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Surgery or therapy for a herniated lumbar disc

AnonymousUserAAnonymousUser Posts: 49,671
edited 06/11/2012 - 8:37 AM in Back Surgery and Neck Surgery
Hi all--New to the forum. Here's the deal...I have had back problems my entire life. I am now 35 years old and I WAS very active until last March, when the back spasms and intense lower back pain were so bad I was in bed for 3 weeks straight. Went to therapist and a chiropractor every single day for about 2 months, then a few times a week for about four months. I was feeling a lot better until I tried to play softball again, and the pain all came back as bad as ever.In addition to the back spasms, I have had nerve pain down my left leg which at times is very painful. I recently had an MRI which revealed a herniated lumbar disc. My chiropractor says that if I stick with the traction and exercises, and remain pretty inactive for the next two years, I have a 50% chance of this healing without surgery. Of course, when I went to see a surgeon about it, he said that the only chance it will heal at all is with surgery. Otherwise I will live with the pain for the rest of my life.
I am trying to decide whether to have a microdiscectomy or go the conservative route with therapy and exercise which could take much longer, isn't guaranteed to work, but is less risky. Any experience with either option that anyone can give me would be great because I am torn as to which route to go with. PLEASE HELP ME WITH YOUR EXPERIENCES!! --Tony


  • Hey there... Gonna keep it short and to the point. Had a microdiscectomy (L4-L5) in 2002 for a 11mm herniation. In 2008, the same disc herniated again this time at 7mm. Did the decompression thing for a while. Tingling in my leg felt a little better but I believe the decompression machine is just a "cash cow" for chiropractors. I did some physical therapy for a while but it wasn't helping. Last option was a 2-level lumbar fusion (L4-S1) and I'm so glad I did it. I'm 6 weeks post-op and never felt better. Surgery should be your last option. I'm not gonna bash chiropractors but they or not MD's. In my opinion, if your herniation is relatively small (under 5mm), I would recommend seeing a physical therapist trained under the McKenzie Institute. They specialize in treating back injuries. Hope this helps. Good luck to you.
  • I guess I couldn't fully agree with either piece of advice you've been given!

    Except perhaps in some circumstances I believe a patient would know within about six months if a herniated disc is going to be able to "heal." I don't mean to contradict your chiropractor, but I have never heard the advice he gave you regarding it taking two years and the 50% chance.

    Current thinking is to try conservative treatment (physical therapy, perhaps steroid injections, etc.)for four to six weeks. If pain is not lessening, then it may be time to try surgery. There are minimally invasive procedures now that people recover from quite quickly. Of course, it is very important to have a proper diagnosis and to find the best qualified spinal specialist that you can....You don't want just anyone who has done the procedure a couple times to take on your case.

    I can tell you that my husband ruptured a lumbar disc and recovered without surgery. He was in severe pain for a couple weeks. He did physical therapy and was able to return to work (office) at around 3 weeks...and it was probably about 6 months before he felt relatively back to normal. This was 17 years ago....He keeps himself at a normal weight, does a half-hour of his back exercises daily (NEVER misses), and is very careful to use proper body mechanics. There are some activities he gave up and others he is very careful with --for example, when he gardens, he knows he can only do so much and then he will come in and stretch out on the floor to let his discs decompress. He is careful, but he still is able to run. He has never had further disc problems.

    You might want to get another opinion from a fellowship-trained spinal surgeon, either a neurosurgeon or an orthopedic spinal surgeon who devotes his practice to issues of the back and neck.

  • Hi

    If you want to try get fit and strengthen your body to try take care of the pain and let the disc heal naturally, there is nothing better than Clinical Pilates but on a Reformer machine, not on the mat on the floor. Find someone qualified in this that has the Reformer Machines and if they are qualified, their knowledge will help get you stronger and fitter. If the disc doesnt heal while doing this, it will have you at peak condition ready for surgery. When you stop everything because of the pain you lose condition real fast and its hard to regain at home and after surgery you lose condition also.

    I personally would steer clear of a chiro if you have a herniated disc. Traction may relieve the symptoms briefly, but unless you plan to live on the traction machine until the disc recovers, you will be aggravating the disc every time you get off the traction and the spine closes back up. Traction was a real no no for me, it gave me immense problems.

    Stick with clinical pilates and get yourself into a heated swimming pool, even walking in a pool is good until you can swim. best wishes....
  • I stopped working 20 months ago due to a small L5-S1 herniated disc. It was a very big pain for me though with pain in my lower back and leg. I had several epidurals and facet joint injections and swear by my infrared platinum heating pad which one of my Pain Managements Doctors prescribed for me for relief of pain. I sought out 2 OrthoSurgeons as well as one Neuro Surgeon for opinions. I would ask your Primary Dr. for referrals to these Spine Specialists for their opinion. My disc herniation was not seen on my 2nd MRI just recently although I still have pain from degenerative discs though. The Chiropractor I went to didn't touch my herniated disc or spine at all. He prescribed only TENs and massage only. I also went to Physio and acupuncture and now am started Heated pool therapy for exercise because I'm unable to walk or lift anything due to weakness and pain. I also use a recumbent stationary bicycle with my Drs. permission. As for any treatment or excercise do get your Doctor's approval first. I'm sorry for your pain and perhaps you need further testing re: an EMG for testing your nerves. Take care and keep us posted to your plan of treatment. Charry
    DDD of lumbar spine with sciatica to left hip,leg and foot. L4-L5 posterior disc bulge with prominent facets, L5-S1 prominent facets with a posterior osteocartilaginous bar. Mild bilateral foraminal narrowing c-spine c4-c7 RN
  • Great comments so far...keep them coming. Just so everbody is clear, I have already done 6 months of traction and therapy, and as soon as I try to do anything really physical, the back problem flares back up. I am also in very good shape already (6'0", 190#, no other health issues).
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