ByczkowskiMemberJune 25, 2012 at 6:21 pmPost count: 3
Dear Dr. Corenman,
I am 30 years old male in good athlete shape. I was injured with herniated L5S1 disc April 16th this year during my bodybuilding training in the gym. I felt a little bit of pain in my backs at the same day and after two days I could not walk. What is interesting I felt only pain in my lower back. I went to the doctor and he told me it might be a result of overexercising. I was prescribed some non steroids drugs with advice of the bed rest for two weeks. After few days I was in much better condition nevertheless I was feeling some pain in my left leg (outside thigh and calf). The pain was not so big so I could easily work 8 hours at my desk at work. I was a little bit worried with this small pain and I did MRI after consulting my doctor. It was done 13th May this year [hide]The results you can find under following image link:
In the meantime I have started physical therapy (exercises plus ultrasounds, TENS, laser etc). I visited three surgeons and they were really surprised of my good physical shape in relation what they saw on MRI scans (negative leg test, no muscles weakness). One of them advised surgery. The other two were not sure if to do surgery. Currently I feel a little numbness in my foot but it is not constant. It appears at the end of the day mostly. I am still missing Achilles reflex in my left leg. I have no constant pain in my leg. It appears rarely during the whole week.
I focused now on conservative treatment but I do not think it is the right way for me. Till now I was a really active person (playing squash, horse riding, some bodybuilding, running, skiing etc.) I partially came back to swimming and biking at the moment.
I was doing some research of the topic and read that in some of the cases the body can absorb the herniated disc. Do you think it is possible in case of such huge herniation as mine? I have read some articles that professional athletes (NHL, NBA, soccer player, even weightlifters) came back with success to their sports after microdiscectomy. Is it possible to reach the same level with conservative treatment?
Thank you for your response in advance.Donald Corenman, MD, DCModeratorJune 26, 2012 at 12:53 amPost count: 8468
You have a typical story for a new herniated disc. Back pain for a couple of days results from the new tear of the annulus. It takes typically about 2 days for the inflammation to create leg pain if the nerve compression is not severe and even with that large herniation, your nerve impingement is not too bad.
There are locations in the canal that a large herniation can situate without significant compression of the nerve root and your herniation has found such a spot. This is the reason you only have mild symptoms.
This herniation can most likely be treated without surgery. Yes, some of the bulk of the herniation will recede as the water in the fragment is absorbed out. There have also been cases where the fragment migrates out of the canal and into the psoas muscle where it adheres to and stays forever.
If you choose no surgery, an epidural steroid injection I think is helpful to reduce the volume of the fragment and make the nerve more resistant to the herniation. If you choose surgery, I have many athletes who have undergone a microdiscectomy and returned to competition.
Dr. CorenmanByczkowskiMemberJune 26, 2012 at 4:31 amPost count: 3
Thank for your response. If I decide for not having the surgery is the probability for reharniation the same as if I have the surgery?Donald Corenman, MD, DCModeratorJune 26, 2012 at 6:58 amPost count: 8468
In general, yes.
Dr. CorenmanByczkowskiMemberJune 27, 2012 at 3:55 pmPost count: 3
I think I will continue with my conservative treatment and see what will happen next. I will come back to you in half year to share the outcomes of my recovery. I have one additional question. Does my herniated l5s1 disc have any impact on strength of my upper discs (i.e. l4-l5)? Is the probability that my other discs herniate higher now? I would like to continue some parts of my bodybuilding training in two months. I am not thinking of any dead lifts or leg presses but i.e. some TRX suspension training. Should I follow the same post op rules when it comes to my return to sport activities despite treating myself conservatively?Donald Corenman, MD, DCModeratorJune 28, 2012 at 9:33 amPost count: 8468
The herniation at L5-S1 does not predispose by itself to any additional herniations at the levels above. However, genetics plays a rule in disc herniations so theoretically, the levels above are genetically predisposed. Do not lose sleep about that.
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