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I'm writing this because I know that somewhere out there, there is another person who will go through the same experience as me, and I want to reassure them that there is hope of recovery, but that it may take a long time.
Background - At the time, 24 year old male in good shape, ran several times a week and lifted. I fell on my back twice, and bad stuff ensued. Only a few days after falling on my back the second time, I began to go numb in most of the lower part of my right leg and part of my left leg. I had foot drop on the right side, and numbness in my right calf. Most of my pain, which was pretty intense, was on my right side. Diagnosed as L4-L5, L5-S1 herniation with severe spinal stenosis at both levels. Had L4-L5, L5-S1 discectomy and right sided hemilaminectomy about 2 weeks after the accident, in August 2010.
Immediate Post-Op - The feeling didn't come back when I woke up. I had foot drop for about a month and a half after the operation. I found walking or standing for even 10 minutes would send zings down my left side to my shin (as opposed to the right side pre-op). In addition to the left-sided sciatica, I had pretty severe lower left back pain which would come on after 10 or 20 minutes of standing or walking.
Further Post-Op - I started doing PT about a month and a half after the operation. It made me feel much less stiff, but didn't relieve much of the back or leg pain. Stretching my hamstrings, quads, and calfs felt good, but it just didn't seem to be helping. And while the exercises they gave me also felt good, they didn't pay dividends in pain relief. This went on for several months, until January 2011. So basically, from the operation until 5 months later (yes, 5 months), I didn't see a significant drop in pain. Yes, I could walk a bit further and stand a bit longer, but not by much. Standing was the worst. I had to take the bus to work, which entailed standing for about 15 minutes. And that was impossible, absolutely impossible. My lower back and leg began to hurt within a few minutes of standing still. I found that the only way I could manage to get a seat on the bus daily was to walk the opposite way toward the bus so that I could get on at an earlier stop. In retrospect, that was a pretty desperate move. Simultaneously with the PT, I was trying to swim frequently. At first it was just really easy breaststroke, which after a month or two progressed into some really easy freestyle, all in a heated pool. While I was swimming, I felt great, but as soon as I got out of the pool, the pain came on even faster.
Second MRI - Because things were progressing so slowly, I had a post-op MRI done. Everything looked fine except for facet arthropathy at L4, L5, S1. Keep that in mind. No re-herniations, which surprised my doc considering my sciatica.
Post-MRI: My insurance stopped covering PT after January. It made me sad and anxious. I continued doing the exercises they had recommended, and was stretching every single morning (yes, every single morning). I was loose, but not pain free. Around January, I went back to an osteopath I had seen right before my operation. He worked on my back, cracked it, and I felt an enormous release from pain. He had cracked precisely the spot in my lower back which had been hurting. He had released a stuck facet joint, and wow, it felt amazing. It felt so good, it made me laugh as a reflex. This was my first hint that manipulation could help. A few weeks later I started seeing a chiropractor, who told me I had facet syndrome (swollen facets), and that he could help. I went to him once a week for three weeks. While I felt really great right after the manipulations, they didnt have any lasting pain relief past the first few minutes, at least nothing I could really notice. But then, after those three weeks, I found that my lower left back pain had decreased significantly. The leg pain was still there, but by golly, the back was a lot better. That progressed for a while, and by about February or March, I would say I was facet pain free.
But, the leg pain was still there, and because my back pain was gone the leg pain just grew to occupy my mind that much more. I still couldn't stand (10/15 minutes) or walk (one hour) for that long because the leg pain would come on. After a great deal of consultation and thought, I decided that what I was sufferring was probably SI joint inflammation on the left side which irritated a sciatic nerve. I saw 2 more PTs about this, who gave me a bunch of exercises to do. Some of them worked, some of them didn't. Looking back on it, some of the exercises which targeted my hips caused my pain to increase then, but as I kept doing them, the resulting pain went away and my hips got stronger. Right around August 2011, I found that I could stand with minimal pain again. That meant that if I stood still for a while, the leg pain would come on, but it would go away. And it wouldn't be very intense. That was ONE YEAR POST-OP. It's not October, one year two months post-op, and I just went to my first concert since my fall. I stood for a few hours, during which I felt a zing maybe three or four times for a few seconds. That's pretty good, and I hope that I will continue to improve from here.
I want to give people the advice that I wish I had heard from someone, so here it is (sorry for the length):
1. Diagnosis. If you have symptoms like mine (leg pain on the opposite side post-op, lower left back pain, and notoriously tight hips in my case), suggest to your medical professional of choice that it might be SI joint pain. The SI joint can cause sciatica, or so they tell me. Strengthen your hips and stretch them, don't ignore them.
