Tell me about your slipped discs!

Since last May, I’ve been having back problems, which have yo-yo’ed seemingly at random between ‘acting ok, but slight twinges’ and ‘AAAAAAAAAAAAAAAAAhhhhhhhhh I can’t stand up and nothing is getting rid of the pain!!!’.

Finally, a few weeks ago, after being told for months that as a 28-year-old girl, it was very unlikely I’d have a proper slipped disc, and it was probably just ‘bulging a little bit’ and would sort itself out in a perpetual few weeks, I got an MRI scan- to find that yes, I have one badly slipped disc, and several others starting to bulge in several different directions.

I only had one phone call with that doctor, (not my normal one, but the one who referred me for an MRI in out confusing system) who has offered to refer me for surgery… Or more physio.
I’ve done the obvious thing, and searched for other people’s experiences, but of course you get a massive bias towards horror stories. And references to ‘toxins’ :rolleyes:

So… I need to decide what to do- what have other people’s experiences been? With or without surgery, or any other treatment. It’s UK NHS, so cost is not an issue (waiting lists still are, but treatment cost is not).
Anyone have any stories about what exercises worked for them? At the moment, it’s really bad, and I can’t even lie flat, or walk more than a few metres without it hurting, which means I’m pretty limited.

I will be phoning the doctor again on monday, I just want to get a few more viewpoints in first, as she decided to be all Elvish, and refuse to advise me one way or the other.
All advice appreciated, unless it’s about the sodding toxins. :wink:

I’m a 30 year old woman, and hurt my back about 2 years ago. See if you can get in to see a physiotherapist or an athletic therapist. I have a herniated disk from a sport, and seeing an athletic therapist (and a doctor for follow-up and pain management) helped focus treatment and be very specific about the necessary exercises and manner of approaching the issue.

In general, the exercises necessary for my level of injury are back extensions and core-strengthening ones; while the disc heals as much as it can, you need your abs and dorsal muscles to be strong to hold things in place. I found a lot of these exercises to be tedious, but well worth it. You really don’t need much more than a yoga mat and maybe a resistance elastic. Again, a PT or AT is the best person to ask for this. I went 2-3 times a week for several months. There was also some electro therapy and heat/ice regimens.

In terms of pain management, it really depends on what kind of pain you’re having. I first had muscle spasms that were excruciating, and so I was prescribed oxycodone, naproxen and cyclobenzaprine (muscle relaxant). One dose of the cyclobenzaprine had me out cold for a day or two, but completely stopped the spasms…since then I’ve just had numbness :smack: At this point, about 2 years out, I just occasionally stiffen up and use ibuprofen or Robax.

I consulted with a surgeon at the time, but as he worded it, I “have a large canal” and the disk isn’t causing any issues requiring surgery, though if things ever change, I’m “in” as a patient. Trying physio for a while is a preferable option to going straight to surgery, so see if you can do anything in that respect.
It sucks, and it hurts, and it’s frustrating, but it can get better.

Good luck!

I realized I didn’t specify my injury - yours might be different. Mine is the disc between the L4 and L5 vertebrae, with pressure on the S1 region of my sciatic nerve, which is what caused the severe back and leg spasms. As I said, other than the odd pain/stiffness in the back itself, now I just have numbness in the right leg - there is surface numbness on the back of my thigh above the knee and on the outside edge of my right foot, which are two areas of pain or numbness that are actually diagnostic for L4/5, S1 apparently. My leg is weaker than the other, but it doesn’t stop me from everyday stuff. I notice it mostly when climbing lots of stairs or skating for a while.

I’m much less active than I was…but I wasn’t that active to begin with. The sport that hurt me (dragonboating/paddling) was the only sport I did, and I pushed too far and tried to do too much and wasn’t in good enough shape for what I was trying to do. At this point I don’t dragon boat with a team, though I still captain one and am learning to steer, and do most of my paddling in outrigger canoes, but it’s more by choice than necessity…I need to work much harder to build up the strength to rejoin a team, and I’m lazy :wink:

I don’t actually know which disc it is that’s causing the problems (or even if it’s only one that is), she didn’t say. It’s causing pains down my right leg (I know ‘S1’ was mentioned regarding nerves, but currently that’s all I know). No numbness at the moment, but sharp leg and back pains, which do seem to come as spasms.

