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L5/ S1 disc protrusion

AnonymousUserAAnonymousUser Posts: 49,622
Hi all some help/ advice would be appreciated!
Only 27 with a young child and played football until 4 months ago.

MRI show disc protrusion of L5/S1 pressing on S1 nerve root.
All my pain is in my buttocks and hamstring and feels like muscle is ripping!. No pain below knee. Is this common?

Worst pain is mornings and when sleeping. Pain eases during the day and can move freely and sit for longer. Is this normal for bad discs?

Recently I have had more pain in the hip area and for some reason (researcH) think this could be the cause of the pain. Does anyone have any ideas?

Questions
Treatments/ exercises should be doing and will it make disc worse?
Sleeping positions?

Hope someone can help!!!!
Please!!!!
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Comments

  • Hi,

    Here are some things that might help:

    No lifting weights. No bending at the waist. No running.

    If you have been sent to PT, they may be able to give you some light exercises that could help you. For me, a few weeks of PT made things much worse, much faster.

    That is great that you only have the hamstring and glute (hip) pain and nothing below the knee. Why on earth would I say that? Because if it gets worse, the next step will be pain radiating into your calf. And trust me, the calf pain is even worse than the hamstring and hip pain. Then, if it gets worse still, you would get the numb/sleeping/needles in the foot thing.

    If you have had an MRI, did they say that this is an L5-S1 rupture, or herniation, or bulge, or what? And how large is it? That will be the kicker on whether or not it will heal on its own, or if it can heal with epidural shots of cortizone, or if you would need a microdiscectomy.

    Since I had a very large herniation the PT just made mine worse. I got a few shots that helped for a few months but eventually caved in and had the microdiscectomy.

    Before I got the shots I was alternating Vicodin and Motrin 800's. You can get away with that for awhile but remember that Vicodin is an addictive narcotic and Motrin 800's will eventually eat your stomach lining.

    Hope this helps a little. Good luck.
  • Each spinal nerve provides sensations to a specific area of the skin. This is called a dermatome. Here is a link to a dermatome chart that will show you where most people with a rupture or herniation at L5-S1 will feel pain, numbness, etc.

    http://www.apparelyzed.com/dermatome.html

    The best sleeping position for the spine is on the side with a small pillow under the head and a smaller pillow between the knees. This supports the spine, with its natural curves, in the best position. You can put pillows behind you to keep you from rolling over. Second best is on your back with a small pillow under the knees.

    Standard advice:

    Drink lots of water Avoid any activities that involve twisting, bending, lifting and reaching, especially overhead. Use good body mechanics and good posture. Do not slouch in a chair or sofa. For now, try to choose a more straight-backed chair.

    If you work on a computer, be sure your whole set-up is ergonimically correct. Get up often and walk a bit. Sitting puts 30% more stress on the disks than standing.

    Exercise is important, and walking is the best exercise for the back. It is low impact, stretches out the spinal nerves and gets fresh, oxygenated blood to the injured disk.

    A bulging or herniated disk can heal on its own without intervention, but it requires a great deal of patience and perserverence because it heals VERY slowly.

    You are lucky the pain only goes as far as your knee. Do not be surprised if it affects the ankle and foot. L5 - S1 supplies the genital area and also the bowel and bladder areas. If you develop any problems with your bowels or bladder, be sure to seek medical attention right away. This is considered a medical emergency as the nerve is sensitive and you do not want to end up with permanent damage. But barring those symptoms, you are uncomfortable, but, you are not in danger.

    If you have not done so yet, you might want to look for a fellowship-trained spinal specialist. You might want to establish a relationship with a specialist in the event that your situation gets worse and you need surgery. You would not want to end up in the emergency room and have to take whoever is on call, if you should ever end up with the need for surgery on an emergency basis.

    One more little tip:

    Any time you have a few spare minutes, stretch out on the floor. Lay flat (it's ok to bend your knees with your feet flat on the floor)on the floor with your arms along your sides, palms up. Breathe deeply and just try to relax.

    Another position is flat on the floor with your hips right up next to a couch or chair, bend knees so that calves and feet are resting on the seat of the couch or chair. Again just let everything go and breathe deeply. Do this for about 5-10 minutes whenever you can. These positions allow the disks to unload, and to escape the force of gravity for a little while. It helps the disks to rehydrate and puff back up a little.

