T Nation

Herniated Disc At L5-S1 Advice (MRI Included)

PowerCrazy, I want to let you know that I appreciate your PM but that I don’t think my replies are getting back to the sender.

But you have to understand that I make my living sorting out back pain (amongst other things) and I have neither the time nor the patience to walk you through your recovery, sorry.

I offered some generic advice and that’s all I have time for really. Either get on it or don’t, I can’t make the descision for you. However if you do ‘get on it’ i guarantee you’ll expand your knowledge a hundred-fold and possibly open up new avenues and even a new career for yourself. That’s pretty much what happened with me. I hurt my back deadlifting, got rejected from the Fire & Rescue service due to poor hearing and so began to study chiropractic.

Now I know everything!!! MUAHAHAHAHA!

But seriously, now I make a living through my one true passion, simply because I decided to become my own back expert. Every day I thank the powers that be for this wonderful opportunity.

So get on it my friend; who knows where the journey might take you…

BBB

[quote]bushidobadboy2 wrote:
PowerCrazy, I want to let you know that I appreciate your PM but that I don’t think my replies are getting back to the sender.

But you have to understand that I make my living sorting out back pain (amongst other things) and I have neither the time nor the patience to walk you through your recovery, sorry.

I offered some generic advice and that’s all I have time for really. Either get on it or don’t, I can’t make the descision for you. However if you do ‘get on it’ i guarantee you’ll expand your knowledge a hundred-fold and possibly open up new avenues and even a new career for yourself. That’s pretty much what happened with me. I hurt my back deadlifting, got rejected from the Fire & Rescue service due to poor hearing and so began to study chiropractic.

Now I know everything!!! MUAHAHAHAHA!

But seriously, now I make a living through my one true passion, simply because I decided to become my own back expert. Every day I thank the powers that be for this wonderful opportunity.

So get on it my friend; who knows where the journey might take you…

BBB[/quote]

yeah i understand and i have “gotten on it” lol

as far as replies go no i havent received any? (shrugs)

i REALLY do understand you may not have the time or the patience but maybe someday youll feel differently, i have been researching like hell and with good results and ive also hired a high respected chiropractor in my state who says he wont promise anything but he thinks based on my mri he can atleast help me reduce the pain and teach me proper posture and body mechanics, which i ASSUME is a good start. but hey if you ever get some free time let me know. maybe we can even set up some sort of compensation for your services

[quote]PowerCrazy wrote:

[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]

It sounds like either a rib issue or just a capsule sprain. My guess is your t-spine pains will go away within a few weeks assuming you dont do anything else to re-sprain/strain anything. Ask your chiro to check out the motion of your ribs, he/she should be able to help if any restrictions. The disc injury which I’m sure you now by now is probably from your repetitive flexion at the lower back and not from the hips or not using the legs more often for lifting. Your new chiro should be able to evaluate this and give you pointers. But your MD is correct, neither one of these is anything to worry about. Just no heavy lifting for awhile. The best thing for you is to become more self-sufficient and positive about your recovery. Good luck to you sir!

been awhile since replying, i seem to be improving slowly however felt like hell these past 2 days …weather maybe?

anyway i AM trying to be more pro-active recovery wise but DAMN this injury can get you down QUICK im still working on it but if i do need surgery someday im gonna have to get it but ill try my best not to let it get to that point.

i have a friend who got surgery and is fine right now lifting heavy and not a care in the world, almost pisses me off because he took the easy way out

PowerCrazy, if your anywhere near RI, check into seeing Dr. Don Murphy at the RI Spine Center. If anyone can get you functioning better non-surgically it is this man. Also, it’s too hard to explain in detail but you may want to look into “neural flossing” for radicular pain.

I have had the same disc bulge as powercrazy, lots of foam rolling, keeping direct vertical loads to a minimum, ice pack my lower back when I can… has caused some of the pain in my back to diminish. But occasionally as gym intensity increases, the pain in my back becomes alot more intense. L3 bulge with sprains in 4,5… pain going dowm my legs, glutes sometimes…

I wanted to know would doing things like planks/side bends/ weighted bent leg raises be good abdominal exercises to increase core strength? Because I heard crunches and situp type movements were quite bad for the spine. Also what glute exercises would be appropriate since squats and deadlifts are out of order hehe… thanks for the help!

