DonnelMemberNovember 21, 2012 at 5:53 amPost count: 1
First off God Bless you doctor. I have a L5 S1 herniated disc. I’m a 19 year old male. I’ve had pain for 6 months. I’ve gone to physical therapy for 3 months, twice a week. There has been a little improvement. Last Sunday morning I was awake on my bed laying down. I sneezed one time. 5 minutes later I got up to get ready and noticed excruciating pain. I don’t know if the sneezing caused it. I went to the doctor today and was prescribed steroids (prednisone). I have not taken them yet because they weren’t ready to be picked up. My doctor doesn’t believe in surgery. We want to avoid it. But if I need surgery then I’ll have to take that path. Here’s my question, is surgery the solution? Or will time heal the disc? If surgery is the solution, would it be best to get an artificial disc or just have microdiscectomy done? Thank you so much, god blessDonald Corenman, MD, DCModeratorNovember 21, 2012 at 8:35 pmPost count: 8652
The increase in pain after sneezing with an already known L5-S1 disc herniation is most likely due to a new fragment of herniation that has been pushed out of the disc space due to the sneeze. With this new increased pain probably comes increased pressure on the nerve. This brings up the question of motor weakness.
Try to stand on the painful leg with weight off the other leg (stand with the good leg off the floor in a one legged stance). Balance your body with your hands on a counter but the hands are just for balance. Don’t help the foot lift up with your hands. Lift up your heel on the painful side 10 times quickly. Compare to the non-painful side. Can you complete the lifting action of the foot as well and as fast as the non-painful side? If not, you have motor weakness. This assumes that this action is not so painful that you develop pain inhibition preventing this activity.
Surgery should not be “believed in” or “disbelieved” either. Your current doctor should understand that surgery is a tool just like medications or physical therapy. There is a time not to consider surgery and there is a time to consider surgery. If you have motor weakness, in my book you need surgery. This gives the nerve the best chance to recover. If you do not have weakness, surgery should be considered if you have had pain long enough and the conservative measures have not given you much relief.
You do not need an artificial disc. If you have a herniation at L5-S1, you would simply need a microdisectomy. See the website for a description of this surgery and an actual surgical video if you so desire.
Dr. CorenmanPLEASE 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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