Central disc prolapse - Does it get any better??

[olexhuliinlivveka]

I am new to this forum and would like help and advice from as many people who have time to respond. I am sorry if my post is not unusual etc etc, I just want to try and find a few people either with similar experiences or potential solutions.

I am a 28 year old bloke who has been diagnosed with a prolapsed disc between S1 and L5. Also it looks like the one between L4 and L5 is having a few problems too. I started getting pain around December last year and was previously very active, playing football twice a week and visiting the gym fairly frequently. I can only guess that the problems eminate from playing football (usually on Astro which is less forgiving than grassre how hard the pitch is)

Anyway, after putting up with the pain for a good few weeks (hoping it would go away) I decided to see a Chiropractor under my works private health scheme. After 10 sessions I had no relief at all and if anything things seemed to be getting worse so I got myself to a doctor who referred me to a Neurosurgeon at BUPA. After my initial consultation, I was rushed in for an MRI scan and the following day was told I needed a discectomy as I potentially had the start of Cauda Equina Syndrome and that it was a real emergency. Obviously the repercussions of this syndrome are immensely frightening (loss of bladder, bowel, sexual functions)andas a very active, social 28 year old you could imagine my worries. I therefore was going togo ahead with the surgery. This is despite in my eyes not having many of the symptoms that are associated with the syndrome (I was simply experiencing immense back pain and slight numbness in the bottom)

Fortunately I have a family friend who is a surgeon (not aback surgeon) who said that I seemed to be being rushed into surgery and to get a 2nd opinion. I did this and had it with a well known specialist who had been personally recommended by this family friend. Hediagnosed me with a central prolapse but insisted there was a lot of distance between the disk and the nerves that cause the symptoms mentioned above. Hesuggested physio and if this didn't work potentially an epidural injection and only in the very worst cases surgery.

Anyway, I had 2 weeks off work to rest the injury followed by a course of physio. The problems did get a lot better and I then stopped having physio (ran out of private medical funding and can't afford to pay myself) Things have been ok (not perfect by any stretch of the imagination, I still get soreness and sciatica type issues) though recently it has been a bit worse again.

I suppose given the above I have a few questions for anyone with time to answer.

1) Will this get better with time and settle down allowing me to return to my active lifestyle of the past (I am resigned to not playing football again but so far I can't run or do anything really without aggreivating it)?

2) Have you any suggestions to try and improve my problems (whether they are alternative or surgical etc)? I should add that I have a desk job and would therefore appreciate suggestions on how to minimise problems whilst at work(I constantly get sciatic pains and pain in the lower back despite trying to keep a good posture andkeep mobile fairly regularly) Has anyone had an epidural for this sort of thing and what is it supposed to do?

3) Has anyone any comments on why a surgeon would diagnose something that scared me to death and almost forced me in to a potentially unneccessary operation that may actually have made things worse?

4) Has anyone gone through such an experience at my sort of age andhow are you now??

5) Can anyone recommend any exercises? I am trying to swim fairly regularly, is this a safe form of exercise?

I suppose I am very worried that the life I once knew is kind of over now and the things I took for granted (being able to play sports, sit for long periods of time without

 

[jfedjuuuikoibtesd]

Hi Steve,

Some doctors seem to think that surgery is the one and all answer...
You can get physio on the NHS, but there may be a waiting list. Also you need to make sure you get a good physio that does make things better.
If you can afford to pay a bit of money therapies like Shiatsu or acupuncture could be really helpful.Might even make the whole thing history, but no one can promiss you this in advance, and there are never any guarantees before you have tried it. Just that as a general rule these therapies (but they are not the only ones, just what I am most familiar with) work really well for back problems.

Desk job: there are some lealfets (NHS?) arround about how to set up your work environment. COmputer screen high enough so you don't have to bend your neck. Chair high/low enough so that your elbows/shoulders areat th eright hieght for the keyboard. You may also need a foot rest -don't want your feet dangling.

Let us know how things develop?

Artemis

 

[Taylor Travis]

Dear Steve,
10 years ago, I was 35, and I was offered a microdiscectomy by a surgeon after a prolapse L4/L5. Iwas in agony at this stage, but kept mobile, took muscle relaxants, and started to feel well enough to refuse the surgery (particularly as I was told that there were no guarantees, that the spine was "a bit of a mystery", but that my bulgingdisc would be particularly good to work on for the surgeon. In the MRI it is squeezing out nearly all the way down to the next one.
My physio had just taken up with Pilatesand told me to forget everything else - just dothe basic core stability exercises and keep moving. And it worked -I noticed an improvement almost immediately, and then gradually after that until today I have no pain and about 95% of my former mobility: I'm only limited when I try to do the advanced exercises. After 5 years I qualified as a Pilates teacher myself.
So my advice to you is - find a good Pilates teacher, with a small class, or who could take you on as a one to one. Practice the exercises three times a week at least.
You will get better.
Also - attend to your nutrition, hydrationand stress levels, as theywill either make everythingbetter or worse.
There is hope,
Sharon.