[quote]Diluted56 wrote:
I have had the same disc bulge as powercrazy, lots of foam rolling, keeping direct vertical loads to a minimum, ice pack my lower back when I can… has caused some of the pain in my back to diminish. But occasionally as gym intensity increases, the pain in my back becomes alot more intense. L3 bulge with sprains in 4,5… pain going dowm my legs, glutes sometimes…

I wanted to know would doing things like planks/side bends/ weighted bent leg raises be good abdominal exercises to increase core strength? Because I heard crunches and situp type movements were quite bad for the spine. Also what glute exercises would be appropriate since squats and deadlifts are out of order hehe… thanks for the help![/quote]

i to would like to know some more ab and glute movements

[quote]Mdougherty40 wrote:
PowerCrazy, if your anywhere near RI, check into seeing Dr. Don Murphy at the RI Spine Center. If anyone can get you functioning better non-surgically it is this man. Also, it’s too hard to explain in detail but you may want to look into “neural flossing” for radicular pain. [/quote]

i live in maine so its possible however i doubt i could get to RI anytime soon :frowning:

spinal flossing hmm ill check it out, i think M2 has some spinal flossing movements thanks!

[quote]Diluted56 wrote:
I have had the same disc bulge as powercrazy, lots of foam rolling, keeping direct vertical loads to a minimum, ice pack my lower back when I can… has caused some of the pain in my back to diminish. But occasionally as gym intensity increases, the pain in my back becomes alot more intense. L3 bulge with sprains in 4,5… pain going dowm my legs, glutes sometimes…

I wanted to know would doing things like planks/side bends/ weighted bent leg raises be good abdominal exercises to increase core strength? Because I heard crunches and situp type movements were quite bad for the spine. Also what glute exercises would be appropriate since squats and deadlifts are out of order hehe… thanks for the help![/quote]
Planks, yes. Side planks, yes. Side bends, no. Weighted bent leg raises, definitely NO.

If your spinal control is perfect on planks, add instability like raising/ moving a leg, an arm, opposite leg and arm. Add resistance by doing ab roll outs with a stability ball, ab wheel, barbell. There are several good articles on core training here on this site, Robertson and Boyle maybe.

More importantly though, you have to get that core stability carrying through every second of every lift.

If that is you in your avatar, you look like you have some leverages putting wicked loads on your lower back!

Yeah well i live in South Africa, we got like close to no powerlifting gyms or personal on knowledge on the lifts such as deadlifts/squats in any high degree. So after my injury to my lower back i did tons of research on technique and found out how i hurt it with deadlifts. Fucking small things, but hey least I know now :slight_smile:

But thanks alot andersons, i will definately start doing alot more plank variations and working on core strength alot :slight_smile:

[quote]PowerCrazy wrote:
ok so ive been diagnosed with an l5-s1 disc herniation pushing on a nerve root causing moderate sciatica in my left leg only…im including an mri of the sag to show it but im also including an ax mri of what looks to me like an entirely blown disc,

anyone with mri reading experience please tell me what this ax image is actually saying because it looks damn odd compared to the others…anyway my story here is ive tried chiro (dumped 2 grand) and physical therapy along with cortisone steroids, now my doc is recommending surgery but the initial results look good (pain free) the later results look terrible (re operations and surgerys etc etc)

i love lifting and i continue to do so however this is severly disabling for me seeing as it is emotionally as well as physically stressfull, im looking for some honest thoughts and opinions on what i should do and maybe someone who could help me out. thanks i hope we can figure this out.

to add some background information im almost positive my hips muscles are very messed up as they feel tight 24/7 also my piriformis muscle might be somewhat to blame aswell because when i do a few of those stretches the pain is gone for a short time,my hams are tighter than humanly possible

[/quote]

Pretty sure I have the exact same injury as you… went to chiro in february this year and got put on a program. When I started I could barely even lift my right leg up (when lying on my back). Now my ROM is a lot better (nearly 90 degrees now).

