T Nation

Sciatica with Disc Hernia Again

Injuries and Rehab
#1

Hi!

The last 10 months I’ve been suffering of sciatica with pain radiating all the way down to my calf. I’ve lost ca 10kg (22lbs) since then, every pound being muscles =(

The first two months where unbearable, even though I tried taking walks and activate myself (I even repainted a whole cottage) the pain forced me to bed most of the day.

This was/is the second time I’ve got full blown sciatica.
The first time was 4 years ago, and al though the pain lasted a while that time, I could feel the improvement as soon as I performed some exercises my physiotherapist recommended. And I was able to start Martial Arts (BJJ & MMA) and return to my normal gym routine after 8months. I thought I was cured for ever and did not even think about proper ergonomics while siting, or removing dangerous exercises from my program (like good mornings).
Sure I could feel some dull pain in the back and buttocks some times, but it did not concern me so much.

When I got my second full blown sciatica period (the current one) I actually felt the dull pain in the back, prior to the actual acute phase.
I did not care about this dull pain and went to play soccer, and that made it a wrap, the second sciatica period of my life was a fact.
A MRI 3 weeks after the soccer game showed a disc hernia at the height of the lateral recess at L4-L5 with risk of affecting the L5-nerve root.
Both L4-L5 & L5-S1 where degenerative and dehydrated.

I’ve read tons of books about the subject and this brings me to the actual question, should I undergo surgery or not?
The pain is down to 3-4 on a 10pointed scale when I take NSAIDs, and it goes up to 5-7 when I’m without medication (I’m constantly trying to see if I can manage without NSAIDs since I hate being dependent of them). I know that most often people can get well without a operation, but I’m starting to suspect that I’m not one of them.
I’m getting frustrated of not being able to train Martial Arts, and not being able to move without worrying about pain.

What more should I try before throwing in the towel and let the butcher try his magic fingers on me.

*I’m training my core muscles with plank, side-plank etc.
*I keep away from squats, DLs, Good mornings, etc.
*I take daily power walks
*I avoid flexion of the lumbar spine (Stuart McGill)
*I hardly ever sit, and if I do I sit on my pilates ball
*I do different nerve flossing techniques daily
*I just stopped doing McKenzie pushups, I’ve done them from day 1, and they don’t seem to help
*I just started with foam rolling my back and hip muscles (actually it’s a steel bar and not a foam roller.
*I stretch my piriformis, quads and psoas major, hamstrings and adductors daily

any other advices?
I read a old thread where somebody gave the advice to sprint since it activates the core muscles in a good way, I’ll actually go out and do that right now before the meds start to subside.

I appreciate the help, thanks in advance.

#2

Just a small update for that it’s worth
I bought a foam roller and a 8-ball (billiard) today. The foam roller was a bit to soft for the back, but it made a good job on the IT-band.
I worked the 8-ball in all small cavities around the hip and lumbar back and I’ll be damned, it worked really good, al though I’m totally devoid of any medication today I can move around smoothly without any pain. As soon as I feel some pain and numbness I just use the 8-ball and I feel fresh again.

I don’t know if yesterdays sprint has anything to do with it, when I ran I could feel how my leg was wobbly and wonky while running, and I had a hard time to properly plant the foot with the heel, and I hade some pain afterwards.

I also did first hyperextensions today, I’ve missed that exercise, but I could not place the affected leg on the device which prevents you from fall over, because I could feel the pain as soon as I started to fold down. So I performed it single legged.

#3

Spine injuries are a bitch, Im dealing with mine at the moment. Have you read a book called 8 steps to a pain free back? If your posture sucks then it will never improve. Hows your mobility? can you touch your toes with a neutral spine? mobilitywod.com will help if you havnt looked at that before (go to episode 1)

#4

[quote]Petrollis wrote:
I also did first hyperextensions today, I’ve missed that exercise, but I could not place the affected leg on the device which prevents you from fall over, because I could feel the pain as soon as I started to fold down. So I performed it single legged.[/quote]

Are you doing them in a Roman Chair or do you have a 45* station?

