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Any Nonsurgical Success Stories for Large Disc Herniations?

nathan.s.dennisnnathan.s.dennis Posts: 22
edited 06/11/2012 - 8:58 AM in Back Surgery and Neck Surgery
I'm new to the Spine Health forum, so please forgive me if I overlooked a message thread that dealt with this topic. And please forgive the length of the message. I figured more information might offer more comparisons with people who have suffered the same injury.

I'm a 35-year-old male who was just diagnosed with a severely herniated L4-L5 disc. The injury most likely occurred on January 1, 2011, when I decided to playfully pick up my wife and then swung around. I immediately knew that something was wrong with my back, but the pain wasn't horrendous, so I more-or-less ignored it, continued to work out in the gym, and even went to Italy for two weeks on a research trip, all the while assuming that the pain was negligible and the occasional numbness in my left foot was due to my shoes being too tight. What can I say, I was completely ignorant of the physiology of my spine or what had really happened, and the pain and the numbness completely subsided on their own.

Fast forward to two months ago on October 2, 2011, when completely out of the blue I woke up and could barely move. I had sciatica pain radiating down both legs (more so on the left), small portions of my left foot were going numb, and, as I discovered the following week, my left calf was starting to lose muscle strength. An MRI confirmed that I had a 1 cm (massive) herniation at the L4-L5 level and the ruptured disc material had migrated 1.9 cm cranially (up my spine). The herniation was not only affecting my sciatic nerve but also my cauda equina nerves, but I have never manifested any signs of cauda equina syndrome.

My GP has informed me that a herniation of this size almost always requires surgery to repair; both a neurologist and a neurosurgeon viewed my MRI and recommended a discectomy; and the physical therapist I was supposed to see doesn't think he can help me with such a large herniation. I have spent countless hours researching my condition, and while I was waiting to see the neurosurgeon (a 6-week wait) I decided to try to treat myself, exploring various options such as inversion therapy (I bought a Teeter Hang-Ups table), therapeutic massage, acupuncture, one stretch from the McKenzie method and two yoga stretches for the piriformis and hip flexors, and now I am virtually pain free throughout the day. Let me clarify, though. I'm nowhere near 100%. I still can't run, go to the gym, or be nearly as active as I was before the injury. I have to be very, very careful about how I move, but there is no real need for painkillers anymore, and I can walk long distances without any problems.

But here's my question to those of you who have dealt with this far longer than I have and can hopefully offer some wisdom and support: Is it even possible for me to "cure" myself through these conservative methods or am I simply postponing the inevitable? The neurosurgeon thinks I need surgery sooner than later because he's concerned that I could get cauda equina syndrome if my herniated disc pushes out even further into the nerves. And even though I feel like I have made enormous improvement over the last two months, the neurosurgeon thinks that my "improvement" is simply my nerves becoming less sensitive to pain. If so, it happened awfully suddenly after I started doing therapeutic massage and stretching, which makes me think he's wrong. To be perfectly honest, I'm scared, depressed, and feeling a little hopeless. My insurance has a very high deductible, so the surgery itself is a bit of a financial burden. I could deal with that, though, if I knew that I wasn't heading down a road of more surgeries that result in a spinal fusion in my 40s or 50s, something the neurosurgeon thinks is inevitable. Are there any success stories out there for treating a massive bilateral herniation with conservative measures? And if not, is there anyone out there who can offer a success story of a discectomy that has allowed them to return to "normal" life for five years or more? I'm trying not to catastrophize my diagnosis, but I kind of feel like the neurosurgeon just gave me a death sentence for how my spine is going to deteriorate in the coming years. Any advice would be heartily welcomed.


  • Hi Nathan,

    So I don't have a long term success story yet, but I am post-op from spinal fusion and dissectomy three weeks now.

    I actually only had my symptoms for about a month but they were so severe that I lost function and feeling in the left side of my body (I am a lefty as well) and the neurosurgeon said that my disc was so largely herniated that if I let it go I could possibly suffer from permanent nerve damage.

    So, after surgery my horrible nerve pain radiating down my arm and leg were gone and I am happy to report that I am gaining feeling in my hand every day.

    I just started PT and I know I have a long road to go but I do want to tell you that if your disc is as herniated as mine was and your pain unbearable, I would definitely recommend finding a surgeon that you are comfortable with and going for it.

    I know that after surgery you are at risk for need for refusion, but I think that if you rest and listen to your PT, fix posture, focus on a healthy lifestyle, and strengthen core there is a light at the end of the tunnel.

    Good luck and I hope that a successful surgery (sso far!) will give you hope.

  • When the radiologist, the surgeon(s), and your doctor all agree it's too large. The likelihood is it is just that. Be very careful of doing PT. If they are recommending a discectomy then don't go doing PT or any work in the gym.

    It will work more or less like this. Try and wait it out and see if it will heal. That means no bend, lift, twist, period. For many months. If you do the discectomy then take it easy, also with no B,L,T. You might heal up. Beyond that the next step is fusion.