Sciatic pain for me is only down the right leg in my case. Painful around glutes/hams/calves/lower back, gym work hasn’t been too bad for it (obviously I have avoided all deadlifts/squats). Been nearly 3 1/2 months since I started chiro and can’t see it being fully recovered for at least another 2 months.

I am targeting 6 months as full recovery (start contact sports/squatting again). Resigned to the fact that I shouldn’t deadlift heavy regularly. Stuff I do is just ice lower back, do piriformis stretch, hamstring stretch (w/band loop), knee to chest, plank, glute bridge, random one arm supermans (not sure what they are called).

Do all of those for 3 sets, 30 seconds each set per day. Seems to be helping so far. Get deep tissue massage done as well for the past few weeks, not sure if it is working, sometimes my hammys/glutes are just so tight the masseuse can’t even get into my muscles.

Not a back expert but my chiro seems pretty smart and intelligent from what I gather… got adjusted a fair few times to begin with, only once a week now… for temporarily relief (ie walking distances/going to gym) I put some deep freeze on my affected areas just to numb the pain… not sure If that’s totally good or bad for me but seems to help temporarily. Also foam roll a bit but have been told not to do excessive foam rolling for my injury…

Rehabilitation of the Spine by Craig Liebenson is worth its weight in gold. If you choose to not see a chiro again there are some things to focus on: stability at that segment so it won’t fail again, restoring a good ROM in your hips by mainly stretching out your soft tissue. Then a good protocol to work on your movement patterns. I might have missed it but how did you injure yourself?

Gentlemen. Be careful if you have a bulge. You will NEED to rest.

A bulge turns into a rupture…rupture bad.

I had surgery on L5 to remove the disc material (1995) that broke through the nucleus of the disc. It helped tremendously, because I had a rupture, and there is no true healing in a rupture. I re injured my back at 35. See my latest MRI showing post operative disc material at L5.

Make sure you do not go overboard.

Stop your deadlifts, stop your heavy squats. Do lots of pull ups and rows for the back. Do lot’s of lunges for the legs. This allows for maximum muscle exhuastion without loading up the spine.

[quote]trentmeister69 wrote:
Pretty sure I have the exact same injury as you… went to chiro in february this year and got put on a program. When I started I could barely even lift my right leg up (when lying on my back). Now my ROM is a lot better (nearly 90 degrees now).

Sciatic pain for me is only down the right leg in my case. Painful around glutes/hams/calves/lower back, gym work hasn’t been too bad for it (obviously I have avoided all deadlifts/squats). Been nearly 3 1/2 months since I started chiro and can’t see it being fully recovered for at least another 2 months.

I am targeting 6 months as full recovery (start contact sports/squatting again). Resigned to the fact that I shouldn’t deadlift heavy regularly. Stuff I do is just ice lower back, do piriformis stretch, hamstring stretch (w/band loop), knee to chest, plank, glute bridge, random one arm supermans (not sure what they are called).

Do all of those for 3 sets, 30 seconds each set per day. Seems to be helping so far. Get deep tissue massage done as well for the past few weeks, not sure if it is working, sometimes my hammys/glutes are just so tight the masseuse can’t even get into my muscles.

Not a back expert but my chiro seems pretty smart and intelligent from what I gather… got adjusted a fair few times to begin with, only once a week now… for temporarily relief (ie walking distances/going to gym) I put some deep freeze on my affected areas just to numb the pain… not sure If that’s totally good or bad for me but seems to help temporarily.

Also foam roll a bit but have been told not to do excessive foam rolling for my injury…
[/quote]
I believe that sciatica can be fixed much faster than that. Even when the root cause is disc putting pressure on the nerve, most of the pain comes from the muscle tension – the kind that your massage therapist can’t get rid of.

THAT MUSCLE TENSION COMES FROM THE BRAIN. (Or, somewhere in the CNS, doesn’t really matter where.) You can’t get rid of it by stretching either because it’s not caused by restricted movement.