#5

[quote]BlueCollarTr8n wrote:
Are you doing them in a Roman Chair or do you have a 45* station? [/quote]

I’m doing them in a 45* angle, and one foot free.
The only time I put both feet on the rack is when I trained my E. spinae isometrically and keeped my body in a straight line.

#6

[quote]Fisherdan wrote:
Spine injuries are a bitch, Im dealing with mine at the moment. Have you read a book called 8 steps to a pain free back? If your posture sucks then it will never improve. Hows your mobility? can you touch your toes with a neutral spine? mobilitywod.com will help if you havnt looked at that before (go to episode 1)[/quote]

That’s actually something I’ve got confused about.
Some authors prise mobility of the back, and other talk about the importness of a stable back.

Hmm I don’t think so, I’ll try to find it.
No I can’t, if the back won’t stop me on a good day, the hamstrings probably will.
I checked up episode 1-2, I have to try his exercises right away.

#7

you should pick up a book called Athletic Body in Balance by Gray Cook, do the self assessments (which you’ll fail…) and then work through the progressions. That should help but it’s a long process.

In the meantime you should be able to perform dumbell split squats, hip thrusts and glute-ham raises without any pain. It’s not as much fun as squatting but you can still get a pretty good workout that way.

Also, check out backfitpro by Stuart MacGill

Hope that helps.

#8

My story is very similar to yours. I was very active, trained bjj and Thai boxing twice a week and lifted another 2 days a week. Long story short I was deadlifting when I knew I should have taken the day off, felt my form breakdown and a pinch in my back. I have dealt with the pain and cramping in my leg for 10 months after that. I tried mckenzie, all sorts of core stabilization, chiropractor, massage, foam rolling, stretching, tennis balls. I even had a period of 3 months when my pain was almost gone after a epidural injection. The injection wore off so I went back for a second, this time the injection had no effect so I opted for surgery. I am currently 2 weeks tpost op and feel pretty good so far, I still have some leg pain left but it is mostly just a minor annoyance compared to the pain I had pre op and the doc tells me as the nerve and surgery site heal the little bit of leg pain I have left will go away.

I’m not saying go for surgery but I just figured I would chime in with my tale. I will keep you updated as to how my recovery goes. I plan on getting back to lifting as soon as my doc gives the ok. I’m told its usually 6-10 weeks post op before you can start easing into heavier exercise. For now I’m just doing a lot of walking and will start to do some swimming and bodyweight exercises soon.

#9

Well not sure if this will help you or not.

Mine was a herniation at L5, pain down the left leg. No relief with conservative measures.

Microdiscetomy with partial lamenotomy performed 3/12/12, told by surgeon heriation removed, and a good amount of “disc debris” that was contacting the nerves and causing pain.

Almost 7 weeks post op now, pain in leg only occurs when I’m really tired but for the most part completely gone.

#10

[quote]lanchefan1 wrote:
Well not sure if this will help you or not.

Mine was a herniation at L5, pain down the left leg. No relief with conservative measures.

Microdiscetomy with partial lamenotomy performed 3/12/12, told by surgeon heriation removed, and a good amount of “disc debris” that was contacting the nerves and causing pain.

Almost 7 weeks post op now, pain in leg only occurs when I’m really tired but for the most part completely gone.[/quote]

Did you need a steroid dose after surgery or did the leg pain fade slowly as you went on?

#11

[quote]Shawnzep wrote:

[quote]lanchefan1 wrote:
Well not sure if this will help you or not.

Mine was a herniation at L5, pain down the left leg. No relief with conservative measures.

Microdiscetomy with partial lamenotomy performed 3/12/12, told by surgeon heriation removed, and a good amount of “disc debris” that was contacting the nerves and causing pain.

Almost 7 weeks post op now, pain in leg only occurs when I’m really tired but for the most part completely gone.[/quote]

Did you need a steroid dose after surgery or did the leg pain fade slowly as you went on? [/quote]

Mine’s gone away without a steroid injection, almost right after surgery.

I still get “flare ups”, reminds me every now and then that I still am getting some swelling in there but for the most part the only pain I have left is low back from surgery.

