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Your thoughts please....but hurry...have to make decision.

AnonymousUserAAnonymousUser Posts: 49,671

Hello, I am new to this site. So here it goes.

I have on a scale of 1 to 10...a pain level of a 7 on my Right Butt, down the right hamstring and a little numbness in hamstring as well.

I had MRI. L5/S1 Disc Herniation. Pain setteled down in about 3 months. Could get by with some Advil for day to day, and was able to sit and drive car with pain level of a 2.

In the last 2 weeks I have had this Pain of an 8 to 9 return to my Right Butt and will not go away. No Pain meds or muscle relaxers make a dent.

I have no lower back pain. I have no loss of strength, I can walk on tip toes, hamstring curls, everything.

Just can't stand for more than 2 minutes or sit for more than 2 minutes. No position gets releif. Laying down is the best on my back...pain drops to a 2.

Going to discuss Surgery with Doc on Thurs. and Friday this week.

Really want to stay away from surgery if at all possible, Especially after readying all the stories on here where people dont seem to be getting better, except the first two weeks after surgery...must be that little bit of steroid they place on the nerve when they are finishing up the operation.

Let's here everyone's thoughts and see what you guys think. After all, expericence is the best teacher and guide I believe.



  • The question you need to ask yourself is "can I live with this pain?" When you have your answer, you will know what to do. That being said, there are lots of conservative, non-surgical options that will usually be offered to you before you are at the point where it's surgery or nothing. Good luck!
  • Yes I have answered that question which at the moment is No. I cannot go through life like this. I can't drive, I can't sit, I can't cook my own food, cause I can't stand for a period of time.

    I have done meds, I have done PT ( 3 weeks ) I have done Chriopactor with decompression...Seemed to aggrivate it more. I have done rest.

    That's why I am down to the surgery section of this...but I don't want it.
  • From my researching, chiro is not recommended for disc problems and my pain doc advised me to seek physical therapy over chiro. I also had five sessions of chiro which made the pain worse.

    I agree with Jeq about asking yourself, '"Can you live with this pain?" If your quality of life has diminished significantly, I would have the surgery.

    yes, surgery has its risks. And sometimes surgery can be successful, but during the recovery phase you can undo the work of your surgeon. I just had my 2nd microdiscecomy because of series hard sneezing. This time around I am ready.

    In my case, I might be need fusion, but not because I had surgery. I have degenerative disc disease.
  • ESIs are usually the last non-surgical option. I think the odds are about 50% that they will work well enough to allow you to get around surgery. They didn't work for me, but it's worth a try. Check with your doctor.
    Fusion surgery is major, but a microdiscectomy is not too bad. Again, that didn't work for me either, but it has at least a 90% success rate. Do you know what kind of surgery they want to do for you?
  • Does the "NC" mean you're in North Carolina? I am, which is why I ask.
  • Yes Charlotte NC.

    Meeting with OrthoCarolina on Thursday

    Meeting with Total Spine Specialist on Friday

    Any opinions on either ?
  • you may require some surgical intervention .make sure that you find a competent surgeon and should you go down the surgical route give yourself plenty of recovery time {12 months} you will be told that you will recover in 3 months ...you wont.. any spinal surgery should not be undertaken lightly as it is a life changing decision .even if you have a good result {IE your leg pain has gone through a decompression} your back will be weaker and you will always have some level of back pain and a risk of further disc problems and arthritis..meanwhile try a TENS and use ice and try a recliner to take the weight from your lower back .. if you want to email me for anymore advice please do on tony.beer1@googlemail.com
  • dilaurodilauro ConnecticutPosts: 9,856
    Based on your MRI findings what actions does your doctor recommend?
    I strongly believe in trying all the conservative treatments first before looking at surgery.
    - Physical Therapy
    - Aqua Therapy
    - Ultrasound
    - Heat/Ice Therapy
    - Passive Traction
    - Acupuncture
    - ESI (Spinal Injections)
    - etc
    The times when surgery is recommended soon is when the disc is impinging on a nerve root causing the nerve pain down the leg, (ie sciatica). From what you have described, it does seem like nerve pain. You can have a herniated disc but do not feel any lower back pain. Instead its the tingling, numbing and pain down your leg. But what is more curious is that you seem to have the strength in your foot, toes, etc. Many times, those are weak when associated with nerve pain.