    So in your case minimal is actually a discectomy. Yes it is surgery but very minimal. Enough to unload pressure of the nerves and give the disc some room to try and heal from there.

    Your report also says disc material and it has migrated. They'll have to clean that out while they are in there. That could haunt you later if it is not removed. There is no guarantee your body will just absorb things like that.
  • to the SH Forum! We're a caring, friendly bunch and we'e all been there done that spine-wise, so you're in the right place for suggestions and empathy.

    An MRI I had a year ago showed, in part, a broad-based L4-5 herniation which encroached on the L4 nerve root, causing moderately severe back pain and sciatica extending to my right knee and left foot. I was referred to an orthopedic spine surgeon, who advised me to undergo a fusion. I refused, instead deciding to have just the 6-week course of PT which the referring doctor said would help me feel better. Continuation of the PT-prescribed exercises and use of ice when the pain is worse have allowed me to carry on without surgery. I'm unable to walk too far, but my quality of life is satisfactory (I definitely can't complain). My hope is to keep avoiding surgery, and I have a feeling the PT allowed the nucleus pulposus (the gelatinous inner part of the disk, which is what protrudes in a herniation) to recede far enough so that it no longer encroaches on the nerve root and thus eliminated the sciatica.

    Best wishes to you, and keep us posted.
  • to add that due to the improvement the PT said to me at the end of the six weeks of treatment, "You may never have to see the guy with the knife."
  • Dear Z06,

    Your assessment is sobering, and I have been thinking the same thing, with the exception of my symptoms getting better fairly rapidly. I really didn't trust the neurosurgeon I met with yesterday, not because I didn't think his recommendation for surgery was sound, but because he refused to listen to me, evaded my questions, and was both arrogant and condescending. I'll get a second opinion, if for no other reason than to find a neurosurgeon that I trust to perform the surgery with an acceptable level of patient care. My fear is not of the discectomy itself. It's the possibility of developing scar tissue that could lead to arachnoiditis or placing myself in a position for reherniation. Admittedly, the arachnoiditis fear is irrational; as horrible as the condition is, statistically it is rare. The reherniation and spinal fusion fear is what grips me the most. I've read a lot of medical literature recently, including an article written by the neurosurgeon I met yesterday, and the rate of reherniation after a discectomy is surprisingly high. I'm only 35. The prospect of a spinal fusion and all of its subsequent complications before I even reach 40 is a crushing and frightening prospect for me. I try to remind myself that it could always be worse. It could have been a tumor on my spine that showed up on the MRI. I know this probably sounds selfish and petty, but this is the first time in my life that I've felt frightened for my long-term health and the quality of life I can have with my family, my job, etc. Your tag line is a good reminder, though: "The only valid excuse you have to give up is if you are dead."
  • Dear essmoe29,

    Thanks for the encouragement. I'm going to get a second opinion from another neurosurgeon or neurologist. If it were just sciatica, I would forego surgery completely. My pain, though intense in the first couple of weeks, is now virtually nonexistent. I could even live with the numbness in my left foot since it affects areas unrelated to how I walk. What worries me is the fact that the herniation is pressing against my cauda equina nerves. I visited the support-group website EDITED last night, and the survivor stories terrified me: multiple follow-up surgeries; paralysis from the waist down; loss of bowel, bladder, and sexual function; and often arachnoiditis. That's the number one motivating factor that's pushing me toward the discectomy decision, even though everyone around me keeps telling me to avoid surgery unless it is absolutely necessary. I'm just very confused since my body seems to be improving so much. I guess now I have to weigh the risk of developing cauda equina syndrome with the risk of reherniation that leads to spinal fusion. No matter how I treat this, the time to heal is about the same, from what I've been told. I'm just worried about what happens next.


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  • Absolutely get a 2nd opinion. Always!!!

    Understand that the neuro you saw with the horrible bedside manner. He's not the only one. The arrogance is ok if he can back it up. Mine was somewhat arrogant but better bedside manner. He did listen to me and talk to me for over an hour, in detail. He was very particular about the surgery. He talked to my wife right before he went into the OR and immediately after to make sure she wasn't freaking out. He also came in to see me that night and the next morning. That really is very good follow up for a surgeon. He can also back up that partial arrogance as his success rate is very high.

    So what I am saying is do your homework. Understand discectomy and fusion. Understand the basics of MRI, CT scan, discogram and myelogram tests. If you sound clueless to a surgeon. Then they will ignore you.

    Now as for your other research. The internet is a wonderful thing, and it's a horrible thing... Stop looking for horror stories. They are all over. Because everyone with a bad outcome wants to yell it out. All the success stories, for the most part, just move on and never post back. That sucks because people see too many bad things and the balance of good/bad isn't happening. This forum is no different. Keep some perspective.

