Herniated disc on OTHER side 5 months post op

///Herniated disc on OTHER side 5 months post op
Herniated disc on OTHER side 5 months post op
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  • Avatarwmiller
    Participant
    Post count: 18

    Hi. I had an L5/S1 discectomy on my right side five months ago–I have no pain and have gained all muscle function back since then and was doing really well.

    About a month ago, I started getting some low back pain on the other side, with radiation down the lateral side of the leg. I was diagnosed with piriformis syndrome and have been doing PT (and a medrol pack) since with no change. The back pain is actually worse, and today I woke up unable to stand up straight. It is not as bad as my initial herniation in which I had foot drop, but I’m in a lot of pain and I have to walk hunched over. I saw a sports med doc today who thinks I have another herniation. I thought this was all behind me and am super bummed! My questions:

    -Extension really aggravates whatever is going on. With my other herniation, it was the opposite. The doctor I saw today said extension can also depending on the area of the herniation. Is this possible? I literally cannot walk standing up straight.

    -I had no injury that caused this (unlike my first herniation). Could my prior surgery have caused this? Again, I have no pain at all on my surgical side.

    -The sports medicine doctor I saw has referred me to a pain specialist to try an injection (I don’t have any weakness this time around, just pain) in L5/S1 on the side on which I’ve not yet had surgery. He said I did not need an MRI before this since they have my pre op one from five months ago that showed some bulging all the way across L5/S1 with the herniation on the right. Is this typical?

    -If I end up needing surgery on this side, does that mean I’ll likely need a fusion if it’s the same level? If so, I’m coming to Vail (already had surgery by Dr. Philippon there two years ago)

    I really appreciate your help!

    AvatarDonald Corenman, MD, DC
    Moderator
    Post count: 7138

    You need a new MRI regardless of the other opinions as your symptoms have substantially changed since the old MRI. Disc herniations can cause lateral recess stenosis or foraminal stenosis, both of which will cause pain with standing relieved by sitting.

    See https://neckandback.com/conditions/lateral-recess-stenosis/ and
    https://neckandback.com/conditions/lumbar-foraminal-stenosis-collapse/

    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.
    Avatarwmiller
    Participant
    Post count: 18

    Thank you–my neurosurgeon left the practice so I will have to get a referral to another one and push for an MRI. So I could have herniated and this caused the stenosis. It is very painful and I have weakness but feels different than my first herniation, which was made much worse by flexion and sitting.

    One last question–is the treatment for lateral recess stenosis/foraminal stenosis similar to discs like injections, then if that doesn’t work, surgery to remove the part of the disc?

    Avatarwmiller
    Participant
    Post count: 18

    As an update, I had an MRI yesterday and was just called with results: large disc bulge causing stenosis. Since it is not herniated, is surgical treatment an option?

    AvatarDonald Corenman, MD, DC
    Moderator
    Post count: 7138

    Surgical treatment is an option with a large enough disc bulge that causes stenosis. You could try epidural steroid injections and physical therapy if you have no motor weakness.

    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.
    Avatarwmiller
    Participant
    Post count: 18

    Thanks.
    I have injections scheduled for next week for the L4/L5 disc bulge (one level higher than my microD this past summer).

    Do you recommend rest from physical activity until this is done? I ride a stationary bike (not in aero position), and it definitely irritates it. I do not want to damage anything further, but is it typically safe to ride as long as the person can endure the pain (I’d say gets to 4/10)? I stopped coming up out of the saddle, as that irritated it a lot.

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