Herniated Disc Treatments: Which Options Make Sense

Dr. Jonathan,
I think this comment will help others. I did all the meds for pain relief and the injections to my lower back. Nothing seemed to help. I even did physical therapy. At one point I had to accept the pain and just live with it. So, I got up every day. Made my bed because it helped me not to crawl back into it. I sucked it up and put in a new flower and veggie garden.
At some point I learn about Lyrica. I found out that it’s like neurontin (sp?) but less side effects. Neurontin was horrible for me. I asked my doctor to let me try Lyrica. Now I call it “life in a bottle.” My nerve pain going down my legs is gone. Although I gained 10 lbs, but change my diet and lost the 10.

Thank you very much for this wonderful video.

I injured myself about 2.5 months ago attempting to carry something heavy. I had sharp pains in my button and running down my legs.

For the first 2 months, my main symptom of pains in the buttocks legs came only when I stand or walk. Since I spend most of my day sitting in front of a desk, I continued my life pretty normally but stopped going to the gym etc.

For the last 2 weeks or so, I get pain in my calf even when sitting. It is shapr sometimes but generally a dull pain. I even have it while sleeping. I am able to walk for longer periods now before having to sit for pain relief (up to about 10 minutes at best).

Am I getting better or are things getting worse?

Rajiv, that sounds so familiar.

And personally, I love the idea of avoiding pain (and disc surgery).

So two years ago after walking (the last two days I could walk before I was floor bound) out of my neurosurgeon’s office scheduled for emergency surgery, two books came to me that got me off the floor and onto my feet in three days (saving me from surgery).

** ‘7 steps to a pain free life’ by Dr. Robin McKenzie (all physical/structural)

** ‘Healing Back Pain’ by Dr. John Sarno (mind creates physical dynamic of pain, not having much if anything to do with bulging discs)

I could say a lot more about all that, but someone is interested in speeding up your body getting itself out of pain, these two books will help you.

(Shelly, the half the first book is devoted to reversing cervical disc issues. Rajiv, the other half is for pain like you describe.)

The information on your website has confirmed what I have learned about my back pain…but I have yet to reach a tretment that significantly reduces it. I have a herniated L5/S1 disc with an annular tear.- that happens now to be resting on the S1 nerve root. The pain in my lower back and buttocks (piriformis area) is excrutianting- even when I am medicated and now I have severe nerve pain in my upper thigh. I have tried injections with little sucess…any thoughts?

Thanks so much for sharing your story and success.
Dina

I have had sciatica symptoms off and on which normally responded to Non Steroidal anti-inflammatory drugs till about 5 weeks ago when after a long haul flight I developed L5 sensory symptoms effecting mainly my 2-4th toe along with calf and Buttock pain on my left leg. MRI showed L4/5 prolapse impinging on the nerve root. The spine surgeon suggested surgery but put it off for now. I have had some improvement in symptoms especially over the past couple of days. It seems to wax and wane though. Would it be reasonable to hold off surgery for another couple of weeks and secondly what is incidence of recurrence with or without surgery?

I have lower back pain in sacrum area also sciatic pain in calf muscle mri shows l4/5 disc bulge on to nerve facet ongoing now for 21 months had cort/inj. to no avail any advice would be appreciated .thankyou keith hannan

Hi Dr Kuttner,

Thankyou for such an informative site.
I have a L2/L3 prolapsed disc. The incident occured 7 months ago and I have been managing the problem as much as possible with the aid of physio/pilates, etc. I am a triathlete, 30y.o, 160 pound so i thought i was an unlikely candidate for this injury. To date I have only run once (less than a mile) in 7 months and the pain/sciatica pain is still present and debilitating daily. I live in Australia. I have 2 questions. 1) i still cycle but with pain, could this be doing more damage? and 2) Is there any professional colleague in Australia you can recommend to look at surgical options for this injury?
Warm regards
Daniel

I had an MRI yesterday showing a prolapsed disc, after 5 weeks of symptoms. My neurology Consultant has diagnosed cauda equina syndrome (numb in the saddle area, leg pain, reduced anal tone etc) but thankfully no loss of bladder function. I feel I am improving and so I am being treated conservatively. My question is, what are the chances of this happening again? The more I think about it, I can remember quite a few episodes of severe pain in my lower back over the years, including some cortisone injections in 1987.
I am worried that the next episode will be worse and give me more “scary” symptoms!

