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Herniated Disc At L5-S1 Advice (MRI Included)

[quote]PowerCrazy wrote:
it still would be helpful to have a roadmap of what to do. rather than just researching blindly i mean couldnt you say like, ok start by correcting this, this and this. im not saying spell it out for me but atleast give me some type of road map.

so far ANDERSON has been the best in this department [/quote]

Jesus man, I wrote:

“As I said above: work on tissue quality of glutes and read good spinal books”

How much more simple do you need it to be.

As I recal, you are the guy who PM’d me saying “please check out my thread. Search for it under ‘powercrazy’ as it’s my only thread.”

In other words you couldn’t be bothered to link me to your own thread. Now you can’t be bothered to heed my simple advice.

All I can say at this point is: I’m glad Andersons still has the patience to hold your hand.

Sorry, but I say it like I see it.

BBB

BBB has spent way more time than me consistently over the years here helping people. I come and go, so I don’t get as burnt out. :slight_smile:

Also I have a special sympathy for sciatica now, because I had 2 bouts with it over the last year, and it was the worst living hell that made all other injuries and pain fade to insignificance by comparison.

When I had sciatica, self-myofascial release and all other soft tissue work (tennis balls, massage, etc.) did NOT help. Soft tissue work actually made the pain worse.

For example, after I foam-rolled a “tight” left piriformis (hard as a rock in spasm) and IT band, I had much more pain than before. It was clear the foam rolling aggravated the situation.

I can’t say for sure this would be the case for everyone, but it’s why I don’t recommend soft tissue work for active sciatica.

(Now it can’t do any real damage to try it if you want. If you feel better afterwards, keep it up; if you feel worse (like me), skip it for now.)

[quote]PowerCrazy wrote:
i find it funny that people keep telling me to stop trying to fix it myself and get the surgery (DOCTORS) and people who say your not a doctor so you cant do it (FAMILY)

i read through all 5 pages of that thread by the way and its hard to understand what could apply to me and what doesnt as you have answered like 30 million peoples questions

:([/quote]
I’m going to be totally honest here about surgery.

Earlier in the thread, I mentioned that 1 in 10 of the surgery subjects achieved better pain reduction. Not very good odds. And the surgery group had greater risk of subsequent instability and the pain and inflammation that accompany that problem over time. Also, very few subjects (1 in 10?) ever achieved complete pain relief. To the doctors, partial pain relief is a successful outcome, even if strength and function are compromised.

However, surgery WAS especially effective for sciatica, more so than for just back pain. But the subjects who got their sciatica fixed experienced more back pain LATER ON.

Often, the link between pain and the mechanical damage that can be seen on MRI is unclear. For example, there might be bulges where there is no pain, or vice versa. Or there might be damage with pain symptoms that seem completely unrelated to the damage.

However, in your case, you have a diagnosis of a bulge at L5-S1 and symptoms that fit the dermatome of that nerve root. So there is a clear link between your disc bulge and your pain. (Google Image search “dermatome” and look at the map for L5 and S1). Therefore, there is a good chance that if you have surgery to get rid of that bulge, you could get fast relief of the pain of sciatica.

However, then you would have permanently reduced disc height, possible issues with instability, and greater risk of future back pain.

Maybe you could reduce those risks with proper rehab after surgery. But, if proper rehab after surgery is critical for a good long-term outcome, why not try proper rehab BEFORE trying surgery, given the risks of the surgery?

Besides, cutting out the bulge is not the only way of getting rid of it. What is causing the bulge in the first place? The forces that are acting on your spine. And those come from your posture, movements, and loading patterns.

My reasoning about my own sciatica was that some posture, movement, or load on my spine was squeezing the (previously-injured) L5-S1 disc such that it was bulging enough to press on the nerve root. The trigger posture for my first bout of sciatica seemed to be sitting in a horribly non-ergonomic airplane seat for 8 straight hours without standing up or moving around. I reasoned that I need to squeeze that disc in the opposite direction or back into place. I flipped through my library of stuff looking for what might do this. I thought that 2 positions from Egoscue would help, static back and floor block. Static back, especially with an ice pack, is about the best thing for acute pain relief anyway. The floor block position should help push those lumbar discs back where they belong. It should do the opposite of what sitting does.

