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L4-L5 Bulged disc right side and Micro-discectomy surgery

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Burton Lindquist · · Madison, WI · Joined Jan 2002 · Points: 4,215

I am 52 years old and suffering from pretty bad sciatica down my right buttock and into the calf and foot/toes. I am scheduled to have nerve decompression surgey in one month. I haven't been able to knock this thing down on my own after a strict regiment of PT (simple floor excersizes for stretghtening core and keeping affected leg as strong as possible and stretching), drugs for pain management and minimizing nerve irratation and long term damage, sitting on a big blow up ball at my desk job (sitting is painful and sends me overboard with the pain and numbness), hanging upside down on an inversion board for brief periods of time twice a day, and finally lots and lots of laying on my back and resting. My question to all you climbers and maybe especially older ones like me that may have had the same nerve decompression procedure near the lower spine....
How was your recovery? Have you been able to gain similar ability to where you were before the the symptoms/malady came on? What did you do to best improve your chances of a reasonable recovery if so?

george wilkey · · travelers rest sc · Joined Jan 2013 · Points: 235

I had exactly the same thing but instead of surgery they did an injection of steroids into my spine. this shrunk the swelling and flushed out the disc debris in my spinal cavity. I was 90 percent better in 3 days and 100 percent in about a month. you may want to ask about this procedure. it may not work for you but if it does it's much better than surgery.

marty funkhouser · · Unknown Hometown · Joined Dec 2007 · Points: 20

What works for some folks with bulging discs and an inability to sit are McKenzie physical therapy exercises. They have a website with a list of providers.

I'm a solid believer that you have to try everything before surgery, but it seems that some just can't avoid it. If you've had pain for 6 months and/or have EMG confirmed weakness then surgery seems like a viable option. Good luck!

Edit: I reread your post about doing lots of resting. It would be much better to find an activity that doesn't flare you up and do lots of it. Movement is your friend.

Dustin Drake · · Unknown Hometown · Joined Feb 2012 · Points: 5

I have an L5/S1 herniated disc causing sciatica. Most of my pain is from sitting with extreme pain occurring when I initially stand up but will go away after walking around for a bit. Fortunately for me, my symptoms have diminished over the past 3 months by doing a combination of stretching, NSAIDs, walking/running and NOT sitting. I have a desk job and I just don't sit anymore. Converted my desk into a standing station and just make due. I'm either standing or laying on my back.

I would at least try the epidural injections before even considering surgery. 90% of people with disc issues can recover from them without surgery. Surgery is dangerous and a really big crap shoot as far as success goes. Whatever you do, don't take it lightly. Get a 2nd and 3rd opinion before going the surgery route.

I've attached a pic of my MRI just so you can get an idea of what I was dealing with initially.

L5S1 herniated disc

Burton Lindquist · · Madison, WI · Joined Jan 2002 · Points: 4,215

Thanks guys for the input. I have indeed had one nerve root block injection which brought brief relief but then symptoms came right back. I have taken oral steriods twice also with only brief relief.
I walk alot and in fact that is about all I can do other then the floor excercises. I am quite aware that keeping moving is key to faster recovery as it promotes better cardio vascular conditon and increased blood flow. I should add that I have some stenosis in the foramen area due to arthritus in the lumbar facets so this is contributing to the nerve root compression causing my sciatica. I am aware that back surgery of this type has a 10% failure rate. The modern versions of laminectomy and discectomy are much less intrusive form of surgery and in fact done as out-patient care these days so I am thinking it is a better bet then in the past. I am nearly 5 months into this. At the start of the acute onset of thhe bulged disc symptoms in Mid Sept of 2013 ( I had felt this coming on slowly over last summer but did not address the issue like I should have... i.e consulted a doctor and scaled back my activities) I could not even walk and was forced to laying on my belly for 4 weeks until the pain started to abate enough I could start to move around more normally and return to my day job. Anyways... I think I have exhausted all my options up until now and I have the agreement of atleast one nueroligist but will certainly seek other opinions as well in the very near future.

george wilkey · · travelers rest sc · Joined Jan 2013 · Points: 235

my wife is a nurse at a hospital that does these surgeries almost every day. she says that most people get at least some relief but that results and recovery time vary greatly between patients. certainly being in good shape would give you a better chance at a quick recovery.

sounds like you have done all you can do to avoid surgery, but sometimes it's the only option.

