Residual pain after healed disk herniation L5-S1


Hello. I found this page while searching "tilt to one side after healed disc".


I am a 43 yo mom of many, working in the horticulture trade, guilty of years of bending at the waist. Aprox 4 years ago my intermittent low back pain began to worsen. I had an MRI, noting slight spinal stenosis, and the L5S1 disk looked black, it said slight bulge.

Fast forward to December 2012. I had some slight pain in my upper back and numbing in my left arm, doc gave me a round of prednisone, and I was fine. This was odd b/c I never have upper back pain.

Then on Christmas Eve I helped someone move a lot of plants, bending, lifting, carrying long distances....

Let me add I was incredibly stressed, depressed and nearly of of touch due to divorce and other issues.

Over the next two weeks this got very bad, numbness in my left leg, a forced limp, shooting pains. I went back to work after break and tried to drag a chair around the large nursery! Looking back, that was so ridiculous! It didn't occur to me right away something much worse had happened, as there wasn't one "ow! I've just snapped my spine!" moment.

Doc sent me for a second MRI. I mentioned the MRI tech, I hoped they could see what was wrong, and he replied: don't worry...let's just say if a picture is worth 1,000 words, yours is worth 10,000. I've attached an image of that MRI. Apparently I had had herniated the disk, with the disk material squishing out and pressing on my sciatic nerve! And more spinal stenosis. Ah ha! That explained it! I was off work a couple months waiting for a cortisone shot, which worked great!!!! Completely FINE for about 3 months.

Then it all crept back, even the numbness, but not as bad. The one major difference was that IT SWITCHED SIDES. As it got worse I went off work again, while waiting for another shot. This time it was injected more to the right side of my lower back, where it did NOTHING. I was sent to surgeon who said he was 90% sure he could fix the issue, but noted 90% of these resolve on their own within a year.....so, I waited, thought about it and by November it has abated enough I went back to work.

Fast forward again about a year, to now. I still favor my left side most of the time and try to not tilt when I walk. Pretty much all sciatica is gone, but I do get (quite intense at times) pain deep in the middle of the butt cheek, and in the hip bones, but I can usually go almost all day without pain. While I think walking all day at work helps, by evening I'm ready to park it!

I am wondering: Does the disk material just get reabsorbed? Does that mean it's all healed up in there? Why did it switch sides and end up leaving early still feeling more pain with the right side? (not the original side). What should I be doing now, and finally do I have this poster medial disk herniation possibly? Thank you for your time, these questions I have been wondering...

Hello Plant Mum,
You've had a torrid time.

That scan isn't indeed great; can you see also that whiteness in the bone? It's called a modic effect meaning that fluid has seeped into the bone. Pain.

Yes, disc material is reabsorbed if you can wait it out.

You are coming up against two different philosophies of back pain; one sees this as an inflammation that needs to be treated with anti inflammatories. Ours is that that there was a physical defect that needs to be approached with either a manual or surgical procedure.

Vital now is that you start doing our lower back exercises every single morning before getting out of bed. Don't ever miss; the initial ones take less than a minute, progressing with the core exercises to perhaps two minutes.

Secondly get yourself some of those pads that strap on the knees, and work on ONE knee, rather than bending at the waist.

Thirdly, accept that your days of heavy lifting are over; if this happens again you'll probably be quite severely disabled.

Sometimes a short leg is part of the problem; if so, an inexpensive insert in the shoe can make a big difference.

The medial disc does occasionally swap sides. It sounds like you've been going into what's called an antalgia; leaning to the side to reduce the pain.

At this stage I'd be hesitant to start with frank manipulation; in the acute phase, yes, but now that you are half way okay, it could stir things up. Some decompressive traction may help, but sometimes aggravates the medial disc.

Lie down periodically where you garden and do the exercises; no more heavy stuff. On ONE KNEE when you need to bend.

Good luck.