Those positions helped immediately.

At the same time, I found the “somatics” stuff and tried a few of the movement sequences. Muscles in spasm immediately relaxed with these weird little movement sequences. So that was my final piece of the puzzle for sciatica relief.

I believe that the somatics movements are so effective because they activate the deeper smaller stabilizers of the spine in a fully supported position (lying on your back), and convince the CNS to let the larger muscles in spasm (QL, piriformis) relax.

So, it is NOT TRUE that only a doctor can fix your sciatica. A good surgeon MAY be able to alleviate your sciatica through surgery. But he cannot make your back function properly, and will probably make its function even worse than it is now.

[quote]andersons wrote:
When I had sciatica, self-myofascial release and all other soft tissue work (tennis balls, massage, etc.) did NOT help. Soft tissue work actually made the pain worse.

For example, after I foam-rolled a “tight” left piriformis (hard as a rock in spasm) and IT band, I had much more pain than before. It was clear the foam rolling aggravated the situation.

I can’t say for sure this would be the case for everyone, but it’s why I don’t recommend soft tissue work for active sciatica.

(Now it can’t do any real damage to try it if you want. If you feel better afterwards, keep it up; if you feel worse (like me), skip it for now.)

[/quote]

One problem is that sciatica is now being used as a catch all diagnosis for any pain radiating from that area and doesn’t specify WHAT is causing the symptoms.

I will agree with you to an extent that SMR and soft tissue work directly over the sciatic nerve will cause a great deal of pain, especially if it is already inflammed. But this is why you can’t just attack the point of discomfort and pain. You need somebody to find where the restrictions and limitations are so you can address those issues. The “sciatica”/nuero symptoms can be caused by an impingement on the nerves or excessive tension/stretch being placed on the nerves. The person could have an SIJD, piriformis syndrome, or a paraspinal/QL issue. Or the person could have an anterior pelvic tilt, tight psoas, etc.

I have personally found great results and resolving my own and other athletes’ sciatica-like symptoms with soft tissue work and SMR/foam rolling. But like you said, each person will react differently and as I previously stated, each situation will be determined by the individuals specific limitations/restrictions. Some may benefit from direct SMR over the piriformis. Others may benefit more from SMR over the psoas and TFL. Depends on the situation.

To the OP, I again strongly recommend finding a qualified practitioner to do a FMS to determine your limitations.

-LH

[quote]LevelHeaded wrote:

[quote]andersons wrote:
When I had sciatica, self-myofascial release and all other soft tissue work (tennis balls, massage, etc.) did NOT help. Soft tissue work actually made the pain worse.

For example, after I foam-rolled a “tight” left piriformis (hard as a rock in spasm) and IT band, I had much more pain than before. It was clear the foam rolling aggravated the situation.

I can’t say for sure this would be the case for everyone, but it’s why I don’t recommend soft tissue work for active sciatica.

(Now it can’t do any real damage to try it if you want. If you feel better afterwards, keep it up; if you feel worse (like me), skip it for now.)

[/quote]

One problem is that sciatica is now being used as a catch all diagnosis for any pain radiating from that area and doesn’t specify WHAT is causing the symptoms.

I will agree with you to an extent that SMR and soft tissue work directly over the sciatic nerve will cause a great deal of pain, especially if it is already inflammed. But this is why you can’t just attack the point of discomfort and pain. You need somebody to find where the restrictions and limitations are so you can address those issues. The “sciatica”/nuero symptoms can be caused by an impingement on the nerves or excessive tension/stretch being placed on the nerves. The person could have an SIJD, piriformis syndrome, or a paraspinal/QL issue. Or the person could have an anterior pelvic tilt, tight psoas, etc.

I have personally found great results and resolving my own and other athletes’ sciatica-like symptoms with soft tissue work and SMR/foam rolling. But like you said, each person will react differently and as I previously stated, each situation will be determined by the individuals specific limitations/restrictions. Some may benefit from direct SMR over the piriformis. Others may benefit more from SMR over the psoas and TFL. Depends on the situation.