I feel for you man. when I went through it I thought my climbing and running days were over but now I'm back out on rock, ice, and trail. just be patient and do what the docs tell you. you'll be back out there in no time.

Burton Lindquist · · Madison, WI · Joined Jan 2002 · Points: 4,215

Thanks for the encouragement George. Yes... I am quite worried I won't be back out climbing cause I enjoy it alot... but I am doing everything I can I think for best recovery. Thought I would throw it out there and see if any other climbers have been down a similar road.

atlclimbingdoc · · Boise, ID · Joined Jan 2011 · Points: 20

Spine surgery done for the right indications is very successful. It can give you your life back so to speak. I would try to avoid comparing the apples and oranges of everyone's personal experiences. While disc herniations are known to often shrink up and resolve a good bit over 6 months, some of them don't, and if you delay too long you can end up with a much longer road to full recovery. It sounds like you have at least been able to keep up your core strength somewhat with PT.

If you have a clear foraminal compression on MRI from a disc protrusion, and there are corresponding neurological symptoms and/or deficits that are markedly interfering with your activities, surgery may be the best option for you. It sounds like you have exhausted the realistic non-surgical options. The procedure may relieve a large part of your symptoms but you may end up with some residual facet symptoms. That is unfortunately part of the deal for many of us as we get older. There is no treatment that can turn back the clock.

Limited incision discectomy is pretty easy to recover from as far as the surgery. What is harder to recover from for an athlete is the months of inactivity. There are plenty of high-level athletes out there playing hard after much bigger spine surgeries. If you have a herniated disc, and you have failed conservative treatment for months are still not back to activity, you may want to get a good spine surgeon and get it fixed so you can be moving forward. Good Luck!

Allen Sanderson · · On the road to perdition · Joined Jul 2007 · Points: 1,203

Another l4/l5/s1 disk poocher here. Happen when I turned 40, when I turned 50 I blew my achilles, can not wait until 60 comes.

It took 9 months before I was doing stuff again. Three rounds of steroid shots before I saw the surgeon. We made a plan and in the end he said I was not a candidate as some of the stuff I did with pain, ice climbing he could not do on a good day. I never lost strength or muscle control, just had pain is my ass and down the leg - classic sciatica.

However, one bit that did come out is that surgery or not within two years people at typically at the same recovery point. Also with surgery while they clean things out there is no guarantee that new material will fill the void with the symptoms returning. So if one can function and managed the pain without the other issues surgery may not be best option.

As for the long term. Pilates is your friend, find a good studio and buck up that you will be going at least once a week. Also find a good PT, about once a year things flare up, if I can get in to see them the issue resolves its self pretty quickly otherwise it takes a week.

Jonny d · · Unknown Hometown · Joined Jan 2011 · Points: 40

All I can say is that you need to do some deep research on this stuff. The science of bulging discs is pretty sketchy when you look at it. Probably 40% of the population over 40 has bulging or slipped discs, yet most of them don't experience pain. However, if you go to a doc complaining of back pain, he does an MRI, and it finds a bulging disc, he will tell you that the cause of your pain is the bulging disc. 95% of the time, this doc is also a surgeon. All I can say is to be cautious and skeptical; do your homework thoroughly before you make a decision to undergo the knife. You may find this NPR piece from January of interest in this regard: npr.org/blogs/health/2014/0…

Best wishes.

Bill Kirby · · Keene New York · Joined Jul 2012 · Points: 480

No horror story here. I started to have pain around the first of last year. It would come and go but I didn't go to the Doc until March. They did an MRI and found two badly herniated disks. The doctors said I could've be paralyzed if I fell down stairs or off a curb. My L4 and L5 were so close together they were almost pinching my spinal cord. Did the micro not fusion and eight weeks later I was mountain biking in Whistler BC. I even flipped over the bars and no trouble. I'm not saying there's not bad things happening out but listen to your doctor. You're active so you'll recover. If you do surgery start walking ASAP. I could walk after 3 days. I walked a mile after 7 and 3 after 14 by week 8, I was walking 25 miles/week.

Watch the pills too. Those things will have you believing you need them forever. I take Advil now and that's it.