 

[M N]

Artemis and Sharon, many thanks for taking the time to respond. I will look into your suggestions immediately, I have even pre-empted you Sharon by taking out a book on Pilates!! I now simply need to ensure I motivate myself to actually regularly work on strengthening the support to my back.

Has anyone got any opinions on swimming? I've got a fairly hectic job but have found that I can get away at lunchto a very local gym/pool. Obviously lifting heavy weights etc etc is not a good idea but what would people recommend I do for 30/45 mins each day. Anything in the gym, or just a brisk swim??

Thanks again for your responses, it's nice to know that with time and effort I may get back to a more normal life.

 

[Henry Spencer]

I have been suffering with backproblems since I was 20 (now 32) and I have totally given up on doctors, in my case they have not even been interested in investigating so I am not sure what the problem is.
I have visited chiropractors and osteopaths and in the last year, bought aromatherapy oils which i blend into massage oil and also use in a bath. These are brilliant, I have reduced my intake on painkillers due to aromatherapy oils by approx 85%

Another thing that has been good is yoga & tai chi and I would wholeheartedly recomend those, although I am sure pilates are good as well.
I think it is very important to keep active and continue exercising as and when you can.

I would not rule out you playing football, but perhaps not for Manchester United after all.

My recomendation is the gentler exercises like yoga & tai chi, pilates to get you on the road to painfree life, and gradually trying football, but gently at first.

And another great thing to have in your front room is the exercice ball, I am sure you have seen these big balls at gym etc.
while watching telly, you can lay on top of the ball and do various stretches with it, in fact you can have a full exercise for the entire body with it, but personally I use it mostly for stretching my back.

I hope this helps, let me know if you want more info on anything....

 

[Milk84]

Oh and meant to say,also SWIMMING GOOD!!!!

 

[Corthghlind]

Steve, about swimming: how do you feel after a swim? If your back feels better, it is probably good fo ryou, if it feels worse, then don't do it! If in doubt, my sugestion would be to refrain. Try and listen to what your back is really telling you.

Artemis

 

[Vahid]

My back normally feels better after a swim. I'm going to try going regularly for a week a so and see how I get on.

Problem with my back is that it is a bit of vicious circle. I injured my back so my active lifestyle stopped (stopped playing football and going the gym) and therefore I started to put on weight (not huge amounts but about a stone since Jan) That can't be good for the back so really want to get fit again and keep the weight off!

Hopefully swimming is the answer and I am doing a lot of walking.

 

[Joe racing]

Hi Steve - generally yes I'd say swimming is good, if you have good style. Generally speaking Front/back stroke are better than breaststroke, particularly if you swim with your head up for the latter. But as Artemis says - do what works for you.
S

 

[cassandras_evil_sister3]

Hi SteveB.
It's a misconception that disk injury isan older persons problem - most are young - middle age.
Have you checked out my Thread on disk injuries - [link=http://www.healthypages.net/forum/tm.asp?m=104]http://www.healthypages.net/forum/tm.asp?m=104[/link]

The type you have is less common and can be very serious as you mention. I gather that when you mention numbness in the bum, that it was around the area of the sacrum (base of spine), which sounds like the only symptom/sign of cauda equina syndrome.

Obviously keep a close check on that and an eye out for any of the other symptoms that I assume was mentioned in the blurb given to you. And if you get anymore then go straight to A&E, don't bother with GP or NHS direct as this will only cause delay and possible permanent damage.

Most disk injuries to settle down and don't need surgery. The long term result is a slight loss of hieght in the disk, which maintains the size of the holes (spinal foraminae) where the nerve roots exit the spine.

In short:

You need to do everything you can to avoid further disk prolapse and maintain the integrity of the disk.

Also there is risk of a condition called nerve root tethering. A good physio that knows about nerve stretching techniques & exercises should be able to help or an osteopath.

Re. Maintaining Disk Integrity the following is what I recently emailed to a patient with a similar problem on the subject. Inversion table mentioned is one wayof helping to decompress the lumbar disks by hanging upside down.

Did you check out inversion tables on eBay?



As we know you’ll have lost a significant amount of intervetebral disk height from the prolapse, for the long term I think it’s best practical option, alongside occasional osteopathic maintenance treatment, if needed.



I think I already said, but as a reminder for other things we know that will help maintain disk integrity;



Plenty of water, preferably filtered. Vertebral discs are hygroscopic, so they tend to hydrate by attracting and taking in water when they are none weight bearing, usually when we’re asleep. This gradually depreciates during the day, when we’re upright and the disks are weight bearing, probably due to the forces on them. So, yes we are that little bit taller when we wake than when we retire.



Glucosamine sulphate from health food shop. X3 a day for a month, then drop down to x2 for month, then you may be okay with 1 a day thereafter.



