was probably not caused by one single action such as picking up a heavy object--that action was only the feather that tipped the scale. It's likely we terrible posture, we sit down for to long of periods. One interesting statistic I've heard is that many long distance runners have lower back pain, and one of the biggest causes for marathon runners stop running marathons is sciatica. All the jogging and the concussive forces from their feet hitting the ground travel up to their spine--messing them up pretty badly.

    During my treatment I very rarely bent down, and if I did, it was with perfect form. I squatted down with my back as straight as possible. I did thousands upon thousands of back extensions and I never did anything that I felt would irritate my Sciatica. That was quite difficult at first, especially because sitting down would irritate my Sciatica. However, I purchased a kneeling chair. It takes all the weight off of your back and puts it on your shins. Pretty cool really. A lumbar roll is also recommended if you must sit down as it keeps a slight lordosis in the lumbar spine helping to keep a flat back and the disc in place.

    For exercising, if you are able to walk without the sciatic pain, walk. Walk a lot. Swimming is also recommended. That's really it though--again, you want to avoid doing anything that may irritate your sciatica as it will set you back.

    If you are in a lot of pain, the steroid injections often do help quite a bit and come highly recommended by many. Again, though they are expensive if you don't have insurance. I had one and it did help. Prior to the injection coughing and sneezing would cause sharp pain in my glute, after the injection I could cough and sneeze as I pleased and I took the time to really go crazy with back extensions as I could do them just about pain free. I would avoid getting more than 2-3 as it may cause tissue damage, scarring, and all that other bad stuff that is associated with steroids including weight gain and what not. That, and the effect is not permanent.

    I don't plan on having the surgery. Surgery is just unnatural, and one should really try to avoid it as much as possible, especially if you are getting results without it. Many surgeons want nothing but to make another dollar, and it's quite obvious surgeons are pro-surgery. So get as many opinions as possible. Especially from doctors who really have nothing to gain from you getting surgery. For certain lifestyles of course, people have to immediately get back to work or their life will fall apart. That is really the only case I feel like that surgery is acceptable.

    Anyway, as to the pain in your foot--it's not good. You'll learn with the McKenzie technique, the closer the pain is to your back the better. In fact, the goal of the McKenzie technique is to work the pain away from your feet, up to your glute, and eventually completely into the back, where it can be worked out for good.

    I'm no doctor, so I could be wrong, but it sounds like you have more than one nerve root that is being impinged. Different nerve roots send pain down to different parts of your leg. So while one of your herniations may be slightly improving (as you said the pain has been moving higher and higher up your leg), the other herniation may not be doing so well, or it's simply moving around a bit, tapping the nerve on different spots.

    Remember, I'm not a doctor--I just happen to be a pre-med student who's seen a lot of doctors, read a lot of books, and has a lot of personal opinions. See a specialist, preferably a good one. Al the specialists I've seen I've looked up on vitals.com and castleconnely.com, ask around. It's like going to a club, some girls are prettier than others. Some doctors are better than others.
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