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  • sfteri
    Member
    Post count: 4

    Hello,
    I’m 35 years old. I have a herniated disc on my L5/S1. I’ve had now for 2 years. I’ve tried every “conservative” method under the sun and nothing has helped. My calf & foot feel numb/swollen all the time + my big toe hurts like I’ve been walking in heels all day…but that’s only part of my symptoms. I have chronic pain in my low back, I wake up at least twice night tosing & turning in discomfort. I can never tie my shoes or bend over without feeling extreme pain. I decided to get the epidural steriod shot in November 10′, reaching for yet another more invasive method to help with pain. IT worked for about a week maybe two? The best part of the getting the shot was the morphine they gave me afterwards. Needless to say, it didn’t work. So now I think it’s time to have the surgery. Ok so now that you know my story I want to ask you this question: If I decide to get the microsdiscetomy surgery will it work after 2 years? Have I waited to long? Help!! I need advice.

    Donald Corenman, MD, DC
    Moderator
    Post count: 8408

    Your symptoms are consistent with a disc herniation compressing the nerve root. When you bend forward to tie your shoes, you flex your hip. This tensions the sciatic nerve which causes more compression of the nerve root. It does sound like you need a microdiscectomy. There is one study that indicates that patients who undergo surgery performed within six months of the herniation do better than ones who wait. Nonetheless- I think you should be happy with the results of surgery. Could there be some residual symptoms after surgery? Possibly- but don’t hesitate to undergo surgery.

    The only worry I have is your lower back pain. Normally, a disc herniation compressing the nerve root will cause buttocks, thigh and leg pain. Lower back pain is generated by the disc or facet. If your percentage of low back pain is equal or greater than your leg pain, low back pain may not completely go away with a microdiscectomy.

    Dr. Corenman

    PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
     
    Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.
    sfteri
    Member
    Post count: 4

    Thanks for the reply. I have question: Do you think having Lower back pain that is generated by the disc or facet can be fixed with exercise or PT? Or by losing weight?

    Donald Corenman, MD, DC
    Moderator
    Post count: 8408

    Boy- that answer would require an entire book but I will give you the “readers digest” version. Disc or facet pain can commonly be managed by core strengthening exercises and ergonomics. Core strengthening will stiffen the lower back, reducing the stress on the damaged discs. Ergonomics is the appropriate way to lift, bend and exercise to reduce load on the spine. Medications can be useful and losing weight can also help. Losing weight will reduce load on the spine but I can tell you that in Vail Colorado, there are many fit and skinny patients that suffer from lower back pain, so weight loss is not a major factor.

    I know it won’t help right now but in about 2 months- I will have a new book out “Everything you wanted to know about the back” and this will allow you understand all the factors for your lower back.

    I am a fan of Pilates for strengthening the spine. Be careful as some instructors may be overly aggressive in the beginning, but this would be a good place to start after you rehab from surgery.

    Dr. Corenman

    PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
     
    Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.
    sfteri
    Member
    Post count: 4

    Thank you. I am most likely getting my surgery done at the UCSF Spine Center in San Francisco where I live. Do you have any recommendations on where I should go?

    Donald Corenman, MD, DC
    Moderator
    Post count: 8408

    UCSF is a good place but be careful that your surgery is done by the attending surgeon and not the fellow. If you were interested, I would be happy to take a look at you but you would have to come to Vail.

    Good Luck!

    Dr. Corenman

    PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
     
    Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.
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