A copper supplement from independent health food shop, take as directed on container. Can be continued or consider a copper bracelet after taking supplement for 1-2 months.



Other stuff:



Whilst copper & glucosamine are the only ones that I know that have research specifically on disk integrity, there are others, that should theoretically help.



It’s important because as yet there are no known reliable surgical approaches to restore disk height and the usual progression

 

[race_car_bed]

I'd just like a bit more advice re my injury that I discussed above some time ago. Things haven't improved very much despite taking up Pilates and swimming regularly and in fact got worse again over Christmas (probably though due to increased amounts of inactivity)

I went back to see my neurosurgeon for some advice and a detailed examination he has suggested trying a cortisone epidural to try and get any inflamation around the nerves sorted.

Has anyone any experience of this, what it does, how it helps and what are the drawbacks and potetial problems with it?

I would appreciate anyones comments.

Thanks
Steve

 

[vaemouweinkiqkehx]

hi steve
dont know if you're still reading this forum but I have had injections in my spine to help alleviate the symptoms of a prolapsed disk...like you I prolapsed my disk playing sport in my case rugby ...this was about 10 years ago..I was in absoloute agonywith intense sciatic pain down my left leg and loss of movement there too...I went to see a local osteopath having been firmly advised by my family doctor not to seek surgical help in thefirst instance ..I had an injection into the spine using a localanaesthetic ..which apparently allows thedisk to settle while helping alleviate the pain..well I have to say it has helped me tremendously .it took about 6months to a year for movement and feeling to return to the left leg ,particuilarily if I gotfatigued but it didget better, I have since for the last 10 years sufferedoccasionally with lower back pain ( ironically thats the reason I was reading your post as its justflared up again ! ) but in that time I have run regularily 3-5 miles at a timeonce or twice a week..I weight train and play a bit of tennis ...so there is hope and it will getbetter but asI am just finding out ..I dont think it will ever go away .if you're in the south of england I can give you the name of the practioner a trained doctor/osteopath who treated me

 

[Wolf Mike]

Peter,

Many thanks for your response. I had my epidural injection a couple of weeks ago and it really helped for about a week. Unfortunately the effects are now wearing off and the pain is back like it was previously.

I have had another MRI scan and will be meeting with my specialist again next week.

I have however really upped the exercises that I am doing (Pilates based etc) and was hoping that someone in the forum knows of any good Pilates teachers in the South Birmingham area?

Steve

 

[Stan]

Sounds like they missed the crucial spot, but then there isn't really much evidence to support the procedure anyway.
I went to lecture a few weeks back by a GP that does cortisone injections and he admitted to having tennis elbow and seems unable to sort even that out himself. [sm=scratchchin.gif]

I offered to treat him, but will be pleasantly surprised if he actually books in.

My point is that the large majority of UK osteopaths, would, well - use osteopathy to resolvesuch a problem.

Cotisone may be indicated in some cases to break the cycle of inflammation, when more conservative approaches haven't worked i.e. osteopathy, acupuncture, etc.,

But it's not really a long term solution as it has done nothing to address the underlying mechanical problem. It's just reduced the irritibility of the local tissues by accelerating the tissue healing rate. Unfortunately tissues that have healed in this way tend not to be as strong as soft tissue that has healed naturally and can be setting you up for a long term weakness & problem in the area. []

Andrew.

 

[Constance Wallace]

Andrew,

Many thanks for your response.

In your experience (or anyone elses advice) what would you advise for me at this point?

I have been back to my Neurosurgeon and given the results of the new MRI he has now suggested a microdiscectomy (sp?!). I have now been in constant pain for getting on for 18mths and from looking at the MRI even with an untrained eye it is obvious that the problem is that there is a pretty large bit of disk pushing into what I believe is called the S1 cluster of nerves. The surgeon has been very conservative with me, he insisted on physio and alternative treatments first to see if the disk would be 'eaten' by the body naturally and it was only after trying all of this that he suggested trying the epidural to try andspeed the healing process. When this didn't work the new MRI scan was ordered and as I say clearly shows a bit of disc stuck in the nerves.

In your experience could this get better with further alternative treatments or should I go for the op and then work very hard at maintaining the strength in my back going forward (regular back exercise, pilates etc?)

As an active 29 year old guy I can't carry on like this forever so need to make some progress and am therefore open to any suggestions.

Many thanks
Steve

 

[RenRemeeia]

Just to say I'm sorry it hasn't improved for you. Mine seemed to improve slowly, but sometimes it hurt more than othertimes - I guess it was of a different order to yours.
In my experience as a practitioner I find there are some positions which aggravatecertain client's back pain- and some help. I hope your instructor is experienced, well-trained andtaking care of you.
Sharon.

 

[the.ash]

[link=http://www.spine-health.com]www.spine-health.com[/link] is a great site for information on back conditions.
Jill