Low back herniation/bulge and rehab
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Leslierussell4134
Posts: 376 Member
How long did it take you to rehab your low back herniation (only lumbar spine, as T and C spine are affected differently) without surgery?
My question may resonate with far too many of you, as low back injuries are so incredibly common across athletes and certain physical professionals.
I injured my L4-L5 in April of this year and it's been a slow and frustrating process to recovery. I know it's only been 7 months, the first two of which I couldn't walk without my right leg collapsing, but I'm just curious to know who's been through it and what the end results were? What activity helped, how long did you do PT? What symptoms did you have before you started to recover?
My symptoms are right low back, hip and lateral leg pain that goes down my thigh, skips my knee area and then through my calve...but it does lessen during movement and certain stretches. Hurts when I try and rotate during sleep. Standing and laying down still are the best positions.
Anyone else ?
My question may resonate with far too many of you, as low back injuries are so incredibly common across athletes and certain physical professionals.
I injured my L4-L5 in April of this year and it's been a slow and frustrating process to recovery. I know it's only been 7 months, the first two of which I couldn't walk without my right leg collapsing, but I'm just curious to know who's been through it and what the end results were? What activity helped, how long did you do PT? What symptoms did you have before you started to recover?
My symptoms are right low back, hip and lateral leg pain that goes down my thigh, skips my knee area and then through my calve...but it does lessen during movement and certain stretches. Hurts when I try and rotate during sleep. Standing and laying down still are the best positions.
Anyone else ?
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Replies
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I herniated my L4-L5 a year ago. My pain, like yours, went from my lower back, down my thigh and into my calve. It was so bad I couldn't sit down, my only comfortable position was lying on the floor on my stomach or standing up. At night in bed I found lying on my side unbearable, but if I lay on my back with a pillow under my knees to keep my calves elevated and a towel rolled up and placed where my spine curves I could relieve enough of the pain to help me fall asleep.
It took 7 months of physio (once a week) and doing back stretches (given by physiotherapist) at least 3 times a day (hourly in the beginning) and walking to get me where I could sit down again.
What you're looking for in your symptoms is the pain centralizing. This means the pain will leave your leg and come only from the lower back. When this happens you'll know you're nearly there.
It takes up to two years for the herniation to fully heal so even when the pain goes you still need to be careful because it won't take much to damage it again.
You have my deepest sympathy though, it was the roughest 7 months of my life. Definitely go see a good physiotherapist and walk as much as you can.
Best of luck xxx
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I herniated my L4-L5 a year ago. My pain, like yours, went from my lower back, down my thigh and into my calve. It was so bad I couldn't sit down, my only comfortable position was lying on the floor on my stomach or standing up. At night in bed I found lying on my side unbearable, but if I lay on my back with a pillow under my knees to keep my calves elevated and a towel rolled up and placed where my spine curves I could relieve enough of the pain to help me fall asleep.
It took 7 months of physio (once a week) and doing back stretches (given by physiotherapist) at least 3 times a day (hourly in the beginning) and walking to get me where I could sit down again.
What you're looking for in your symptoms is the pain centralizing. This means the pain will leave your leg and come only from the lower back. When this happens you'll know you're nearly there.
It takes up to two years for the herniation to fully heal so even when the pain goes you still need to be careful because it won't take much to damage it again.
You have my deepest sympathy though, it was the roughest 7 months of my life. Definitely go see a good physiotherapist and walk as much as you can.
Best of luck xxx
Thanks so much for your response, the 18 month to 2 year range is what I fear, seems like an eternity.
Walking seems to be my best friend, I did PT for about 12 weeks (twice weekly) , this is all that was allowed, as I was hurt on the job and they cap the number of visits allowed.
I'm so glad you found some relief.1 -
Has an lumbar epidural shot been suggested? I have juvenile disc degeneration disease (so several herniated discs + sciatica), and the shot does wonders for me. Since mine is a progressive disease, I have to keep taking it, but if it's a single injury, one shot might be sufficient.1
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Leslierussell4134 wrote: »I herniated my L4-L5 a year ago. My pain, like yours, went from my lower back, down my thigh and into my calve. It was so bad I couldn't sit down, my only comfortable position was lying on the floor on my stomach or standing up. At night in bed I found lying on my side unbearable, but if I lay on my back with a pillow under my knees to keep my calves elevated and a towel rolled up and placed where my spine curves I could relieve enough of the pain to help me fall asleep.
It took 7 months of physio (once a week) and doing back stretches (given by physiotherapist) at least 3 times a day (hourly in the beginning) and walking to get me where I could sit down again.
What you're looking for in your symptoms is the pain centralizing. This means the pain will leave your leg and come only from the lower back. When this happens you'll know you're nearly there.
It takes up to two years for the herniation to fully heal so even when the pain goes you still need to be careful because it won't take much to damage it again.
You have my deepest sympathy though, it was the roughest 7 months of my life. Definitely go see a good physiotherapist and walk as much as you can.
Best of luck xxx
Thanks so much for your response, the 18 month to 2 year range is what I fear, seems like an eternity.
Walking seems to be my best friend, I did PT for about 12 weeks (twice weekly) , this is all that was allowed, as I was hurt on the job and they cap the number of visits allowed.
I'm so glad you found some relief.
