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Level of pain before considering surgery?

Hi All, 

New to the forum. 
I'm 32 years old and very active (avid surfer) and suffered a disc herniation at c4/5 about 18 months ago now. I had an MRI to prove it to be the case. 
I respond ok to PT, but flair up often and surfing doesn't help it. The doctor says I should give it up, but its the only thing that keeps me sane.
During flare ups I kind of self manage with high doses of codeine as it's still over the counter here in Australia up to 15mg and with a tiny bit of knowledge of how soluble opiates are in water vs the other junk, I can avoid a trip to my GP for a script.

The problem is that the pain is getting worse, the flare ups more frequent and the self treatment is becoming ineffective  (tolerance probably). To make matters worse, Codeine is getting up scheduled here from next year, so I will run out of that option. My GP has given me a referral to a surgeon but doesn't actually recommend surgery and he personally thinks results are inconclusive (even though I have read plenty of success stories). In terms of pain management he's also very conservative and wants to avoid me getting addicted to stronger pain meds. His honest suggestion is take it easy, stop surfing, PT and avoid flareups to damage it further. 

So to the point of my story, how strong does the pain have to be before anyone here considered surgery as the option? 
I like to think I have a high pain tolerance but it is slowly becoming debilitating and depression is something I have had in the past and I am bloody scared of walking with the black dog again. 
To put my pain into context, it's like I have a permanent dagger through my neck and radiating through my trapezius. I do occasionally get arm pain back, and often get numbness and tingling. It tends to switch sides for some reason. Pain on 1- 10? At worst I'd say a 6 or 7. I'm dealing with an average 4 on a daily basis. 
Is that enough to go through surgery, or do you recommend I wait until I have an absolute blow out?

Thanks for reading .




  • Hi Aussie T

    I had two level acdf five months ago.  I would stop surfing for a while and let my back heal.  I would try all conservative treatments first.  I would not have surgery unless pain is so severe you cant stand it.  I would find a good pain management dr and try different medications.  I would try PT also. 

    After my surgery by month three all my pre-op pain returned and then some.  No guarantees surgery will eliminate pain.  Try everything possible before surgery.  Also due to a physical job and my advanced years I now have a good sized bulging disc in lumbar area affecting root nerve and if that is not enough a T12 fracture.  Good luck.  Be sensible.


  • memerainboltmemerainbolt IndianaPosts: 3,421
    Hello AussieT

    Having surgery is a major decision that should be your choice. If it were me, and you are trying to avoid surgery, as dmo said, stop surfing. Do you want to risk permanent damage and make it worse? How much pain do you want to live with the rest of your life? 

    One of our moderators here has a very good story, Bruce My Story, please read it. It will give you some insight into this.

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  • Thanks DMO and memerainbolt. Really appreciate you taking the time.
    I'll have a look at Bruce My Story.

    And After a lot more reading, I will say that my pain could be manageable enough currently. While I do have constant pain and discomfort, some people seem to be agonising and I feel so much for them. I couldn't say that I'm in so much pain there is no other option, and I think I'm going to wait for if/when that happens. I think seeing a pain management doctor is the best next option.

  • memerainboltmemerainbolt IndianaPosts: 3,421

    Everyone's pain is different. My level 5 could be your level 8. Just listen to your body and make wise choices of what you do and don't do.

    Just talk it over with your pain management doctor and make a plan that is comfortable for you right now.

    We're always here if you need anything. Take care.
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  • jimandjrjimandjr Dallas TXPosts: 463
    All 3 of my spine surgeries followed days/weeks/months where I could not get out of bed because of the pain. All 3 got me out of bed. Very important! 
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  • memerainboltmemerainbolt IndianaPosts: 3,421

    Very profound statement. I hurt so bad every day I could just lay. That's where I'm comfortable and it doesn't hurt but I know I shouldn't.
    So I don't. I don't push myself either.
    Spine-Health Moderator
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  • jimandjrjimandjr Dallas TXPosts: 463
    I, literally, could not stand or sit. I, also, could not walk to the fridge. I lost 35 lbs in 2012. Had 2 other surgeries that also laid me in bed. 

    I could only take 2 steps and pain would shoot down my leg or arm and knock me back in bad. 

    Thank goodness for my ortho surgeons. Saved my life. 

    I'm sure most people take for granted the ability to stand and walk or even sit in a chair. Trying spending 6 months, on your back, waiting for surgery. 

    I am entertained by people who have pains while they are in the weight room. Uh....you're so lucky you can make it to the weight room. I can't relate. 
  • Having surgery is a major decision that should be your choice, Make sure you try other options first
  • Go to a doc first 
  • itsautonomicitsautonomic LouisianaPosts: 2,561
    Most will say just give up surfing and I am not saying I disagree, but giving up something you love and have loved all of your life is something a lot more complicated than that standard answer we give.  Truthfully its when you reach a point you cannot take it, if you want to surf and want the pain gone you also deal with the downside if surgery goes bad.  If surfing is your goal then you need to have a great conversation with doctor about risk. You might have the surgery and be worse or have the surgery and never get back to surfing or and here is the big if, you have the surgery and return to doing what you love.  No one but you and your doctor can make that choice.  You are new to this life of pain and chronic issues, us here are not we look at every move and calculate it based on our health issues and the way it will affect them.  In short it sucks and takes all adventure and spontaneity out of many decisions.  You are lucky to have those dreams, that passion and not yet know if what you suffer is permanently going to keep you out ( by lucky I just mean you are not jaded yet).  Hold on to those dreams, get multiple opinions from top doctors, research and advocate for yourself by learning and looking for others that surf after injury and their stories, try to find another hobby while you are down and maybe you will fall in love with something else.  Disc herniation is a disc herniation they can cause pain or not, but before surfing again make sure you know the dangers of permanent damage if a nerve or spinal cord is involved.  Hold on to your dreams as long as you can, it keeps you going sometimes, but prepare for the letdown if it comes.

    As a side note, have you looked into ADR ( artificial disc replacement), if you decide on surgery it may be a better path.  Certainly worth talking to doctor.
    Do your due dilegence, trust you know your body and question everything if it does not fit. Advocate for yourself and you will be suprised what will be revealed trusting your body and instinct.
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