Extruded Disc

[PaulW]

I started to have this knife like pain in my lower left back. Finally went to Dr., did the drugs for week, no change. Went back to Dr., sent me for an MRI. Today he informs me of an extruded disc in my lower back. I guess it falls between a buldged disc and a herniated disc. Getting tired of sitting around. Have new limited blaster that I am itching to shoot and now I get to go for steriod epidurals.

GodI sound pitifull.......someone slap me!!

[rhino]

The epidurals can be a little uncomfortable for some people, but they're really not bad. If you're in a lot of pain, you won't even notice the needle. The worst part is probably getting into position so the doc has access to the disc, which can be challenging if you're a big guy.

The good thing is that they will usually introduce a local anesthetic with the corticosteroids. When that local takes effect, it will be like God Himself gave you a big hug and took the pain away. It will only last for a few minutes, but those few moments of blessed relief are indescribable if you've been in a lot of pain for any length of time.

It may take a few days before the shot helps you significantly, but it should help quite a bit. Your other friends are 1) ice and 2) physical therapy.

If you can tolerate walking, do as much as you can. Believe it or not, walking is excellent therapy for disc injuries as long as you can do it.

Good luck with your procedure!

[Chriss Grube]

BTDT the shots suck as bad as the original pain. Get a second opinion on treatment. I wasted 8 months screwing around with shots and no relief. Went to another Doctor that laughed and said only thing that will fix it is going under the knife. Then 3 more said the same thing. Got cut and almost back to where I was in 2001.

[jef]

When I saw this title, I thought it was referring to powders like Hogdon Clays, which I hate too!

[mcoliver]

What causes extruded discs?

[texasag93]

I have had friends take the steroid shots for back problems. Helped one of them, didn't do crap for the other. Seems like a hit and miss treatment for back pain. I have had back pain for 16 years. When I can't get out of bed, guess I will have to look in to pain treatment . Good luck with what ever you decide. TXAG

[rhino]

I think all conservative options should be exhausted before resorting to surgery.

In cases where the only symptom is pain, then it makes sense to try everything before surgery. Surgeries are not always successful, and in fact are probably split three ways equally by those procedures that help, those that don't change the situation, and those that make it worse. Obviously when weakness, numbness, and muscular atrophy are involved, surgery is indicated.

My own surgery was very successful eventually, but it was only one element of the level of recovery I've made so far. Physcial therapy ... learning to walk again (for the third time) was essential. Due to my size, I was unable to find a neurosurgeon who was willing to work on me until I was actually paralyzed from the waist down. Obviously I was an extreme case (in more ways than one), but I still think it's worth trying what is available before surgery.

I fought back unbelievable pain, weakness, and intermittent loss of feeling from 1994 until I was paralyzed on 01-Nov-01. Most of that time I was an invalid, sometimes being confined to bed in excess of a year at a time. Even though I lost nearly a decade of my life (during the most important part too), I still think conservative treatments were the best course of action. I do think I should have been able to get surgery sooner, but all is well that ends well.

[Kimberkid]

Rhino obviously has far more insight into this than any of us could ever want, and I will second his thoughts on the 3 split surgery thing. My mother had to go through 3 surgeries that should have been 1 to get her back fixed. The first one helped for a while, then they did a second to help it, and messed it up more than before the first surgery, then did a 3rd to finally do it right. It still isnt good, and bothers her intermittenly, but life is now liveable.

[PaulW]

WOW, thanks for all the insight guys. My pain is there I would say 75% of the time and with certain movements. When I lay down I am fine. So at least I can sleep well. I get a little numbness at times down my leg, but not bad. The Dr. does want to try the conservative stuff first, which I am in favor of trying before the knife. My concern is it has gotten worse as time has gone by. First I thought it was just a muscle pull and over 8 weeks has become a real pain.

Reading online is sounds like the success rate of the epidurals are between 50-70%. Not bad I suppose. But what are the chances of the disc actually healing itself once we have taken the inflammation away? I had a disc injury in my shoulder that did heal after about 14 months. Thats my main concern...will it heal over time or am I just masking it with the epidurals.

Thanks again guys....

