Hello everyone - I am a newbie here. I am on the steep part of the learning curve related to what was described to me as a "large rupture at L5/S1". I just saw a neurosurgeon today, and have a TON of questions. First a bit of background - I am sure much of it will be irrelevant - but I gotta start somewhere.
45 yr old male. Very active lifestyle. I love riding and racing motorcycles offroad - and want to be sure I can return to that.
7/19/08 is my date of "injury" though I suspect it was really just the last straw the broke the Mike's back! I have had a lifetime of spinal abuse - going back 18 to 20 years I used to run 50 miles a week, then a time period with lots of backpacking carrying heavy packs in the mountains, and of course MANY MANY miles of off road motorcycle riding, and in more recent years, racing off road. The last straw was a ride on my bicycle - nothing out of the ordinary - but a physical sort of conditioning ride - not a crash off the bike, but shortly after the ride - I could hardly stand. Pain was from hip/buttocks, down thigh, behind knee, into outer calf, outside of foot and in heal. After a few days, the pain eased a bit, but was still pretty bad.
I (Attempted to) ignore it for a few weeks - did a couple more races, pushed much more than I should of. Saw a chiropractor a few times after about 1 month with minor relief, overall was feeling a bit better, but still hurting. I continued to push to hard for about 4 more weeks, pained stepped up significantly. I went for several weeks where I felt lucky to get 3 hours of sleep a night. I finally saw a Doc - did one course of Prednisone - which seemed to help a great deal, and started PT. Doc also referred me to a neurosurgeon , which I finally saw today (a bit of a wait for an appointment). I have now been in PT for about 4 weeks.
I am feeling significantly better day to day. BUT...I am dramatically less active than my norm. I used to walk, hike, ride my mountain bike, ride my dirt bike, work out etc. regularly. I rather actively trained for my races. Now, I am basically inactive - the most exercise I get is 5 minutes on recumbant bike, and the various exercises I do during my PT appointments 3 times a week. Walking - well, sometimes I might manage 200 steps with managable pain, other times, it is only 25 steps before I am hurting. Over the last 2 weeks - I would say on a scale of 1 to 10, max pain level is now maybe a 6 or 7, and basically any time I am sitting still I may have a few hours with no pain, or a pretty low level of pain. Sleeping is at times rough - seems I am generally hurting when I try to sleep and have found I can sleep better on the couch than in bed. I have no clue how I would feel if for example, I headed out for a 5 mile hike in the woods like I used to do. So for me to say I am doing much better, I must note, it is with a reduced "quality of life" as I am not doing the things I love to do.
Onto my appointment with the surgeon today. Mixed bag - hard to really follow him! Initially he was clearly going down the " you need surgery" path (micro discectomy I think?), commenting that I am now almost 16 weeks post injury, and have done the conservative treatment paths I should, and I need to "get it fixed" (he would never say the actual word "surgery".). I commented that I dont necessarily want surgery, but what ever path I take, I want to be sure I can return to my prior level of activity. Suddenly he did a 180, saying I should do 4 more weeks of PT, then see how I am doing. So that is the plan I walked out of his office with.
So, onto my questions! ( about time huh?)
1) Which approach is most likely to allow me to return to my prior level of activity? And so you understand - saying I can no longer ride my dirt bike is not an option!
2) I have read of the steroid injections - should that be considered?
3) I understand the ideal time frame for surgical success is 3 to 6 months post injury. (after exhausting "conservative treatment options") If I do 4 more Weeks PT, to then determine it has not worked and I need surgery, I will be looking at a full 6 months (optimistically) post injury before it is done. Is this really pushing it time line wise?
4) Have I really exhausted conservative treatment options? After this next 4 weeks PT, I would be at 8 weeks PT, 1 course of prednisone, chiropractic care, and 5 months post injury.
Any other bits of advice appreciated!
Thanks in advance.