Dr B

Comments for Residual pain after healed disk herniation L5-S1

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Oct 14, 2014
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one more question please :)
by: Anonymous

Dear Doc,

I read your response above to my daughter, 14, and she said yes, I do tilt. Actually, she said "mom I've been meaning to tell you that you kinda waddle." Then shenter did a penguin imitation. I walked away from her and she observed, "it's the right one! You lift that one up more."

My right side is the one that hurts. The pain starts in my lower back near center and follows a line down into my deep butt and hip, then coming down my inner right, usually stopping above the knee. Related: A small marble free moving soft "lump"in my upper, inner thigh. Been a couple monthas since I noticed this. It seems like it maybe slightly painful as its in the line the pain "line" runs, as if through or next to it.

Does this path sound like anything common? I would like to start taking measures to increase my flexibility and ease of movement as I grow into my middleyes age more....my mother died at 59 from complications after a 19 year battle with severe Rheumatoid Arthritis. It was awful, destroyed her.

Chiropractic, exercise, yoga and healthier eating. I'm anxious to find out if my hmo covery and manipulative work.

Massage, I wish I had the fundage for regular massage. My grandparents, depression area farmers from middle of Nebraska. The 40 years or so they lived out here they went for massage, and adjustment, in Calistoga once a month. They swore by their treatments and lived in pretty great shape until 86 and 98!

The last 3 years or so the pain and or difficulty doing certain everyday movements has scared me, but I love stretching in all ways, I just experiment looking for the best stretches by feel. Gosh I don't mean to monopolize your generosity of your time, but you have told me more in this brief interaction than any the docs who saw me.

Peace,
Tina

Hello Tina,
I don't think I've much more to add. Really what's needed is a thorough chiropractic exam; I'd suggest you start talking to friends and fam and get a name of someone conscientious.

You have to budget for your health, you know.

dr B


Oct 14, 2014
Rating
starstarstarstarstar
one more question please :)
by: Anonymous

Dear Doc,

I read your response above to my daughter, 14, and she said yes, I do tilt. Actually, she said "mom I've been meaning to tell you that you kinda waddle." Then shenter did a penguin imitation. I walked away from her and she observed, "it's the right one! You lift that one up more."

My right side is the one that hurts. The pain starts in my lower back near center and follows a line down into my deep butt and hip, then coming down my inner right, usually stopping above the knee. Related: A small marble free moving soft "lump"in my upper, inner thigh. Been a couple monthas since I noticed this. It seems like it maybe slightly painful as its in the line the pain "line" runs, as if through or next to it.

Does this path sound like anything common? I would like to start taking measures to increase my flexibility and ease of movement as I grow into my middleyes age more....my mother died at 59 from complications after a 19 year battle with severe Rheumatoid Arthritis. It was awful, destroyed her.

Chiropractic, excersise, yoga and healthier eating. I'm anxious to find out if my hmo covery and manipulative work.

Massage, I wish I had the fundage for regular massage. My grandparents, depression area farmers from middle of Nebraska. The 40 years or so they lived out here they went for massage, and adjustment, in Calistoga once a month. They swore by their treatments and lived in pretty great shape until 86 and 98!

The last 3 years or so the pain and or difficulty doing certain everyday movements has scared me, but I love stretching in all ways, I just experiment looking for the best stretche's by feel. Gosh I don't mean to monopolize your generosity of your time, but you have told me more in this brief interaction than any the docs who saw me.

Peace,
Tina

Oct 13, 2014
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Thanks!
by: plantmum6

I appreciate your feedback and advice and answers! I'm going to wear the knee pads, that makes alot of sense. Right now my back hurts at least a little every day but only a few nights when the pain keeps me awake, and more and more it's my hips, they feel like bone on asphalt, when really I'm not skinny at all, need to lose a few...I suspect it's my crummy bed. I'm going to start your exercises tomorrow. I have found stretching (especially with my legs vertically up against wall,body laying on floor) and when it's really bad COUNTER PRESSURE. Hey, can anyone tell me why that relieves the pain? Wether it's a child sitting on the right spot or my DH pushing on my lower back hard, that kind of pressure relieves all pin, until they stop. Is it just compression of a nerve?

