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I know I'm supposed to bend backward, but...

jalashkarjjalashkar Posts: 2
it hurts like hell.

Bulging/herniated L5-S1 like many others here. A went to PT 2 years go for many sessions, and they determined what I should be doing are those classic McKenzie prone presses and press-ups. But at the time, even lying prone flared up sciatic pain in the left half of my butt that was so fierce I couldn't stand it for more than 15 seconds.

2 injections later, pain gone and I was able to get through the exercises. I worked on flexibility and core stability, and I thought I had it licked. 3 weeks ago doing a workout I've done several times over, I noticed a good deal of pain back there. Within a couple of days I was right back to where I was 2 years ago. Slightly more mild than before.

I really don't want to head back in for an injection. It's not a cure, it just shrinks swelling. Unless you deal with the cause, the swelling will eventually come back. Right?

So now I'm trying to lie in prone position and it hurts. Lying supine also hurts unless I bend my legs and let my spine flatten out a bit. Here's the interesting part: if I'm up on all 4s I can do the extensions. If I keep the extension constant in my lower spine and slide forward so that my legs start to straighten out behind me and I lower myself into a prone position, the pain flares up. So it seems like the extension itself doesn't hurt much, unless my legs are outstretched.

I started digging into this and learned about the function of the psoas muscle. Odd that no one ever mentioned it or tested it for tightness/weakness before. If tight, it will pull on the lumbar spine as you extend your legs. If weak, it should let your back go too flat. Research shows that I should be able to stretch that muscle by lunging. Of course, a prone press-up would also do it. But any of those motions hurt like hell.

So what's a guy to do? Head in for injections to kill the pain enough to get through stretches and PT? Suffer through the pain and ice after? Could it be something else entirely?


  • First let me say welcome to spine-health. AS you have noted there are many here with the same lumbar issues. Some will do injections, and all conservative type treatments, while others will be candidate for surgery. What type of doctor are you currently treating with? If you have not seen a spine specialist, you might want to get their opinion to your different treatment options. As far as the injections go, many do them, they work fine and are about living life, kind of as the relief you have had in the past. Will it come back is anyone's guess. Yes the size of the herniation can back down once the inflammation is removed. Also by strengthening your core muscles it will take some of the pressure of your spine.

    Now if you don't want the conservative measures then of course there is surgery if your a candidate. But also remember surgery is no magic cure. Some will do good with it and some will be worse than they were prior to surgery. Also surgery is a long process of healing over a two year time frame, and tons of PT as well.

    At the end of the day you need to work with your doctors and find the best treatment options for your individual situation. Also in many situations the insurance companies have a protocol that you have to adhere to. So you might have to do the PT, injections, medications and all forms of conservative type treatments before a surgery is even on the table. As many will attest it not a short process, as in , fix it and move on.

    Just thought I would stop by and welcome you to spine-health. Keep us posted on what you decide to do and the treatments you choose. Any questions ask away as there are so many here whom have gone through all of the available treatments.
  • Thank you for the welcome, and the reply.

    2 years ago I met with a neurosurgeon in the area who does the microdiscectomy procedure. I decided that removing part of the disc that's being pushed out is not the real solution. The solution I want is to figure out what is causing the pressure and bulging, then get rid of that. I was good about it for some time, then got lazy, and here I am again.

    I will say this much, I was just thinking about the last few months and I wonder if what I've been feeling has led up to this recurrence...

    About 3 months ago I started to notice a discomfort (not quite a pain) deep down in my lower left abs. I now know that's where the psoas lives. I didn't think much of it, figured I just strained an ab muscle (I'm very active, this stuff happens). About 2 months ago I was messing with my running stride and ended up really straining something deep in my left leg along the groin area. I figured it was a strained groin muscle, hip flexor, quad, or some combination. But it's on the same side as where I was feeling that deep ab pain.

    I'm wondering out loud of I have a serious psoas imbalance from injury. I just did a strength test and passed on the right, failed on the left. I wonder if this is torquing my lower spine about and led me to re-injure the already weak disc. If so, perhaps the temporary relief from an injection could keep the pain away long enough while I rehab the psoas and rebalance my core muscles again.

    I know what you're saying about eh insurance protocol. When I last went through this I had to take oral steroids, then go through PT, then get an MRI, then get the injection in order for the insurance company to be happy. I'll call them up and see if I have to go through that or if the previous assessments can be used.

    Thanks again.
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