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Surgery and Consequences

Hi there! I am new so please excuse me if I am posting in the wrong section.

I have a large herniation in L5-S1. I also have a bulge at L4-L5. The pain at first was horrible but after a steroid pack and rest I am feeling much better. I do still have on and off back of thigh pain in my left leg as well as numbness. The calf is much better but tends to get week if I work out on it too much. The left anterior of my foot is slightly numb as well.

I have read so much about different surgical options and am curious which is right. I have read that the surgery is often more effective within that first year but years 4-5 is when simple PT and non surgical options hold out best. I have also read that many times with the disc surgery there is a fusion needed down the road.

I am so confused as to what is what and the difference between. I go to see my spine doctor in a few days but want to be able to know a little of what the options are.

I prefer to give PT a good run and see if I am able to heal. I do think I had a pinched nerve before, about 8 years ago. I had severe sciatica (hard to even stand up or sit in my car) but I never saw a doc about it, just dealt with it and in about 6 months in healed so I know it can happen.

Any thoughts will be greatly appreciated!
Dani Rae


  • SamBSSamB Posts: 1
    edited 09/17/2014 - 4:21 AM
    Hi Danirae,
    I wrote this in general and was just about to post it. It is my first post also and hopefully this is helpful for you. It won't answer questions about surgery, but provides an overview of my recovery through conservative treatment.

    I am recovering from a relatively severe L4/L5 and L5/S1 disc herniation, suffered in early December, 2013. It was a large disc hernation, with a detached fragment, putting pressure on my thecal sac. This was the second time I’d injured my back in this way, the first was in 2002. I recovered without surgery both times and I found this forum to be a great support this last time. As I found on these Boards, every back is different and this is what worked for me.

    During the worst of the pain, the best piece of advice I read on this Board was that “you’ll find the right help at the right time”. I thought I would post my recovery in the event that it helps someone. Background: I am 6’3 male, 32 years old.

    Dec. 2013: Somehow I herniated my L4/L5 and L5/S1 in December 2013 and for the first month, I could not sit at all without getting intense buttocks and sciatic leg pain down my left leg. It radiated to my ankle. Walking was OK, although still a little tough, especially in the morning. I tried 3 sessions with a Chiropractor, but didn’t find that it was a good fit for me, as I was nervous about any spinal manipulations. The traction felt good though.

    Jan. 2014 to Apr. 2014: In early 2014, things changed, such that I could barely walk. I speculate that it was due to a physio session where she loosened up my back, meaning that my muscles weren’t as rigid, placing pressure on the disc (but I am just guessing…). I had trouble walking half a block.

    I went to the doctor and luckily I didn’t have any hard neurological signs, such as foot drop. I was basically unable to stand for anything more than 1 minute, couldn’t walk or pick up my kids. Sleeping was becoming difficult at this time, as I would wake up in pain. I was on a pretty steady stream of Naproxen and Ibuprofen, depending on the day. I ended up needing to take these to sleep and things seemed to be getting worse.

    I would try to do physio exercises, but I had less than zero extension and just about anything caused very, very intense pain. I would just lay back in a lazy-boy recliner and try to manage the pain.

    Apr. 2014 to June 2014: I hit a low point in early April and figured that a microdiscetomy was likely my only option. I got an MRI and this confirmed the severe herniation. I ended up getting a prescription muscle relaxant and I didn’t find it all that helpful, but it did help me sleep.

    However, before resolving to the surgery, I wanted to make sure that I gave physio a final kick. I went to a new physio who had a great approach. He did ultrasound and traction on my back, along with about 15 minutes of “massage”, which often involved him pushing on my discs very gently to loosen them up (I luckily had coverage so I went twice to three times a week).

    We started very gently with the following (try to do 10 to 20 of each, or more):
    • Ball roll outs
    • Hump and hollow while on all fours (very, very helpful)
    • Baby yoga pose
    • Hip flexor, hamstring and quad stretches
    • Lying on my back and rocking with my knees as close to my chest as possible

    At the start, this was all extremely difficult and I could barely do anything. The aim was to get more flexion and extension in the back. After about 3 to 4 weeks of trying to do the exercise 3 to 4 times a day, I was seeing some improved mobility and less pain. I also did lots and lots of swimming, focused on back crawl when front crawl was too painful (3 times a week or so).

    I also dedicated myself to walking, as the only way to gain mobility is through mobility, I think. Another good piece of advice that I read was from someone who suggested that you try to add a half block to your walk every day.

    After about four weeks of this, I was able to add the following to the exercise routine:
    • Sloppy push ups (very difficult to start with)
    • Planking
    • Pirformis stretch

    The key was flexibility in my legs to take pressure off my back. Another key is time, as I think I needed the full 8+ months to recover (and I count myself lucky it happened relatively quickly). I am not sure if this helps, but I also lost about 30+ pounds to get down to 220lbs.

    July 2014 to Now: Things are getting back to normal, where I can pick my kids up, walk, etc. I am still trying to stay limber and have added in some more difficult back stretches, which would have seemed impossible 6 months ago, including “draping”, where I put a back roller under my tailbone and lie for a minute. I am hoping to go running soon and am focused on maintenance of my back right now and pain outside general stiffness is just about non-existent (knock on wood).

    Herniated discs are extremely painful, I read that it would fall as a 7/10 on the pain scale, where a 10 is passing out from so much pain. I also saw a study that said that two years after injury, outcomes for conservative and surgical patients were the same. That’s easy for someone who hasn’t herniated a disc to say, as those two years could be very, very painful.
    So, you’ll find the right treatment, at the right time! Whatever that means for you, keep on working at it, and hopefully the severe issues will become a memory.

    Word of Caution There is not one exercise that is good for everyone. Before anyone tries any of the exercises presented by other members, review it with your doctor. only your doctor can approve or disapprove of a given exercise. While the majority of the exercises presented by members are safe, you should never make that assumption.
  • Thanks for the reply and great to know! I have read that 4-5 years after surgery, the patient who had surgery is in not as good of shape as those who are able to take the time and heal themselves. I had it bad for 6 months at one time and totally recovered and healed. I think I can do it again I just have to be patient. I really am NOT trying to go under the knife if I can avoid it.
    Dani Rae
  • While conservative measures are the goal for almost all patients, in some cases, the herniation can become so large as to obliterate the spinal canal or the spinal nerve roots. In those cases, the only option is to remove the compression of the herniation on the nerves. Leaving it too long, especially in the canal can and will result in permanent damage to the spinal nerves contained in the dura.
    Before undergoing any excercise program or stretches, see the surgeon, go over the images, his exam and his suggestions for treatment. If he feels that it is not risky to post pone surgery, he will not recommend it and will recommend alternative , conservative measures first.....if there is risk to the nerves, he will tell you that surgery is necessary.
  • Thank you Sandi :) I see the spine specialist tomorrow and have a 2nd opinion for the following Friday. I want to see what both say and think about where to go and what do to. I may even seek a 3rd opinion. Its the only spine I've got so I don't want to ruin it for down the road. Good thing I already have my MRI in hand so we know what we are dealing with.

    Fingers cross and prayers up for conservative treatment that works. I am a lucky case that the pain is very manageable, its only after sitting too long that I get a bit of thigh pain in the back of my leg. I do have some numbness in the back of my thigh and anterior of my foot so I am sure that will be monitored for improvement as well. So far, I have been improving slowly but surely. I have to remind myself though that these can take a very long time to heal and not over do it.
    Dani Rae
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