Burton Lindquist · · Madison, WI · Joined Jan 2002 · Points: 4,215

Finally.... someone whao has actually had a Micro-discectomy....
I am not afraid of having the procedure and I am looking forward to it as I have not been able knock my symptoms back although I am better off then I was at the first acute onslaught of the nerve compression.... like I stated above... I could not walk for about 4 weeks because the pain and numbeness would just overwhelm me. I have been avoiding taking any major pain killers myself because I do not handle them well despite the pain killing effects of taking them. The side effects are just to much for me and I believe they may actually hinder proper tissue healing. I have only been taking a mild dose of Naproxen, ossasional dose of Flexirol, and finally a mild daily dose of Gabapentin. I have stopped now even taking the Naproxen because Docs and nurses want me off all blood thinning agents either homeopathic (Green tea etc.) or doctor prescribed one week before the procedure and I have been reading lately about the Fed concerns about long term use of them and heart health. I am all ready walking on tread mill daily and flat, as dry as I can find, sidewalks and packed snow foot trails every so often as I walk my dog so I am ready to take that step ASAP after first stages of the recovery are over.. May I ask Kirby?.... were you unable to walk before the procedure?
Thanks for you input...up until your response... all the responses did not include one person who has had a Microdiscectomy... I do appreciate every ones input but none of them actually addressed my question.

gf9318 · · Unknown Hometown · Joined Sep 2013 · Points: 0

My 2 cents...

I had the double bulge at the ripe old age of 23 with no specific injury. In my opinion back issues are lifestyle and habit based. By living and moving well you can fix whatever your problem is. I was told there was no way I would recover without surgery, and now am climbing and skiing harder than ever before sans knife.

I got a lot of help from Rolf-style massage and strength training. Not PT, but real live weights. mobilitywod.com will provide a lot of background on addressing your specific movement and restriction issues. Diet and posture play a big role. Stay hydrated. Stand up. Try something new; I can't count the number of personal healing methods I explored, from Mckenzie to Feldenkrais.

Something will work for you, and it might be the knife. But try to stay open minded.

Bill Kirby · · Keene New York · Joined Jul 2012 · Points: 480

Ok I know I'm being unproductive today as I'm replying 11 minutes after you posted Burt! Haha.. Forget about it! I'm happy to answer any questions. It's sketchy thinking about back surgery. You hear so many horror stories that the good ones often are forgetten. I do know three guys and one girl who have had micros and have recovered well. I would definitely take the gamble and do micro discetomony before fusion. My neighbor did the fusion because he wanted only one surgery. It took an entire year for him to recover.

I could walk before surgery but I took pain killers... lots of pain killers. I started out saying no to drugs. Within a week the pain was so bad I couldn't do anything. Couldn't walk sit or lay down without Morphine and Percocet. Your a brave man for staying sober. Why no drugs? Do you have the addiction jean in your family?

Let me know if you need anything else. My email is williamk@nasercon.com if you need it.

NickinCO · · colorado · Joined Sep 2010 · Points: 155

I feel your pain Burt. I've had SI joint dysfunction and what we now believe to be a bulging disc at L5/S1. (From cross fit at work) Up until today my PT has focused solely on the SI joint. It's been difficult because it can have the same symptoms as a bulging disc. Initially I had sciatica (pins/needles) all the way into my left foot. That has been gone for some time but I still get an ache in my thigh and calf when I do certain movements.

I haven't had an MRI but I did have some X-rays taken at work and there is slight narrowing at L5/S1. I was given some abd exercises and told to try to keep my lower abs flexed and pelvis rolled forward as much as possible (flexion in the lower back area). I've given myself a 6 week time table before I move to the next more invasive step (the steroid shots). It sucks because I have a 50 mile mountain bike race in mid April, a 100 miler in june, and hopefully the leadville 100 in august. I haven't been able to ride a bike pain free since october. The PT did encourage hiking and climbing though. I know this doesn't help with your issue, but I feel your pain! I'm only 29.

Burton Lindquist · · Madison, WI · Joined Jan 2002 · Points: 4,215

Actually Nick... I am quite interested to hear how your problem was narrowed down to a SI Joint issue. X-Ray? I feel like I have pain in my SI Joint right now in fact. Th docs (even the Nuero-surgeon) all say the bulge at my L4-L5 looks mild on the one MRI I recieved back in Oct 2013. I have not had an X-Ray yet since this sciatica came on. I had many x-rays in the past of my pelvis and lower spine because I have arthritus in both my hip joints and in the facets of my lumbar spine. I recieved a BHR hip joint implant 7 years ago and I have been thinking all along that my sciatica is somehow related to the hip replacement surgey... One of my major issues with all this is the deep gluteal muscle Piriformis hurts alot and is nasty tight...I can't stretch it with out making matters worse and I can't hardly lift my leg in forward direction and with knee bent inwards (like trying to sit Indian style)... can't bend over or tie my shoe and I am wondering if it is because of my SI Joint? I have time until the actualy surgery and another MRI plus consult with the Nuero-surgeon a week before the knife in order to further evaluate everything before I finally commit.