2. When you go to PT, ask them about stretching with a towel under your back. I did piriformis stretches on my back for four months without realizing that the entire time, I was flexing (curving) my lower back so that I could get the stretch. This was bad for my discs, and made the stretch less effective. It probably also made by SI symptoms much worse. Solution: fold a towel, put it under your back right below your belly button. This forces your back to extend (as if you were standing very straight), and then the stretch works much better. DISCLAIMER: I'm not a medical professional, this is not meant as medical advice, but rather as something to ask your own medical professional about. It worked for me, it may be terrible for you, I don't know. But please do ask. I learned the technique at yoga, and I have to say that the towel probably had the single greatest impact on improving my flexibility of anything I did. It is so effective, you would not believe it.
3. This is a mental battle you are about to undertake in your recovery. Talk to people, let friends know you need help. The good ones will reach out and talk to you. Honestly, consider springing for a therapist once in a while. I didn't have one, but I wish I did. Remember that you will have many, many dark days. Keep a blog about them, so that when you get to the next, you can look back at the last and witness your progress. I kept an excel spreadsheet of how my back pain was daily, including detailed comments, 0-10 rating of pain, and logs of activities (walking/swimming/biking) I did that day.
4. Chiropractic/Osteopathic Medicine: These helped me a lot. They may/may not help you. They may make you even worse, I don't know. But ask someone about them, like your surgeon. If you get the thumbs up, give it a try. I would say wait a few months post-op before you go, because manipulation is pretty dangerous if you haven't healed enough.
5. If you have SI pain, do the bird-dog exercise. Do it every morning. Seriously. I started doing it again every morning about 9 months post-op, and felt a pretty significant difference a week after I started doing it. I learned about it at PT 3 months post-op and did it on/off for a while, but it really only had an impact once I did it every day. I do 30 reps on each side. You should be fatigued by the end. Make sure you have good form, don't twist your back.
6. Swimming. Once I figured out how to strengthen my hips during swimming, I felt like I derived much more benefit. I realized my kicking was really weak, so I started using a kickboard. It was nearly impossible to do a single length because my hips were so weak. Now it's not, my hips feel stronger, and I have less back pain. The first few times I used a kickboard, it hurt quite a lot after I got out of the pool. But then, it started going down. If things hurt, don't be deterred, but BE CAREFUL. You have to know when to push yourself and when to bow out.
7. If you take ibuprofen, take it consistently for a week. Don't take it when you're in pain, take it constantly. I did 400 mg 3 times a day.
8. Spend your newfound time (no longer spent going out) learning how to do something. I wrote a story. It was incredibly cathartic, and looking back on it, I never would have been able to write the way I did if I wasn't going through so much.
9. Keep a detailed log of your progress. I made an excel spreadsheet where each day I entered pain level on a 1-10 scale, how much I walked, swam, biked, and then a comments section where I left details on how long it took pain to come on, exactly where the pain is, etc. You may not realize it now, but pain is impossible to recall retrospectively. You may think the pain is unforgettable, but after a month, you won't remember whether that pain on the outside of your knee just below the kneecap is new, or whether it is actually just some old thing you've always had. Write stuff down. Keep a blog too. On the especially dark days during flareups, take a look at it. Use Excel to make a plot of pain vs. time. Know what you'll find? There is probably a steady downtrend, but interspersed are little peaks of pain where your flareups happened. Get it in your head that flareups are transient and that you'll get past them.
10. In the beginning, keep your back warm. I always wore an extra layer and spent 20 bucks on a heating pad. Great idea. After a while, you'll probably find that you won't need the heating pad. It took me a while (maybe 8 or 9 months) to get to that point though.
11. Do planks for your abs. They are so good for you. If you hurt your back, your abs aren't strong enough. I had strong abs. But they weren't strong enough. So strengthen them. Shoot for 3x a week. Enough said.
12. This is the last thing. STOP LOOKING AT FORUMS LIKE THIS ONE. When I was bedridden for two months, I was a hawk on sites like this. Believe me, they only bring you down. Stop looking for people in situations similar to your own. Most of the stories you read are not representative of your own recovery. How did I learn to stop reading sites like this one? I came across a story about a man who was in absolutely perpetual, constant pain for the last five years. No position would relieve his pain. He wrote three pages about it. I'm sure he wasn't lying. But that isn't me, and it probably isn't you. When I read that story, I knew reading this stuff was absolutely ridiculous. Let this be the last post you read.
Remember, healing your back takes time. Mine isn't done healing yet. Over a year out of my surgery, and I still feel like I am getting better and better. Let that encourage you. Now go and do some planks.
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