    Regarding exercise: There are some pretty standard exercises that most PTs use to strengthen the "core." If you look on the internet you will find a number of websites that will show specific exercises....It would be better if you could consult with a physical therapist who specializes in orthopedic issues.

    Do not lift your little child until you have healed. This could take at least six months. Oh, and use ice on your back. This will help if there is any inflammation. You can also use a heating pad. Some people prefer one over the other. I use heat on my back all the time. It helps the muscles to relax and keeps them from going into a spasm.

    Hope these tips help a bit. Many people have a disk problem at a young age and are able to recover from it without surgery.
  • I found it helpful to objectively note my progress. Trying to remember if I was experiencing more or less pain a week ago is near impossible. For example, 3 weeks ago it was excruciating to get my sock on in the morning even with my fingertips. Now it's uncomfortable, but not torture.

    And don't drug yourself up and think you're okay. It's very tempting to do, but when the drugs wear off, you'll realize what you did. Be careful.

    I too have a protrusion (migrated) L4/L5. I'm determined to beat this without surgery. Been less than 2 months and it's the hardest thing I've ever done.
  • A month ago when my back threw me for a loop (I have the same thing as you, but more sevear) I figured I would blow some money online and try some things that may be a waist of money. I bought this ebook and it did a great job of explaining everything. It is no substitute for ciropractors and doctors, but it gave me a much better understanding of what to do.

    I am in no way afilliated with the guy who wrote this guide. As you can see in my posts, I am clearly just a guy with a really bad back problem. CAN SOME ADMIN LET ME KNOW IF I CAN POST THE LINK TO THIS OTHER WEBSITE WITHOUT GETTING INTO TROUBLE. This has been a very rough month for me and this site and forum (www.spine-health.com) is really helping me get thru this. I don't want to get into trouble or get banned.
  • My pain also was always worse when i over did it or slept still is. I had a micro done on l5 s1 noverber 13 o8. On my fibnall visit to back doc i told him my back hurt more when islept then any other time he said it was unusuall but could be the disk trying to rehydrate itself. Told me to take advil and i also wear a lumbar corsett to bed cause since the surgery i realy toss and turn in bed sometimes vilently do to the frustration of not getting comfy.Be care full with your back like the others said, i would do alot of walking ice your back and keep those hamstring streatched out. They say most people with low back pain have tight ham strings but is it a result of or a contibuting factor. hope ya feel better
  • Thanks for the advice.

    Think my problem is the same as a bulging disc. British NHS likes to have its own terms just to make it difficult!.

    Do buging disc repair themselves?

    A few friends have recommened McKenzies back programme. Very good for strengthening the back.

    Everything seems doom and gloom. Does anyone get better without surgery? Def dont want that have heard about so many problems.

    Thank god walking is good! I am a PE teacher and spend all day teaching sport and on my feet. Trying not to pick up little boy is impossible as only 2!.

    Hard to know what to do. Some people say PT works other made worse. From everything I have read (lots) exercise is the best way to get better.

    The best bit of advive a specialist told me is "dont let back pain ruin your life" know it is difficult but we are all still hear at least (father in law died over christmas aged 55). My new aim is to power through the pain and just enjoy spending time with family. It seems everyone has some problem with them we are the unlucky ones with bad backs.

  • Yes, there are many different terms to describe pretty much the same thing. I beleive that a bulging disc can heal without surgery, assuming it is not too large. I was told by my surgeon and pain specialist that over 50% heal without surgery. That being said, you do need to understand that it will never be "as good as new" again, and you will need to make some life adjustments. You need to alter how you pick anything up off of the floor by not bending at the waist. This is the main thing. Otherwise, your attitude about not letting it beat you is great! Most doctors will tell you that if you can walk without generating great amounts of pain, that is the best exercise. I am now walking 55 minutes a day and just got permission to add a little light elliptical and very light jogging to my routine. You are the only one that knows what kinds of activities make the pain worse or better, so listen to your body. One more thing, try to find some kind of abdominal (core) strengthening exercises that you can do without aggravating things. Having strong abs can go a long ways towards protecting your lower back.


