Buldging Disc - Surgurey or No Surgurey?

Just wondering how many people out there have had surgurey for a buldging disc? I've got a slight buldge at the L5-S1. It's not un-barable but I can't go for a jog, or really do any heavy lifting without it being really sore for the next couple of days afterwards. I know my doctor isn't for the surgurey because of the risks involved. However, I don't know what the success rate for that surgurey is. On one-hand, I realize it could make it worse. On the other hand, I'm only 25 and don't really want to be limited in terms of physical activity for the next 50 years. Anyone have any advice?

I had a 3mm and two 1mm buldges at L5-S1 on 3 separate occasions and was able to get better without surgery both times. I was 26 when I did the 3mm, 28 when I did the first 1mm and 31 with the last one. PT 3 days a week for a month and a half with the 3mm protrusion and 1 month with the 1mm protrusion. I have been able to resume all physical activity without a problem. It all depends on your MRI and how bad the protrusion is. If it is not completely ruptured then most good PT's will tell you it can be controlled without surgery.

Biggest piece of advice I can give you is after the rehab is done make sure you get a good post rehab workout program together for your core. Your core, contrary to some beliefs, is from your knees to your nipples on both sides of the body! Too many people, including yours truly, have done crunches and TVA exercises for days only to forget about the glutes and hamstrings which are just as important if not more so than the abs. You need to balance both sides of the body, front and back, in order to kick this issue. I didn't realize this until my 3rd L5-S1 protrusion. Haven't had any disc issues since hammering my hamstrings and glutes. Keep them strong and stretched. Good luck.

AMO, thanks man. That's good advice. You're right, I didn't know that core should be more focused on glutes and hams than abs. I will definitely keep that in mind.

I'm not quite sure what you mean by 3 different protusions on the L5-S1. Maybe my anatomy isn't that great. How did you have three protusions on the same disc?

I totally agree with AMO. I went to PT a year ago for one month and he told me to continue the exercises after I was done with that month. Today, I have slacked off and my back is killing me again. About a week ago I started the exercises back up again and the pain is reducing but again, I wish I would have done what they said for me to do.

I had issues in the same place and got the surgery as the pain in my leg became unbearable.I tried everything before but nothing worked. I will say recovering from surgery was the worst pain i have ever been in but in the end it was worth it as (knock on wood) I have not had any issues. If you have any questions please feel free to PM me or maybe Andy Nitzel as he has had major surgery on his back and he helped answer a lot of questions for me.

Greg, I had 3 protrusions in that one disc at 3 different times. 26, 28, and 31 years old. When I started learning how to use my glutes and my hamstrings correctly (proper firing sequence) the back issues went away.

Don't forget about your abs, just do the same amount of work with your glutes and hams as you would on your abs. It's about balance.

When we injure ourselves we create compensations to help the body do what it is supposed to do (fight or flight), but maybe at 50-75% effeciency. Those compensations take the same amount of time to get rid of as the time you were using them. 1 month of compensation due to an injury equals 1 month of proper exercise to get rid of said compensation. In some cases it can take longer. Stay patient.

(Message edited by amo on December 15, 2009)

what kinds of exercies are they getting you guys to do, ive had lower back issues for a month or so now, the physio really hasnt helped that much at all, in some visits its made it worse imo. Its only when ive been sitting (at work ) all day that it really comes on and like you guys mention at above it feels like the hams and glutes are so tight they are making it worse. Got physio in an hour and a recommendation from doc to get mri so i think its time for the mri.

Great advice AMO!! I had surgery for a disc on L4-5 in 1997 and I am sorry I did. I now get steroid injections every 3 months to keep me pain free and riding!! I dont think they are doing this anymore but IDET really helped on L3-4. They coil a wire in your disc and heat it...it makes it shrink back. Worked great but the damage was already done to L4-5. Good luck man!!

Jeff, are you getting shooting pains, or localized back pain low on the spine? The MRI for me was crucial the first time I hurt my back. A good physiatrist and MRI tech can get you the answers.

I would strongly agree with those who say strengthen the core. I also suggest a chiropractor. I was very close to having surgery on my neck for a bulging disk and went to a chiro before a surgeon. The chiro has me fixed up and feeling much better. Worth trying. Once you try it you will wonder why you waited so long to do so.

AMO's advice is right on. I let mine go until it ruptured at L5-S1 and now I pay the price. Absolutely no vertical impact sports for me i.e. running, wakeboarding, etc... It's mountain biking, snowboarding (no park) tele skiing. I do the best I can at all the suggestions AMO made but really focus on stretching the hammies, everyday. I hate to say it but at 45, I'm probably looking at surgery down the road as the pain after exercise still requires meds...

