Injuries and RehabTell us where it hurts! Do a quick search before asking about your shoulder injury to make sure your question hasn't already been answered (about 50 times), and read the sticky post first.
Longtime lurker...needed to finally post as everyone is always so helpful around here.
Like most here, I am an avid personal fitness fanatic. Train everyday, from weight training, running, swimming, spinning, basketball, and racquetball amongst other things.
Anyway, about six weeks ago hurt my back. It got worse, shooting pain in the lower back down the butt and upper back of my leg. Initially went to a massage therapist--nothing, PT--not much, and Chiro-nothing. Kept working out as in the past it would go away, but it only got worse.
Went to a spine specialist, got an MRI indicating herniated disk L5/SI and began with a week of oral prednisone--nothing, and have subsequently had two epidurals with a third this Wed. Have vicodin which doesn't work, and taking Gabapentin four times a day. Been going to PT for three weeks and usually just feel worse the next day.
Hurts ridiculously (tears and I am 6'4 220lbs) when I first get out of bed. Cannot sit down as it hurts too much when I get up. Getting in and out of cars is torture.
Any suggestions would be very much appreciated as I start a new job where I will be traveling a bit and very anxious about having to sit for any period of time.
Thanks everyone!!
Oh and I followed Willie (aka Kate) and she seemed to recover but was able to sit...
Wow... that really sucks. I am particularly worried that your traveling may exacerbate your condition.
Have you been to a neurosurgeon yet? If not, I would suggest doing so. You may be a candidate for a spinal fusion.
Some things to ask if you do indeed need surgery. You may just have a bulging disc pressing on a nerve, but the joint may still be pretty stable. If that is the case they will do what is called a "lum lam" (lumbar laminectomy). That is where they simply cut away the piece of bulging disc, and it should bring you pretty immediate relief from pain.
If your joint is extremely unstable they may have to do an "instrumented" case. It is a pretty invasive surgery where they dissect through muscle, remove the spinous process and ligament of flavum, and then they scrape out all of your disc, then put in a piece of cadaver bone or a synthetic bone material called PEAK. The joint is stabilized with large peticle screws and rods. Depending on the doc you will probably get either a "T-lif" or a "Plif".
The results are actually pretty good on those, but it will seriously interfere with a fitness program. The recovery is pretty rough. Try to avoid it if you can. If you have more than one level that is unstable they can do 2, 3 and even 4 level fusions. You don't sound like you're that bad off though.
Check around the surgeons and see if any of them do a new(ish) procedure called a "facet fusion." There are only two companies nationwide who can provide the bone and instrumentation for it: TruFUSE or NuFIX. They are both pretty similar. The thing I like about these procedures is that they can be done minimally invasively or percutaneously, which means MUCH less dissection.
Basically they just tap a couple of bone dowels into angle-drilled holes in your facets. Recovery is a lot faster, and the result (IMHO) is better. The main difference is that you have to wear a back brace for about 6 weeks post-surgery. This is only a problem because relief from pain is so immediate that patients can be tempted to skip it and start to be active before the bone has fully fused, causing the dowel to back out.
I hope you don't need surgery at all, but if epidural injections are touching this problem you may have to. If you can get a neurosurgeon as opposed to an orthopedic spine surgeon I would recommend that. I'm just picky when it comes to my spinal cord I guess.
Update us in this thread when you have news either way. Best of luck to you.
Thanks for the replies.
I have full strength in my left leg, the stabbing pain only goes down to the top part of the back of my left leg not all the way down to my foot. I have not lost function of my bowels or when walking. The doc and PT are not concerned at all with my strength right now.
Once my day is started, I function fairly normal again with the exception of the act sitting down or standing up again, in and out of cars and waking up in the morning. I do still go to the gym and workout with the exception of doing anything overhead and any leg exercises. I walk on the treadmill slowly and then stretch my hamstring afterward (and do it before working out). My doc ( a Physical Medicine and Rehabilitation/Interventional Spine Management) and PT said to continue to workout, but if it hurts at all do not do it.
