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Diagnosis: Sciatica/herniation

Old 02-10-2014, 03:47 PM
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Default Diagnosis: Sciatica/herniation

Hey guys, 63 with never any back problems. I'm active and walk every other day, 6 foot /240lbs. I'm in my desk chair 10 hours a day. Two weeks ago, I got up out of the chair to meet with SEARING pain down right leg and inability to walk. Next day my ortho of 10 years saw me and felt it was a pinched nerve. So he ordered an MRI and here was the summation:

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So next, I have an epidural this thurs and rehab sched after that.

I trust my doc but he was a bit short with me:

Only one main question. In two weeks it really has not got any better with heat, ice and oral cortazone....I still can't walk without a huge charley horse pain after. 30 yards or so....

1. Will this ever heal, or will the epidural and therapy just get it to a manageable state?

Thanks in advance
Old 02-10-2014, 03:56 PM
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Take that wallet out of your pocket first . Do not set on it all day. Before you get up in the morning lay on your back and pull your knees up to your chest or as close as you can a few times . Then stretch back out and get up.
Old 02-10-2014, 04:03 PM
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your back got you to 63, you're playing with house money
the epidural is an injection of an anti-inflammatory steroid into your spine
its a temporary fix for most people

its not gonna heal, you just must learn to manage it
dont let them cut you open
Old 02-10-2014, 04:04 PM
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Glen,

Its surgery time my friend, bulging and herniated disc do not repair them selves.

John
Old 02-10-2014, 04:05 PM
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Originally Posted by cgrand View Post
dont let them cut you open
After 2 fusions and 2 decompressions I disagree.

My back is stronger than the rest of me...

John
Old 02-10-2014, 04:09 PM
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I just had a laminectomy to relieve pressure on my nerve. Went through all the injections and treatment.....to no avail. The surgery is the only thing that helped instant relief the next day from sciatica pain and not a bad recovery time.
Old 02-10-2014, 04:10 PM
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I know a lot of people don't believe in them, but I can attest to the ability of chiropractic to solve problems similar to what you are describing. Talk to people you know in your area and see if you can get a recommendation for a good one in your area. Most insurance plans cover treatment from chiropractors now.
Old 02-10-2014, 04:27 PM
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Suggest continue with epidural as required for now. Focus and take serious PT for core body strengthening, takes time. Since you are not ruptured, I would be surprised if surgery is in your future at this point. Learn your limits to minimize inflaming till you get stronger. Lose all the weight you can, it will help a lot.

Some folks recover from this condition nicely but it requires a significant awareness on your part of what works for you.

Good luck and give it time.
Old 02-10-2014, 04:43 PM
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I'm 31 yrs old and 6 years ago I had a herniated disc that was giving me a siatica. For 2 years I tried everything, I did not want surgery. Two years of barely being able to walk having tears in my eyes from the pain. Finally I seen a surgeon who told me I needed surgery. So I was going to have a micro distecotomy. Dr said surgerys 40 mins long and I will wake up pain free and not need pain meds. I said BULLSHIT. But I woke up no pain and only on anti inflammatory for the wound. I should have had the surgery sooner. I was back to work after 7 weeks (I'm was a construction worker). Full recovery was closer to 8 months. I surf, fish,and work no problems. During my whole recovery I did NOT take any pain meds! Yes there was some pain from where they cut me open but nothing more then what I was used to before the surgery. I know surgery is a big decision so take your time and get a couple opinions. I use Dr Fedirrico Giradi at the Hospital for Special surgery. Great hospital. Good luck
Old 02-10-2014, 04:43 PM
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Originally Posted by My Gal View Post
Suggest continue with epidural as required for now. Focus and take serious PT for core body strengthening, takes time. Since you are not ruptured, I would be surprised if surgery is in your future at this point. Learn your limits to minimize inflaming till you get stronger. Lose all the weight you can, it will help a lot.

Some folks recover from this condition nicely but it requires a significant awareness on your part of what works for you.

Good luck and give it time.

Thx....great info....
Old 02-10-2014, 04:46 PM
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I've got an l3/l4-l4/l5 thing going on after a fall. Did the shots X's 2, it helped quite a bit but I still get what I call stingers in the spine. The idea is to exercise and strengthen your core muscles while the shots take away the pain. It does help at least for me, but like I said the stingers I get will stop you in your tracks.

I'm hoping mine doesn't come back like it was, crawling on the floor is not a good place to be. I'm going for decompression treatments starting tomorrow, will let you know how it goes.
Old 02-10-2014, 04:56 PM
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Originally Posted by Glen E View Post
Hey guys, 63 with never any back problems. I'm active and walk every other day, 6 foot /240lbs. I'm in my desk chair 10 hours a day. Two weeks ago, I got up out of the chair to meet with SEARING pain down right leg and inability to walk. Next day my ortho of 10 years saw me and felt it was a pinched nerve. So he ordered an MRI and here was the summation:



So next, I have an epidural this thurs and rehab sched after that.

I trust my doc but he was a bit short with me:

Only one main question. In two weeks it really has not got any better with heat, ice and oral cortazone....I still can't walk without a huge charley horse pain after. 30 yards or so....

1. Will this ever heal, or will the epidural and therapy just get it to a manageable state?

Thanks in advance
I've administered many epidural steroid injections. I told every patient before the procedure the following. 1/3rd of patients will get no relief. 1/3rd will get some improvement and 1/3rd will get a great deal of relief. How long the relief lasts varies.

