Yesterday morning, I got up, made a coffee, parked my arse in front of the telly to watch the early news and coughed, just once.
:eek:
As those of you who have experienced this incredible event will attest, the pain was overwhelming and crippling: took me many minutes to muster up the courage to move at all, and then only to hobble, tears streaming down my face, back to bed.
Got to the Doc an hour later, who informed me it is impossible to slip/rupture/prolapse a disc from something as innocuous as coughing :rolleyes: prescribed some pain-killers and sent me on my way.
I know that time heals, and that gentle movement helps the process along too, but I was wondering whether my SDMB fellow sufferers might have some handy hints for getting through the next days/weeks without too much torture.
Not sure what a prolapsed disc is, but it sounds awful. As someone who’s had one of those “innocuous movement resulting in emergency surgery” experiences; you have my sympathy and best wishes.
The best relief when I herniated a disc in my back was ice packs and Advil.
I didn’t even cough with mine… just woke up with a backache that got progressively worse as the day went on. At the time I worked in a wine shop so lifting & carrying 40 lb cases of wine was normal for me. Obviously I did damage over time to my back there and one morning, poof, out it went.
At least it didn’t rupture… I get the heebies just thinking about that.
First there was the physical therapy and pain killers. When six weeks went by with no improvement, oral steroids. That worked for as long as he took them, but when he stopped, problem. So last week a steroid injection into his spine. Follow up with PT. Wait and see. It took about three months from the initial “ow!” to the injection.
This. I’ve herniated a disk three times and it doesn’t hit you suddenly, it slowly gets worse over hours or maybe a day. The one time I could figure out what I did to injure myself, it was something that I’d done the previous day. Basically, the tissue around the disk gets more and more distressed, and eventually you’ll get a) very painful muscle spasms, and b) moderate to severe nerve pain (sciatica and similar).
I failed to address the OP’s wish for suggestions. INAD, but here’s what I recall:
Prescription strength Ibuprofen or Naproxen will over several days considerably lessen the inflammation, which will make the muscle spasms lessen or disappear. Take it faithfully, do not miss a dose. It really does help a great deal. Also apply ice packs to your back to calm the muscles, lessen the inflammation. I think using heat initially is not wise because it will make the inflammation worse.
Obviously pain-killers help, but it sucks being too out of it to even watch TV, at least in my experience.
If you have nerve pain, i.e. pain that shoots down your leg (sciatica), or other places not immediately near your injury, you may need to find positions to rest in that don’t compress the nerve. I used a kneeling chair like this, which helped enormously and was the only way I could sit without pain (driving totally sucked, it hurt like a son of a bitch to sit ‘normally’).
I had a really good chiropractor who helped me with gentle heat/cold treatment at first, and eventually flexing the joint which helped enormously. I don’t recommend this for everyone, as there are a lot of incompetent chiropractors out there, and I’d only recommend seeing one if you get a direct referral from a satisfied customer. And maybe not even then.
I went through a variety of lower back supports/braces, and these help a great deal when muscle spasms are a problem.
IANAD, but I have survived a slipped (and cracked) disc. You’re a few steps ahead of me, since you’re not pregnant. I strongly recommend against the whole constantly gaining weight and changing your center of gravity aspect.
Sugegstions:
For the muscle spasms, one Naprosyn and one tylenol will kill more pain than two of either. They hit the pain in different ways, I guess, and so work better in concert. Also, Robaxin works well without completely removing my ability to think. YMMV however, as another friend was knocked out by it.
Nothing addresses the nerve pain (except possibly Lyrica) so don’t drug yourself out trying to kill it.
The only thing that helped me was an inversion table. The relief has been astounding. I got mine fairly cheap on overstock.com. Be sure to check the brand for ratings, and go for one fo the higher weight rated ones, as they are much sturdier.
IANAD, but I have a herniated disc and have been receiving treatment all summer.
See an athletic or physiotherapist if possible. They will provide you with an exercise/strengthening regimen suited to treating your injury - it’s going to take time to heal. If you can get an MRI, it will confirm the diagnosis, but won’t really change the treatment plan. The trick is to reduce the inflammation through anti-inflammatories and ice, reduce the stress on the disc through limited and controlled movement and build muscle strength in your abs and back to prevent it from happening again. The disc won’t “go back” into place and it’s likely to become dessicated and always remain a little weaker/fragile.