I was quite active, but I’m not sure what exactly it was that started it off- I was in a fire performance group, doing a show including hula hoop and stilt walking at festivals, basically just for the free tickets. It could have been the sleeping on the floor with a crappy air mattress, or the performance itself, I’m not sure. It was fairly gradual, so I didn’t want to drop out for a problem I thought was muscular and I could just push through, as it was all group synchro stuff, and I didn’t want to let everyone else down by dropping out last minute.
Oh well, nothing like hindsight. :slight_smile:

Thanks for your experiences :slight_smile:

There isn’t always just one cause…it’s often an instability due to time, wear and tear, poor posture, strain, whatever that contributes to it. In my case, we suspect that a minor “tweak” to my back about 10 years before probably was a disc injury that didn’t heal well and led to the full rupture when I asked too much of it. The pain gradually got worse, and I went to see a doctor about it…then a week later I had a crazy big sneeze in the shower and the pain nearly made me black out! That night I ended up in the hospital with the spasms; I remember my husband staring at my leg and the crazy way the muscles were twitching and the look on his face scared me! There was no medical emergency (which can happen if your bowels/bladder/genitals are affected), so I was sent home with the drugs I mentioned. I don’t remember much for the next couple of days thanks to the cyclobenzaprine, but my husband says I was rather hilariously sleepy and stoned. I thought I was out for about 18 hours…turns out it was more like 30 :smack:

One thing that my AT stressed right away is to keep your back straight. You need to try and stop using it, to let any inflammation die down. Even little bends, like when you lean over doing the dishes or to brush your teeth, are likely to cause additional stress on the injury. Bend with your knees and limit twisting/rotating for now - at least until you can talk to an AT/PT. I spent the better part of 2 months lying on the floor! Ice your back for as long as you can stand (I loathed icing my back, it’s so cold!) a couple of times a day. By the sounds of it, your injury is similar to mine, and right now it’s the inflammation you need to control.

I had a slipped L5/S1 disk with massive extrusion of the pulp that badly hurt my right nerve root and somewhat bothered the left and the cauda equina. I did 6 months of PT before changing medical practices and getting surgery, a diskectomy and foramenotomy. I did another few months of PT after, plus therapy with a nerve med whose name escapes me. Overall I took 1200 Percocets along with various other painkillers and anti-inflammatories.
Now, 7 years later, I still have daily pain, but not much. My left foot is partly paralyzed. My toes curl and I can’t straighten them, and one of them gets weirdly calloused and sort of flares out at the end from being curled all the time. I can’t stand on my heel on that side, walk a little unevenly, trip going up steps, and wear out shoes unevenly. The surgeon told me at the time he would relieve a lot of pain but probably the paralysis was permanent, and that if he had seen me at the start, he would have operated immediately. He did accomplish what he said he would.

But I plan to go for a hike as soon as my wife gets back with groceries and I unload them. I enjoy about three to six miles on trails with fairly steep hills. Other than having relearned some movements, like keeping my torso rigid and doing all my flexing at the hips, I have my old life back.

Tips: avoid flexing and twisting the lower back, especially with a load on it, especially repetitively. Buy Stuart McGill’s book “Low Back Disorders” and study it until you can make sense of the most relevant parts (it is technical and a popular text for physical therapists). And if you have more trouble with your extremities (from nerve damage) than pain in your lower back per se, lean more towards surgery. Well, don’t lean, you should stop leaning. I mean, more seriously consider surgery.

There’s also a useful e-book called Rebuild Your Back that has some good, simple exercises.

Your doctor should be able to do what’s called a nerve test to see if the nerves are damaged/at risk of more damage from the compression on the sciatic nerve. If they are reasonably stable, the advice to try PT and other non-surgical methods, at least for a few months, seems to be almost universal.

I don’t know how the NHS operates with specialists, but assuming it’s similar to here, don’t ask a neurosurgeon or orthopedic surgeon if surgery is indicated, unless you want to be put on the surgery list. Surgeons like cutting. Physiatrists are more likely to take a balanced view of when surgery is indicated vs. when PT and other therapies may suffice. (There is a non-crazy school of thought that says that even when disc herniation is present, the real problem sometimes comes from non-herniation-related spasms, and treatment with stretching (Google piriformis stretch in particular) and topical lidocaine injections (Google trigger point injections) is sometimes quite effective for some people).

Finally, if you choose a surgical intervention, see if the NHS has an endoscopic discectomy option. It’s relatively new and very minimally invasive. The non-endoscopic surgery works for many but though it is characterized as “microsurgery” and “minimally invasive,” it still involves cutting through healthy muscle and retracting nerves, and complications or subsequent weakness/recurrence (Google “failed back surgery syndrome”) are not super uncommon.