I also had two laminectomies one year ago. Like you I had a bulging disc at L4/5. Unlike you, mine had not ruptured. I can confirm what someone else has already said. Ruptured disc's don't heal themselves---- ever. My primary disease was spinal stenosis, and the second operation was because of an incomplete decompression on one side. One month later, the neurosurgeon went back in and got a good decompression. It's been a year now, and I have minimal back pain and my severe sciatica is gone. (My pain was bilateral.) I had two or three shot's and they really didn't help. My case progressed over a year until I could not sleep at night and could barely work. I'm 62 btw.

By all means, get the shot, and follow the orders for everything. You might put off the knife, but I doubt it.

Finally, get thee to a Neurosurgeon. Your orthopedist may be a great guy, but you have a degenerative condition that will progress with age. I started out with an orthopedic surgeon and he wanted to put in some new type of posterior fusion gizmo right off the bat. I may eventually need a fusion, but one of my classmates has practiced Neurosurgery for 30 years. He told me the following....."Oh yeah, we did a few of those ILIF operations. They don't work!! We quit doing them."

Last edited by dssmith; 02-10-2014 at 05:07 PM.
Old 02-10-2014, 05:03 PM
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Try a GOOD Chiropractor! I'm 58 and have Killed my Body all these years.About 20 yrs. ago at Work I did something to my Back . Couldn't even stand straight or barely walk.Went to a long time Friend of my Wife's Family[Chiropractor] And no B.S....I walked out of there,straight and felt a million times better!Now You do have to go back for adjustments and core strengthening.I have 3 Screwed up Discs in my Neck,Degenerating Disc disease and Arthritis in my back..The Arthritis does not bother me one bit for some reason.My Neck kills me.Going to start going back for adjustments real soon.Also Once You get straightened out some,see about getting an Inversion Table.They help stretch the spine.Gravity is always pulling you down.They work.
Old 02-10-2014, 05:13 PM
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Glen'
I had an epidural about a month ago and worked fine. I had a lamendectomy 6 years ago and the sciatica pain from scar tissue from the surgery reared its ugly head. My left side is herniated far worse than the right side which is what I had surgery on yet zero pain. So the epidural was my next stop if that did not work they wanted to do a fusion with the steel rods etc etc. Fortunately the Epi worked great. I would not hesitate to do the lamendectomy its 2 days in the hospital quick surgery and when I had mine done 6 years ago and post op was amzing it was like someone turned a switch off on the pain it went totally away until just recently I highly recomend it.
Old 02-10-2014, 05:27 PM
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I had bulging/ruptured L4-L5. Pain down left leg. By the time I saw my neurologist my leg was wasting away. Lost all muscle tone, thigh was several inches smaller in circumference, very weak, and absolutely ZERO reflex when hit on knee with hammer. I had the surgery. That was about 6 yrs ago. I've had 2 relapses. 1st one I took it easy for several days and got better. 2nd was much worse and got another MRI, saw the neuro again. He said not operable, was scar tissue. I then got the epidural injections (they do nothing). Rested more and finally got better. Have not had any more issues. 2nd relapse was about 3 yrs ago. I think I'm home free til the next one bulges/ruptures.

I would get the MRI read by a neurosurgeon. You have a nerve problem, not a bone problem.

You may get better with PT if it's just bulging. They can recede back in. Mine was ruptured and splayed out. I'm glad I got the surgery. That pain was unbearable at times.
Old 02-10-2014, 05:37 PM
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48 years young now and I had 26 or 27 facet injections and epidurals in my late 30's for stenosis and bulging discs. After 12+ years I finally aggravated it again lifting something very heavy in an awkward position, but I know that a little rest will get me back to normal.
Do the shots, learn the pelvic tuck, and go easy for a bit. If that doesn't work get more aggressive, but give yourself a year at least.
Old 02-10-2014, 05:41 PM
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Been there. Herniated is ruptured. Think of the disk between the vertebra as a jelly filled donut.
Bulged disc the donut gets squished and is pushing out if shape against the nerve.
Ruptured/herniated disc the jelly filling (actually about the consistency of crab meat) has broken out of the donut and usually putting more pressure on the nerve.
The new surgeries are much better and less invasive. Because you have two levels herniated, you might be a candidate for a fusion over a more simple "cleanup" where the disc material is removed and some bone removed (laminectomy) to give the nerve more room.
Find a middle aged neurosurgeon with lots of experience and IMO, stay away from teaching hospitals/universities.
I can highly recommend Dr. Fine in Sarasota if you want an opinion.

PS. Lose some weight and keep it off. Not saying your fat but we pretty much all can lose some weight and its more important for you now.
Old 02-10-2014, 05:41 PM
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Like said above, find a neurosurgeon for your problem.
Old 02-10-2014, 05:43 PM
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i had back surgery 20 yrs ago, delt with the pain for 2 yrs, never stopped working and finally could not walk any more and had the surgery, back then the surgery was much more involved but i was pain free after surgery, never took any meds, i have scoliosis so i do have back pain that will never go away, some days good and some days bad, 2 years i over did it again and another disc herniation, went for mri and confirmen it, i decided to not get out of bed for 3 weeks, not easy to do but if this did not work it was surgery again, well it worked, pain slowly went away and i been good for 2 yrs now, try doing nothing, do not sit or stand just stay in bed and believe me i bet your pane subsides, i am 50 yrs old and a self employed plumber with 2 kids so it was not easy for me to do but it worked, also watch the meds your doc gives you i had enough meds to open a drug store and i never took anything, i can see why its so easy to get hooked on meds, good luck!
Old 02-10-2014, 05:45 PM
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Originally Posted by PeteH View Post
but give yourself a year at least.

But keep an eye on that leg. Mine disappearing before my eyes was very scary. Scarier than a scalpel near my spinal cord (evidently).

Glen, I hope the non-invasive stuff works out for you.

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