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Herniated Disc Questions

Hey there, folks! I've read a few of the forum posts here, and a number of you have some good input on matters like this.

Let me start at the beginning and give you a little background. I can fill in more details if you need them. I'm a 33 year old male. About 3 years ago I managed to injure myself playing tennis. Lunged sideways for a ball, and had a shooting pain down my right leg. Walking 5 or 6 steps and the pain would shoot down it again. If I concentrated, I could unclench muscles and walk again. I stayed off it for a day or two, and then begin about a 2-3 week recovery, ending with no lingering issues.

A year later, I was sitting on the couch, leaned forward to get up, and bam, same thing. I applied the same treatment and things got better. No issues again.

Now, October of 2013, it recurred, this time while leaning over the sink. Felt nauseas, laid down for a moment, and when I get up, it was back. Applying the same idea as before, I waited a few weeks and it started to go away. Alas, about when it was getting better, it came back.

So, having figured it was more than just a simple issue that would work itself out, I went to see a chiropractor. He did a number of adjustments up and down my spine between mid October and December. After which, he said I was good to go and that all future adjustments would be 'maintenance' visits. I still had some occasional pain in the saddle area, occasional twinges in the right testicle, and the odd 'ghost' feeling in my right leg. Nothing really painful, just obnoxious. He said I would always have degenerative pain, and to get used to it. I didn't believe that was true.

So, I went to see a spine specialist. He prescribed some PT which I started the following day. Two days after that, I felt really nauseas and my neck hurt. I felt miserable, so asked the doctor about it. They gave me some anti-inflammatories and said to go to my general doc to make sure it wasn't a stomach issue. I went to visit them, and it wasn't.

I did get a referral to an orthopedic spine doctor who ordered some MRI's. The neck seemed to be fine, likely the result of a sprain or strain of some kind. That seems to be getting better. The devastating news was that I had a L4/L5 disc herniation. Picture below, that shows right of center spine (I have the rest of the images if it helps).


It's not really bothering me to the point of pain, it just is mildly distracting and the ghost feeling is a little scary. All of it comes and goes, so none of it really seems to stick around permenantly. There's some small discomfort laying down with my back angled upward, or sitting up, but again, it's not awful. Just annoying.

My orthopedic doctor seems to be leaning toward a microdiscectomy, but I'm not sure I really need one since the pain is so minor. But, on the other hand, I don't want to wait 2 years to find out I'll need it anyway, but because I waited so long it's unlikely to help.

So, my questions to you folks are this: What are my conservative treatment options? I'm already seeing a PT guy, but I'd like to make sure he's got me on the right track to deal with this. I'm considering asking him about traction to see if that would help the disc reduce some. I'm also considering talking to a Chiro that specializes in Cox technique as well, and see if that might help. I understand both are a form of decompression therapy, but I'm willing to look elsewhere too. My insurance covers up to 25 chiro visits a year at 10% copay. So the cost isn't too high, so long as the treatment doesn't take more than 25 visits. PT, seems to have no limit.

I'm pretty flexible in what work I can miss to go to PT sessions, and I'm willing to do 4-5 sets of exercises a day (at home) as well as anything I can to avoid surgery. Even though it's a minimally invasive sort of thing, the 3-6 month recovery time sounds awful, never mind the 2 weeks of post-surgery pain. I'm also not sure surgery will leave me better off than I was before, as right now it's not too bad.

That leaves me wondering if I have any further options to help this go away. I'd love to hear some advice, since this is all still very new to me. It's got me a little scared, depressed, and a whole host of other emotions I almost never express.

And lastly, about when should I consider surgery an option? Some people say 'It's never an option unless the pain impacts your life significantly'. I'm not there right now, but I obviously don't want to wait until it won't help any either. Dealing with long recovery times for nerve damage doesn't sound appealing if it can be caught earlier.

My current plan is to hit as much PT, exercise, stretching, and conservative treatment as possible between now and around may. If the symptoms aren't gone by then, perhaps surgery would be an option. I'm not sure if that seems reasonable or not, given the minor impact of the issue, but as I said I'm concerned about long term damage.

Thanks for any advice you can provide. It's very much appreciated. If there's a better forum to post this in, please let me know and I'll either repost or a moderator can feel free to move it.


  • Some people have success with cortisone injections as a conservative treatment.
    Compressed Discs/DDD - L2/L3, L3/L4
    Major Herniation - L4/L5
    Bulging Disc - L5/S1
    "no healthy 24 year old's back should look like this without a major trauma"
    MicroDisc L4/L5 Nov 7, 2013
  • Jessica11 said:
    Some people have success with cortisone injections as a conservative treatment.
    From what I understand, those just mask the pain for an indeterminate amount of time. Since I don't really have much pain (I don't take any NASIDs or anything now), I'm not sure it'd really do much for me. I don't expect a herniated disc to just 'go away', but I have heard of it happening for people. So I'm looking for methods that might help promote that. Surgery seems overkill for this minor of a problem, and I'd rather not hide the pain in case it decides to get worse.
  • LizLiz Posts: 7,832
    Please take the time to read this post and refer to it when you have questions

    I am sure that you will find your time on Spine-Health very rewarding. This site is a powerful and integrated system that is dynamic and growing.
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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
  • dilaurodilauro ConnecticutPosts: 9,839
    edited 01/30/2014 - 3:47 AM
    everyone should exhaust all conservative treatments to see if that can clear up a spinal condition. Its only when all those fail (and perhaps some of them tried more than once) is surgery considered. The decision to have surgery is very personal and is something that you, your family and your doctor need to discuss in details. With every good, there are potential bad things.

