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Once herniated always herniated?

I'm 38 years old & I can recall having lower back pain for at least 12 years now.  Not sure what I did but about 3 years ago I really tweaked my back & it was the first time that I had imaging done which showed a bad L5-S1 herniation.  Went to a neuro & they went with conservative treatment (PT, pain mgmt, epidurals) & after 3 months the sciatica & lower back pain started to subside & in 6 months I was relatively back to normal.  

Recently I was getting a physical @ my GP & mentioned how I still occasionally have flare ups & he wanted to do imaging since last set was 3 yrs ago.  GP called me w/ latest results that showed a bad L5-S1 herniation & he wants me to go back to my neuro. For the most part I only have 3-5 flare ups a year & otherwise mostly pain free.  When I do have a flare up I'll have some pretty nasty acute pain for 1-2 weeks but then it tapers off & in 2-3 weeks I'm typically back to normal.   By no means do I consider myself a surgical candidate & probably wouldn't be going back to my neuro except my GP is requesting I do.

But my questions... Am I right to assume that once you have a herniation that it's common that it really never goes away??  I'm no Dr. but in my mind my disc is always herniated & retracts/shrinks minimal amounts which is enough to release off the nerve & why I'm pain free most of the time, but then when it's aggravated I get a flare up.  Also are there any issues with having a herniated disc if it's not causing issues, i.e. you're not doing more damage by simply living with it herniated if it's not causing problems??  


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Comments

  • There are reports of people being able to fully heal a disc... from my reading I think that this is only possible in cases where the disc bulges are small. 
    This is because the blood flow in and around the disks is minimal and therefore the healing will be slow. I read a medical paper before saying that the half life of the disc is ~80 years. So there will b some healing but never fully heal. 
    Now also as the nerve gets used to  the disc compression it becomes a little less sensitive and therefore less pain.
  • hvillshhvills Suzhou, ChinaPosts: 971
    edited 10/10/2016 - 7:03 PM

    Mike

    You are correct a herniated disc never really "goes away".  It can be reabsorbed somewhat but it never really "heals" like when you cut your skin.  Lots of people have herniations for years without issue... it's only when the herniation causes instability in your spine or pressure on your nerve roots that it's an issue.   In the case of the nerve roots getting crushed by the herniation it's possible to create permanent nerve damage but you will know this as the pain is horrible.  In my case I waited too long on my second fusion surgery and I now have permanent nerve damage that causes numbness across the bottom surface of my right foot.

    Harry - 65 year old male...
    PLIF L4-L5-S1 due to disc degeneration... May 23, 2013
    PLIF L5-S1 due to failed fusion and broken screw... Jan 19, 2015
    Microdiscectomy, decompression L3-L4 due to herniated disc... Jan 19, 2015
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  • catapamcatapam AustriaPosts: 157
    I had a L5/S1 disk herniation at 25.
    I lost power in left foot and I was proposed for surgery which I refused.
    I struggled with this condition for 12 years having limited mobility and not able to do any sport except swimming. 
    At 38 I had lost my force in right leg and this time I went for discectomy.
    A big amount of my disk was found broken sitting bellow S1 nerve root.
    I was one of the luckiest with 14 years of pain free after surgery but reading around a lot of people seems to have a second herniation during 1 year after surgery.

    So there is no way that a herniated disk will move back in his position and also surgery did not guarantee you are healed.
    If you are doing surgery in my opinion, you have to have great care of your back. Going back to normal activities is probably a major cause for fail surgeries. I had 4 months off from my job after surgery 
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