During my PT sessions (I do 1-4, 8 at home):
Lay on my back, hold back of hamstring and gently kick up
On back still, use band on foot and extend foot 30x, then use it to stretch hamstring
On back still, place feet on ground and rock knees back and forth--Trunk rotation
Cobra pose or Back Extension Stretch
Transverse Abdominus exercise
Deep massage of the back
He has done electric stim, but feels it isn't doing anything
Ice
I have not yet seen or spoken to a neurosurgeon, but may after my third cortisone shot tomorrow.
If you weren't getting your shots from a neuro then you probably weren't getting epidural injections. Sounds like they just gave you a local cortisone shot, which can relieve pain, especially if there is a spasm involved, but not nearly as effective as an epidural. Those are usually done by neurosurgeons because it is a very tiny target (the outer layer of the spinal cord) and phys med docs aren't generally qualified or trained to do that. Find out what you have been getting thus far.
My shots were done in the spine clinic at the hospital by an anesthesiologist, thought the last one was done by a radiologist. Your post reads like you've gotten them pretty closely together, while I had to wait about 8 weeks between each one.
I'm so sorry you are going through this! It is awful, isn't it? BUT, I can tell you, that avoiding surgery was the smartest thing I've ever done. A year later, I am rowing and lifting (almost) as hard as I ever was. The only thing I'm missing is heavy squats and deadlifts.
I'm walking 60 miles for a breast cancer cure, September 11-13, 2009! Please support my walk and help me raise funds for cancer research by donating to the Susan G. Komen Breast Cancer 3-Day: http://www.the3day.org/site/TR/Walk/...nal&fr_id=1300
Jean-Paul: My doc said it is an epidural and I will call to verify. I am placed on a table and have four anesthesia shots in the lower back area. They then use an x-ray machine to take pics while everyone is in the room and inject on the top area and then the lower area of the L5/SI. So, I believe it is an epidural (but again will check).
Kate- I have followed your progress and heartache through the pain and I totally understand what you went through as I am going through the same. Being as active as I am, it absolutely kills me to have to pare down my workouts--just as it did you. I am definitely going through the ups and downs of this whole experience. I am typically very upbeat, but when the pain is there I am selfish, irritable and depressed?!? (which is not me!)
I have received the epidurals about a week and a half apart. I know that is sooner than most and know that I am limited in the number I can have, but due to starting a new job and wanting the pain to be manageable we have gone this aggressive route.
I do not want to have surgery as I have read the efficacy is similar to that of more conservative treatments. I have not thought about acupuncture and not sure how I feel about it. Again, I do not want surgery as I feel that in a couple of years I will be back in the same position I am now.
As, you all can probably tell I am getting to my witts end about this and just want to cut the disc off myself...
Yeah, it definitely sounds like you got an epidural. I don't recommend a third one in such close proximity to the other two. They say you should only do about two a year or you could wind up with degenerative disc disease, which may already be in effect for you.
Ugh. So sorry. I definitely suffered depression as a result of my injury. The fear of the unknown-- you know, "is this really ever going to heal? What is my risk of re-injury?" really weighed on me.
I had mixed feelings about acupuncture as well, but was finally convinced to go by my grandfather, a retired neurosurgeon. I figured, if he's the one advising me to check it out, I should go. I can't tell you that acupuncture was a catalyst to my recovery, but it surely didn't hurt!
I'm walking 60 miles for a breast cancer cure, September 11-13, 2009! Please support my walk and help me raise funds for cancer research by donating to the Susan G. Komen Breast Cancer 3-Day: http://www.the3day.org/site/TR/Walk/...nal&fr_id=1300
Well, went to PT and felt a little better today--he did a lot more manual therapy which hurts during but loosens things up. As the day goes on I do feel better. It is in the morning where it is bad, but slowly improves during the day. I asked about a neurosurgeon, as I agree with you Jean-Paul I should probably be seeing one, and he told me to speak with my doc and ask what the next steps are. I simply want to avoid any kind of back surgery as I have not heard definitive results from it.