Avoid bending at the waist - even something as little as when you do dishes or brush your teeth. Do gentle back extension exercises (this is where an AT/physiotherapist comes in!), and when walking or sitting contract your lower ab and dorsal muscles (don’t suck in your gut or hold your breath!).
And while a cough or sneeze alone isn’t sufficient to herniate a disc, odds are the disc was already somewhat weak/herniated when you coughed and that caused a minor shift or increase in inflammation that led to pressure on the nerve/pain. It’s exactly what happened to me (massive sneeze in the shower in the morning after several weeks of minor pain, and that night I was blacking out from pain and muscle spasms and ended up in the hospital!)
In an extreme case, if you have severe numbness, particularly of the genitals/saddle area and/or bladder or bowel control issues, that is a medical emergency requiring surgery - don’t wait if it gets to that (here’s hoping it won’t!)
So nobody’s recommending dangling crystals over my lower back or invoking the Disc Deities to perform an exorcism??
Thanks for the advice though folks. Still doped up to the gills with painkillers (which do take the bulk of the pain away, but still really damned ouchie all the same).
Oh, and re the confusion about the terminology, slipped, ruptured, herniated and prolapsed are all interchangeable wrt discs. However, my description to the Doc the other day when I explained my symptoms as ‘Geez Doc, I think I blew a disc’ earned me a glare and the reply, “There’s no such thing as blowing a disc”.
Charming man, such a delightful sense of humour too.
Slight nitpick, I believe slipped, ruptured and prolapsed are one thing (when the disk starts squeezing out) and ruptured is something else (when it breaks).
But, inversion tables can be surprisingly helpful. I can hop on mine and with a little directed thought and dangling upside-down, get the muscles to unlatch. If you have chronic lumbar/sciatic problems, I recommend getting one.
I’ve had both the big name brand (Teeter) as well as a much cheaper off-brand (Ironman) The cheap one is what I have now - cost about $125 at Amazon - and it will hold you upside-down just like the expensive one.
The good news is that if this is a new occurrence, chances are better than even that with some rest and conservative DIY therapy (cold packs, NSAIDS and inversion) it will self-resolve. But don’t trust us - trust your doctor(s). Unfortunately, as you’ve already found, most internists know absolutely jack about musculoskeletal problems and spinal injuries other than “take advil and take it easy.” If I had a dollar for every time I’ve gotten advice like that, I could have paid for most of my surgery.
Hopefully you won’t wind up like me with a ruptured L5-S1 disc that required surgery, and having doctors look at the MRIs and saying “I wouldn’t have expected you to be able to stand up.”
I had a herniated disc with a pinched nerve this spring. What helped me most was what usually helps when these occur (this wasn’t the first time): heat, chiropractic and NSAIDS.
I did buy a new desk chair to relieve some pressure points, but a microwaved rice-filled sock was my best friend for a few weeks.
I had a ruptured L5S1 disk with massive extrusion of the pulp, 5.5 years ago. It was miserably painful. Conservative measures failed and at 6 months I had a diskectomy and foramenotomy, which gave me a great deal of relief, and then a few months on gabapentin (a.k.a. “Neurontin”) which brought me back almost to pre-injury condition. I still have some paralysis and pain and numbness, but am back to enjoying life.
I can imagine coughing could do it. That is, a pretty common course is to have done some substantial damage to a disk, and go to bed unaware, with the disk in a weakened condition. Then it swells with fluid at night - they’re supposed to, that’s their circulation - and in the morning the pulp is all juicy and ready to pop out through the damaged plies of tissue surrounding it. In my case it was shoveling snow and reaching and twisting very unwisely with snow on the end of the extended shovel the evening before, and pulling on underpants the next morning. Many disk injuries occur within the first hour of waking up.
My big lesson is that sometimes “conservative” measures can result in serious permanent harm. The surgeon that fixed me told me I had waited too long, and the paralysis was probably unrepairable now, though the pain would improve with surgery (which it did). He said I should have had surgery shortly after I injured it, and I would have recovered control of my foot. Now I’m clumsier, and sometimes trip going up stairs because I can’t extend my ankle well, and on long walks that leg drags.
A rule of thumb I found was that surgery to fix nerve problems in the extremeties is about 85% effective, whereas surgery to fix pain felt in the back itself is only about 50% effective.