I had a small herniation in l5-s1 and moderate herniaiton in l4-l5 and it was affecting my right leg. in abount 2 years it all went away and life was pain free. however about 2 month ago l5-s1 herniation has developed and was diagnosed as a big herniation. when it first happened I wasn’t able to move and the pain was severe in my right leg (especially when I sleep) and currently after 2 months of treatment of pain killers pain is much less in my right leg and there is no back pain at all. eventhough I stopped all medications 2 weeks ago.
The problem is there are ups and downs to the extent that some days I am totally pain free and some other days it’s difficult to get out of bed and sometimes I am limping.
recently I had EMG test and the result was that the pressure on the nereve is not hard

I have seen many surgents most of them think that microdiscectomy is a must. and a few think that I should try cortizone injection first.
I joined a new company and I would want nothing to affect my career
so should I try the cortizone injection or a microdiscectomy would be a quicker and more effective solution? what are the risks of microdiscectomy and what are the chances for imrpovement??

and actually there is one more thing that I don’t understand
if the slipped disc is not going back in place howcome can someone get better with a surgery? and why people can have it removed and still feel pain?
sorry for making it long but I hope you can help me with that decision

Kind Regards

I have had two episodes of back/hip/buttock/leg pain in the last three years. The first was in March 2008, when I was confined to bed as I was unable to stand or walk for two weeks. I was given Tylenol 3, Lyrica and Neproxen, every four hours. At one point we were forced to call an ambulance and was taken to hospital. I received three doses of morphine during this stay. After three weeks the pain disappeared and I was back to most of my normal activities within a month. In April 2010 I had a similar occurence where I was again unable to stand or walk, and again went to hospital where I was given gabapentin, oxycontin, etc. The pain subsided in two weeks but has never completely gone away. I have had lazer treatments and accupuncture and have been told I have periformis syndrome. I continue to take neproxen and Tylenol Arthritis for pain. I have had a recent MRI and am waiting to see a neuro-surgeon. A previous MRI showed a bulging disk at L4-L5 and I assume it was pressing on a nerve as I had severe pain in my left ankle as well as the buttock area. Do you think that surgery might be my only recourse?

Hi Jonathan, I am 55 years old and developed a bulging disc L5/S1 last August. Have had it for 9 months now. I have pain in buttock and lower outside calf . things have improved a lot and am now able to do without regular painkillers but still take ampitriptiline at night. I have had a cortisone nerve root injection but it didn’t give me any more relief. Now surgeon is talking about surgery to remove the disc pressing on the nerve. I would obviously like to avoid this if I could but as my lifestyle is so restricted at times (can’t sit long car journeys or stand in one place for longer than 30 min then I get so sore I have to sit or lie )Im not sure if this is ever going to go away completely. Have you any advice……

my husband have herniated disc he been try hydrotheraphy at westmeat hospital but the nex day he could`n move at all. What else`s he could try,any sagestion for him please???????

I have 2 partially herniated disks (L4 and L5). I have recieved 2 injections of cortizone within 2 weeks of each other. The doctor who has been treating my pain said that the ultimate goal is to have the injections take care of the pain for atleast 4 months and recieve another injection. After the first injection the pain went away for the first week and gradually came back as i approched my second treatment. After the second injection the pain stayed away for around 3 weeks and now at a month later i can barely move i am in so much pain. My question is…with cortizone injections, should the pain gradually over time decrease and eventually heal it self or is this a sign that with pain, already returning 3 months earlier than once hoped for, is here to stay? I cannot take any narcotics or medicine that can alter my mind or body due to a high risk job that i have, so i am stuck taking aleve or advil to manage the pain, which seems to barely touch it anymore. I live an active life and i would love to maintain that lifestyle and not become a home body afraid to do anything for fear of pain the next day…..any suggestions or advice would be appreciated. I am 31 years old and am fearful of what my life may be in my later years at this point. Thanks for your time.

Dr. why are there no replies to the last 3 or 4 questions – one of them being mine? I am still waiting for an appointment with my neurosurgeon. He has my latest MRI results and I have not heard what it showed.

