2-year old Herniated Disc

[JayneWayne]

Hello, I was referred to this site via a San Francisco area personal trainer, Gary Tanaka, who took time to help me find help where there has been very little.

I am a small animal veterinarian, 55 yrs old. I am also also a rancher who rides horses a lot and does tractor work (bulldozers, jarring, etc). Over the years, I have done a lot of sitting, standing, bending over animals at my practice, and horseback riding.

I've also been a runner-- up until about 10 years ago--and used to move bales of hay (many of them @ 100+ lbs each) which stopped after the injury about two years ago. Below are answers to the questions as directed earlier in this forum. I appreciate any direction you can give me as to which direction to go for help and am curious how the experts feel about Active Release Techniques followed by some strength and stability training. If professional help in the San Rafael area could be suggested, I would greatly appreciate that kind of help, too.


1. When did the pain begin?
I have had chronic lower back pain for years before a more acute episode of pain in Nov of 06.
2. What were you doing at the time? Or did the pain come on gradually over time?
It was a gradual onset, but I think that the jarring of driving the bulldozer contributed to the acute pain which was later diagnosed as a herniated L5-S1 disc.
3. Where, anatomically, is the pain? Lower back.
4. What does the pain feel like? Sharp? Dull? Aching? Stabbing? Shooting? The pain is currently aching to sporadic stabbing pains which extend down my legs and, sometimes, into my feet.
5. Is the pain constant, or intermittent, or only on certain motions? Intermittent and depend on my level of activity, as I tend to keep active.
6. What motions make your pain worse? Bending forward, flexion and extension, horseback riding, and sex (embarasing as that may be to mention on this forum).
7. What, if anything, makes your pain better?
Massage helps a little, occasionally icing. Anti-inflammatory meds don't seem to help.
8. Does your pain radiate to any other part of your body?
The pain radiates, at times, to buttocks and tingling in feet.
9. What things could you do before, that you cannot do now because of your injury?
Bend over without discomfort, horseback ride or have sex without pain.
10. What is your main concern regarding the pain and its consequences?
The chronic pain affects my quality of life. My sleep is usually disrupted from the pain. I would like to alleviate as much pain as possible and be able to continue to do ranch work and veterinary work--bending over, etc.
11. Have you ever injured that part of your body before? If so, how? no.
12. Is your pain getting worse over time? And if so, how much worse over what time period?
It is sporadic. I've had gradual improvement of pain with sporadic flair-ups.

Surgery was discussed with doctors about 2 years ago. I ended up waiting to see if the body would absorb the material. I've also tried spinal taps but have been without that kind of pain management for some time now.

Thank you for any suggestions you can give me to get me on my way to a better quality of life.

Many Thanks,
Dr. W

[UConnJulie]

Dr. W,
Have you had any physical therapy for this?

What does your current workout program look like (ie exercises, reps/sets, frequency)?

Do you do any flexibility work?

How about foam rolling?

What type of help was Gary able to give you?

[JayneWayne]

UConnJulie,
I tried a physical therapist associated with my insurance, Kaiser, but the exercises we tried caused more pain, so I hired another, private, physical therapist. That, also, caused too much pain for me to continue. The exercises we tried involved maintaining pressure on a blood pressure machine (to keep my back in a neutral position) and doing core exercises. That was about 8 months ago.

Recently, I tried working with a yoga instructor who specialized in back injuries/rehab, but, again, there was significant pain after those workouts.

I do not do flexibility work--other than what was tried with the yoga nor have I tried the foam rolling. I would be willing to try anything if you think it would help.

I am active with my ranch work and veterinary work along with some biking (about an hour 2 x's per week), but do not have a routine at a gym. Riding often causes significant flair-ups, but it is something that I enjoy and is essential for the ranch work I do.

I gave Gary the information I posted on this site, and he suggested ART (Active Release Technique) to get a handle on the pain then, immediately moving to the flexibility and core strengthening program. He provided some local contacts for people who perform ART. He had a harder time coming up with a qualified PES/IFS trainer in the area for me, so I'll need to do some research to find someone like that.

Here's what Gary said:
"Looks like typical over-use injury from years of sitting (horseback/tractor, etc.), running, and lifting hay without any specific strength and flexibility training to correct those imbalances. Anti-inflamatories will be of little help since there probably isn't much swelling. Probably more unbelievably tight muscles around the hip flexor and lumbar area, possibly upper back as well (just a guess).

Ever heard of A.R.T. (active release techniques)? Here's a website that gives some info on this: http://www.activerelease.com/what_patients.asp

Give that a shot, then if that helps, get right on a flexibility and core strengthening program. I don't think stretching and strength training would be a good idea just yet, since most motions will cause him pain. So, basically try to alleviate the pain, then work on flexibility and strength. Be patient; what took years to do, may take that long to undo."

____________

I understand I will need to make some significant changes with regard to a fitness routine. I would like to get the the best start in that direction as I have had little qualified information since this injury. What Gary said made sense to me. He also thought I should get the input from the highly qualified people (like you) on this site.

I would appreciate any direction and help you're willing to offer.

Thank you for your time,
Bill (Dr. W)

[Willie]

Sorry you are dealing with this!
I am rehabbing a herniated L5-S1. It's taken a year (so far) and I almost pain-free (still uncomfortable, but no pain for about a month now). Acupuncture, Physical Therapy, and Chiropractic care have all helped me avoid surgery. I've also had three spinal injections.

I don't know what advice to give, other than to listen to what Julie tells you and keep trying new things! I would also do more flexibility and core work. My uneducated guess is that your back is so tight from all this pain that you can't release the muscles to begin healing.

[UConnJulie]

ART is good stuff if you find the right practitioner ...

Typically what you would likely benefit from is ...

*get the glutes firing properly (they will not be given the nature of your injury)
*mobility work for your T-Spine, hips, and ankles
*foam rolling for all your muscles (as they likely have many trigger points from all the pain)
*flexibility work for all the muscles
*core stability work (glutes and abs)

[JayneWayne]

Kate & UConnJulie,
Thanks so much for your words of support and assistance. Sounds like great advice. I am making an appointment with a local ART practitioner who is also a DC. He, apparently, works with the best local PT's--in San Rafel--so I hope to find a good local PT as well.

I'll be in touch as to the progress with that.

Thanks again!!
Dr. W

[Cola717]

Hi Dr. W-
I just joined this forum and started NROL last week.
I ruptured a disc in my lower back almost a year ago. Had the whole excruciating pain- Charley horse that won't go away, numbness, tingling.
I also avoided surgery by taking a wait-and-see approach. It took about 5 weeks (of course it felt a lot longer!!) and 2 courses of Prednisone. Now it's mostly gone but the numbness still runs down my leg most of the time. Of course I am a total chicken when it comes to doing anything that might aggravate it!!!

I hope the ART therapy gives you some relief.