Also,get an inversion table. Use it a couple of times a day for about 3-5 minutes. Works wonders!

i find it a strange pain, occurs after sitting at work for a while, lower back below dimples and now referring pain into front of groin and right hip. I can still do mostly everything but do not squat or deadlift at gym as causes crazy pain. Getting up in deapwater start on board also gives me epic pain throughout the day and into the next couple. Scotch seems to work better then the painkillers if have...both combined work great aswell haha. Its not so much as a shooting pain all the time but a dull ache and sometimes shooting pain. Cannot bend backwards much at all and thats where the shooting pain comes in. Physio yesterday told me to go get my xrays then come back when docs had a look, closest MRI machine is a long way away from my town.

Jeff, you need a MRI man. Any shooting pain is not good.

AMO, so the first bulge you had was 3 mm... and then it bulged out another 1mm, and when you were 31, it budged out another 1mm??? So it was a total bulge of 5mm? Or were the bulges in different directions? Sorry, I'm just trying to visualize that.

Anyone tried traction or decompression? If so, does it work well?

Anyone tried those gimmicks on TV (back 2 life, light relief, back joy, etc.)???

Gregg, I had a herniated disc at the age of 25 and the pain sent a shooting, burning pain through my leg constantly. Was also L5-S1. Typically doctors want to see the leg pain to do surgery - as surgery for the back is no guarantee as to results. Do you have any leg pain? I think the stat is that 90% of back injuries can be solved without surgery. For me, I tried therapy, decompression, and chiro, all to no avail. The decompression treatment that I paid big bucks for could have been replicated with a couple minutes a day on an inversion table. I recommend getting one, they are only about $150 for a decent one.

I had the surgery end of February 2007 and was riding by June. I am now able to ride pain free. I do have less ability to ride the wakeboard for 30 min, then ski, then golf all in the same day without pain eventually though.

Hey Erik, thanks for the advice! I don't have any shooting pain in the leg. A little tightness in the ass-cheeks and in the hams. Sometimes it's a little sore in the tail-bone area... I find ice helps with that.

I have heard about inversion tables but never knew if they actually worked well or not... so, that is good to know!

I haven't tried chiro.. maybe I should try that.

Greg, the medicine service I am currently on right now is for spinal surgeries so I have been getting to seen firsthand the effect of surgery on the patients. So far EVERY person has said they are in less pain the day after surgery then they were before they went in and this is after a major operation. Granted they are on pain meds but most were on pain meds before. The last study done which was over 7 years ago so I consider it outdated showed that only 30% of people get a true improvement from spinal surgery. It is hard to tell your level of pain over the Internet but if it is something that truly impacts your activities of daily living then I say go for it. The technology now is amazing .

Greg, my protrusions happened 3 different times. My first one was 3mm and went away with therapy. I then had a 1mm protrusion and it went away with therapy. The last 1mm protrusion went away with therapy as well. These were 2-3 years apart from one another and 2 of 3 happened in the same spot on that L5-S1 disc from what the doctor told me.

Careful with the chiro if you do not have MRI pics to show them. High velocity twisting can make it worse.

(Message edited by amo on December 17, 2009)

Kyle, I'm pretty sure I'm NOT one of the people that require surgery. I only really get sore when I've been sitting in a car for a while.. or if I go for a run, or do a hard work-out at the gym. With the being said, it's just hard to accept that I'm restricted from being very active in general. I'm a very active person. So, my reason for looking into surgery was to get rid of these restrictions. I'm only 25 and I have a lot of life left so.. it'd be nice if I could run a marathon in my lifetime. There is absolutely no way I could do that now. People say to get surgery if it prevents you from do daily activities. Well, I guess it really depends on how "daily activities" is defined. If I were just to go to work, come home and make some dinner, and call it an evening... than no, it doesn't affect that. But, I like to at least incorporate a bit of activity into my every day life. Yes I can do light workouts and be fine. Could I go for a 30 minute jog on the treadmill? Not without being sore for a day or two. In which case, I would have to hold off on activity for a day or two afterwards. Am I in absolute agony? No! Do I have burning and numbness through my legs? No! I guess I should try some traction and keep my core strong.

AMO, I didn't know it was possible for a budge to go away! Did the disc actually go back into place? Is that what you were saying? Mine has been about 2.5 years. I had CT scan when I first injured it, and then again just recently. Both times it was considered to be a mild to moderate budge. I don't know how many millimeters. They wouldn't tell me that. Then again, I haven't been doing much core work or traction/decompression in the last 2 years. Maybe if I kept at it for a year or so, it would heal itself or go back into place (if that's possible).

I'm no doctor Greg, but the protrusion from what I know is next to nothing now. You're right, the protrusion never totally goes away, but it will go back into place enough where you won't get the shooting pains. After that its all about strengthening the core to prevent further damage.

By that explanation Greg there is no way I would get surgery. The hardware doesn't last forever and at your age, you will be getting it fixed in 15 years.

