Viewing 6 posts - 1 through 6 (of 7 total)
  • Author
    Posts
  • Damcab
    Member
    Post count: 4

    First of all i’d like to thank you for the website and this forum.
    I’ll try to make my long story short.
    I’m 34 years old, 80 kilos and 1.90 mt. I used to play tennis, run and, swim.
    4 years ago i had a disc protusion at l5s1 level. On the left side. During this time i’ve made everything my doctor has recomended me. I have always left surgery as a last resort. But in the last 6 months the pain has become unbearable. My last mri said that i have a L5-S1 extruded left disc herniation compressing the left S1 root.
    The pain goes to left buttocks and radiate down to the bottom of the foot. The pain increases in my low left back with sitting and bending forward (legs extended) and is relieved by standing and walking. I have not problems pushing my foot down or up. However i do fell it is much more easy to do this excersise with my right leg. My doctor gave me two choices. 1) microdisectomy or 2) lumbar fusion. He told me that my spine shows signs of inestability therefore doing the microdisectomy might not fix the problem. honestly having read a lot about lumbar surgery and all the problems that it could bring in the future i dont want to have a lumbar fusion unless is my last option. Therefore i am considering doing the microdisectoy snd then hope for the best.
    I would apprecite if you could give me your opinion about my condition.
    Thanks in advance. Damian

    Donald Corenman, MD, DC
    Moderator
    Post count: 8460

    Your history is classic for a disc herniation that the same level most likely has developed a recurrent disc herniation on top of the preexisting one.

    Having a disc herniation for three plus years, most individuals have adapted to the nerve compression and the pain becomes tolerable. If the pain has significantly increased in the last six months, something must have changed. Most likely, another disc herniation had occurred at the same level in that six month period of time.

    Remember that the tear in the disc wall (see website) never heals as the disc is avascular and incapable of healing. The same process that dried out the nucleus and allowed it to “flake off” and herniate the first time still occurs over time. Increased pain is most likely from a new hernation that now sits on top of the old one.

    Your symptoms are typical for a herniation. The nerve is stretched over the bulge in the front of the canal. Extension (bending backwards) slackens the nerve and with less stretch, there is less pain. Bending forward tensions the nerve so more pain is generated.

    You note no lower back pain of significance. Even if there was severe degenerative disc disease present, you have no symptoms from this. If that is the case, a simple microdiscectomy would be all the surgery you would need.

    Dr. Corenman

    Damcab
    Member
    Post count: 4

    Thanks for your kind answer.

    Damcab
    Member
    Post count: 4

    An update on my situation. I had the microdisectomy done a week ago as the pain spread to my leg and them it got mildly numb. A severe cough triggered it. I’m now recovering from the surgery and it seems everything went well, at least is what the doctor have told me. I’m walking as much as i can, aprox 2 miles a day. I do have pain in my leg specially if i try to stretch it while i’m seat. I have read that the nerve takes time to heal and in the process it hurts. Just wondering if the pain i feel with the stretching is normal and if it is advisable to try to stretch it.
    Thanks in advance
    Damian

    Donald Corenman, MD, DC
    Moderator
    Post count: 8460

    The nerve is still inflamed. The surgery removes the compression from the nerve but the nerve has to heal and this takes time. Stretching the nerve to some extent is important but you can stretch the nerve too much and irritate it. This is where the “art” of medicine comes into play.

    The nerve does need to be stretched somewhat as adhesions that form during the recovery period will also be stretched, preventing the nerve from being adhered down. Too much stretch will cause increase inflammation and more nerve symptoms.

    If the nerve is really “hot” in the post-operative period, I will give my patients oral steroids to reduce the inflammation. For especially symptomatic patients, I occasionally will obtain a new MRI. Hematoma or even rarely, a recurrent herniation can occur and can be dealt with accordingly.

    It can take up to six months for a nerve to “calm down”.

    Dr. Corenman

    Damcab
    Member
    Post count: 4

    Just wanted to share my recovery with Dr. Coreman and everyone that follow this forum.

    6 weeks after the microdisectomy I’m feeling better every day. The nerve pain in my leg is decreasing continuosly. Sometimes it feels as if it is the same that the day before, but if I mesure it against a week before I can certainly notice the difference.

    My doctor recomend me to start doing fisioteraphy to strenght my back/abs and stretch my back. Having search a lot in internet I have found a program called Mat and Upright therapeutic Exercise Program that was specially design to recover from a back micrdisectomy.

    I wonder if you ever heard about this Program and the most important, if you would recomend your patiences to follow it.

    Thanks in advance.
    Damian

Viewing 6 posts - 1 through 6 (of 7 total)
  • You must be logged in to reply to this topic.