To the OP, I again strongly recommend finding a qualified practitioner to do a FMS to determine your limitations.

-LH[/quote]

what is a FMS? so far ive only seen it stand for fibro mayalgia

[quote]PowerCrazy wrote:
what is a FMS? so far ive only seen it stand for fibro mayalgia
[/quote]
ALWAYS Google before you ask.

[quote]andersons wrote:

[quote]PowerCrazy wrote:
what is a FMS? so far ive only seen it stand for fibro mayalgia
[/quote]
ALWAYS Google before you ask.
[/quote]

Thank you andersons. I just googled FMS just out of curiosity. Here are the top 2 results:

  1. Financial Management Service: A Bureau of the U.S. Department of …Provides central payment services for all Executive agencies, operates the Federal Government’s collections and deposit systems, provides governmentwide …
    www.fms.treas.gov/

  2. FMS, Functional Movement Systems, is a physical fitness screening …A powerful shift in athlete development, FMS is a ranking and grading system that documents movement patterns to accelerate performance and reduce risk of …
    www.functionalmovement.com/

PowerCrazy, I will let you determine which one applies to you specifically to this situation…

And on a side note, just by you asking what FMS was instead of googling it yourself goes right along with how you have handled this whole topic and thread. If YOU want results, YOU have to put the work in and not expect all the answers to be given to you. Unless you want to pay me, then I will give you all of the answer you desire!

-LH

WTF i did google it i wrote exactly “what is FMS” and got

web definitions for FMS . False Memory System

what is fms. Fibro Mayalgia Syndrome

Foreign Military Sales Program

The Federation Of Materials Society.

i find it disturbing how maybe my choice of words or even the fact that i have very little posts have been attributed to me being of lesser intelligence than others or having very poor work ethic which is 100 percent false but hey this is the internet what can i expect, either way i wont take offense to it im just simply going to move forward, however i request that from here on out we assume im putting in the work needed to learn, let me just say that i have had no education on the back or proper back mechanics other than what i was taught in school or by trial and error, i now realize this was a very pathetic thing to just “wing it” but now i have become far more enlightened and im very determined to reverse this problem and any future problems, NOW i appreciate all the reply’s here even the ones that are rather insulting simply because they only help me to understand different points of view, but please lets keep the insulting posts to a minimum, LH and anderson i appreciate how your trying to help without directly insulting, i may have stupid questions but sometimes those stupid questions really help me out so bear with me

[quote]PowerCrazy wrote:
WTF i did google it i wrote exactly “what is FMS” and got

web definitions for FMS . False Memory System

what is fms. Fibro Mayalgia Syndrome

Foreign Military Sales Program

The Federation Of Materials Society.

i find it disturbing how maybe my choice of words or even the fact that i have very little posts have been attributed to me being of lesser intelligence than others or having very poor work ethic which is 100 percent false but hey this is the internet what can i expect, either way i wont take offense to it im just simply going to move forward, however i request that from here on out we assume im putting in the work needed to learn, let me just say that i have had no education on the back or proper back mechanics other than what i was taught in school or by trial and error, i now realize this was a very pathetic thing to just “wing it” but now i have become far more enlightened and im very determined to reverse this problem and any future problems, NOW i appreciate all the reply’s here even the ones that are rather insulting simply because they only help me to understand different points of view, but please lets keep the insulting posts to a minimum, LH and anderson i appreciate how your trying to help without directly insulting, i may have stupid questions but sometimes those stupid questions really help me out so bear with me [/quote]

I can appreciate your sensitivity to the situation. But I just typed in exactly what you did for the google search “what is FMS” and if you had just gone past the first page of the search results, you would have seen at the top of the second page “Functional Movement Systems”.

I think the reason most of us, myself included, feel that you aren’t putting the work in, is because of your initial responses, especially to BBB regarding the advice he gave and basically cutting his response down in favor of andersons, after (according to BBB) you PMed him requesting his advice on the thread. And the fact is, not knowing what andersons may have said to you in a PM, andersons and BBB’s responses in the thread were very similar.

Now that you do realize the errors of your ways and if you do want to educate yourself, buy the resources that were recommended by several of us already, read until you go cross eyed, apply the knowledge, and get yourself better.

