ahall93MemberMarch 28, 2012 at 6:46 amPost count: 1
Doc. I’m 36 years old and up to this point a very fit man. My back problems started in 2005 when I was moving a couch and my back locked up and had me on the couch for several days. In 2006 I had a riding mower fall and I caught the full blunt of the mower while bending with my back. I felt it pop in the back and I had to crawl to the house in agony and again was on the mend within several days. From those 2 episodes I continued to re-injure the same area every 8-10 months with some type of movement causing my back to tighten up and have me out on the couch for 2-3 days.
Last April (almost 1 year ago) I started to get extreme sciatica and after an MRI, found out that I had a herniated disc in my L5, S1 with extreme degenerative disc disease. My pain was a 9-10 and I started extensive treatment through chiropractic care, ice, heat, exercise and decompression. My pain level has dropped to a 3-4 level but I can’t seem to get over this last hurdle. I have tried shots with only minimal effect that wears off within a couple weeks. I do have an inversion table that gives me temporary relief and I walk daily. I don’t know what else to do and every time I try to push myself a little further in excerise, things flare up again.
At this point, I wonder if surgery is the only option left? I’m fearful of it and have heard some people say that DR’s tell them…it could help, worsen or stay the same after the surgery. My thoughts were to get another MRI next month to see where I have progressed and then proceeed from that. Thoughts, suggestions, would be VERY helpful!! Thanks!!Donald Corenman, MD, DCModeratorMarch 28, 2012 at 11:38 amPost count: 8378
You have the typical history of annular tears with loading the spine finally resulting in a through and through tear which allowed the disc herniation. I am in favor of conservative treatment for about six month. If the symptoms do not resolve by then or there is motor weakness, surgery might be in order.
You mostly likely have exhausted most if not all of the conservative measures and probably need to consider surgery. A new MRI is warranted and if there is still compression of the nerve root, you most likely are a candidate for surgery. The length of time the nerve is compressed is a factor with a higher chance of a chronic radiculopathy (see website) with a long standing compression but still with reasonable odds of a good result with surgery.
WIth any surgery symptoms could become worse, stay the same or become better but it is the percentages of results that you need to pay attention to. Understanding that I have never seen you- in general getting better with surgery after an HNP compression of the nerve for one year is probably an 80% chance of improvement. Staying the same is about 19% and the chance of getting worse is less than 1%. This also depends upon the amount of compression of the nerve.
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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