I know you are supposed to have time between epidurals, but given my situation and starting a new job with travel and sitting...I need to get this fixed. And I will ask the doc about disc degeneration and what the future will hold.
Tonight was chest night, but not your normal routine since the injury thus I called it "chest-lite" since I stayed away from dumbells/barbells and did cables and machines, then walked two miles (slowly), and finally stretched. I am now icing and getting some late night dinner. I hate these wimpy workouts, I feel like I didn't accomplish anything (I think you said the same thing many times Kate!?!)?!?
I will let you all know how the conversation with the doc goes tomorrow and the plan and of course the epidural...fun fun!!
Snuck in a really light shoulder workout (no military press) prior to my third and final epidural--had too for sanity sake.
The doc said that there is not degeneration at this time based on the MRI which is good. I was switched to Lyrica which is supposed to be better than Gabapentin. And unfortunately, she said if this continued conservative treatment does not work (which includes another month of PT) surgery is the next step. A discectomy (sp?) to be precise. I still want to avoid surgery at all costs, so pray that this last epidural works.
Try to avoid surgery if you can, but I have my worries based on what you've said so far. A discectomy will still be considered a "possible instrumented case," which means that once they're in they'll test the stability of your joint. If it is unstable, they will have to fuse the vertebrae. If it is stable, then all they have to do is shave off the bulging part.
Definitely inquire about the facet fusion as a possible procedure before you go under the knife. Request a doctor that knows how to do it "minimally invasively." Since you actually want to get back in the gym, you want to have a little dissection as possible. With a MI facet fusion there is virtually no dissection.
On an instrumented case you are fully opened up and they use a big tool called a cob to literally scrape your muscle away from the spine so they can get full access to it. It's necessary if you are so unstable you require a PLIF, but you would need to have more than 3mm of instability for that to take precedence over a facet fusion. Recovery on that one sucks!
Just wanted to jump in and say that I have had both a MI discectomy (lumbar) and a cervical fusion (single level) and I am very happy with the results of both.
The MI surgery was amazing..I walked out of the hospital hours after the procedure and have not had any issues since (this was almost 2 yrs ago).
The fusion has been a bit more difficult to 'recover' from but I am now at the point where I am as fit (or more) as I was prior to the surgery (in October).
So if the doctors all agree that surgery is the best option it doesn't mean the end of working out..not at all. I have used these as motivation to come back stronger (of course I have slightly adjusted 'what' I do in the gym but I still walk out dripping in sweat and happy)..
JP- I will be and have been avoiding surgery at all costs. I am giving the Lyrica and PT sessions another month or two and then will re-evaluate. I start a new job which requires travel, so we shall see how I fare in the upcoming weeks. The neuro spine surgeon I go to will most likely be out of Rush here in Chicago which is ranked really well nationally. But, when and if I do go in I will ask him what you said in your post. Thank you so much for your continued postings. What else do you think I can do to heal my herniation? Your help is much appreciated!
Jcruverp- tell me more about the MI discestomy. Recovery time, back to work timing, workout timing, etc.,. I would love to hear more about it as everyone is different and I want to hear from someone who works out.
My workouts to this point have been depressing me as I cannot push any weight and the cardio side is non-existent. My bball buddies dropped me from the emails, how depressing is that? My saturday full body workout is on hold and that is my favorite one as it is all supersets and heavy weights. Oh well, patience is needed and actually more concerned about having to sit all day for the new job.
I had lower back pain on and off again for many years prior to this and had been a GP who in the past had given me painkillers and little else.
Then I injured myself lifting (bad form on deadlifting - was doing high reps with medium weight and twisted a bit) and again went to my GP. He gave me painkillers and put me on a steriod to help the swelling.
