L4, L5, S1 disc herniations again after surgery 4 years ago

by Shahid
(Lahore, Pakistan)

The Slump test for Sciatica gives you an idea of how the condition is progressing.

The Slump test for Sciatica gives you an idea of how the condition is progressing.

L4, L5, S1 disc herniations again after surgery 4 years ago reminds one there is no cure, only prevention through exercise and common sense.


I have pain in my lower back with numbness in thigh and feet. I had operation in December 2013 but again my disc is herniated in last month.

Though I have relief in pain and have started walk again around 2 km. My spine doctors have again recommended operation.

Hello Shahid,
Firstly, accept that there's no such thing as a 'cure' for what you are experiencing. Long life commitment to back exercises, every morning before getting out of bed, and an acceptance that heavy lifting is not for you is absolutely vital, no matter what treatment you have.

Otherwise it just comes back, then there's a third and fourth operation and even more misery.

Generally my experience is that if the pain in your leg goes away, given time and common sense, it may well heal without surgery.

The thing to look out for is the development of weakness in the lower leg muscles; can you raise your big toe and lift your heel off the ground?

I treat what you have on a daily basis, but I don't think there are many chiropractors in Pakistan, if any.

Chiropractic is moderately successful in treating a sciatica, but again it's not a cure; exercise, exercise, exercise, and avoid heavy lifting.

I hope this helps in making your decision.

Dr B

» » L4, L5, S1 disc herniations again after surgery 4 years ago




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Oct 03, 2017
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by: Shahid Sohail

Thank you very much for your detail answer. The Exact word of my MRI report says "
-- Diffuse posterior Disc Herniation at LV5-SV1 Level Causing of Bilateral exiting and Traversing Nerve Roots.

-- Diffuse Disc Bulge at LV4-LV5 level causing Impingement of Right Exiting Nerve Root.


Your Answer has cleared many misconceptions in my mind. I have already foot weakness and unable to lift my left toe. The weakness exists prior to my operation. The doctor had told me before operation that it might not be helpful in removing foot weakness but it would be helpful in giving relief in pain. It happened exactly the same and I was pain free for almost 4 years.

There are a few Chiropractors in Lahore (Lahore is the 2nd largest city of Pakistan) but i have doubt on their abilities. The chiropractor I met was mostly treating with electrolytes and not doing much manual spine adjustments contrary to what I had seen on youtube. In my view if there is temporary relief in pain via chiropractor and disc slip is the same there is no use of it.

Pls. help me in selecting exercises. I am feering that all web exercises related to my problem are not for me. As already told that I have restarted walk and covering 2.5 km (40 minute) without much pain.I am avoiding exercise fearing it might aggravate my problem. I feel numbness in lower thi and on foot and pain in thi area. Also do brief that this numbness is harmfull to my limbs or have any side effect.

I would be grateful for your detail answer.

Good day Shahid,
It's certainly of concern that you cannot extend your great toe; did it not recover after the first operation, or is this something new?

There are always a few ifs and buts; the impingement of the L4/L5 disc is on the right, but the toe weakness on the left; hence my questions as to whether it recovered fully after the first operation. Establishing which level is affecting you is vitally important; an operation at the wrong level would bring no relief.

True, it is likely that after chiropractic correction, further injury down the road may occur; you interpret that as temporary relief. But the surgery four years ago also only brought you temporary relief.

A lifetime of good back care lies ahead of you which every way you turn; otherwise there will be a third and fourth operation.

Good luck.

Dr B

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