The movements/positions that convince the brain to let go of that tension have the following characteristics:

  • the spine is fully supported
  • the vertebrae and discs are PASSIVELY decompressed, taking pressure off the nerves
  • small movements are done to activate small deep muscles that have not been firing sufficiently (like the scapular retractors)
  • small movements deliberately contract muscles in spasm, ironically enough triggering them to subsequently relax (like the QL and piriformis)

The real magic comes when you coordinate the contraction of an underactive muscle with the contraction of a spasmed/overactive muscle, then release them together – especially when the muscles are meant to coordinate in ordinary movement.

[quote]andersons wrote:

[quote]trentmeister69 wrote:
Pretty sure I have the exact same injury as you… went to chiro in february this year and got put on a program. When I started I could barely even lift my right leg up (when lying on my back). Now my ROM is a lot better (nearly 90 degrees now).

Sciatic pain for me is only down the right leg in my case. Painful around glutes/hams/calves/lower back, gym work hasn’t been too bad for it (obviously I have avoided all deadlifts/squats). Been nearly 3 1/2 months since I started chiro and can’t see it being fully recovered for at least another 2 months.

I am targeting 6 months as full recovery (start contact sports/squatting again). Resigned to the fact that I shouldn’t deadlift heavy regularly. Stuff I do is just ice lower back, do piriformis stretch, hamstring stretch (w/band loop), knee to chest, plank, glute bridge, random one arm supermans (not sure what they are called).

Do all of those for 3 sets, 30 seconds each set per day. Seems to be helping so far. Get deep tissue massage done as well for the past few weeks, not sure if it is working, sometimes my hammys/glutes are just so tight the masseuse can’t even get into my muscles.

Not a back expert but my chiro seems pretty smart and intelligent from what I gather… got adjusted a fair few times to begin with, only once a week now… for temporarily relief (ie walking distances/going to gym) I put some deep freeze on my affected areas just to numb the pain… not sure If that’s totally good or bad for me but seems to help temporarily.

Also foam roll a bit but have been told not to do excessive foam rolling for my injury…
[/quote]
I believe that sciatica can be fixed much faster than that. Even when the root cause is disc putting pressure on the nerve, most of the pain comes from the muscle tension – the kind that your massage therapist can’t get rid of.

THAT MUSCLE TENSION COMES FROM THE BRAIN. (Or, somewhere in the CNS, doesn’t really matter where.) You can’t get rid of it by stretching either because it’s not caused by restricted movement.

The movements/positions that convince the brain to let go of that tension have the following characteristics:

  • the spine is fully supported
  • the vertebrae and discs are PASSIVELY decompressed, taking pressure off the nerves
  • small movements are done to activate small deep muscles that have not been firing sufficiently (like the scapular retractors)
  • small movements deliberately contract muscles in spasm, ironically enough triggering them to subsequently relax (like the QL and piriformis)

The real magic comes when you coordinate the contraction of an underactive muscle with the contraction of a spasmed/overactive muscle, then release them together – especially when the muscles are meant to coordinate in ordinary movement. [/quote]

Kind of get it now, would you support Rockstar’s view that I should do more rows/pullups and lunges? I have stopped all squats/deads and that has seemed to help.

How about soft tissue release from the massage therapist? that seemed to help a bit when I got it done once (was done by the better/stronger therapist).

[quote]trentmeister69 wrote:
Kind of get it now, would you support Rockstar’s view that I should do more rows/pullups and lunges? I have stopped all squats/deads and that has seemed to help.

How about soft tissue release from the massage therapist? that seemed to help a bit when I got it done once (was done by the better/stronger therapist).
[/quote]
Well, I certainly support the view that if you have symptoms of a disc bulge causing pain, for goodness sake stop doing things that make it bulge. That would include deadlifts and squats.

As far as rows and pullups, I guess so…but can you do them with good technique? How’s thoracic extension and scap retraction? How well can you activate your lats, rhomboids, lower traps?

For someone with bulge at L5-S1 causing sciatica down one leg, chances are, not well.

Along with discontinuing anything that might load that disc in a position of flexion, I would do the movements/positions that I mentioned earlier in the thread to decompress the spine and restore its proper curves.

The movements I recommend also get the muscles in spasm (like the QL, piriformis, etc) to relax somewhat. When all your muscles have normal tension, the sciatica should be mostly gone, and you should be mostly pain-free. This took me less than a week, doing these movements every day, and doing NOTHING else (no chiro, no ART, no massage).

