Not new to Spine-Health but have never posted. I wanted to get a post going seeking your thoughts. The Facts: 25 years old, healthy other than back issues, formerly varsity level tennis player and more recently trained as a heavy weight (205 lbs) powerlifting and doing Muy Thai plus Brazilian Jujitsu ~4 hours daily hard exercise starting in 2011 and ending fall 2103. In 2012 I started physical therapy for what I thought was muscular pains in my back/weak core/ tight leg(s). Small hernaition at L5-S1 detected fall 2013 following intense pain (low back and hips both sides) and sciatica (Right side, glute, hamstring and down to right side of calf. Prior to surgery I completed around a year and half of Physical therapy and 3 rounds of Epidural steroid injections with mixed or fleeting results FYI.
Had microdiscectomy L5-S1 December 2013 which removed ALL symptoms. I desperately wish that was the end of my story.
I started VERY conservative exercise ( no weights ,no bending, no twisting, no running) and 6 months out I started to slowly work up to being able to safely add resistance training to my workouts. The workout I designed consisted of barbell bench press, body-weight pull ups, calf raises, and single leg split squats. I got strong really fast! Really! It all came back quick! I went from my the 165 lbs I had gone to from being inactive up to 190 lbs of lean muscle. I wish this too was the end of my story.
I was feeling great! Back was better than ever and so I added in another leg exercise: pistol squats. They were easy and I thought they would help my balance etc. etc. My legs got strong, and It was a great core workout. I think they slowly started to hurt me however; but I was symptom free and riding high.
In January of 2105, a year from surgery, I re-injured in the gym (but lets not focus on the behavior or cautioning me please). At the bottom of a pistol squat, I suddenly felt intense sciatica and some back pain. It mimicked exactly my prior injury, except the sciatica went much lower; hitting my right big toe like a constant tingling or shock. There was incredible back pain. "I must have re-herniated" I thought in a panic. I experienced the full range of emotion that night.
I went and got an MRI and met with a neurosurgeon two weeks following. It was January 26, 2015 and by then the back pain had subsided completely but the terrible sciatica remained and even increased. A reading of the MRI showed multilevel Degenerative Disc Disease (determined to be non-symptomatic), scar tissue from my previous surgery, and *No Herniation*.
The professional determination was that it may be an annular tear causing sciatica. It is now 4/30/2015 and the sciatica persists in full. Right side sciatica: Tingling and numbness in the toes, a throbbing (top outside right) weakened calf, and a "bite" down the middle of the hamstring. Back gets achy and irritated easily now. Most painful when sitting. After sleeping I wake up with less symptoms rather than more; I know that is a good sign as it was the opposite for me when I had a herniated disc. I am taking baclofen 40mg which takes care of the "bite" in my hamstring, and Gabapentin 2400mg which mildly alleviates sensation of sciatica. One epidural steroid injection did not provide results.
I hope this gives a comprehensive view of my symptoms. It is so frustrating that the diagnosis is unclear.
My question ( and the point to all this) is to ask: What should healthy expectations be regarding an annular tear (unproven- no discogram; but no herniation)? Healing Time? Could the disc heal and there be residual sciatica? What is the likelehood of permanent nerve damage if it is just sciatica from the chemical irritation of an annular tear?
I am 3 months into re-injury and the sciatica seems to be getting worse. Activity is limited as a precaution. I have gone bike riding 4 times and my back/sciatica improved while I was active. Same goes for super light weight lifting such as cautious bench press, pull ups, and bodyweight step-ups but I refuse to do anything else in the gym. The focus is on engaging my core during my workouts and even all through the day.
All responses will be based on members personal experiences and not formal medical advice