Elaine

Since my last question on April 18th things have taken a downward turn. Had a 2nd injection but after 10 days I was in severe pain and ended up in hospital leaving me with numbness in my foot and calf. Seeing the consultant and repeated mri s being done it showed that the L5/s1 prolapse had worsened. So Im for surgery next week disectomy and will let you know how I get on. Like others who have written in my life has been on hold for 9 months and I want to get out and about again without worrying about pain.
I do enjoy your site Jonathan and your knowledge is invaluable. I was wondering after surgery is there anything I can do to encourage the feeling back into my foot, unless it goes away with surgery but there are no guarantees of that.
Thanks.

hello Dr. Jonathan
i suffered a prolapes disc L1-L2 2 weeks ago (there was no obvious event) and i now have mild to severe pain in the area depending on which position i adopt (bending forward for extended periods causes sever pain)… but luckily no sciatica.
compared to my usual lifestyle as full-time rock climber i have been relatively idle in fear that i might slow down the healing process by applying forces on the disc that might disrupt disc healing. but after watching your video i feel i should start moving around more, is there any time frame? surely forces on the disc can’t be good for healing? are their any specific exercises or interventions that i can do to speed up recovery, or improve healing as to not have a relapse? i have heard that an inversion table might help?
thank you very much for your time!!
Scott
BSc. Sport Science (Stell.)
Med. Hon. Applied Anatomy (UCT)

Hi Dr.Jonathan,

I’ve been diagnosed with a disc bulge (L5-S1) 2.5 months ago. I used to have some pain in the lower back before that, but it was not severe. However, 2.5 months ago, I was lifting some weights in the gym and I could feel a sudden pain in the lower back. I knew something went wrong right away and in the next few days, I began feeling pain in my right buttock and in the side of the foot. After consulting with an orthopedic and having an MRI done, he suggested complete bed rest for a week and physiotherapy after that. After 2 months, the pain subsided but it never went away. It only pains while I’m sitting and I can move around and sleep without any pain. I decided to consult another doctor and this time, he suggested myotherapy. The myotherapy is not helping and I feel that it’s only aggravating the condition. I’m a 26 year old male with no previous history of back problems. What do you suggest in my case? My job requires me to be able to sit and work for 8 hours a day and I need to get well soon.

I was falsely diagnosed with piriformis syndrome in June of 2011 after running a half marathon. I went to physical therapy for 8 weeks. Finally, I had an MRI which revealed a moderate 20mm bulge at L4-L5. The bulge is pressing on my L5 nerve root. I had pain running down my leg, into my calve, top of my foot, but the most pain was in my hip. Especially when getting up from a sitting position, or while laying flat on my back. After seeing a neurosurgeon whom suggested the cortisone shot into the back, and if that didn’t work surgery…. I decide to start icing my back every 2 hours for 20 minutes at a time. I started taking advil every 4 to 6 hours… I also started taking some vivix and drinking lots of water. I must say that I have very little pain at the moment. I can feel it slightly when getting up from the couch or if I were to lift something heavy or bend wrong, but I feel like I’m healing after almost 5 months. Just wanted to share my experience!

I have been suffering from lower back pain for over a year now . I went to the chiropractor and that didn’t help, then to my primary care who did an x ray and found nothing. I see a rhuemotologist who said my primary care doc should take care of it.I went back to him, he ordered an MRI which showed a herniated disc. I then went for the injections which only helped temporarily. From there I went to a surgeon who said the disc would heal on it’s own and be patient.I’m back to not being able to sleep and have my limp back as the pain also goes into the left groin. Although my pain is in my lower back, it is actually in the very low portion of my back . I have had several injuries to my tail bone so I am wondering if the problem is actually in that area since it is not responding to any treatment. I am frustrated and tired (I am on an anti depressant at night but it’s not helping) Should I get a second opinion?

Hi Dr.Jonathan,

I have been suffereing from L4-L5 disc buldge for the past three weeks.I’m 26 years old.I dont have radiating pain in the leg.The MRI report says that there is no disc herniataion. But still Im having back pain and the discomfort. What time it will require to heal completely. Also how can i avoid from the reoccurance ??