    If the surgeons tell you it is critical because you could become paralyzed then you need to make a decision. If they tell you they see no real permanent nerve damage concerns. Then take your time and figure it out. Trust me, you'll know when you have had enough pain to go get it done.

    While I don't consider essmoe29 to be a success. S/he says Quality of Life is acceptable. That is what it comes down too. If after PT and waiting I had constant pain and "couldn't walk very far". I'd consider that unacceptable and do something. That's an example of where we all have differing opinions on this.

    I had a discectomy and it was working. Unfortunately a tractor trailer tried to kill me a couple of months later. The shock caused a reherniation in a big way. The disc dried out and died. We tried everything to stop it. I ended up getting fused. That is 2 years ago. Mine is successful. I could walk forever. I exercise 5-6 days a week. I can do almost anything I want. I don't suck down pain killers every day. Do I still have some bad days, oh yes. It goes with the turf.
  • These posts point to one thing: since different opinions are involved on the part of SH members (for that matter, all members of the human race), it certainly wouldn't hurt for you to get a second opinion, Nathan.

    In my case, the course of PT not only eliminated the sciatica but also improved my back pain to the point where as long as I'm not active it's at a level of 3 on a 1-10 scale at worst, unless I've had to walk far, in which case ice relieves it. I'll gladly settle for that (yay!!).
  • Thanks, Z06, for the sage advice on not looking for the internet's horror stories. My family mentioned the same thing recently: When people have problems, they seek answers; when the problems are resolved, they usually move on. It's really difficult to find success stories, and I'm really glad that you shared yours with spinal fusion. Most people I know, either personally or second-hand, who have had spinal fusion are still in the early stages of recovery. It's nice to hear a success story two years post-op. The one place where the success stories are located--but it's by no means a very personal, anecdotal source--is academic medical journals, which I've been reading off and on. Sure, the statistics for failed surgeries are there as well, but when you see them compared with successful surgeries, the failure rate tends to be relatively small. I've pretty much made up my mind to have the discectomy, but I'm still going to get the second opinion, mostly to see if I can find another neurosurgeon that I trust. Neurosurgeon #1 would barely give me the time of day.

    I do have a specific question for you, though. I live in Baltimore, so I have access to fairly highly-rated neurosurgeons at Johns Hopkins, the greater Baltimore area hospitals, and even D.C. In talking to others in my area who have had spinal surgeries, some have had neurosurgeons do the work and others have had orthopedic surgeons work on them. Personally, I would default to a neurosurgeon, but some of the orthopedic surgeons in my area come highly recommended. In your experience, should there be a natural preference for one over the other?

    Thanks so much and have a great weekend.
  • Hi,

    I'm a little late to the thread here, but thought I would contribute. Glad you found Spine Health, this place kept me sane when I went through my back ordeal. Like you, my hernation was large at 1.3 cm from L4-L5 and I had a second at L5-S1 at .9mm. When my back pain started I was at L4-5 with a .4mm buldge. I went through PT and the symptoms of "I literally can't move" started to ease and eventually I didn't notice too much discomfort. I ignored it, hoped for the best, and figured it would go away. A few months later I twisted my back playing volleyball (that's how active I was again) and I felt my back just...blow out. I knew something was wrong and I too, lost feeling and full use of my left foot (drop foot).

    I saw a nuero and after he ran tests, he said it was too big to ignore and that I needed a fusion.
    I came back at him after having done some research on my own and said, "Can I have the disectomy instead? It's less invasive."
    He said, "No. The discs are being crushed by the vertebrae and eventually your spine will fuse itself. It's like a jelly doughnut loosing it's jelly, and soon it will be flat. I can fuse it and keep the space between vertebrae as it should be and releive the pressure from the nerve."

    I said, "Convinced."

    And I was. I understood at that point that my back would eventually fuse on it's own. That my nerves were at higher risk and the drop foot lost more and more chances of healing the longer I left that buldge on that nerve.

    Today, I'm glad I did it. I wouldn't change anything about my decision. It was, for me, an outpatient procedure. Yes, I didn't have to stay overnight (partly my surgeon rocks). I am fully fused. I have full use of my foot though I do have some nerve damage that causes it to cramp from time to time. Second opinions are good, but when more than one say the same thing it's time to listen. Best of luck, I hate to hear that you've suffered this kind of injury. It's scary. It's back surgery, right!? Watch out for horror stories and stats, that's all they are. Do what YOU need to do to take care of you.

    I hope that helps some. Just want to return the favor SH gave me and to share my success story with you since we have/had a common injury.
  • Here's an opinion from a surgical nurse who's also had the operations: If after a short period of conservative care you are able to bring your pain level close to the nil mark, it looks good for recovery without surgery. Whether you have it or not, you'll have to take it easy for a few months; you don't seem to be in acute distress at the moment.

    If it were me, I'd opt to wait a while, continue conservative measures, and see just how much I could improve as I add in more of my regular activities over time. Then, if the results weren't what I'd like, and pain/numbness increased, I'd revisit the topic of surgery.