I have two herniated discs (L-3/L-4/L-5) diagnosed by an MRI in 2000 when I was 42. I’d had periodic back pain since my late 20s. That’s the last imaging, anyhow…lord knows what they look like now. Still hurts. :frowning: I’m quite physically active and I’m not sure whether that’s a good or a bad thing as far as my back goes but I pretty much live with low-level chronic pain, which occasionally flares up quite badly. No clue how I did it - I’ve been a painting contractor for decades (quite physically demanding work) and have always been an avid hiker, and for several years, skier. So who knows. I emphasize, though! Back pain can be truly miserable and debilitating.

However, it doesn’t stop me from doing anything, and I’m frankly terrified of back surgery! I do core and back exercises daily and hike with my dogs several miles at a time; every day (like before work, very early) if weather and schedule permits. I’ve noticed that bad-back episodes tend to occur when I’ve been less active and more sedentary. During one year where I worked out religiously at a gym 5-6 days a week, my back barely hurt at all. I take painkillers (Flexeril, Vicodin) rarely - only during bad flare-ups, a few times a year.

Completely anecdotally: I’ve known and know more people who’ve had unsuccessful back surgeries than people who truly benefitted. I know one guy who’s had eight back surgeries and is still disabled, a friend’s husband had “minimally invasive” surgery in August and is no better. Two doctors have told me to only consider surgery as a last resort, or if the injury gets as severe as what Napier described.

So…with no clue as to what your specific situation is, my opinion also is to embark on a solid course of physiotherapy with qualified therapists, and exercising, if you can tolerate it, and see if that does the trick.

I subscribe to a newsletter from this site - fairly common-sense information and no set agenda.

One other thing to note about putting surgery off as a last option unless there’s an acute problem is that it is possible for a herniated (“slipped” gives kind of an inaccurate image) portion of a disk to dessicate or harden over a period of a year or so and basically just shrink to a smaller, “leathery” (orthopedic surgeon’s technical term) remnant. In doing so, it may retract from pushing on whatever nerve it was hitting, and the hernia sort of re-seals (this is all what I’ve been told, IANAMD).

IANAPT either but if you are cleared to exercise at all, the single best thing I’ve found for low back pain and sciatica is the Cobra yoga pose, which consists of lying on your belly and doing a pushup-type raise with your hands (it’s not a pushup 'cause your legs are on the ground), for a couple of minutes. You can do a standing approximation by putting your hands on your hips and leaning backward. The mantra you’ll hear is that your back should be upright or even concave; never convex, with your trunk bent forward.

Thanks- I think I’m going back for the physio. I don’t want to have surgery unless there really is no other option. It didn’t massively help before, but they didn’t really have a proper diagnosis at that point (my physio as much as told me at the time that she thought it was on my notes as something much less severe than it really was), and I wasn’t responding well, so she quit the sessions until I got one- for fear of making it worse, if it was unclear what the problem was.

Unfortunately, currently my back’s stuck in a hunched, bent over position- I can’t even lie down flat, forget bending up into a ‘cobra’. I’m hoping this is some temporary inflammation or something, as it certainly wasn’t the case a few weeks ago.

FWIW here are a few more tidbits:

As a rule of thumb, at least 7 years ago: lower back disk surgery to relieve crushed nerve symptoms is about 80% effective, but to relieve back pain is only about 50% effective.

There is a theory that nerves emit a corrosive chemical when they are irritated, and this chemical serves to erode a path in things such as discs that intrude on the nerve’s space. There is also a therapy aimed at exploiting this to fix lower back disc herniations. The patient sits on the edge of a table, and alternately assumes two different positions. One position has the legs sticking out, straight at the knees, and the head tilted back. This slides the spinal cord downward inside the spinal column. The other position has the knees bent so the heels are under the table trying to touch its underside, and the chin tucked to the chest. This slides the spinal cord upward. Going back and forth moves the cord by about a centimeter, and moves a larger portion of the nerve through the crush region, depositing its corrosive chemical and sawing away at the intruding disc. The method is called “flossing”.

Stearoid injections may help. Once the nerve is injured, it swells, which makes the limited space even more limiting. Even if the disc is shrinking and retreating, this swelling keeps the pressure on. Sometimes the injection stops the swelling, and the shrinking disc retreats far enough that the nerve is no longer crushed, so it never swells again even after the stearoid wears off.

Gabapentin is the drug I was on. It was very helpful. It is primarily used for other purposes but in the case of crushed nerves it has the effect of reducing nerve activity triggered by the crushing.

I was told that damage/involvement of the cauda equina was considered a medical emergency - when I ended up in the ER with the spasms they verified this and pretty much told me that I would have been in surgery that day had there been any effects with regards to my bowels, bladder or genitals.