Hi everyone I said I would let you know how I progressed after my lumbar dissectomy. It is now 5 months after the op and I am doing very well with practically no pain at all. My life has returned to normal although I have to be careful with no heavy lifting. My only regret was that I did not have the surgery earlier as it might have saved me the damage done to the sciatica nerve and means I still have a numb right foot. However, i am hopeful that this may lessen as time goes on and the nerve heals. apparently a nerve only heals 1millimetre a week. so it could take a while. I wish everyone all the best and hope they get relief soon.

I love that you suggest to get moving as soon as possible! Don’t forget that about 20% of people have disc herniations that are non-symptomatic. I try to teach my patients that that they will get better with time and that this isnt the end of their life. Conservative and alternative treatments should absolutely be tried before surgery.

hello, i am 20 years old, injured my back at gym due to heavy lifting week ago.my mri shows disk herniation at l5 s1 level.it says left paracentral prostrution compressing the exiting nerve.i hv read about the excrutiating pain and tingling sensation. I hv pain in my lowerback and sometimes hv tingling feeling in my legs. Ihave been resting for now and start pt. Can u plz tell me the process of disk healing? Will the herniated portion that is pressing thenerve will shrink along with disk. Also less symptoms are good or bad signof slow healing? Any light on this matter will be great help.
Thankyou.

Hello everyone,

I have been suffering from herniated discs for the past 2 years. It started with lower back pain and a short time after I started to feel pain down my leg. I did some physiotherapy and it actually got better for a while but came back a few months later after I had moved (lifting heavy boxes). I tried physiotherapy again but it did not seem to help. The symptoms started to get worse, I started to feel numbness in my foot and leg in the morning which would go away as soon as I would sit down for a few minutes. Eventually the numbness continued during the day to the point where I had difficulty walking. A few months after the pain came back, I felt my entire leg (the other leg, not the one that I felt pain in) get numb. I then decided to go to the hospital as I was quit worried. The Dr. ordered an MRI right away and after the results, scheduled a microdiscectomy for the next day. I had a really bad disc herniation at L4/L5 that was severely compressing the nerve roots. I had the surgery and felt really good right after, no pain, no numbness and recovered very quickly and well. I was so happy to be pain free, but that was shirt lived. About 3 months after the surgery, I started feeling similar pain again and it has gotten worse. I now feel some numbness in my foot and leg. I have been doing physiotherapy and do stretching and reinforcement exercises every day and also work out (elliptical/fast paced walking) on a regular basis. I had another MRI done and simply showed some scar tissue that may be irritating the nerves as well as 2 other small disc herniations at L5/S1 and L3/L4 but no pressure on the spinal sac. I am very discouraged that I felt so good after the surgery and now feel worse than I did prior to the surgery. I am hoping the Lyrica will have an effect on the pain without too many side effects as it is getting difficult to carry on my daily life. I sit a lot at work, so I’m sure that doesn’t help either but I try and get up and stretch every 20, 30 minutes. Do you have any suggestion what else I can do to get rid of the pain and numbness? I am worried that I will be in a situation a prior to my surgery where I would be in such bad shape that an immediate intervention would be necessary.

Thank you

thanks for the great video.i still dont understand does the disc heal back like before and perform the functions of shock absobtion like before? Because i was told it does not,like ‘a grey hair doesnt get black again’. Also after healing is it more vulnerable for further damage.
Thankyou.

I have a 13mm rupture in my L5, S1-S2. Some days I am not quite pain free, but others I feel as though I’ve been hit by a truck. I have surgery scheduled in a few days. My concern is that I’ve had four or five pretty good days. Should I try to not do the surgery? I still have quite a bit of pain right before bed, but it’s not nearly as bad as it was at its worse. I have two concerns. 1) that surgery may be unnecessary, even though the surgeon said the rupture is so big that it won’t be absorbed and it’s been 4 months with little relief and 2) if I put the surgery off, that I’ll end up with the horrid pain again and have to wait another three months for surgery. I notice on wet, cold days, my pain is much worse than on warm, sunny days.