    While herniations at the levels near the original one do happen, they are not all as severe as some would think, nor do they always require surgery.

    As long as your doctor hasn't mentioned emergency situations such as tethered cord or cauda equina, try not to worry yourself about every possibility under the sun. While you may see the herniation on film seeming to press into the nerve space, the actual physiology of that area -- those free-floating nerve fibers in the "tail" -- aren't impinged upon in the same way as the actual spinal cord, which ends around L-1.

    Now, as for neurosurgeon vs. orthopedic surgeon: I've worked with both, seen great, good, adequate, not so good. They exist in all areas of medicine. Your job, should you choose to accept it, is to research the surgeons you find to make sure: 1) they are experienced; 2) they treat you with respect, which is different from being touchy-feely; 3) they share your general philosophy regarding surgery (e.g. conservative first vs. just what's needed vs. try to get everything that *might* be a problem in later years. Don't be afraid to ask them if there might be a patient or two of theirs who have had the procedure you're contemplating who would be willing to talk to you about what you can expect. (Just keep in mind that their experience is unique to them and NOT a promise of what *you* will experience.)

    Me personally? I think the focus of neurosurgeons, for me, made them the best choice for me in both my cervical and lumbar procedures. Both will have spine monitoring technicians keeping track of your nerve response throughout the procedure. Both will use essentially the same type of equipment, implants, etc. But many orthopedic surgeons don't specialize in spines, it's one of many areas they work on. (Not that it speaks for all cases, but I've yet to work with an orthopedist who has worked only spines.) Orthopods also do not brain surgeries, and some want to only do lumbar procedures. Neurosurgeons only work on brain/spine. It was just my choice, good for me, the same as others have been happy with their choice of an orthopod.

    You sound like the best kind of patient, one who does his homework. Just be sure when "talking" online to take what's shared as opinion only, not fact. The same goes for every single thing I've written, but it was offered as "food for thought" only.

    I wish you the very, very best!

    P.S. -- My entire spine, all three areas, is full of congenital defects (herniations, stenosis, mild scoliosis, a syrinx (a fluid-filled sac within the spinal cord itself), spondylolisthesis. That's been going on for more than 20 years, long before I had my first surgery in 2006. Despite that, I worked many hours as an exercise instructor, personal trainer, massage therapist, and held a full-time "real" job at the same time. This schedule lasted for probably 12 years. So, your life definitely doesn't have to come to a halt. :)
  • Nathan,

    I don't pick one over the other. You want a surgeon who mainly does lumbar surgery since that is what you need. Since it doesn't sound like you have all sorts of issues I would find the surgeon that you trust. Stick with that.

    I used an ortho for my discectomy and a neuro for my fusion. Not because either wouldn't be suitable in either situation. The ortho was just too far away to see after he moved. The neuro have great ratings and I found many local people who he did surgery on and they were very happy with him.

    Don't get too hung up on the #1 in the country either. These comments make me laugh. I've read posts from people all over the country who had "the best" surgeon in the country. Funny, that guy must travel and lot and be busy as hell... =))

    When you talked to the 2nd one. If you're still concerned then go see a 3rd one. After that sit down and write down the pros and cons of doing it and not doing it. Then one for the 3 surgeons. Ultimately you decide and move forward with it. Be careful and then stick to your guns. No living with regrets after and whining. This site is sadly got too many on here that are failures. They are NOT the majority. Do what you need to do for you.

    Good Luck

    I will update my surgery post so you can find it on this page. It is for an AxiaLIF at L5-S1. Read it if you get chance. It's like a diary in a way. You'll find that people are successful.

  • Dear wahini202,

    If you don't mind me asking, how long ago did you have your spinal fusion done and how active are you today? Can you still play volleyball? My neurosurgeon didn't even mention spinal fusion as an option. My MRI from a month-and-a-half ago shows that my L4-L5 disc has lost a lot of height from the herniation, but the neurosurgeon said a discectomy is all that is needed at this point, although spinal fusion will be inevitable in the future. It kind of makes me wonder if I should just get the spinal fusion now and be done with it or if I should buy myself some time (if I'm lucky, into my 40s) by trying to keep what's left of the damaged disc. Also, did your diagnosis after the larger herniation include any impingement on the cauda equina nerves?

    With kind regards,

  • Dear wahini202,

    If you don't mind me asking, how long ago did you have your spinal fusion done and how active are you today? Can you still play volleyball? My neurosurgeon didn't even mention spinal fusion as an option. My MRI from a month-and-a-half ago shows that my L4-L5 disc has lost a lot of height from the herniation, but the neurosurgeon said a discectomy is all that is needed at this point, although spinal fusion will be inevitable in the future. It kind of makes me wonder if I should just get the spinal fusion now and be done with it or if I should buy myself some time (if I'm lucky, into my 40s) by trying to keep what's left of the damaged disc. Also, did your diagnosis after the larger herniation include any impingement on the cauda equina nerves?

