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Herniated L3L4,Annular Tear L4L5, DDD, sciatica, facet j synd.

edited 06/11/2012 - 8:43 AM in Lower Back Pain
I have a question for anyone who has been somewhat close to having any of the problems i've mentioned in the subject heading. Actually, it's not too specific, but just anything you might be able to share about what it's like or has been like for regarding waiting to see if with non-invasive methods, injections, massages, acupuncture, and of course, more physiotherapy everyday?? I am afraid from all of the articles I've read about how we how suffer in pain from WHATEVER the cause may be to our herniated lower back, on sciatic legs, that sometimes waiting to long to try to get surgery can be as damaging as going on the other extreme of no waiting, and jumping straight on to the OR table. Has anyone ever run across these articles, or heard this from their physiotherapist or gp? I even had a relative mention this one, so that was the last time I would just think about it before bringing it up with the spine health crew!:)
If any one has an opinion regarding the don't wait too long or don't jump right in theory, please feel free to fire back some feedback...the more i learn from others experience, the more i have continued hope regarding my own.

oh, and how (silly question) do i update these signature details at the end of my message/posts? things have changed a tad bit, and I would like to put up what is most recent.

thanks for reading, and i wish you all the BEST care, support, treatment, and decreased suffering in this life!



  • To change your signature, click at top bar of sh forums page for My Account, then click the edit link near top of the My Account page.

    From most of my research, in the states, the common period for conservative treatment is 6-12 weeks. I am guessing that is the period most can have success with physical therapy, injections, etc. without worry of permanent nerve damage. Almost all websites concerning back pain, show most wait that time period. Now I am not giving advice on a proessional level, but the SH site itself is great for looking at treatment options and has many articles showing a concensus for 6-12 weeks being the conservative treatment time table for herniated disks.

    Here is a link. http://www.spine-health.com/conditions/herniated-disc/treatment-options-a-lumbar-herniated-disk

    Of course this is a US based site and UK protocol probably varies.

    Best of luck with treatment!
  • I had a herniated L5-S1 and annualar tear as well as facet joint arthropy (arthritis) and I had an MRI 18 months after and it showed the herniation had healed. Unfortunately now I have DDD from L1-L4 and a repeat of x-rays showed still facet problems though the MRI didn't show that.

    I've tried Physiotherapy, massage therapy, acupuncture from my PT and injections facet and ESI's. My first PM Dr. also did a hundred trigger point injections to elongate the tight muscles in my lumber area and recommended an infrared platinum heating pad which can help the pain from annular tears. But as always ask your PM Dr or Primary if that would help you. I can't even sit if I don't have my infrared on my back or leg! I also just purchased a TENs unit and it feels great.

    I wish you all the best with your upcoming Orthosurgeon appointment. Have you had an EMG/nerve test yet? That showed that I had no nerve issues so I could wait longer to see if conservative measures would help in my case. At the time of the test I saw a Neurologist.

    I hope your appointment goes well and the Surgeon can help you. Take care. 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
  • I've had the herniations and the annular tears, etc. Went through the gambit of cautious treatments -- you can see it all in my signature. The micro discectomy really did help, but I wish it had been for longer than six month. I understand not rushing into surgery. Believe me, you do NOT want to have to experience all I've been through. However, if you don't get better, some times you just have to do what you have to do. I'm finally healing. I'm out of pain (almost all the time) and just dealing with the stiffness. Life is much better than it was pre-surgery, but not as good as it was pre-injury.


    3 level spinal fusion, L3/4, L4/5, L5/S1, November 2008. Stiff, but I can walk.
  • I don't know about the tear, I have never had the discogram. Surgery is not really an option for me at this point because my anatomy is really abnormal due to my injury (see sig). So, yes, lots of experimentation- I haven't tried acupuncture yet. I can't say what works and what just makes me feel like I'm at least trying. My back is kind of deteriorating, so everything is one step forward, 2 steps back. I'd say GOOD physical therapy is the best.
  • The answer to you question depends on what is wrong. If you have an injury that is pressing on a nerve or the spinal cord then waiting might be a bad idea. Or if waiting will cause further damage to your spine waiting could be bad. Your doctor should be able to tell you if this is the case. With medicine and insurance today doctors like to try other treatments first. Many people find relief with non-surgical treatment. The body is an amazing thing.

    Only your doctors can tell you the right answer. Make sure you ask the question clearly and get a clear answer. He should be able to give you an idea of how likely a treatment is to help.

    Good Luck
  • Your history sounds very close to mine. I have been through the gamut and my opinion is that every possible non invasive procedure should be tried before surgery unless your doc says that waiting will risk permanent damage.

    Surgery holds no guarantees. Once surgery is done it can not be reversed. By trying all conservative measures first you still leave yourself the surgery option. It will not work the other way around.

    Good luck to you and please keep us posted.
  • My injury happened in Dec 2008, I spent all 2009 up until April 2010 going to pain management doc. I have had facet injections, nerve blocks, neurolysis,trigger point injections, epidurals out the ying yang. 3 times a week chiropratic. I have been on Loratab 7.5 mg, Zanaflex and Mobic for over a year now with no lasting relief. I finally went to the Neurosurgeon in April and endured a discogram that I wish I could have stabbed the Doc in the eye with one of his needles. Found L5 S1 torn, stenosis, sciatica DDD.After the consult and many days talking with the wife I decided to get a L5 S1 fusion. Mine is more for numbness and leg and butt pain, low back aches all the time but on my pain scale it is a 3 to 4. I don't want to risk any more nerve damage due to the beating I have given my body after 38 years of skateboarding.
    I am a realist and know that I will never be pain free again, but in my book getting to a 2 on the pain scale is close enough for me.
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