    Some of the conservative treatments are geared towards additional diagnostic aids and the objective of all of them is to attempt to 'quite' down a problem...When that does happen, it will give our bodies a better chance to start healing without surgery.

    The classic conservative treatments include:

    • - Physical Therapy
      - Aqua Therapy
      - Massage Therapy (both soft tissue and deep)
      - Ultrasound (by a therapist) Tens (at home by yourself)
      - Special Stretches to address specific problems
      - Acupuncture
      - Spinal Injections
        * ESI Epidurals - steroidal * Trigger Point -lidocaine to numb and relax a troubled spot * Facet
    - Lidocaine Patches
    - Medications (each to address specific areas)

    • + Pain
      + Nerve
      + Muscle

    Personally, I would stay away from chiropractors. Once you have been diagnosed with a spinal problem you should only be treated by those professionals who are experts in dealing with discs and the spinal nerves. Most chiropractors are not trained to that end and could cause serious problems. There are scores of threads here talking about the problems created by chiropractors.

    I am going to put a list of various threads and articles that I think you should read. When you have spinal problems, it is best that you become as educated in the area as the person who is treating you.

    Questions to ask your doctor

    Questions to ask your surgeon before back surgery

    Difference between a Bulging and Herniated disc

    Chronic Pain Treatment - Step by Step

    The Blend

    All about Degenerative Disc Disease

    All about Herniated discs


    And one last one. This will provide you detailed information with all types of treatments

    Spinal Treatments
    Ron DiLauro Spine-Health System Administrator
    I am not a medical professional. I comment on personal experiences
    You can email me at: rdilauro@veritashealth.com
  • dilauro said:
    Some of the conservative treatments are geared towards additional diagnostic aids and the objective of all of them is to attempt to 'quite' down a problem...When that does happen, it will give our bodies a better chance to start healing without surgery.
    I appreciate the response! I've already been to many of those pages myself and read over a number of them in detail.

    I am already seeing a Physical Therapist, but want to find some way to 'grade' him on his work, so that I know he's exploring all of the options. I'm not sure what specific techniques that exist that I should ask about to make sure we're covering all the bases.

    I will look into aqua therapy, massage, ultrasound, tens, and acupuncture. I'm already trying out Yoga to stretch and relax, so hopefully that will have some benefit at some point.

    The others I'm not sure are really options. Like I said in my initial post, I'm not in that much pain. It's very light, only in certain postures, and in general doesn't bother me that much. The concerning part is the occasional 'ghost' feeling in my right leg. It's not a numbness as I can still feel the entire leg. It's just an off sort of feeling.

    I've done some more research today and see that traction and decompression therapy are potential options. I've seen some mixed information on its safety and use. Some people have said it's safe, others have reported worse problems afterwards. Does anyone have any practical experience with these, or know of the risks?

    Lastly, is there anyone out there with a similar situation to mine? No real pain, minor neurological annoyances, and such? Did you consider surgery at all, or would surgery be the 'I can't function any more, I need it' approach? I can't really imagine doing surgery for this, but I also don't want to live with it forever, so I'm hoping that some treatments will eliminate these effects so I can get on with my life.

    Thanks again for all your help!
  • dilaurodilauro ConnecticutPosts: 9,839
    edited 01/30/2014 - 7:45 AM
    can dictate if/when surgery is required. The times when surgery is better sooner than later is when a disc is impinging a spinal nerve root. Left untreated for a while and you risk some permanent nerve damage. After my second lumbar surgery, I procrastinated in terms of the third one. I waited too long and as a result of the disc pressing on the nerve for over 10 months, I have some permanent nerve damage in my right leg below the knee mostly in my right foot so know I have a partial dropped foot. This I could have avoided by having the surgery sooner.

    But as I stated to start this, if you can deal with what you have know and your doctor(s) agree then by all means avoid the surgery.

    In terms of the other devices and treatments. I've been dealing with this for over 35 years now and have tried or witnessed almost every possible device or so called miracle cure for back problems. There AINT any!

    Those decompression units, the DRX9xxx, Belts, Hanging upside down, zero gravity ,etc really do not help. In many ways they are just fancy names or costly devices to do what standard physical therapy traction does. I've had the Lumbar and Thoracic traction dozens of times, plus for years I had my home over the door cervical traction unit. They all work very well until you have been fused.

    Honestly, I dont know many out there that are like you. Not a lotta pain, minor nerve variations,etc. So many people here come in brand new with pain levels of 10+ want surgery tomorrow, but in many cases the diagnostic tests do not validate those actions.

    Continue to research and watch for significant changes in your condition. They could be as minor as a daily headache, to having trouble getting up , stumble a bit or two. Dont get too upset if you experience something like that once, but when it persists, thats when you want to look into some more.

    Ron DiLauro Spine-Health System Administrator
    I am not a medical professional. I comment on personal experiences
    You can email me at: rdilauro@veritashealth.com
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