    With kind regards,

  • Dear babybubbles,

    Thank you for all the information. Yes, I will be getting a second opinion. I mostly want to know the medical reason for why my symptoms have subsided so quickly and also to find a neurosurgeon that I trust enough to do the surgery and provide post-operative care as needed, if indeed surgery is the most effective treatment option for me right now. The one thing that concerns me is that my herniation is, in fact, within the cauda equina zone, so although there is no impingement at the moment, the neurosurgeon was concerned that if the herniation extruded further into the cauda equina area, it COULD impinge the nerves, thereby leading to cauda equina syndrome. The chances of that happening might be slight, but what I'm having to weigh right now is a nearly identical healing period no matter what I do, but the potential consequences would be 1) reherniation or possibly other pain-related complications following a discectomy vs. 2) the development of cauda equina syndrome if something happened to worsen the herniation. When I look at those two options, it seems like the lesser of two evils is the discectomy, but I'll wait to hear from the second neurosurgeon before I make a final decision. Believe me, I would love to hear that my condition could be treated conservatively, and I would even be willing to get quarterly or at least six-month MRIs to see if the herniation is, in fact, being resorbed or is receding. It just seems like a big risk to wait that long. I only know of one person who made a full recovery from cauda equina syndrome when he was 20 years old, and he had to relearn to walk. It's a frightening prospect. Any additional insight you might have is obviously very welcomed right now. I have to call my insurance company tomorrow to find out the process for getting a referral for another neurosurgical consultation, but I'm hoping that I can get in very soon so I can make a final decision on surgery before Christmas.

    With kind regards,

  • I had my fusion (L4-S1) done two years ago. The initial injury is unknown because I developed pain overtime before I found out that I had a 4mm herniation at the L4-5. At that time surgery was ruled out on all levels and PT was the course of action. They did some traction and some core stuff for about 4-5 months. I did get relief but as I stated before it was when I twisted to my left that I knew something was seriously wrong. Literally, it was like my symptoms nearly vanished. I had a few moments that it would hitch but I had minimal pain until I twisted to the left that one day. That was all it took. From that first MRI to the next it was only 7 months and the damage wasn't just the extent of the hernation, now at 1.3cm, it was that my L5-S1 were also compromised as my L4 was simply crushing it. There was also some discussion about having DDD (degenerative disc disease) because the origin of the injury was unknown.

    I had nerve testing done as well as having the MRI. The nerve tests showed that I didn't have any major nerve damage to the S1 root (this is where my hernation was the most prominant). I had drop foot, however, so the extent of any nerve damage done to the foot was unknown and would be until the hernation was removed.

    When I saw my Nuero for the first time he looked over my stuff for like twenty minute and came back with, "You need a fusion."

    I'd done enough searching at this point to ask him about the disectomy and a few other options. His response was the same each time. Fusion. Fusion. Fusion. The reason he said I shouldn't have a disecetomy was that in his experience the disc would rupture again and by that time there would be scar tissue to contend with on top of having to go ahead and do a fusion. He wasn't against them for all patients, but in my circumstance and as my vertebrae lost their height, it was obvious my discs were unstable enough to do a disectomy. It wasn't going to reabsorb and my L3 could be compromised if I waited too long. Everything I asked, he explained and did in such a manner that I knew the fusion was the only option I (personally) had. 1 month later I had the fusion done. He would have done a disectomy had I asked for one, but I understood that my vertebrae were collapsing and that a fusion was the only way to keep them apart and remove the herniation. I was confident that a fusion was my best option at keeping my back healthy as I got older.

    Additionally, I had donor bone so I didn't have it taken from my hip and the surgery was done through my back and not the front. The donor bone fused perfectly.

    No, thankfully the hernation was not in the Cauda Equina. It was in the S1 nerve root area, so I had wicked bad sciatica, numbness in my left leg and no use of my foot. I do have full use of it now, and 1 numb patch across the top of my foot. It has a weird tendency to cramp from time to time but, hey, that's better than having floppy foot.

    My activity level now is remotely what it was. I can play volleyball, but I guess the only way to describe this is that...I know my body's limitations and it's new "normal". I know that I can't bend or dive a certain way, so I don't. It really hasn't upset much in my daily activites. I am mostly pain free, with a dull ache because I have metal in my back on colder days or after prolonged sitting. I think sitting is the hardest thing even still. I've traveled on planes, done road trips, gone to Disney World, been boogie boarding at the beach. The hardest thing is sitting for too long, but a ten minute stand and walk or stretch does the trick.

    An aquaintance of mine had the exact same herniation levels from L4 to S1. She had a disectomy done by a surgeon and when she had lingering pain she went to my surgeon and he performed a fusion. She is pain free today as well (our surgeries were about six months apart). Amber always said she wished she'd had the fusion done first because she did lose disc height from letting it linger.

