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12 weeks of conservative care for L4-L5 herniation & bulge @ L5-S1

Hey everyone. Great forum. Very active individual..snowboarding, snowmobiling, weight training for years and a coal miner for 17 yrs. Simply bent over to get something small 12 weeks ago and my back went. Spent 2 weeks on my back on pain killers. Did PT for 8 weeks after that. I did chiropractic care for 4 wks 3 times/wk then 4 weeks 2 times/wk. Suppose to start for 4 weeks once/wk. Then that's suppose to be the cure all lol. Well I've been off work for 12 weeks now. I was doing my stretches and exercises..nothing intense what so ever…went to stand up and felt a horrible pain in the low back again. This was 2 days ago. I am now contemplating the next best thing….surgery. Any thoughts and suggestions would be appreciated. I really am not too happy with the thought of back surgery but I have to get back to work one of these days. There are some major scary post surgery stories on here…yikes.


  • hello. i'm sorry you are having pain.
    but did your pain ever improve during these 12 weeks?
    or stayed the same.where are you having the pain?
    have u ever been diagnosed by MRI? and based on what your exercises were given?
    as for my opinion.i think 12 weeks without improvements. something must be wrong.
    and excuse me you cant see in the first phase a PT! it may cause u way more pain during the first weeks of cure.
    exercises, gentle ones will be required. and not a PT!!!.
    for my case, i ve had rest , for 3 weeks already, aqua exercises with swimming, and i have improved up to 70%.
    i hope you know how to cure your case.considering you are avoiding a surgery.unless you had your decision to go for one.
  • Have you had an MRI done? My guess would be "yes"? PT and chiropractic care would be (only) useful if they knew WHAT to work on.

    Yeah don't go do stretches and stuff too fast. My GP told me I had sacroiliac pain and gave me stretches and it just prolonged the symptoms I had of leg pain and back pain. bad bad bad. particularly since I think I have a L4-L5 bulge...whivch isnt even that horrible pain presently.

    I'm totally new to this low back pain thing (age 35), but mine is Slooooowly improving here in week 4. I'll have a while feeling pretty good, then some minor leg discomfort, then shifting to low back only, then fine again. EVERYTHING for me now is a knees-bent lift. No more lazy bending over at the waist to do anything! Then in the last few days my upper/mid back has gotten sore in spots because i am using those muscles more to take up load.

    Yeah there's tons of scary surgery stories on here, it seems like surgery is the last last last ditch thing. Unless you have some situation where nerves are being compressed and lasting pathology could result. I pray I never need surgery. But if I do it would be something I approach like my daugher's heart surgery -- interview multiple surgeons and do tons of research. Then pray some more.
  • Afield and WT thanks for the input. I appreciate it. Yeah I had the MRI. That's what revealed the L4-L5, L5-S1 bulge. The pain management doc said the L4-L5 looked torn and leaking disc liquid onto the nerves. That area was also solid black in the images verses the clear white discs. Interesting though the MRI report said they were bulges…nothing torn. There's definitely nerve issues going on. Like I said it's been 12 weeks from work. Pretty much 12 weeks from anything other than nursing the injury. Very active person so it makes things even worse. I'm pretty much committed to getting the accurascope procedure done. They make a 3mm incision at the base of the sacrum and can go in with the laser and trim discs or bone where the nerves are compressed. Suppose to be a quicker recovery. I just want to fix the issue and get to playing again. It is a hard decision because I was doing a lot better last week and then coming up off the floor from stretches something went again. Can't keep hoping after months and months it will resolve…although it could. Lots of hard decisions and lots of prayer.
  • Just make sure that you do some research into any surgical option . Have you consulted with at least two surgeons? I usually suggest to people that seeing at least one board certified ortho and one neuro spine surgeon is a good idea to make sure that they both are mostly in agreement regarding what needs to be done, and it helps ease your mind as well.
    They are talking about a microdiscectomy? The most important thing about having spine surgery is that you must be willing and able to commit to following the post surgery restrictions and activity levels to the letter or you may as well not do it.......
    Spine surgery isn't like having a knee surgery or an appendix removed......or most any other surgery for that matter.......it isn't a go in and have them fix it and a few days later , you are back to moving around and doing whatever you did before...
    If you do that with spine surgery, you most likely will change the outcome of the surgery. The surgeon can repair what damage is done, however, you have to be willing to make changes to what you did before , how you did it, and in some instances not doing it again, at least not in the near future, while your body recovers and heals.
    The spine is the center of your body, everything depends on your spine......movement, strength, agility, so taking it slow and easy, and following the post op restrictions and excercises is to your benefit and greatly improves the likelihood of a successful surgery outcome.
    Check out the back and neck surgery forums, the recovery forum and the surgical buddy forums, under the treatment section of the forum main page......
  • it depends on how large a tear it is, and of course, how deep it is....in some instances you can see it, in others not . And you may be able to see if the disc material is leaking simply due to the amount of inflammation/irritation and fluid buildup in the area near the tear, if it is large and severe enough .
    In some cases, tiny tears can be seen on MRI but not be deep enough to cause leakage , and others they can be quite shallow, but I think that in order to determine if there is leaking for sure, a discogram is probably the best way to ensure the answer one way or another.
  • Thanks again for the continued input. I do realize surgery of any kind is not a little walk in the park. My pain management doc took me through the MRI images one on one. We looked at the tear and the leakage. It is not too hard to see. He said the disc fluid is similar to battery acid on your nerves. Obviously his terminology of a very painful situation. Like I said above just some difficult decisions to make.

    Sandi…I did check out the post surgery forum. Not something I would want to focus on too much. A lot of horror stories it seems. I prefer not to fill my head with the gloom and doom and misery. I realize it will be challenging…but so has 12 weeks of misery and no work or any other activity I enjoy.
  • Mentioning that u've been through 12 weeks, of conservative care.
    well i don't know i just feel down today, its my 6th week. been doing great for 3 for weeks.and today, i dont know how, went for a walk, as scheduled , for an hour, and had terrible pain, maybe cos i did sit for like 5 to 10mins too.and then turned same as day one, though daily im lying on my back, and having short walks, and swimming.which been doing great.
    i dont know for what reason, honestly. this is happening.is it possible that during the recovery there are simply "BAD DAYS"?
    or is it rolling over and starting from zero.as i'm lying on my back now. i'm not sure when going to swim tonight how it will be.
  • WT....sorry to hear about the misery. No fun at all. I'm use to going full force. This has been unreal. Seems everyone is the expert. I've been off work for 12 wks too so I'm looking to go the next step. And injections....they can keep that masking of the real issue. Good luck WT. I'm sure the experts on here will disagree but I think its a go with your instinct decision. I know there's an issue that needs addressed and its not chiro 3 times per week and PT....been there still doing it.
  • I don't recall anyone calling themselves experts and am not sure why you posted if you didn't want feedback and opinions.
    The members and the moderators do their best to provide new members with accurate information and to support any decision the member makes with their doctors but also to provide caution and advice regarding a patients responsiblity to themselves regarding research and learning about their conditions and treatment options.
    Offending the people who tried to provide advice or caution to you is not what this website is about, so if you don't want advice, don't ask for it.
  • Sandi...not meant to offend. Just took your advice as though what me and my doctor discussed as not the case. There are many variables and I'm aware of that. Just here to see what others are going through not to be told that what happened doesn't happen. Thanks for your help.
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