In November I was diagnosed with a mild small herniated disc L5 S1 that did not appear to be touching the nerve root. Ihave had all kinds of problems since that time. I have seen 3Dr.’s and now seeing a Osteopath. I can’t seem to get back to normal. I first hurt my back in September. It took 3 to for 4 weeks to get back to normal. I was finally able to walk a mile again. I have always walked 2 miles every day and I have always been very active. In October around the 20th, I went to the fair. Up and down hills for 5 hrs not sitting down. I reinjured my back again. Hip and leg pain all on the right side. I have had repeated leg pain from hip stiffness and tightness to a constant butt burning pain that lasts 2 months until I got a cortisone injection in my butt. stopped for 3 weeks and then I guess I did something again and hurt my back. I teach Kindergarten and I sit in small chairs and bend down a lot. aim now having hip pain and some low back pain.I did not mention earlier that I have lots of pain sitting. It comes and goes. I also experience leg weakness and can only walk a short distance. It too comes and goes. I failed to mention that my herniated disc is on the left and all my problems is on the right. It has been 7 months.I have also been to therapy . My Osteopath now says it is bursitis and I got another injection. My other Dr.s were all Orthopedics. They said I would be fine in 6 months. I am not !! Should I have another MRI? Should I have a injection in my spine? I have only had about 3 weeks that I felt no pain.I think all my problems are the disc. Please advise!!!

I was asking yourself what is up with that weird gravatar??? I know 5am is early and I’m not looking my finest at that hour, but I hope I don’t look like this! I could however make that face if I’m asked to do 100 pushups. lol

Hi Saurav, I am 22 years old even i injured by back l5-S1 disc prolapse my while working out in gym. My MRI suggests the same as yours only mine is right paracentral protrution. My orthopaedist had put me on Pelvic traction for a week and than had me ake complete bed rest for 1 week after that. He had me start my PT sessions after that but still had me on bed rest for 2 more weeks. I go to work now but he has given me a Lumbo sacral support belt which i have to wear all the time except when i am sleeping. its been 6 weeks since i was diagnosed with this problem. I went in for a check up today. He told me to that i don’t need to wear the belt any longer but have to take care for 4 more months and make sure i don’ stress my back much. He has asked me to continue with the back exercises lifetime. He has told me that I can work out normally but my disc will not be as strong as it was earlier as a scar tissue will cover up the tear. so i have to strengthen my back muscles so that i don’t stress the my DISC

Dear Dr. Jonathan,

I am 52 years old and have had pains radiating from my hip joint down to my legs for more than 5 years. Series of medications could not help the issue. MRI test carried out showed ‘lumbar spondylosis; multilevel disc bulge with narrowing of the foramina exit’. How do I get in touch with you because I want to see you personally for treatment.

Please help.

Thank you.

Hello Dr Jonathan,

My problem is that I had a very profound disc herniation of the L5 S1. It was so bad that I was practically housebound for 4 months, the pain was excruciating in my left leg with also numbness and loss of ankle reflex. Physio Therapy did not work. My condition led to Cauda Equina Syndrome and I had emergency Microdiscectomy decompression surgery. At first, it seemed to ease my symptoms and I was able to walk with the aid of crutches. After five weeks I resumed Physio Therapy again, it made my condition dis-improve again. After being sent for another MRI scan six months later it turns out I have herniated the same disc plus another. Do you think a second surgery will work? My movement is getting less and less everyday with increasing pain and numbness. I take Lyrica 150mg 2-3 times a day, Tylex 30/500mg 6-8 time a day and Anxicalm 5mg once at night. This only lessen the pain, it is still severe, I used to take Diafene but my GP took me off them as after so long on them the caused edemas in my ankles and feet. I am waiting to see my consultant Neurosurgeon, I would love to hear another opinion on the matter.
Thanks
Edwina

Hi, I discovered 3 months back that i have a disc herination. L5-S1 on the right and L4-L5 on the left . Initially i had pain but mediation and Physical therepy helped me overcome that ..I use to be a sports person 7 years back and feel frustrated of not being able to jog anymore or play a sport or go try so many fun things other people do . Is there life after a disc heritaion. Also at work i often feel uncomfortable as all office chairs have wheels and i really need to balance my feet to avoid moving in the chair and hamper my back. Can anyone suggest what can be done .