  • I have just started to do core strengthening exercises. Have def made my back better!. Lifting using legs is def good advice even though it looks funny. Also my calfs are weakening from not playing sport. Calf raises on the stairs have really helped.

    Not sure how far disc is out all the results say is protrusion to right. Waiting to see specialist but the NHS take at least 4 weeks after MRI!!!!.

    Are you having op?
  • I already had L5-S1 microdiscectomy 6 months ago. Mine was a very large rupture. I did the PT and got 5 shots in an attempt to avoid surgery but my rupture was very large and I ended up having the surgery anyway. The surgery was a piece of cake and I was back at work in 2 weeks, but then scar tissue brought back much of the same pain. Had 1 Selective Nerve Root Block shot to try and schrink the scar tissue. That was almost 3 months ago. Pain is down to about 1.5 out of 10 now. It is easily bearable without any pain medication so I am pushing ahead with getting back to my life. I beleive that the more I get back into physical fitness, the better it gets. It seems like physical activity helps to not allow the scar tissue to adhere to the S1 nerve as much. I have been walking 55 minutes a day for the past couple months and last night did a little 5K training with my 10 year old daughter. We just did 10 minute mile pace, so 31 minutes. And I don't feel any worse this morning. My surgeon says to keep the jogging very slow, so I will try. Not running at all for the past year was very difficult.
  • How was the scar tissue diagnosed as the cause of your pain, and at what point after surgery did the pain begin to develop?
  • No one really knows. You know what my NS told me? He said scar tissue is never an issue. When I asked him about an inversion table he said he recommended it. When I asked him if a large rupture can heal itself, he said he had a patient with a huge rupture that disappeared in 6 months. I only agree with his last statement since that's a certifiable fact.

    Every rupture and person is unique. Some people smoke and do labor for a living. Others exercise regularly and do office work. We're all different ages and builds. And there are a host of complications that can make it difficult to determine if you're healing.
  • Gwennie17, I requested an MRI after the pain came back pretty bad about 2 months after my surgery. I really, really thought that the disc had re-ruptured since the pain came back pretty suddenly and in the same areas as before the surgery. I never did see the films as they sent them directly to my surgeon, but he told me that it was pretty obvious.
  • Can anyone tell me if an L5/S1 problem put pressure on the Sciatica nerve?? :?
    Had PLIF in 2008 and a Laminectomy. One level fusion, L4-L5.
  • I have severe sciatica from a l5s1 herniation.
  • chezlycchezly Posts: 24
    edited 09/21/2012 - 12:14 AM
    If a large herniation can disappear within 6 months, what about a small herniation (3mm), can it ever disappear?

