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Extruding L5/S1 Disc Just Discovered After 3 Years

I'm looking for nonsurgical options for a large and broad extruding L5/S1 and protruding L4/L5. Here's my story:

I'm 26 years old and in good shape (although I sit at a desk all day long - for the past several years)... I was very active until 1 month ago, playing aggressive sports (e.g., ultimate frisbee, racquetball, basketball and flag football) through what I thought was just chronic back pain. Being active didn't cause any more pain, at least not during the activity. I was just more tight afterwards. I have been to chiropractors since the age of 14, ranging from three times a week to the occasional adjustment. I went to physical therapy once. Throughout my years of chiropractic adjustments and physical therapy I was never asked about an MRI or recommended to get an MRI. As I said, I thought it was chronic as I've always had issues, but my mobility has been even worse over the past three years (ever since a football related injury that I thought was a pulled back muscle).

Two months ago I decided I wanted to get an MRI, just to see if there was something more. Turns out I've had an rather large and broad extruding L5/S1 for at least three years, and that football injury was actually the rupturing of the disc (hyper extended my back). I likely had bulging discs that never healed and then the L5/S1 ruptured (l4/l5 is still protruding)... this would explain the chronic low back pain and the related nerve pain. Both discs are degenerative. First opinion was to either do surgery right away or get a cortisone injection and it would likely heal within 6 months... they didn't listen to me when I said I haven't recently injured my back and that it has been 3 years at least. Second opinion was to do 600 mg of ibuprofen 3x a day rather than cortisone and to avoid surgery at all costs... although the second opinion also clarified that it would never actually heal. He gave no indication that the material could be reabsorbed but rather indicated that the inflammation could go down and mobility/strength regained. He also recommended yoga and no running for 30 days.

I am having a really hard time understanding what the right balance between rest, stretching, and exercise is. I am constantly working on my house (i.e., bending over, squatting, etc.) and I sit all day at work, but I have stopped all forms of exercise other than targeted stretching... so far I have no noticeable improvement. I'm still really confused with what to expect down the road. I want to be able to run, play sports, etc. as I'm still young, but not seeing any improvement over a couple of months has me discouraged. Am I being impatient or am I still doing too much moving/sitting/bending, etc.? Should I just go with surgery? The second opinion I got indicated it would never heal but would be "better." So if I regain my mobility and strength and get the inflammation down, am I just going to reinjure it when I start being active again? If I can never be active I might as well do surgery now.

Any success stories or advice related to several years with an untreated or unrecognized extruding disc? Should I move on to PT or is it too soon? I don't have much confidence in anyone as I was never told to get an MRI or asked if I had an MRI by my PT or one of the five chiropractors I've been to over the last ten years. Each time I would explain the history and was always discouraged to have no improvement or clear solution offered.

Thank you for your help!


  • LizLiz Posts: 7,832
    edited 09/05/2013 - 9:04 PM
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    Liz, Spine-health Moderator

    Spinal stenosis since 1995
    Lumber decompression surgery S1 L5-L3[1996]
    Cervical stenosis, so far avoided surgery
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