Thanks
Bubble

I have had numerous cortisone injections to try to cope with pain in the lumbar, sacral area, both hips and buttocks,and down both legs, front, sides and back, ( worse in back ) and in both knees. I have been diagnosed with arthritis, spinal stenosis, (years ago with lumbago?) and a pinched spinal nerve. I have had numerous cortisone injections with diminishing results so I have discontinued this treatment. Chiropractic used to help after my first fall but since my second fall it is no longer helpful. PT treatment has included walking in water (which felt good but resulted in increased pain the following day. Subsequent PT included myofascial release treatments which temporarily helped loosen my extremely tight muscles in hips and legs but led to periodic episodes of increased pain. I have tried pain meds (neuronic which led to confusion, poor judgment and a near fatal accident; and tramadol which led to confusion, immediate memory loss and dis-orientation.) I now take only two Aleve daily and am tempted to increase the dosage. Is it likely that continued efforts with trigger point work will help or will my “pinched spinal nerve” act as a continuing trigger to keep my muscles in painful contraction?

I have had numerous cortisone injections to try to cope with pain in the lumbar, sacral area, both hips and buttocks,and down both legs, front, sides and back, ( worse in back ) and in both knees. I have been diagnosed with arthritis, spinal stenosis, (years ago with lumbago?) and a pinched spinal nerve. The cortisone injections became increasingly less effective, so I have discontinued this treatment. Chiropractic used to help after my first fall but since my second fall it is no longer helpful. PT treatment has included walking in water, which felt good but resulted in increased pain the following day. (Walking on land is very painful.) Subsequent PT included myofascial release treatments which temporarily helped loosen my extremely tight muscles in hips and legs but led to periodic episodes of increased pain. I have tried pain meds (neurontin, which led to confusion, poor judgment and a near fatal accident; and tramadol which led to confusion, immediate memory loss and dis-orientation.) I now take only two Aleve daily and am tempted to increase the dosage. Is it likely that continued efforts with trigger point work will help or will my “pinched spinal nerve” act as a continuing trigger to keep my muscles in painful contraction?

Edwina,

My situation is very similar to yours (see my posing above). The physio seemed to have made things worse after surgery and a later MRI showed 2 other small bulges besides the Herniated L4/L5 I was originally operated on. I tried Lyrica, it did not do much and weas disrupting my life in terms of concentration and memory and made me feel slugish. I discontinued it. I started to see a chiropractor and noticed immediate results. I feel a lot better and have days where I feel almost no pain at all. After strenious excercise and higher impact excercice such as cycling. Just have to find a good balance. I find the more active I am the better I feel. The chiro gave me strenghthening and stretching excercises to do every day which take about 30 minutes and suggested I walk a lot, drink a lot of water and consume a lot of vitamine C. i was a bit sceptical about these things but they seem to be working so I am going with it! Hope this helps!

Thank you for your video, I injured disc. L4, L5. I have been slowly recovering from this for the last three months. I just started back work about a week ago. I started physio about five weeks ago. I have been taking Lyrica for three months. I actually am starting to feel optimistic about my future again. I had to really push myself to participate again in everyday life. I thank you for your words of encouragement. My doctor will be making an appointment with a surgeon. After this information I think I will continue to do what I am doing.
Thanks again.

Dear Sir,

I have had a work accident by lifting and carry a water compressor `12 January.
The MRI show two prolapsed disk L4/L5 I have went back to work until I have collapsed in November, since than I am off work.
I have been trough the Tramadol, naproxen ”therapy” and I have received passive physiotherapy, means DIY 🙁
In the begging was able to use my inversion bench on the daily base and it felt good, if I would try this today it feels really bad, like when a old scare opens up 🙁
After 9 months I would consider myself 70% better compare to day 1.
The major inflammation and pain is gone but there is a bulging disk poking to the rear left as a result I have pain on my left hip as it is ”raised” by the bulge and also developed pain and over sensitivity in my right feet as I tend to lean right.
now I have been scheduled for injection and I would like to ask what do you think?
do i need it or is there any other way to treat my problem?

Hi Dr. Kuttner,
I had fusion of L-4, L -5 in 9/2011. I have had off and on tailbone pain every since. X-Rays show no bone structure disorder. Have re entry gone to therapist that does trigger point an myofacial release. Helped other areas of my back, but not tail bone. She wants to send me to a therapist that does internal muscle release. Your thoughts, please. Thank you, Julie McGrath