Greg, I had L5-S1 discetomy/laminectomy in Jan 05. It was 3 months to recover where I could go back to work etc. It stayed sore but liveable for 6 months plus. The 2 discs above are bulged and give me trouble occasionally but nothing like the leg pain from the first one. I consider my back fragile and really temper my activity becuse of that. I ride but mostly enjoy driving the boat and watching my wife and kids progress.

The way my doc explained it is that if you have radiating pain in you buttocks, legs etc. that doesn't respond to PT, you are a possible candidate for surgery. If the pain is localized, PT and cortizone epidural are usually the course of treatment. The leg pain is from a pinched sciatic nerve and isn't something to take lightly. Since your pain is mostly localized, have they suggested an epidural. I know several people who have done the epidural with PT and fully recovered. Then again I know one who hasn't recovered. Every situation is different but I'm surprised this option wasn't offered to you.

What has already been said about core strengthening and proper stretching can't be stressed enough. Good luck.

Yeah I was doing the core strengthening and it was working really well, almost to the point where I didn't notice my back being sore at all. Then, I think I got carried away with back exercises, and it is really annoying me now. I think I over-did it! I have stayed away from the gym for the last couple of weeks in hoping to give the injury a rest but.. its still really sore. I don't know at what point I should get back to the gym. It's been about 3 weeks or so since I re-aggrevated it. It doesn't seem to be getting much better. Should I keep resting it for a bit longer? Or should I get back into my routine? How do you know at point it has been rested enough? Right now, it gets sore and there is a bit of tightness in the buttock and hams.

Thanks for everyone's advice again.

I'm not sure about the cortisone injection. I have heard that they work well for pain for a little while, but they can start doing more bad than good after a while. They start breaking down muscle, or bone, or something like that.....

Greg

The thing you have to keep in mind is that the pain you feel is your body's warning that something is not quite right. Wherein it might be right for some people to get injections that mask the pain, it may not be correct for your injury.

I have two bulged discs, one affecting my right side between my C-5 and C-6 and the other affecting my left side between my C-6 and C-7 (two different embarrassing roller blading landings ) and was a candidate for surgery.

I tried an epidural which injected steriods between the bulges and the nerve cords (the steriod reduces the swelling and provides a cushion) and two of these injections worked beautifully. I was completely locked up in a Quasimodo position and had to keep my left arm over my head to reduce the pain. I am now among the homeo erectus once again.

Surgery is a last option for me so I went the route many have already discussed: building your core strength.

However, it is more than just exercising from your "knees to your nips" (I loved that description). I know this sounds corny, but Yoga is an excellent method to not only strengthen your core but especially to STRETCH your core.

I am sure you find yourself hurting when you exert yourself and pull or compress your spine. Keeping that area strong yet flexible is a huge key to reducing your pain and especially, not being caught off guard with one of those abrupt-movement-breath-sucking-stabs-of-pain that can come with the bulged discs.

I agree with a previous post about getting an MRI. Once I saw the directions the discs bulged, I knew what positions I had to move my neck and which direction to stretch my back to relieve the pressure on that particular bulge when I had a pain flare up (or when I began to lose feeling in my arm).

Finally, be aware of the pillow you use and how you sleep on that pillow. Even your lumbar system is tied into how you position your head and neck on a pillow. Remember, you are maintaining a position on that pillow for approximately 1/4 to 1/3 of your life.

Good luck

I had two CT scans done. I wonder if the doctor still has them on file. I imagine they would but... I guess we'll find out. I will try to find out the direction of the bulge. I believe it favors my right side if I can remember correctly.

Another question... if my hams and butt or tight right now, is it a good idea to start exercising them again? Or is that going to make them more tight? The question remains as to how long to wait until i start strengthing my core again. Yeah nipples to knees is a great way of putting it. I always thought it was abs and lower back.

You need to get the inflammation out of your back before you start any exercise. Not doing so will just worsen the problem.

Thanks AMO, that makes sense. On a positive note, today it has felt really good. Hopefully the inflammation is calming down. I don't tend to get my hopes up about these things until it proves it self for at least a few days though.

Ok one last question, does anybody have a good core workout routine? Something that I can do 3 times a week or whatever. Something that would include: upper/lower abs, obliques, hams, glutes, quads and lower back. I believe that is everything that the "core" is made up of. But, correct me if I'm wrong on that one.

I have had 3 discectomies at three different levels and a laminectomy and it was the best thing I have ever done. I also did PT and tried nonsurgical routes but with the right surgeon have the surgery!

Hey Greg,

You should look into prolotherapy. (http://www.getprolo.com) It's a nonsurgical procedure for tightening up damaged tendons and ligaments. I have 2 bulged disks in my neck and the prolotherapy that I have had over the last year has helped a lot. I have had prolotherapy on my neck shoulder and lower back and it has done wonders. Kind of expensive but totally worth it.