After a few weeks (and after the steriod) the pain became unbearable and I went to the ER where they ran a catscan and said i needed a nuerosurgeon and an MRI. This confirmed a severely herniated disc and the nuerosurgeon suggested this : http://www.ubneurosurgery.com/handle...late&cpid=6668
I went in surgery at 7am and walked out of the hospital around 3pm. The pain that had been so intense and ran down my entire leg was gone. The only 'pain' I had was from the incision (which was about an inch long if that). I was out of work for a week (mainly because they recommended that..it wasnt due to pain).
I dont exactly rememember how long I waited till I started working out again (but I do recall how difficult it was waiting..because I really wasn't in pain but wanted to heal properly) but it was not long at all. I eased back into everything as much as I could. I returned to doing just about everything I had in the past (running everything by the doc of course). I increased my strength to a level higher than prior to getting the surgery. (added over 50lbs to my deadlift since).
I have had a cervical fusion since but it really isnt truely related. Doc says I have degenerative disc disease and may even need another level fusion down the road (he didnt do it this time as I am in good shape and he has hopes that I wont require it).
But as far as the MI disectomy...I cannot tell you enough how much it helped me (like I said before..I had issues with my lower back for many years and these are all completely gone).
Let me know if you have any more questions I can help with..(I cant answer anything 'technical' about the procedure of course...but as far as my experience).
and I REALLY need to post a diff photo..but I am not on my macbook here...
Jcruver- So it sounds like you are 100%? It just seems like most people that go down the surgical road are not 100% and need to go under again in the near future. I cannot bear that thought! Were you able to sit for long periods of time at work? You were really able to go back to work after a week?
Well after seeing the PT yesterday, I decided to "ban" the gym for a while. I will be there to stretch, do my transverse abdominous exercises, neuro flossing and a little walking. I need to let this thing rest, but remain active enough to keep the blood flowing to the area.
This will be a real test of will power to stay away from the weights. Also, I will let you all know how the first couple of days of work go. Hopefully, there will be a lot of chances to stand up and stretch a little.
Can you swim?
I was a swimmer in high school, so when I got super frustrated about no lifting, I got into the pool. It wasn't great, but at least I felt like I was still doing something.
I can tell you that after all of my treatment, I am completely 100% recovered (with the caveat that I'll probably never deadlift again). In fact, I just carted 32 kids around D.C. for five days, when exactly a year ago I couldn't stand for longer than 45 seconds without pain.
I'm walking 60 miles for a breast cancer cure, September 11-13, 2009! Please support my walk and help me raise funds for cancer research by donating to the Susan G. Komen Breast Cancer 3-Day: http://www.the3day.org/site/TR/Walk/...nal&fr_id=1300
I was also a high school swimmer and have asked my PTs about it and both said not to swim at this time because of the rotation at the hips. I would love to swim, but they did tell me to walk in the pool (I would much rather swim). What did your PT tell you in terms of swimming?
It is great to hear that you are at 100%. I went though your whole journey and don't remember how long it took you...
I was also a high school swimmer and have asked my PTs about it and both said not to swim at this time because of the rotation at the hips. I would love to swim, but they did tell me to walk in the pool (I would much rather swim). What did your PT tell you in terms of swimming?
It is great to hear that you are at 100%. I went though your whole journey and don't remember how long it took you...
I initially hurt myself in August 2007. I felt "good" by July 2008. It took until March 2009 to feel like I could do everything I wanted to do, full-out, pain- and worry-free.
Hmmm... my PT's said swimming was fine. Do they have water-joggers at your community pool? They are weighted vests that sit around your hips, I believe. I don't have any first-hand experience, but I know a few people with other injuries who have used, and liked, them.
Also, what about using a pull-buoy? Less hip rotation?
I'm walking 60 miles for a breast cancer cure, September 11-13, 2009! Please support my walk and help me raise funds for cancer research by donating to the Susan G. Komen Breast Cancer 3-Day: http://www.the3day.org/site/TR/Walk/...nal&fr_id=1300
Just wanted to throw my 2 cents in....I have the same exact symptoms as you Chi E-man. It happened very suddently. I tried the pain management and therapy but that did not work. I ended up in the hospital 3 times. During my 2nd stay, I was heavily sedated with dilaudid. About 4 am, i hear all this commotion over me. They had overdosed me on dilaudid, and were trying to revive me with narcan. Very scary moment for me. I left the hospital the next morning because I didnt feel safe. That lasted only a few days because I was in the most pain of my life.
