SpinefriendMemberApril 25, 2013 at 12:37 amPost count: 0
Hello Dr. Corenman,
I am writing in about a friend who is stubborn, and mostly computer illiterate (so he’d never find resources like this). Several months ago, he started lifting weights with some ex-marines from work, and trying to compete with them, did leg squats with far too much weight to start with. For his efforts, he got some spinal fractures and herniated discs between his T9-T10 and T10-T11 vertebrae. The doctor he went to see suggested operation as the only real option for recovery, but my friend didn’t think the risk was necessary, and I agreed. There were no suggestions made for injections or physical therapy. He was told to “rest” for as long and as much as he could and hope that things get better. Unfortunately, he works hard (physical labor) all week to support his family, and can’t “rest” without taking time off work.
For the first few weeks, he continued at work and heavily medicated with pain killers and anti-inflammatory drugs. It was to the point where he could hardly walk when he got home. He weened himself off the pain killers and over time his pain has reduced, and he has had fewer twinges and numbness. On last visit to his doctor, the fractures had healed. His pain is manageable, but the doctor is still only suggesting surgery for treatment of the herniated discs. I have to imagine that there are other options. From what I’ve read on this forum, there seem to be. What are your thoughts on the situation?
Concerned FriendDr. CorenmanModeratorMay 12, 2013 at 9:11 amPost count: 3549
Surgery for thoracic herniated discs is only called for if there is cord compression leading to myelopathy (see the section on myelopathy on the website) or significant deformity (an abnormal curve called a hyper-kyphosis greater than 30 degrees).
Conservative treatment includes therapy, medications and activity restriction. If it doesn’t hurt and the cord is functioning normally, there is no reason to perform surgery.
Dr. CorenmanWRL1994MemberMay 2, 2014 at 11:25 amPost count: 1
Dr. Corenman – these forums are a godsend, thanks for creating them.
I also have a T10-T11 herniation (large 0.5×0.7×1.4 cm (AP by ML by CC) left foraminal disc extrusion extending superiorly, severely narrowing the left foramen). No spinal cord impact, but when it is inflamed, pain radiates around my rib cage into my belly button. When I go long periods with little activity, the pain recedes. But when I do something that impacts it, it comes right back.
Is this it for me, limit my activities for the rest of my life or have the chronic pain? I cannot even teach my son to play baseball, because the throwing and especially the swinging really creates stiffness followed by pain, so I am anxious to find non surgical remedies that will improve my baseline health level. You mentioned in one of the other forum topics about thoracic herniation that posterior chain muscle strengthening would help take pressure off the disc – but my doctors told me to not use a rowing machine or do sit up activities that cause my back to break its straight line, since that is where the injury is. Do you think it is ok for that kind of exercise? I have also read where some prescribe a combination of supplements involving glucosamine, Chondroitin and methylsulfonylmethane (MSM – which I have never heard of). Is this a regular treatment aid?
Also, I worry about the herniation worsening so that it does start to impact the cord, and I have to have surgery. Is it ok to continue seeing a chiropractor, or does create a risk if additional herniation? Also, I have avoided things that my kids want to do, like jet skiing or amusement park rides, or really anything where I am exposed to a jarring impact. Are they a real risk for me?
Any advice would be very welcome.Dr. CorenmanModeratorAugust 6, 2014 at 1:35 amPost count: 3549
Do not worry about a recurrent disc herniation causing further problems. There are case reports in the literature but these are so rare that you should not worry about this potential.
The irritation to your peripheral nerve (the chest wall pain and numbness) can be reduced most likely with an epidural injection. Time should also reduce this irritation. If this pain does not recede and continues to thwart your life, a posterior decompression and fusion of this segment can be done.
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