    As you know, it varies from person to person. Ask questions and do your research. Find a doctor you trust and make yourself well informed. For me, personally, the fusion was the only thing that made sense for my long term health. I had an MRI done recently and my L3 is very healthy as is the rest of my lumbar. The report showed that I didn't have DDD afterall, and my back is strong.

    I hope this helps, keep us updated. If you need or want to ask me anything I'll be checking in :) Best of luck going forward.

  • I didn't want to take a conservative wait and see approach. I did that with my first round of physical therapy.

    I wanted it fixed.

    I never made an irrational decsion about my back. I made an informed one with a surgeon I trusted who gave it to me straight. The morning of my surgery, while waiting to go back, I was joking with the staff and watched the Price is Right. I had minimal anxiety because I was that sure. Do what's best for you. You sound very well informed as is, and I'm sure you'll make the best decision for your back going forward.

    Again feel free to ask me anything and hope you've had a good weekend!
  • Hey Graham,

    Thanks, again, for all the information and advice you offered earlier when I was searching for nonsurgical options for my herniated disc. I'm going in for surgery on January 4, 2012. I got the second opinion, and this time, fortunately, it didn't take 5 weeks to get an appointment. The second neurosurgeon was baffled as to why I wasn't in pain and had really good mobility in spite of the large herniation on my MRI from October. He ordered a new MRI, which showed that the herniation was still just as large, but apparently it wasn't pressing that hard on my sciatic nerve anymore. The neurological deficit in my left foot, however, has gotten a little worse (more numbness and weakness), so we were all in agreement that I needed to get the microdiscectomy. The neurosurgeon doesn't think the numbness and weakness in my leg will be permanent since it has only been a little over 2 months since the initial injury, but no one can ever tell. I'm at peace with the decision, happy to get the ball rolling toward a substantive recovery, my bosses and colleagues are all working with me on the recovery schedule, and I really trust this neurosurgical team, which is a lot more than I can say about the first neurosurgeon I consulted.

    I'll try to remember to post following the surgery, ESPECIALLY if it's a success. I completely agree with you that most people post when they have ongoing problems, partly to find answers and partly to offer support to others. The success stories, however, are conspicuously missing. When you're healthy, you move on with life. I'll keep everyone posted, and hopefully I'll be one of the success stories.

    Have a great Christmas and New Year's.

  • My brother-in-law is about 33 and had a large lumbar herniation. They initially thought his intermittent numbness and severe sciatica and back pain were something that PT could handle. He started physical therapy and it started to help but then things got worse. His PT was wise and sent him back to the Dr. for MRI.

    He had a severe herniation (not sure how big) but they said they would try the shots (ESI?) but that he was likely going to have to live with the pain or choose Microdiscectomy.

    He got the first shot and it helped for a few days. When he was allowed, he got a 2nd shot. He was good for 2 days, woke up and moved...and ended up in the eR. We though for SURE he was going to need surgery but nope. I guess after being so tense, his back finally took to the shot and his muscles just locked.

    Since the ER visit with some morphine and the 2nd shot of ESI...he's good as new. Seriously! I'm a bit jealous to be honest but so happy for him.
  • I had a microdiscectomy at l4 l5 four years ago and I am glad to report I am 100% recovered. I injured my back in childbirth and had it fixed when my son was 6 months old. He is now 4 and a half and I have gone on to have another baby, experiencing no more back plain than a normal pregnancy. My youngest is almost 2, and I am still pain free and regularly run, cycle and do pilates.

    My surgery wasn't really optional, I had been in severe constant pain for 6 months, had trouble walking and had lost muscle and function down my left leg. The ruptured disc was tangled in the sciatic nerve and took the surgeon a while to remove all the fragments. I knew when I came round from the anaesthetic that my nerve pain had gone, it just felt like I had been kicked in the back really hard a few times.

    The recovery was straight forward, 2 weeks at my parents place then back home being a full time mother to my baby and toddler. I did have some pain on the opposite side to my injury that took a few months to settle, but didnt need pain medication after leaving the hospital. I think part of that was because I hadn't taken any prior to the surgery as I was nursing the baby, and once the nerve pain was gone it seemed easy to cope with the post op pain, although I know not everyone gets that effect.

    I check spine health now and again to give some positive feedback, I a very lucky to have got such a good result, not sure why I have recovered so well when not everyone does. I would say I am careful with my back, I have given up skiing and contact sports but it's a tiny price to pay for a good quality of life.

    Merry Christmas and good luck with your situation.