I was admitted to the hospital and the Dr. recommended I have surgery. I had it the next night. I was VERY glad to have the surgery microdisectomoy of the L4-L5 and L5-S1. I was up and walking the next day. It relieved ALL of my pain. I was back to work in less than 3 months (police officer).
I think JP said it best, avoid the surgery if you can but if you cant get it done. It has been exactly one year since my surgery. I can do all of the things I was doing before. Just make sure you properly stretch, I never stretched very well or much before doing physical activities.
This is kind of a brief story about me and my issues, I hope you well and wish you the best.
Kate- my pool is only 3.5 feet all around and the PT does not want me to wear any weight up top being as tall as I am. But, I will take your advice about the water dumbells. The pull buoy is a great idea!! I may give it a try in the next week as I get even more anxious to do some physical activity.
BAD- I love to hear positive stories like yours. My question to you is, were you able to be in a car or seated for periods of time right after your surgery? I realize you are a police officer and have a physical job, but were you able to get in a car go to work and be at a desk all day? Appreciate your answers, as I cannot take off that amount of time and my job is not a physical one.
First week of work almost completed. The Lyrica,, the last epidural, PT, stretching and NO working out seems to allow me to sit, albeit when I get up I am still in pain. But at least I can sit!? I just need to get rid of the transition (getting up from the seated position) pain.
Thanks again all for your comments...I love hearing from you all!
I can sympathize with you. I had a diffused L5/SI. Started with oral meds, the original Dr. diagnosed it as bursitis (sp?). When pain started getting worse with shooting pain down my left leg he sent me to a pain clinic. Had two epidurals. I am a pastor, spent a lot of time visiting people and laying on the floor. I could stand and I could lay down, could not sit. On my third visit for epidural, the Dr. heard me coming down the hall. Said is sounded like a horse. I was getting foot drop. I was referred to a surgeon. Since I was only 2 hours from Birmingham, AL. (1995), I went to the back guy in Dr. Anderson's group (The folks who treat all the pro athletes). Dennis Rodman had just been in the day before I went in. After a ton of tests, mri, bone scans and a mylogram, they finally decided the best course was a lamonectomy and discectomy. That was in January 1996. I began lifting in 2007. I have not had any major problems since the surgery. I am very careful when I lift, however. I am very form conscious. I am with JP, get to the best doctor you can find.
Just reread this post, sorry for the rambling all over the place, guess I need to head to bed.
Bama- good to hear your story too!! You didn't have to wait 11-years to workout did you? Or did you just begin to work out in 2007? It's only been a week since I stopped working out and it is driving me up the wall!!
BAD- I love to hear positive stories like yours. My question to you is, were you able to be in a car or seated for periods of time right after your surgery? I realize you are a police officer and have a physical job, but were you able to get in a car go to work and be at a desk all day? Appreciate your answers, as I cannot take off that amount of time and my job is not a physical one.
Yes, I was able to get in and out of the car and you could be seated. You will have to take probably a short time off of work. Obviously, back surgery is a major surgery. One of my recommendations is also go to a sports affliated physical therapist. I went to Catz Sports and their staff did a great job of doing funtional types of movements to help in the rehab. I think you could still do your job if you had to. Just be dilligent with your therapy.
Pastor Bama hit the nail on the head. When working out and/or playing any sports, you have to be conscious of your limitations. I would love to be back playing full contact ice hockey but I dont think its a smart idea especially at my age (43). I played golf a few months after my surgery and shot a 75 (Par 72, best score of my life). So I belive you can do anything you wish, within reason!!
Herniated Disk L5/SI
Linear Mode