    How long would it take?
  • I had very large extrusion on my L5 S1 it was only there for 6 weeks but in that time I suffered much strength loss. The calf pain like said above is EXCRUTIATING!!!! I had a micro discectomy and am still having back, hamstring, calf and foot pain and numbness 4 months out of surgery. It can be avoided if you are improving! I do have a torn disc to up above and I have no idea if they heal or how long. From what I understand your body can absorb the bulging material and most people improve on their own. If you are getting worse or say can't get up on your toes you might need the surgery.
  • chezlycchezly Posts: 24
    edited 09/23/2012 - 11:39 PM
    nkay said:
    I had very large extrusion on my L5 S1 it was only there for 6 weeks but in that time I suffered much strength loss. The calf pain like said above is EXCRUTIATING!!!! I had a micro discectomy and am still having back, hamstring, calf and foot pain and numbness 4 months out of surgery. It can be avoided if you are improving! I do have a torn disc to up above and I have no idea if they heal or how long. From what I understand your body can absorb the bulging material and most people improve on their own. If you are getting worse or say can't get up on your toes you might need the surgery.
    When it first happened, I was in excruciating pain. My whole body was in spasm (shaking violently), very painful stabbing pain behind my right knee and extremely painful calf pain. I did have an improvement with strength but my numbness never go away. I have this numbness for nearly 4 years now. I could do toe raise but then I can't run. I even have trouble walking properly. I limped as I walked. What really worried me is that, since my nerve has been compressed for so long (nearly 4 years), will I end up with permanent nerve damage?
  • samantha-heelsssamantha-heels Posts: 1
    edited 05/28/2014 - 5:19 PM
    I have prolapsed disc on L5 S1 which been told is on the sciatic nerve its strange that you can move about and only getting what seems to me a tiny bit of pain compared with what i get, I cant walk for more than a few steps, my lower back, hip, thigh, calve, right to my ankle, which i find is the worst pain as the pain in my ankle is in the center where the bone is, the pain is extreme that is why after the doctors tried that many meds with me im now on 60mg of morphine a day and amytripyline to help me sleep, it doesnt work tho, as i dont sleep anymore, the morphine doesnt kill the pain in my opinion morphine is crap, i have the tablets zoromorph and liquid oramorph, i have 5 other medical conditions so alot of meds n effects aint great, im only commenting because you asking for help yet what you wrote does not seem like the pain i know from a L5 S1 disc as it goes all the way down your left leg, ive had mri's the nerve root crap injection that eased the pain a little for 3 days, My neurosurgeon has said i need surgery but i could have another knacked disc on opposite side so awaiting results. be greatful your pain isn't as bad as mine and many other peoples, your lucky to be able to walk around im also 27, so age thing doesnt matter. i have to use walking aids around the house. If you have problems with your pain ask your doctor to give you stronger meds. And i agree with the other persons comments PT is not recommended as ive been told not to exercise or anything at all, if your one of those people who scared of gaining weight as not able to exercise as normal then the doctor will give you weight loss pills. and i get numbness, in feet, bum, thigh and even knee pain, so its not a nice thing at all. i cant sit, stand or anything its too painful, if i lay on my bed im still in pain but not as much pressure on it. even tho i hate being in my bed 24/7, surgery cant get here quick enough. i slipped the disc back in 2010-11. so years of constant 24/7 pain, just getting worse every day, no better just worse. when i originally took to hospital on stretcher with gas n air when i occured the injury when i got to see a doctor i wasn't even examined was told to keep the area warm with hot water bottle, i couldnt walk, sit, i had to crawl, i was given no painkillers and told it probably a slipped disc, months later, saw my doctor was told it wont be a slipped disc or broken bone it will be nerve damage, i asked her for xray, so she booked me for mri at the time EDITED by Moderator

     
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    S Heels
  • ShoreshSShoresh Posts: 1
    edited 08/20/2015 - 4:25 AM
    hi My name is Shoresh and I have been in some pain in my back and bottom even lags some times specially when am standing for long time
    but when am relaxing for some time I don't have pain in my lags just some pain my low back but it is not strong pain just not comfortable little bit
    I did the MRI and the Dr said that it is disc protrusion and he advice me to do swimming so am wandering will it heal by it self and what should I do

    http://www.spine-health.com/conditions/herniated-disc/lumbar-herniated-disc
    Please click on link for helpful information
    Welcome to Spine-Health
    Liz -spine-health moderator
    Best regards
    Shoresh
  • anyavaanyav Posts: 1
    edited 08/20/2015 - 8:03 PM
    [My pain start 4months ago. In the buttocks, down the leg, feeling of burning under the foot and numbness in my toes.Very very painful. Pain was control with medication Gabapentin.All is gone except the toes are still numbs. A dural tear leaking fluid happen and a second little procedure seem to have solve the problem so far.uote=Anonymous]Hi all some help/ advice would be appreciated!
    Only 27 with a young child and played football until 4 months ago.

    MRI show disc protrusion of L5/S1 pressing on S1 nerve root.
    All my pain is in my buttocks and hamstring and feels like muscle is ripping!. No pain below knee. Is this common?

    Worst pain is mornings and when sleeping. Pain eases during the day and can move freely and sit for longer. Is this normal for bad discs?

    Recently I have had more pain in the hip area and for some reason (researcH) think this could be the cause of the pain. Does anyone have any ideas?

    Questions
    Treatments/ exercises should be doing and will it make disc worse?
    Sleeping positions?

    Hope someone can help!!!!
    Please!!!!