    Ps - it was a neurosurgeon that did my op, the worst part was having the 10 staples out afterwards, that hurt a lot.
  • I'm glad that your brother-in-law was able to heal without surgery. I was wondering if epidural shots would be an option for me, but my herniation is so large (1 cm out, 1.9 cm cranial migration) and the numbness and muscle loss in my left foot are so constant (and getting progressively worse) that surgery is my only option to avoid the potential for permanent nerve damage. If the numbness and muscle loss weren't there, I wouldn't even bother with surgery since I don't have any sciatica pain whatsoever. I was really careful in the first couple of months after the injury and managed to eliminate the pain altogether and get off of pain medication completely. I'm just looking forward to getting back to normal, even if it occurs slowly.
  • Hi Cheeka,

    Your story is very encouraging. Like you were before the surgery, I too am not on any pain medication, but I'm also not in any pain. It's just the numbness and muscle loss that's concerning everyone at this point. It's a huge herniation (1 cm out, 1.9 cm cranial migration), and since the numbness and muscle loss are getting progressively worse, there's a real potential for permanent nerve damage if I don't get the nerve roots freed up soon. I had a lot of pain in the beginning, but I did a lot of research on my condition and managed to eliminate the pain completely and get off of pain medication. I'm hoping that I won't need much (if any) pain medication post-op. We'll see. It's good to know that you're still active after the surgery. I lead a pretty active lifestyle as well. Of course, I know there will be certain physical sacrifices, and I will have to be much more mindful of body mechanics when I exercise, but I'm looking forward to the healing process and getting back to normal. Thanks so much for posting your story.
  • As promised, I am returning to the forum to give an update post-surgery. I had the L4-L5 microdiscectomy on January 4, 2012. I am now 3 weeks post-op, and so far, so good. I had a very large and somewhat complicated herniation, and the surgery took 2 hours to complete. After waking up from the anesthesia I passed all the discharge tests quickly (ability to urinate, stand, walk), so I was discharged only about 1.5-2 hours after the surgery (I was originally told that I might be held up to 23 hours for post-surgical observation). I had a very brief episode of bilateral sciatica when I got dressed to go home, but other than that, I had no significant pain and I still don't. However, in spite of my massive herniation, I never had much pain before I had the surgery. The main problem was the muscle weakness and numbness in my left leg, both of which are still present. My left leg is getting stronger (I think), but the numbness has actually been worse. I contacted the neurosurgeon and he said that an increase in numbness is common after surgery since the nerves are inflamed, especially in my case: The herniation was tangled in the nerve roots, so the surgeon had to "tug" on the nerves to free them up. I'm getting a little concerned that the numbness may take a very long time to subside, if at all, but I am thankful that it doesn't affect my ability to walk. I've been asked to be virtually immobile for six weeks, which has been very hard to do. I've transformed my bed into a work station--it's not ideal, but at least I can get something done during the day. My neurosurgeon is very conservative with his post-op treatment and only wants me walking 10-15 minutes at a time now, even though I feel well enough to walk for much longer. That said, I probably walked a little too much yesterday, because today I feel some tightness along the sciatic nerve line of my right leg. I wouldn't quite call it pain, but it isn't especially comfortable either. Therefore, I'm resting a lot more today and will probably do the same tomorrow. I need to return to work at the 6-week mark, so I feel like I need to increase my stamina for walking and standing, but it's a balancing act. If I walk too much, the nerves get irritated and I start to feel a little bit of sciatica. Any recommendations? The surgery was apparently a success, and the neurosurgeon said that my body had already sealed off the point of the herniation, although he also noted that there was some scar tissue building up around the nerve root due to the herniation rubbing against the nerve for a couple of months. If anyone out there has any advice on post-op recovery, let me know. I think everything is going well, but I'm always open to suggestions.
  • As someone who has had two microdiscectomies on my L5-S1 disc. Yes the numbness can take time to go away. If it isn't making it hard to walk then I wouldn't worry about it too much. When I had my first microdisectomy I had severe muscle weakness in my left calf muscle before the surgery. I could barely walk. Had a really bad limp without the ability to use my calf muscle. And my left foot burned like fire but a lot of the pain had subsided after taking methylprednasalone which is a steroid anti-inflammitory and I was left with muscle weakness like you.

    Immediately after the microdiscectomy I gained the use of my left calf muscle again. I still had numbness in my foot when I would walk for up to a year. It did go away after about a year. It was not extreme. So yes the numbness can last a while. It takes time for the nerves to heal after being compressed like that. Just be very careful and follow the doctors orders. You don't want to herniate again. You'll always have to be careful with your back. The hole where the disc herniated is not as strong as it once was. It's just scar tissue there now and it can herniate at the same spot again. I am not trying to scare you but I just wanted to point out the importance of following the doctors orders after surgery.
  • Hi Jessica,

    Your original response to my post was back in November, so you should be a few months post-op by now. I just wanted to see how you're doing, if your numbness and/or muscle weakness have dissipated, and whether you've been able to resume normal activities. I went ahead and had the microdiscectomy on Jan. 4, so I am now a little over 3 weeks post-op. Since I had managed to alleviate most of my major symptoms before I had the surgery, I haven't felt a radical difference after the surgery. In fact, I have more numbness in my left foot and it doesn't appear to be subsiding. The doctors have told me not to worry about it and that my body would likely take care of the numbness in time. I'm not in any pain, although if I cough, sneeze, or sometimes move a little off axis, I can feel a mild sensation (I wouldn't quite call it pain) running down the sciatic nerve of my right leg. I'm sure my nerves are still inflamed from the surgery, so it will take a while for everything to settle down. I have to go back to work at week 6, so I've been trying to walk a little more lately, even though my doctors want me to stay in bed most of the time. I can't go back to work cold-turkey without having built up my stamina for standing and walking, so I'm trying to take it easy. I was curious to know if you've gone back to work yet and how your stamina has been after surgery.