It sounds like to me you have a simple anterior pelvic tilt or otherwise known as lower crossed syndrome. People with this usually have “tight” hamstrings and no matter how much they stretch them they never fully feel relaxed. They also have very tight erectors and hip flexors. You should be training your abdominals more as well as the gluteal muscles as they are usually pretty silent in these cases. I saw someone recommended the book by Stuart McGill which is a great recommendation for your issue. A good doctor should figure out what the cause of the disc herniation is first before figuring out how to treat it. It’s not likely your workout per se but what muscles are inhibited and which ones are overactive. I would find an ART practitioner to do some work on your erectors as well as tend to your rectus femoris and psoas.

As to treatment for your current problem I would try to find a chiro/PT/MD who performs felxion/distraction to fix the disc. Surgery is not likely to help you in the long run and you should stop injections right away as they will eat up your connective tissue over time. If you tell me what state you live in I can point you to some of the best practitioners to deal with this problem ASAP. The hardesr part of these injuries is just to have patience. Good luck!

i live in the state of maine and am going to see a chriopractor tommarow who is also a sports med who is well trained in the flexion distraction method, i am also in the meantime while i wait patiently to work out again am researching spinal and core stability along with alot of other articles, i can most certainly say my core muscles are all noticeably tight (not abs but hip muscles low back, but mostly i notice a TON of stiffness in my glutes and hamstrings and hip muscles especially when im not moving around much, my day job is demanding so it keeps me loose however my days off i seem to stiffen up)

the hardest part of this entire thing is i dont have medical insurance im stuck in a limbo since this new law has passed

[quote]LevelHeaded wrote:

[quote]PowerCrazy wrote:
WTF i did google it i wrote exactly “what is FMS” and got

web definitions for FMS . False Memory System

what is fms. Fibro Mayalgia Syndrome

Foreign Military Sales Program

The Federation Of Materials Society.

i find it disturbing how maybe my choice of words or even the fact that i have very little posts have been attributed to me being of lesser intelligence than others or having very poor work ethic which is 100 percent false but hey this is the internet what can i expect, either way i wont take offense to it im just simply going to move forward, however i request that from here on out we assume im putting in the work needed to learn, let me just say that i have had no education on the back or proper back mechanics other than what i was taught in school or by trial and error, i now realize this was a very pathetic thing to just “wing it” but now i have become far more enlightened and im very determined to reverse this problem and any future problems, NOW i appreciate all the reply’s here even the ones that are rather insulting simply because they only help me to understand different points of view, but please lets keep the insulting posts to a minimum, LH and anderson i appreciate how your trying to help without directly insulting, i may have stupid questions but sometimes those stupid questions really help me out so bear with me [/quote]

I can appreciate your sensitivity to the situation. But I just typed in exactly what you did for the google search “what is FMS” and if you had just gone past the first page of the search results, you would have seen at the top of the second page “Functional Movement Systems”.

I think the reason most of us, myself included, feel that you aren’t putting the work in, is because of your initial responses, especially to BBB regarding the advice he gave and basically cutting his response down in favor of andersons, after (according to BBB) you PMed him requesting his advice on the thread. And the fact is, not knowing what andersons may have said to you in a PM, andersons and BBB’s responses in the thread were very similar.

Now that you do realize the errors of your ways and if you do want to educate yourself, buy the resources that were recommended by several of us already, read until you go cross eyed, apply the knowledge, and get yourself better.[/quote]

i AM doing that, im researching to the point my girlfriend is getting frustrated telling me im not spending enough time with her. as she puts it “your just looking at back stuff” LOL

first and foremost i did pm BBB (although it wasnt in the best possible way) as i thought his advice based on other threads would be invaluable and also to clarify andersons did pm me with a full list of things to try and i have been having positive results he also responds quickly to all my pms which is a great help, i know this kind of support is not a given and i have thanked him for that.