    Bottom line, discuss all of this with your doctor. Talk about the pros and cons regarding surgery. What happens if you DONT have surgery? Will it get worse?, and discuss
    having the surgery, what kind?, how long is the recovery period, etc?

    When there is a disc involved, I would stay away from chiropractors. The standard manipulations done there could be more harmful to your condition.

    Many people are frightened regarding spinal surgeries. Yes, you can read many stories here and on other sites that talk about problems after surgery and other nightmares.
    Spinal surgeries have been more and more common, and you can be assured that there are MANY successful outcomes.
    Ron DiLauro Spine-Health System Administrator
    I am not a medical professional. I comment on personal experiences
    You can email me at: rdilauro@veritashealth.com
  • I had one ESI and it did not phase me that I know of. I was still in the same pain 2 hours after leaving the hospital. They said it would sometimes take up to 10 days for the medicine to be soaked into the injured area and bring releif.

    I just did another steroid pack last week...no help.

    Today, I feel good. I sleep at night fully with no pain. As long as I lay down, I am ok. But when I stand up or sit...the pain hits like a ton of bricks in my butt and hamstring.

    Was thinking it might be Piriformis Syndrom, and if I could get a Botox shot in that muscle I would know for sure if it is the muscle causing the pain or the disc....

    What are your thoughts on this ?

  • Hey NC!
    I'm in Atlanta, so we're kind of neighbors! I herniated my L5-S1 in July of '08. I had 5 ESIs which really didn't help much, but I have a good friend who had enormous relief with the injections and hasn't had a problem for over a year now. We're all different. I had an lam/disc on 3/2/09. Prior to the surgery I had very little loss of strength, maybe just a bit in my big toe. No numbness, no tingling, just excruciating pain. Today I feel much better - I don't know yet about tomorrow as I'm taking it one day at a time. The others are right about your quality of life...that is the indicator, but I'm sure you'll be offered the more conservative treatments before anyone speaks of surgery. I know how you feel, nerve pain sucks! There are a lot of treatments available and I'm sure you'll find relief. Good luck and keep us posted...
  • Had the same thing as you but pain was a 9. Giant L5-S1 herniation. If you have not had any ESI's you should try one or two and see if they help enough to convince you not to get the microdiscectomy. If not, do the microdiscectomy. It's not that bad. Make a fusion your last resort. I would even suggest looking into artificial disc replacement before fusion. Physical therapy WILL NOT help you. It will only make the pain worse faster.
  • dilaurodilauro ConnecticutPosts: 9,856
    There are so many different aspects of Physical Therapy. Treatments vary by the problem they are trying to address and by the therapists.
    There are so many people today that are able to walk and live a more productive life because of the help they received in Physical Therapy.

    I am a firm believer in Physical Therapy, I understand how to achieve the most from it and I am also very aware of its limits.
    Ron DiLauro Spine-Health System Administrator
    I am not a medical professional. I comment on personal experiences
    You can email me at: rdilauro@veritashealth.com
  • I'm in Greensboro, so unfortunately, I don't know anything about those places. But, if you are unhappy with them or just want a 2nd opinion on your options (and don't mind the 1.5 hour drive) I think I have one of the best neurosurgeons around. He has a phenomenal reputation, and has been incredibly supportive. And he didn't push surgery on me either, he actually cares about his patients. Send me a PM if you want his name. I hope you get some good news from your specialists!
  • My ESI took about three days to kick in. The 2nd and 3rd didn't do anything for me.

    BTW, did your chiro diagnose the Piriformis Syndrome. The chiro that I saw treated me for PS and used active release therapy. They totally ignored my MRI that I gave them and took more Xrays. According to my pain doctor, the Xrays do not show disc problems which the MRI clearly showed that I had a 7mm herniation. I don't even know I had piriformis Syndrom.

  • I agree with you. My first physical therapy treatment gave me enormous relief. I couldn't even touch my toes and later I gain the range of motions that I had before the pain.

    The second round of physical therapy was not useful because the herniated disc was too big.

