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L5/ S1 disc protrusion

AnonymousUserAAnonymousUser Posts: 51,489
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?

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

Hope someone can help!!!!


  • 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.


    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?
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