Now i fully understand the initial posts i made were incorrectly worded at best, i was not under cutting BBB i was simply comparing the information from his answers in my thread to those in other threads, from the first thread i read i ASSUMED (my fault here) he was like a google service haha “hey bbb what do i do here, or what is this,” and he just chimed in with answers no questions asked. however stupid that sounds that was my initial thought just based off other threads i either over estimated his generosity or i came into it expecting to much (again i admit being wrong here), i understand the need to learn versus being spoon fed the answers however i felt his initial posts were to generic or to “text book”. Nothing against you BBB of course was just an assumption i made out of falsity and im sorry for that.

now as far as research goes i would like to ask what type of resources that havent been already stated are beneficial to my case. i know of mcgill and sarno and amir but im more interested in resources regarding core and spine stability such as mcgill and even some more stuff on rehabing this type of injury would be helpfull.

complete side question- does anyone read muscle and fitness? i noticed they really dont speak at all about injury prevention and i have never even really seen an article on injurys and how to prevent them, you would think that would be a huge part of the overall package . nutrition, workouts and injury prevention

Keep us posted as to how you progress if you dont mind. I’m a chiropractic student and my mother is a physical therapist so this kind of injury is right up our alley. Flexion distraction is probably your best bet without going under the knife. BBB was correct as there seemed to be some degeneration in the mid-lumbar disc as well. I would have your new chiro determine any muscle imbalances that was likley the cause. I’m kind of curious what your typical workouts consists of and what your job entails? Either way good luck to you and I hope you’re able to get in the gym soon!

[quote]mlane16 wrote:
Keep us posted as to how you progress if you dont mind. I’m a chiropractic student and my mother is a physical therapist so this kind of injury is right up our alley. Flexion distraction is probably your best bet without going under the knife. BBB was correct as there seemed to be some degeneration in the mid-lumbar disc as well. I would have your new chiro determine any muscle imbalances that was likley the cause. I’m kind of curious what your typical workouts consists of and what your job entails? Either way good luck to you and I hope you’re able to get in the gym soon![/quote]

my job entails alot of standing on hard surfaces and alot of twisting and bending i work at a grocery store for now stocking so it can have its downsides, also pushing carts on occasion, it pays well in this economy but not very friendly on the body.

my typical workout WAS a 2 bodypart per session per week for example

week 1

mon- chest back
teu-bicep tricep
wed-off
thur-legs
fri-shoulders traps
sat- core and any muscle groups i feel need more training
sun- off

pm me if you want a more detailed explanation of exactly what a workout looked like i still have the logs

oh and the chiropractor said he was trained in COX felxion distraction therapy

PowerCrazy,

I am actually impressed that you are willing to accept fault for how you worded things to begin with. It is a step in the right direction.

Sorry to hear about the health insurance deal. Without starting a war of politics, I don’t think the new law will be helping out much in that aspect of your situation unfortunately. But you gotta play with the cards you’ve been dealt.

As for other resources beyond McGill’s books, I would recommend the Assess and Correct DVD set. Also, check out Eric Cressey’s “Low Back Savers” series on TMuscle. Here is a link to Part 2 of his series. http://www.tmuscle.com/free_online_article/sports_body_training_performance_repair/more_lower_back_savers
There is a link to Part 1 in the article.

Eric does a great job of explaining things so that a layperson will understand it well. It is a good starting block and will probably help you progress into reading up on McGill’s works.

[quote]LevelHeaded wrote:
PowerCrazy,

I am actually impressed that you are willing to accept fault for how you worded things to begin with. It is a step in the right direction.

Sorry to hear about the health insurance deal. Without starting a war of politics, I don’t think the new law will be helping out much in that aspect of your situation unfortunately. But you gotta play with the cards you’ve been dealt.

As for other resources beyond McGill’s books, I would recommend the Assess and Correct DVD set. Also, check out Eric Cressey’s “Low Back Savers” series on TMuscle. Here is a link to Part 2 of his series. http://www.tmuscle.com/free_online_article/sports_body_training_performance_repair/more_lower_back_savers
There is a link to Part 1 in the article.