When you are pain-free in ordinary everyday life kind of stuff, I would then go buy Cressey/Robertson/Hartman’s Assess and Correct DVD. Assess your posture and movement/ROM deficiencies, and start doing the corrective movements. Do them diligently EVERY DAY. EVERY DAY. Progress from the easier moves to the harder moves till you can do all the ones relevant to your initial deficiencies.

Once you have normal ROM and control in all these movements, intelligently program your training. Always start with mobility and activation. Always ramp up to heavier weight. Don’t overload your lower back too much in one workout, or in consecutive days.

(The thread “Cephalic_Carnage, how do you train?” has great stuff about this, though it is an epic-length thread that’s difficult to wade through, what with everyone’s routine in there.) Make sure your core is always tight and stable. Make sure your hips are mobile. (If you were diligent with Assess & Correct, they will be.)

Include single-leg movements in your programming, but be sure to do them with good technique too. It’s possible to do lunges in a way that’s hard on your spine. (Of course, even with bad technique, they’re less damaging due to less loading.)

andersons knows his stuff, helped me tremendously…my sciatic pain has gone from a 90 percent HOLY FUCK OUCH WOW OUCH to ouchie i got a boo boo in 2-3 weeks for me.

my question is my posture/alignment of the hips etc are still wicked fucked up, still have pain in my mid spine and also have some weird clicking on the outside of my hips when i walk …its weird, how do i go about fixing these lol

BTW try not to get overwhelmed its a long road to recovery my friends and honestly i tried the chiro TWICE both times sucked, infact the second time i felt like i got SET BACK from making progress

anyway good luck guys, keep this thread alive for the poor souls who end up in our shoes

[quote]PowerCrazy wrote:
my question is my posture/alignment of the hips etc are still wicked fucked up, still have pain in my mid spine and also have some weird clicking on the outside of my hips when i walk …its weird, how do i go about fixing these lol
[/quote]

Make sure to check your T-Spine mobility (both extension and rotation) and scapular stability/mobility. To go along with the scapular assessment, check your pec major/minor for tightness, serratus for activation, rhomboids and lower trap activation, latissimus dorsi for proper length/strength, etc. All of those issues can contribute to the mid-back pain.

Is the clicking inside your hip joint or do you feel like it is more along the outside of your hip? If it is inside, you worry about labral issues. If it is along the outside of your hip, then you may have “snapping hip syndrome” (read: TFL/ITB tightness). Continue with the hip mobility work you are already doing. Do some focus SMR work with a LAX Ball or any similar instrument to loosen up the piriformis, glutes, and TFL/ITB.

Also, if you have a poor pelvic alignment, especially into an anterior pelvic tilt, one muscle people forget to assess is the latissimus dorsi. Two origins of the latissimus dorsi are the thoracolumbar fascia and the iliac crest, which can both be a cause for pelvic/SI joint mal-alignment and low back/mid back pain.

Hope this helps!

How many millimeters is the bulge? I had a 2 mm bulge with similar symptoms, and did some stretches and was fine within a month.

[quote]PowerCrazy wrote:

anyway good luck guys, keep this thread alive for the poor souls who end up in our shoes[/quote]

Ha!Ha! and here I am. Blew my left out last week after 7 years of dealing with right side. (believe I’ve posted on it extensively in the past) Same exact pattern as my right side: L5-S1 dermatome all the way to toes but also front of hip like SIJ referral. Prednisone seems to have knocked the inflammation down these past few days and I’m feeling optimistic (last week was hell though, pain right up to the “number 10 on a scale of 1-10”. Ironically, I was stretching right side because it had been stiffening up past few months. Anyways, good advice on here. Am reviewing it all. Remember BBB helping me in the past. Thanks man. Ordered McGill’s latest editions to get the in depth scoop, resting it up then back to stability exercises (I hope). Had been doing them all along as well as unilateral stuff. My problems seem to stem from too much joint mobility, so really going to lay off the extensive stretching habit I picked up in martial arts. (I mean it this time, damn it!) I don’t need to be palming the floor or kicking over my head anymore.