#12

I would suggest having the surgery, I put it off for years and wish I would have done it sooner. I ruptured 1 disk and herniated 2 others L4, L5, and S1 during squatting. I tried to keep up with someone more advanced in lifing without a back brace and of course hurt myself. This happened when I was 17 I am now 35 and had the surgery almost 4 years ago now.

Technology has come along way since I was 17 so maybe it may be for the best that I waited. I tried everything from chiropractors to physical therapy and probably anything else you could think of with little to no help. Of course some things helped for a short time but nothing fixed the problem. I took so many percocet and muscle relaxers that the white of my eyes started to turn yellow my liver was giving out.

I also was drinking heavily with the medication to kill the pain. Finally I said enough is enough I was tired of band aiding the problem. I decided to go through with the surgery and wished I would of done it sooner. It took a while to be absolutely pain free, alot of strenghening my core and stretching. I got to the strongest I had ever been. Until I reinjured my back again being careless. I had gotten to a point where I could leg press 1300+ lBS free weight. and incline bench press 330 for 3, flat bench 360 for 5 reps.

Well with that being said all it took was being careless and lifing a pair 100LB dumbells wrong and twisting at the same time without a belt. I was trying to hurry and get them to a bench during a peak hour at the gym before someone else would get the bench. Dumb I know now but i thougt it couldnt happen to me I was feeling great before it happend.

Ever since then I have been getting reoccuring episodes when I least expect it. Its been about 8 months now and things dont seem to be getting any better. I wish I would have just worn by back belt for every excercise like i do now even though its too late the damage is done. I guess what I’m saying is yeah the surgery is a good thing but you have to be really cautious about how you do things after the surgery even if its a few years later. The back is always gonna be suseptable to injury where you have a weak point. I am in the process of seeing if I can get another surgery done but my doc is a real dick so I think im gonna change doctors and see if its worth going through another disectomy or just fuse the disks. Well good luck in what ever decision you make just keep in mind once you feel better you can still get hurt.

#13

Hi

I have just registered as I was lurking and read your post and it relates to similarar problem I had.

Back in 2006 I ruptured L4-L5 disc. I was unable to move paralysedised by the pain. I was taken to hospital and pumped with lots of morphine which did nothing to the pain. Later that day after tests the hospital said I had to go home and rest for couple of days until I could see a specialist. My wife and mother in law carried me out of the hospital.

embarrassed and in agony.

I had a MRI and the spinal surgeon said I had a ruptured disc and my sciatic nerve was been trapped causing lots of the pain which ran down through my right glute causing spasam and pain down my leg to my big toe.

I was advised by the spinal surgeon that surgey would be the only way to deal with this as the disc was split. I was told no more weight training. I could eventually ride a bike if I was lucky and gentle walk.

My world was looking suddenly a bit dark and with all the pain medication I was getting depressed and desperate. Not being able to hit the gym was the most frustrating thing ever.

I was self employed and could not work for a few weeks but had to work drugged up and still in agony. Not nice dealing with customers.

After lots of research I read many horror stories about surgery. The surgeon wanted me to have the ruptured disc partialy removed and then fusion to my spine.

I read that an injection can sometimes work, this is called a “Ganglion nerve root block” (excuse spelling)
This carried out under local anastetic as it can be too dangerous if your are knocked out. This can block the pain to the nerve that causes the sciatica.

I asked my surgeon about this and he very reluctantly agreed to give it a try. I went in hospital in the morning and in the evening I walked out having this procedure carried out and I was 99% pain free. I was soooo happy.

This is when I was able to address a few problems that caused this ruptured disc.

First, I bought the “lose the back pain” system. Carried out targeted stretches and continued with no pain. Then I looked into another system called “The X Pain method”

These 2 systems helped me address muscle imbalances that I had.

I then made the most important purchase I have ever made. I bought an inversion table. I used this every day for 5 - 10 minutes.

Trust me, I spent £1000s on phsyios., chiro treatments and they never helped me.

So now? I have little sciatica every day. Scale of 1 - 10 id say 2-3. I still use my inversion table once a week, I have trigger point therapy and sports massage evedead lifteeks and this helps me.

I deadlift, squat and dwouldn’the things my surgeon said I wouldnt.

Sorry for the long post but before you head for surgery try and inversion table at least.

Good luck.