Eric does a great job of explaining things so that a layperson will understand it well. It is a good starting block and will probably help you progress into reading up on McGill’s works.[/quote]

thank you LH

i also have another question to pass through to someone who might know, i noticed that along with my l5-s1 disc herniation ive been having pain that i can only describe as like a sore spine that is in the t7-t10 region if i were to guess, i can feel it intensify with forward flexion and even when i puff my chest out and pull my shoulders back i can feel its sore in that region, not a muscle sore but a bone sore, when telling this to my md her response was “dont worry about it” LOL but i kind of always felt like it holds some importance

[quote]PowerCrazy wrote:
thank you LH

i also have another question to pass through to someone who might know, i noticed that along with my l5-s1 disc herniation ive been having pain that i can only describe as like a sore spine that is in the t7-t10 region if i were to guess, i can feel it intensify with forward flexion and even when i puff my chest out and pull my shoulders back i can feel its sore in that region, not a muscle sore but a bone sore, when telling this to my md her response was “dont worry about it” LOL but i kind of always felt like it holds some importance

[/quote]

Any imaging done on that section of your spine? Where specifically do you feel the pain - lateral to the spine? directly over the spine? In your opinion, what is the difference between “muscle” and “bone” soreness? Do you remember doing anything specific that initially caused the pain? Besides the 2 listed movements, anything else that bothers it?

Tons of questions would need to be answered before even remotely giving any advice. It honestly could range from just a paraspinal muscle strain to something more significant with the vertebrae.

[quote]LevelHeaded wrote:

[quote]PowerCrazy wrote:
thank you LH

i also have another question to pass through to someone who might know, i noticed that along with my l5-s1 disc herniation ive been having pain that i can only describe as like a sore spine that is in the t7-t10 region if i were to guess, i can feel it intensify with forward flexion and even when i puff my chest out and pull my shoulders back i can feel its sore in that region, not a muscle sore but a bone sore, when telling this to my md her response was “dont worry about it” LOL but i kind of always felt like it holds some importance

[/quote]

Any imaging done on that section of your spine? Where specifically do you feel the pain - lateral to the spine? directly over the spine? In your opinion, what is the difference between “muscle” and “bone” soreness? Do you remember doing anything specific that initially caused the pain? Besides the 2 listed movements, anything else that bothers it?

Tons of questions would need to be answered before even remotely giving any advice. It honestly could range from just a paraspinal muscle strain to something more significant with the vertebrae. [/quote]

imaging is done and it doesnt indicate anything (my md would have noticed i hope)

no lateral pain very local it doesnt go across stays in the spine

my definition for bone soreness vs muscle soreness- muscle sorness feels like a burning kind of tiredness with movement across the entire muscle also feels crampy when not in motion, i guess the better way to put bone soreness for me is like a bruise, if i had a bruise on my spine id think it would feel like this

no other movements aggrivate it its only when the spine is in flexion or extension

as far as i remember this has been here for the same amount of time the herniation has

it almost feels like i havent bent over in so long my back is locking at that point if you could tell me how to locate this spot on mri i could easily throw a picture up here

[quote]PowerCrazy wrote:
now as far as research goes i would like to ask what type of resources that havent been already stated are beneficial to my case. i know of mcgill and sarno and amir but im more interested in resources regarding core and spine stability such as mcgill and even some more stuff on rehabing this type of injury would be helpful.
[/quote]
I’m not a big fan of Sarno or Amir. Sarno claims that psychological factors cause muscle tension which in turn cause back pain. I DO believe that muscle spasm or hypertension causes the majority of pain in any injury, but Sarno doesn’t give you anything whatsoever to help with the tension except to ignore it and not worry about it. This doesn’t do the job when you have a big old bulging disc pressing on a nerve.

If you love the pop psychology self-help genre, go with Amir. He takes Sarno’s idea but then puts every self-help idea ever written into a 12-week plan or so to get his subconscious under control. Things like, if his subconscious would allow him to walk barefoot down the stairs without pain (or something), he would reward it with some ice cream. LOL

I was reading Eric Cressey’s blog last night, and that is a great source of free information. You’ll find occasional links to helpful resources for injury prevention, rehab, and performance. You don’t have to read every single post, of course, just the ones that are relevant to your interests.

I noticed he has a new DVD called Assess and Correct. It’s to guide athletes to assess their own movement patterns and fix them. Now that’s some useful self-help. I strongly recommend you get that DVD ASAP.