Kirby.... I had to take Vicodin at the onslaught to kill the pain but I kept it to a minimun. I took Vicodin when I had to get on a plane back in Oct as well to make sure the pain didn't ramp up mid-flight. I am not open to addiction issues by any means (except maybe too much tasty craft beer and occasional smoke bud for calming nerves).... just really concerned about long term use for general health and fitness issues. I drink alot of water as my daily routine.

marty funkhouser · · Unknown Hometown · Joined Dec 2007 · Points: 20

There is good evidence that the SI joint can be a source of pain. Usually it is thought that some trauma occured to the joint or an inflammatory process is present. Any PT who is familiar with the Laslett tests outlined below can make the diagnosis. Treatment is usually stabilization/strengthening/core exercises and sometimes a steroid injection.

ncbi.nlm.nih.gov/pmc/articl…

Some PT's, chiropractors, and osteopaths still treat something called SI Joint Dysfunction in which it is believed that the SI joint somehow becomes 'mechanically flawed' and the pelvis becomes 'out of alignment'. Although the treatment they offer is safe, there is no evidence that I'm aware of that supports it. The article above provides a nice summary.

Bill Kirby · · Keene New York · Joined Jul 2012 · Points: 480

Burt, When you say long term use that sounds scary! I went to my family doctor the end of March. She ordered the MRI right away since the pain started three months prior. She didn't order any PT because I was active. So I went right to speak with the surgeon. Dr Chang said the herniation was so bad that surgery was the only option and that it should be done immediately. Now I know I could've this and maybe done that but I had lots of accidents. I always listen to the doctor. Call me naive. So May 3rd was surgery. I walked out of the hospital instead of riding in the wheelchair. Eight weeks later I was in Whistler BC. I took pain killers from April to mid June. Therefore I'm surprised you say you would take them long term. It sounds like you got worse problems than me or maybe your solution isn't as clear cut as mine. No punt intended.

I hope you get what you need to get life back to normal.

Burton Lindquist · · Madison, WI · Joined Jan 2002 · Points: 4,215

Kirby.... At this point I don't think I am worse then you were. I am just not able to get past a certain point of recovery. I am able to walk around and do my daily duties such as home stuff and my 40 hour a week desk job. Sitting at work is a real challenge... it makes everything hurt more and especially after an 8 hout day. I sit on a big blow up excersize ball for 45 minute stints and then stand for 45 minute stints between sitting my office chair in the absolute most upright fashion. I get up and do walk laps around the office cubicle maze. I walk on a tread mill down in the office basement workout room for a mile every day at noon. I walk my dog alot. I do floor PT twice a day for core and leg strength and flexibility. I am not able to run, ski, ride my bike, rock or ice climmb, and or any heavy lifting. I am in pain most of the time all day but it is now more low grade with little spikes of worse pain here and there depending on the movement. I can't bend over to put on sock or shoe and I can't hardly tie my shoes. I am ready for the surgery because I can't seem to get past this level of recovery and it has been 5 months now.

Bill Kirby · · Keene New York · Joined Jul 2012 · Points: 480

Good luck! It sounds like you held out and tried everything else. Sounds to me like you're outta options.

Kingsmountain · · Unknown Hometown · Joined Feb 2014 · Points: 0

I've been searching the web to read about different experiences with microdiscectomies. This is the first time I have posted. I am due to get one in 3 days and I am petrified about the procedure. I have never had surgery or been under before. I pinched a nerve (L3/4) back in Sept. 2013, had an ESI in October that got me up to 85% better, had a relapse in December and another ESI in Jan. that barely helped. After talking to 2 Ortho spine surgeons, they felt a Micro was needed (confirmed by a MRI). In the meanwhile I had another ESI that has got me to about 75%. I suffer from pain in the knee and the shin. I'm conflicted about the surgery due to my fear of something going wrong in surgery (ie. reaction to the anesthesia, stroke etc.) and not getting the surgery and suffering permanent nerve damage. I have spoke to the surgeon about all this but was wondering if anybody had a different insight. I have a physically demanding job that I need to get back to. Sorry for the long post.

Guideline #1: Don't be a jerk.

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