[Chriss Grube]

If you have the leg numbness don't screw around with the shots. I had the same thing and now have permanent nerve damage in my leg. It won't heal itself you'll just mask the pain if your lucky. They didn't do squat for me except put off the surgery and recovery for months. Mine was FUBAR from a crash and needed a fusion because the disc was blown to pieces and the vertebrae was knocked out of place. They have new outpatient repair for the discs. They go in a remove the bulge and seal it up. Should be back to work in no time. I got to see alot of people come through PT in the 9 months I was there. 2 guys had that done and were back to work as roofers in 3 weeks. Go get a second opinion and then a third. I ended up talking to 5 different ones. 1st tried the shots last 4 said surgery. Only one out of them said I could go back to work full duty so he did the surgery. 9 months of getting my ass kicked in PT and been back full duty since March. I still get some pain but at least I can do 98% of the dumb stuff I used to do and now I can set of metal detectors.

[rhino]

Yeah, if you have numbness, you might want to make that clear to your doctor. That is an indicator of a worse problem than pain, and he may want to go ahead and refer you to the neurosurgeon. A second opinion is always a good thing!

As to whether or not discs can heal ... I think the jury is out. It used to be that no one believed they could, but now some do, especially those who advocate "vertebral axial decompression" therapy (a fancy kind of traction called "VAX-D"). Who knows?

Here are some good resources:

http://www.back.com/

http://www.vaxd.com/ <--- I am unconvinced this works ... I did the therapy for double the length of time a couple of years ago ... but they claim a pretty high success rate

[Detlef]

Over 40, huh?

I've had intermittent, sometimes severe lower back pain for 17 y. Did not take it seriously until 6 mo ago. Caused (MRI) by a 4mm herniated disk.

Here my learnings:

1. Get an MRI or two (you did that already).

2. See 3-4 doctors with it (orthopedist, neurologist, neurosurgeon, at least)

3. Make your own story of it, chances are they will all tell you different causes, treatments and prognoses.

4. Take your condition seriously and find out what helps you.

5. In my case, physical therapy really seems to help best, but you need to do those exercises daily (once or twice at least) yourself once you know them.

6. Weight control (dunno whether that applies to you, but every pound is relief for those disks).

7. Become/stay physically active. I feel best after exercising (the orthopedist suggested 45 min serious workout every day, while the neurosurgeon admonished to stay away from physical activity until pain levels improve).

8. Take your condition seriously. Chances are it will never again in your life go away, you have to keep it under control.

I have thus far not done the epidural, and not undergone surgery (they chop off the disk herniation). Was told that, on average, 10 y down the line, those who udnerwent surgery and those who didn't are equally well off. But I have not been paralyzed (yet...), or been in excruciating pain for weeks. I am sure those things would change my mind about surgery, then relief is necessary to get you on a healing path.

Get informed. And did I say take it seriously?

--Detlef

[davidwiz]

What's the fix for fused vertebrae?

[PaulW]

Good input, thanks guys.

Who said over 40? I turn 34 tomorrow. Dr. also said I have some degenerative arthritis in my lower back to boot. So that does not help things.

I'm am taking things seriously. The numbness is VERY subtile and the Dr. liked all my reflex tests he gave me. So that is good.

The epidural does not relieve the pain in ALL people, as Chris can attest. It has around a 50-70% success rate.

I am not one to run under the knife, and if that be the case I will get a 2nd and 3rd opinion.

I could stand to loose 10-15 lbs, these last 8 weeks of doing nothing has added at least 5 of those pounds. So I need to watch that.

I will have to find some low impact cardio to do as running on hard surfaces KILL my lower back and is not good. A bike or eliptical machine would be good.

The pain is really tolerable untill I get up or move a certain way, and then I usually can stretch to get it to subside most of the time. The muscles in my lower back are giving me problems due to them fighting trying to walk erect and not hunched over.

It could be a lot worse, so I'm trying not to dwell to much on it......I just want to be able to get out and shoot again. Going through withdrawls...LOL

I know, there are more important things in life...but NOT many!!! haha

[Detlef]

sounds very much/exactly like what I have. I just bought an elliptical trainer. Stopped running long ago and took up rollerblading, great workout w/o the impact. The inflammation/irritation/swelling causing the pain will subside. When I was 30s, it took only a week or two, now (43) it takes months. I also stopped lifting anything heavier than a steel target or 4-y old New setup at work (I do mostly computer work, got a desk that can go from standing to sitting, and a kneeling computer chair). All little things, but they help. Chiropractor used to bring relief, but was ineffective and expensive this last time (March), you might want to give it a try but it's a borderline medicine-man kind of thing...

