I am a 30 year old physically active male with a bulged and/or herniated L4/L5 disk that originally was injured 10 years ago. I have a very specific question about the condition, but need to lay out my history before it will make sense. Skip to the end if you just want to see the question.
2004, Age 20 – Experienced “popping” sensation in lower back while weightlifting in the gym. Massive sharp, electric stabbing pain and inflammation localized in lower back set in over a few hours, mostly immobile for about a week following that. Thought it was muscle related so didn’t do anything for it afterwards. Heals up to about 70% over the following months.
2004-2006 - Since initial injury in 2004, have been experiencing consistent low-level pain in lower back, and some off and on minor burning sensation down into right glute, especially upon waking in the morning. Also experience multiple (4-5x per year) “mini” recurrences - tweaks that cause sharp stabbing pain and inflammation localized to lower back and put me out of commission for 2-3 days at a time, and with reduced activity for weeks following.
2006 – Another episode of bending, lifting at gym causes major recurrence, symptoms same as initial episode – mostly immobile for about a week. See neurosurgeon in Baltimore MD, obtain MRI. Diagnosed herniated L4/L5 disk. Prescribes physical therapy. Attend physical therapy 2x per week for about 2 months - traction, massage, ultrasound, electrical stimulation, core strengthening, etc. Injury heals in same fashion as before – only to about 70%. Physical therapist indicates that because I did not get it treated initially in 2004 it likely was not going to go away completely. Also purchased an at home traction device around this time and used regularly for about six months.
2006-2009 – Persistent low-level pain daily with minor off and on burning in right glute. Pursue aggressive core strengthening, stretching, physical therapy routine on my own. Learn to hip-hinge, support weight with glutes/hamstrings to maintain neutral spine in nearly all movement to protect area. Purposely lose about 20lbs bodyfat to reduce weight that spine has to support. Start cutting out all weight-bearing exercises in the gym. Still experience “mini” recurrences every few months despite strengthening and protection.
2009 – Another major recurrence, worse than initial two. Even with pain meds, mostly immobile for 6 days on living room floor, unable to climb stairs. Heals a little better this time, burning sensation in right glute goes mostly away, optimistic, but still experience mini recurrences every few months.
2010 – Another major recurrence, immobile for about 4 days.
2010-2013 - Continue to experience mini recurrences every few months from sports and mundane movements. Purposely lose another 10lbs of bodyweight to help reduce compression on lower back, and continue with regular core strengthening, physical therapy routine. Now at 195lbs and sub 10% bodyfat so cannot really lose any more weight.
2014 – Major recurrence, playing ping-pong. Sharp, stabbing, electric pain in lower back upon any movement. Minor burning sensation in right glute and down into hamstring upon bending, mostly abates after 5 days of rest. See 2nd neurosurgeon in Pittsburgh, PA. Does not order new MRI's, looks at MRI's from 2006 and tells me that it is a bulging disk (not herniated?) Tells me I have "tall disks, well hydrated - genetically predisposed to this problem" and that without major leg pain symptoms, any type of surgury is just going to make it worse. Basically, don't bother seeing any more doctors until it blows out completely and I start getting leg symptoms and at that point he will be happy to do my surgery.
So, my main questions - Is it normal to have a bulging/herniated disk with little to no leg symptoms? Is my case because its L4/L5 and not L5/S1? In every case, my injury heals back up to about 70% and I am able to resume a mostly normal life albeit no heavy lifting. The doctor said that beyond what I have been doing, there is absolutely nothing else that can be done to fix the problem unless I develp major leg symptoms. I guess this is true and good medical practice, but at the same time I feel skeptical/nervous about the underlying philosophy of "wait until it gets really bad before doing anything".
Anyone else with this type of situation? Does it get better over time? I don't care about the pain anymore, I just want to prevent these major blow outs from occurring every year or two for no reason. Need some support....