Thanks Again.

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Interesting challenges of the day

1. Mr S is a 76 year old man with neck pain of some 9 months duration. Luckily, most of the discomfort is upper cervical which is only rarely arthritic; his lower cervical spine is a degenerative mess that I've left alone. After seven treatments his pain and stiffness is 50 percent better, and he's happy in the circumstances. He can sleep through the night now and that makes a huge difference.

2. Mr P is 32 year old man with very severe lower back pain radiating to the big toe which is 30 percent numb. He had an episode three weeks ago, took anti inflammatories and was soon better as is typical of the medial disc herniation. But before it healed, after a trivia it came roaring back, much worse. The characteristic crossed sign was evident; sitting in a chair, straightening the right leg provoked severe left back pain and tingling in the leg. He's doing well.

3. Severe lower back pain is scary; just ask Mrs P. Just watching her get out of the car I she was in trouble; she had a slipped disc at L4 making her lean towards the opposite side; luckily she had no pain in the leg. Despite family pressure that this was far too severe for a chiropractor, she persevered. Within five days she was standing upright, and after two weeks almost painfree. 

Despite a hectic job, she wisely took my advice and stayed home for what I call exercising bed rest.

4. Mr S has had lower back, groin and back of thigh and calf pain for fourth months.

He has a pincer deformity in the hip causing the stabs in the groin, and a degenerative facet causing the sciatica. Both are responding well to chiropractic and he's well pleased; sixty five percent better after three treatments.

5. Mr T is a wise man; he's taken a warning TIA seriously and has lost 15 pounds, and has at least as much again to lose. A change to a low starch diet and half hour daily walk has made the difference; but the walking is making his foot and back miserable. The expensive orthotic is hopeless; luckily his hips and back are fine, but he needs a simple heel lift.

6. I too have had serious lower back issues, luckily fixed by my own chiropractor; so I too have to do my exercises, take care when lifting supers full of honey, gardening and using the chainsaw. Regaining the function of your spine is just as important as the pain.

7. My own granddaughter, only 7 is hypermobile giving her pelvic, knee and ankle issues. Xrays show a mildly dysplastic hip. Years ago we would have called it growing pains. She too regularly needs chiropractic care and luckily responds well. Increased range of motion is more difficult than too stiff in my opinion. Our care is for kids too.

8. This 65 year old lady is a serious gardener; every day she is bending, lifting and digging for 2 to 3 hours a day. It regularly catches her in the sacroiliac joint, so she has a treatment once a month that sorts it out. She does her lower back exercises faithfully.

9. This 88 year old lady is an inspiration; every day she is busy in the community. With a nasty scoliosis she manages very well with a chiropractic adjustment every six weeks and exercises faithfully done.  

10. Mr X is a 71 year old retired man who wants to continue with maintenance care every six to eight weeks; he had suffered from two years of lower back pain when he first came a year ago. He has no discomfort now after 8 chiropractic treatments, but is aware that danger lurks.

11. Mrs C has been having severe headaches, and taking a lot of analgesics. It's a non complicated upper cervical facet syndrome, and she's doing well.

12. Mr D is a 38 old year man with chronic shoulder pain after a rotator cuff tear playing cricket. It responded well to treatment, but he knows he must do his exercises every day; for two years he couldn't sleep on that shoulder.

13. Mr D, a 71 year old man, has a severe ache in the shoulder and midback since working above his head. Trapped nerve tests are negative but he has advanced degenerative joints of Luschka; after just two treatments he is 50 percent better. Can we reach 90?

And so the day goes; chiropractors shouldn't be treating the elderly most medical sites state but that's so much bunkum.



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