    All the best,

  • Dear mchell6789,

    Thanks for your response. Yes, I'm trying to follow my neurosurgeon's post-op orders as closely as possible, with the exception that I'm probably walking a little more each day than he would like, but it will be a disaster if I show up to work at week 6 post-op with no stamina for standing or walking around the office. I start PT after 6 weeks, so hopefully that will assist my stamina a little more. You're right about the numbness. It doesn't bother me that much, although I was hoping to see improvement by now. I crushed my left foot in an industrial accident when I was 18 and I was left without feeling on the top of my foot for 5 years, so I know how long it can take nerve damage to heal. As long as it doesn't affect my ability to walk or my balance, then it's not that big of a deal. I do, however, wish that I could get the weird skin-creep/burning sensation that occasionally flares up in my pinky toe to stop, but I suspect that it's a by-product of nerve inflammation and will subside over time. It happens when I'm completely at rest, so I don't think it's sciatica per se. I'm sure the neurosurgeon could prescribe something like Neurontin for it, but I don't think it's severe enough to warrant medication. Along with the pinky-toe peculiarities, I sometimes get "twitchy" legs at night (restless legs syndrome, perhaps, but it's more uncontrolled twitching of my left foot). It doesn't happen a lot, but when it does, I just chalk it up to the nerves healing--hell, at least my brain's sending a signal down there!

    All the best,

  • That's true at least your brain is sending a signal down there ;) Yes Neurontin works really well for nerve issues. I took it for about a month after my second microdiscectomy and it really helped a lot. And yes PT will help a lot. As soon as I started PT my leg issues really decreased. I had this pain in the back of my left leg that actually went away within just a couple sessions of doing PT. I have continued to do PT exercises for the last 4 years. I cut back on some of them but am starting to do more again. The PT printed out all of my exercises so I have them at home still.
  • Hi Nathan,

    What kind of work do you do? If you have a desk job I would think you could stand or sit at your desk after being off work for 6 weeks. If you have a more physical job then yes obviously you'd need to build up some strength. Why does your doc want you in bed that much? Mine wants me moving around and taking lots of small walks throughout the day. (I had a microdiscectomy for a 1 cm herniation at L4L5 on 1/27.)

    I am off work for three weeks and then I go back to a desk job. Take care, and hope the healing goes well.
  • Hi Granadilla,

    I'm a graduate student/researcher. My job mostly entails lecturing for undergraduate classes, sitting for reading and writing/typing, and researching in museums, so there's nothing too strenuous involved, unless you count carrying heavy loads of books, which I don't do anymore. My neurosurgeon has a reputation for being very conservative with his approach to post-op recovery. He doesn't like his patients doing much until the six-week mark. I understand his hesitancy--it significantly reduces the risk of reherniation during that critical window when the body is building scar tissue. However, it's not very realistic for people who have to go back to work. From the research I've done online, six weeks is fairly standard for a microdiscectomy recovery period, so it surprises me that your doctor has prescribed such a short recovery time. I'm sure every case is different, but I had a bit of a complicated herniation. As for getting out and around, I can definitely tell a difference in how my back feels when I sit for too long. I went out with friends last night for dinner. Although I tried to get up occasionally to stretch and relieve pressure on my lumbar spine, I noticed later in the evening that I was getting mild sciatica again. The same thing happens if I walk too much. I also get tired easily. That's the stamina part I was talking about. I know it will get better, but I've been asked to walk for only 10-15 minutes at a time. I'll be walking a lot more than that when I head back to work full-time in two weeks, which is why I've been pushing my walks to more like 30 minutes at a time, sometimes longer. I've also been told that once I start physical therapy, that will greatly increase my stamina.

    All the best,

  • I live in Los Angeles and when I was researching surgeons and recovery recommendations, they all seemed much the same. They all stressed exercise as a way to help heal (minor amounts of exercise, not walking miles and miles each day). So far I've only been walking around the apartment or a tiny bit outdoors. I'm hoping to walk all the way down the block and back by the end of the week. :) It's the little things.

    I'm not allowed to sit for more than 10 minutes at a time so I haven't gone out with friends. I'll sit and eat a quick meal then stand up or walk around or lie down again. My op was 4 days ago and I'm already ancy and wanting to do more. It's going to be hard to keep from bending, lifting, twisting in the upcoming weeks. I start PT after 4 weeks if all goes well.

    Be careful not to overdo in the next two weeks before you go back to work!
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