    I am going to start PT again which I am looking forward to.
  • there was a time when PT was very good over in the UK .you would go to your doctor and he/she would refer you to the local hospital and you would be seen by a qualified physio they would do everything from massage to aqua therapy to SWD{short wave diathermy} TENS and heat etc..but all we get now is a list of exercises for your particular problem .they are impossible to do and hurt like mad when you try to do them .so i payed for 6 sessions with a private physio .i showed him my list that the hospital gave me ..he laughed and threw them in the bin!! he says that he gets loads of people coming from the hospitals physio department with a list ..physio is a hands on profession .its the same old story you get what you pay for.having said that physio did nothing for me .swimming pool hydro pool is about the best..and that's what i would recommend for anyone with back pain
  • Your symptoms sound just like mine -- I was perfectly pain free whenever I was lying down or sitting. But I could not stand at all. I put a high stool in my kitchen so that I could prepare meals. I would cut an onion for 30 seconds and then plop down on the stool...pain would go away. Then I'd stand up and cut a little more...etc. I was driving to the end of the driveway to collect the mail because I couldn't walk that far. I had no pain in my back...I could walk on my heels and on my toes just as well as I always could, etc.

    It made it difficult whenever I went to the doctor or in for an ESI as they'd always ask "What's your pain level NOW?" I'd say none and they'd look at me like "Well, why are you here???"

    Obviously I don't know what is wrong with you, but what you describe is the classic case of radiculopathy almost always caused by the compression of a nerve in your lower lumbar spine -- in your case, from the herniated disc pressing on the nerve root at the L5-S1.

    I am happy to see you are getting several opinions from spinal specialists. Surgeons are very conservative these days and will only do surgery after trying conservative treatments first. You will have a better idea of your options after your appointments tomorrow and Friday.
  • I get so scared when I hear from you and others about the NHS in England. Its coming here soon!
  • I had the same problems as you and I just couldn't handle it anymore so I took the chance of having surgery. I had already tried rest, medication, PT, using a tens unit, and several epidural injections. I knew I had to do something to fix my back and surgery looked like a viable option. Well, I did have surgery to take pressure off the nerve but things didn't go as planned. A month later I suffered a post op reherniation which was found on an MRI. To sum it all up, I went on to have a fusion but today I still have ongoing chronic pain and nerve damage. Please remember that there were complicating factors with me, but a lot of people do get better and go on with their lives. It is a difficult decision to make, and it's best to do some research and perhaps get a second opinion. What really made me have surgery was the fact that the pain was constant, even after taking pain pills. There was no time where I could say the pain went away. My surgeon and I thought is was the best thing to do
  • Sounds like your having a rough go of it. I would like to know what ortho had to say today. I too am having some of the problems you discuss. hope all goes well.
  • that you shouldn't be swayed by all the stories in the forum that have not gotten relief from surgery. There are tons more that have. The L5/S1 area is a great place for a fusion, if there is such a thing as "great place for one". Sorry, that sounded weird. But I have a couple of friends that have had a fusion just at that level and have had total immediate success. One even took a 8 hour flight 6 weeks afterwards to Las Vegas from Alabama and stayed there for a week. She was tired out, but made it and enjoyed herself. She had the anterior approach fusion.

    The ESI injections might help with inflammation and swelling but will not fix the herniation at all. You said it'd been 3 months since the herniation. What are your current tests showing. Have you had a new MRI? I had to have a myelogram and discogram to show everything that was going on.

    I hope you continue to research and are able to make a good decision and find the right doctor for you. Good Luck.

  • Visit was fine. As expected. Dr.said that I had a pretty good herniation. That it might get better with time...but to what degree...can't answer. Will it come back ? more than likely.

    Since I was in so much pain, and it was stopping me from doing my daily activities...like riding in a car, and standing up...then he suggested surgery.

    That the L5/S1 was the most common surgery and it was not that big a deal. That he has done over 2ooo of these, and it has an 85% Longtime effect of never having another issue.

    He knows my original dr. that I am seeing tomorrow, and said it did not matter who I chose to do the surgery that I was in very good hands either way I went.

    He was not trying to sell me on it, but he was more or less saying ...What kind of life are you living now ? and how long can you live like this ?

    That is it. No more. That I had a rate of a 7 or 8 out of 10 as far as the size of the herniation. That it was not the largest he has seen, but it was not the smallest either..... He suggested surgery and be done with it.

    ONE MORE Doctor tomorrow to visit. and I know what he is going to say. Just have to decide who I want to use I guess.
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