    ***********************
    Nobody on the forum is medically qualified or permitted to give advice any responses will be based on members personal experiences only


    Please click on link for helpful information
    Welcome to Spine-Health

    Liz -spine-health moderator
  • That's how mine started- I advise anyone to be very cautious if they stumble across these forms looking for answers for there similar sounding pain. I also think the resting period should be as long as it takes to be able to stand with or without help, up until a week or two at least so not to make the blow out worse. I think doctors push the physical approach of treatment to quickly and I think it's ass backwards to not get a screening mri or something before giving advise to physical Theropy. I realize the economical risk, but perhaps there could be way to make the system a little better. If I knew my condition earlier there may have been a way to prevent the extreme of it, instead I exercises and attempted stretches recommended to me. All I had to do was walk on a treadmill and I collapsed after the session. I never did it again and sitting in a vehicle was almost enough pain to vomit, as was initially trying to go to the bathroom.
    I thought I first tore muscles in my glutes and hip region - and then on it worsened to the degree described earlier in the thread- extending to ankle center line heal bone and earlier in the progression, the side of the foot, and also now may have a disk buldging above affecting the right. Take it easy I am trying to heal as much as possible naturally by supplying the body what it needs. Walk as much as you can and endure as much pain as you can, I feel like eventually your neural networks adapt to a degree so you can survive where as the pain medication interferes with this. My pains are all still in the regions as they were previously however slightly weaker after ignoring pain meds for a couple weeks. When it's awful I take a hydrocodone but only when I can't stand it anymore. My mri didn't look any different with these updates only possibly a little "fatter" looking and wider bulge with similar depth. I'm a little past 6 months but I had a large herniation that hit the back wall of spinal canal and squished the s1l5 nerve root pushing towards the spinal canal centrally rather than off to the side like many diagrams. I feel like my disk may be solidifying more as I go and walk and take nutriants - I do fear that the next step in the healing process with a herniation this large is that after some healing the 12 mm protrusion may collapse and separate from the "healing disk" I just hope it does and hope that they let me get another mri to see if a disk can rehydrate too. There are lots of posts about the possibility of healing smaller herniations and even larger- but I never see the mri's with rehydrated disks and some take a year or more to resolve if without surgery at all and this is far after nerves can be damaged. Is there anyone who can add to this? If I manage to make it without surgery and get another mri I will show the results here. I do heavily believe that the healing capability for speed and recover is determined with the amount of disk damage all together not just how far the material is blown outwards which results in pain.

    For others is like you to know that around the 3 month mark for me the electrical pain seemed to less and go away and occurred around a period of oral steroids which by the way I do not believe did anything, I believe the nucleus pulposus material that spilled out was finally eliminated from the nerve root and the reaction of foreign cells calmed down. The pain is more like a bite and knawing pain with some sharp stabs with incorrect movement. Unfortunately my right leg is a bit worse but still only in hip region with migration occasionally to calf. My nerve root is still physically squished though.

    Again if people have large herniation healing stories please share. I am 26 and did hard masonry labor and deffinitely over did it for the last few months before accident/ onset and would question if I pushed the human limit at some points. (Carrying 120 lbs up and down 4 flights of stairs for hours daily) My slow healing time may be do to the physical stress on the disk rather than one solid action that blew it out or malnutrition. I ate well and was exceptionally strong and fit.

    Depending on what caused your herniation or if you had a weighted mri to visualize annular tears, (they seem to cause my burning back pain either that or that's the blood vessels growing into them to heal) but there are ways to ease this pain usually walking and then resting (really both of them not one or the other does it alone) resting makes it go away but without walking it's like a multiplayer and the burning will just get worse.
    I'm really trying to avoid someone from falling into similar pitfalls. My limp is heavy after sleeping and I often question if my inability to align myself Is damaging other disks. Stomach is the best for sleeping unfortunately for me (also not helping recovery) but still takes tossing and turning. If given the option of surgery, if I could go back in time I would do it if no one else can say they recovered from something like this. I hope there is because this feels like it's almost been a year of my life that was almost not worth living. its been a long battle but I'm actually in good spirits now and have found new meaning for life in some ways while missing my old life very much so.
  • chop my leg offcchop my leg off British ColumbiaPosts: 56
    An MRI with contrast (needle of some kind that will make scar tissue show) is how they can tell.  
    L5S1..2 microdisectomies in 30 days maybe one more on the agenda. 4 bulged discs and one of them loves my spinal canal X2 :/ and a compression fracture . And now scar tissue wrapped around the nerve causing horrible neuropathy all over again.   VICIOUS CIRCLE :(
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