--Detlef

[bountyhunter]

I think all conservative options should be exhausted before resorting to surgery.

For many more reasons than most people know. The typical surgery is fusion (bolting together with titanium rods) the vertebrae above and below the blown disc. It works, if you define works as getting rid of the pain. It also increases the stress load on the disc directly above and below the fusion point, often leading to more surgeries down the road. Losing the flexibilty of one of the disc junctions is not good. The other thing is, the moment the pain is gone, people go back to doing whatever it was that trashed their back in the first place.... and here come the next surgeries following additional disc injuries.

[bountyhunter]

What causes extruded discs?

It's like a stepped-on jelly donut. Extreme sompression over time weakens the wall of the disc. One day it will rupture and the gelatinous inner material will bulge out into the space near the sciatic nerve. It puts pressure on the nerve causing pain which can be indescribable. The sciatic is like the "main phone cable" that conducts all the nerve signals from the sensory nerves up and down the body. A little nevre in your hand can make your brain feel the pain of a broken wrist.... imagine what pain you would feel if that whole nerve bundle was pressed or pinched.

Been there, done that: the pain is so immense it feels like it is bigger than your whole body and so excruciating it is hard to actually feel it is in any specific location.... pray you never have to go there, because if the nerve is impacted it takes weeks for the swelling to go down.

[Chriss Grube]

Actually a one level fusion doesn't really decrease the flexability much at all. The extra stress on the other discs is a big point of debate that has never been proven one way or the other. A good doctor will make damn sure that you do a good bit of PT after a fusion. I spent 9 months 3 days a week there. Fusion is reserved for extreme cases these days. They have disc replacement along with a bunch of other new treatments. Unfortunately due to the damage caused by the old fart and his car they weren't an option for me. I could have done the conservative stuff and tried to live with the pain but life is too damn short to waste years being screwed up and not being able to live. I took the chance and got sliced and fused. I'm back to work, shooting and can play with the kids. Maybe down the road I'll have to do it again but I'd rather have few good years than live the rest of my life crippled up.

[mcoliver]

Thanks bounty.

Once in a while, esp. during mornings, I feel som pain in my lower back. This becomes really painful a day after a match (which is spent standing most of the time.) Maybe it's time to go visit the doc.

Thinking abut this, I think I'm starting to feel the effects of all the dead lifts I was fond of doing while I was in college. It was a minor discomfort then, something I just didn't pay attention to.

[rhino]

I had a laminectomy and disc excision, but not fusion and no replacement.

[PaulW]

WOW, I had my first steroid epidural, easy as can be. Put me out for 3 minutes and when I woke up it was all done. I had instant relief. Now don't get me wrong, I'm not 100%, more like 80-85%, but much, much better. Go again next Tues. Hopefully I'll be back at the range and my old self again in 6-8 weeks. I'll have to work back in slowly, but thank goodness for some major pain relief.

[IPSCDRL]

Paul, good luck with your treatments. I sure hope they work for you. Back pain sux. I am the only male in my family that has not had his back opened up and I think it is only a matter of time. My three older brothers have had six back surgeries between them and my father has had six of his own!

Not fun. I feel your pain quite literally. I am experiencing muscle spasms as I type this.

[rhino]

Paul ... I am very glad to hear you're getting significant relief! Sounds like putting you out while they did avoided the minor discomfort associated with the procedure, too! I wish I could have done it that way!

Now ... don't forget:

1. Even though you are feeling better, you still have a disc injury. That means do not do things that will make it worse, even if you feel okay while you're doing them.

2. Do ALL of your physical therapy, even after you start doing the exercises on your own.

[PaulW]

Thanks Rhino.....

I know I really have to listen to my body from now on. And once I SLOWLY work back into shooting matches I'm going to make it a habit of taking of my equipment between stages.

The only physical therapy they have given me is; walk as much as I can handle, and swimming. Swimming did feel good even before I had the epidural.

Thats some good sh*t they gave me. But it still needs to heal....time will tell.

[rhino]

If I were you, I'd ask for some formal physical therapy. They can show you some excellent exercises to help strengthen your trunk muscles all the way around, and increase the flexibility in your lower back and hamstrings (good for pain management).

They can also teach you how to pick things up from the floor without injury.