You may want to check the law on the bolded part if you haven't.1 -
Each of my many lumbar disc herniations have been different, depended on the size and location of the herniation and what nerves were impinged,
What has really helped me avoid the threatened fusion surgery has been finding a brilliant Osteopath who treated the chronic episodes really well but crucially also started me on a good rehab path including building my core strength to compensate for my back weakness. Losing weight also made a considerable difference as vertical loading is something that can badly affect me with my shortened disc spaces.
I'm hesitant to offer specific advice, and you should check with your treatment team, but when my sciatic nerve was compressed sleeping with a pillow between my knees made a remarkable difference.2 -
I didn't rehab, I just continued to strength training through it with a useful intensity at a ROM that didnt effect my training and it eventually resolved itself.
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I feel lucky. Hurt mine two months ago and I'm pretty much back to the training full on again. I just think it varies with the severity of the injury and if you push it when injured.2
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I think it's different for each person and each injury. I had herniations in L4/L5 and L5/S1. I injured myself about eight years ago while pregnant and not using proper body mechanics to lift patients. My main symptoms were back pain and shooting pain down the back of my right leg. Rest is really what helped me. I got pregnant again about five years ago and had the same symptoms. Finally having my last baby and losing weight was also a big help. I still have to be really careful because even now of I'm not mindful of form it's easy to exacerbate.2
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90% of people with confirmed (by MRI) herniated discs have them in L4/L5 and/or L5/S1. I have both and spinal stenosis and some degenerative arthritis. No sudden onset or injury; occasionally it will flare or get aggravated. I have had the image guided cortisone injections a couple of times. Those can help. Mostly it's biting the stick and exercising.2
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I had a couple herniated discs (L4 & L 5) about 10 years ago as well as stenosis, scoliosis, and spondylitis. When I first had the herniated discs, walking was pretty much all I could do. I couldn't sit for more than an hour or two, nor was I comfortable standing for long either. However, it gradually got better. I did PT which helped. I also found a good chiropractor which helped me immensely. And believe me, I was terrified of chiropractors! Today I do yoga, walking, weight training, biking, the elliptical, etc. I do avoid any high impact workouts.
Walking might be all you do for months and really, that's just fine. Give it time. It takes a while to heal, but you will, just be patient. As you gradually add in more activities over time, be mindful. If anything hurts, stop. You can always try it again later.
Stretching can really help as well. Often, tight hamstrings can cause lower back muscles to tighten which can cause pain. Try some gentle stretching and see if it helps. When my back is really bad, I spend a solid half hour stretching.
Massage can also help with back pain.
Using a foam roller to release tight muscles can also help.
It'll take some time, but you really have to find what works best for you. Just be patient and be kind to yourself! But don't give up. It will get better!
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I notice a couple of posts using past tense - "had herniated discs". If they were herniated, they still are. Adaptation in how you sit, stand and move plus strengthening muscles around it is what makes it better. I think we also get conditioned to some pain there; if I think about it and pay attention to how my lower back feels, there is always a little pain but I just subconsciously ignore it unless it spikes higher.6
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@CarvedTonesCarvedTones wrote: »I notice a couple of posts using past tense - "had herniated discs". If they were herniated, they still are. Adaptation in how you sit, stand and move plus strengthening muscles around it is what makes it better. I think we also get conditioned to some pain there; if I think about it and pay attention to how my lower back feels, there is always a little pain but I just subconsciously ignore it unless it spikes higher.
Not really accurate - the jelly like nucleus pulposus that escapes through a tear in the fibrous ring (annulus fibrosus) gets reabsorbed over time and the tear in the annulus fibrosus heals.
The herniation (which means tissue protrusion through a tear or weakness) has gone. You had a disc herniation in other words.
The pain (or other other symptoms with the various nerves impinged) reduces as the bulge gets reabsorbed - that aspect is making it better, but not as good as it was before.
A couple of my lumbar disc are very shortened due to the lost pulposus but you can't see any protrusion on an MRI now. When I have a chronic episode (fortunately quite rare) it's "just" the fibrous ring tearing but there's nothing to escape - no herniation. Symptoms are very severe but lasts days to a couple of week rather than months.
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By the way would the person who is woo'ing every post in this thread please learn what the woo button actually means!
"WTF" or "too good to be true" is the meaning - if you think every post meets that criteria please engage and explain your disagreement.6 -
@CarvedTonesCarvedTones wrote: »I notice a couple of posts using past tense - "had herniated discs". If they were herniated, they still are. Adaptation in how you sit, stand and move plus strengthening muscles around it is what makes it better. I think we also get conditioned to some pain there; if I think about it and pay attention to how my lower back feels, there is always a little pain but I just subconsciously ignore it unless it spikes higher.
Not really accurate - the jelly like nucleus pulposus that escapes through a tear in the fibrous ring (annulus fibrosus) gets reabsorbed over time and the tear in the annulus fibrosus heals.
The herniation (which means tissue protrusion through a tear or weakness) has gone. You had a disc herniation in other words.
The pain (or other other symptoms with the various nerves impinged) reduces as the bulge gets reabsorbed - that aspect is making it better, but not as good as it was before.
A couple of my lumbar disc are very shortened due to the lost pulposus but you can't see any protrusion on an MRI now. When I have a chronic episode (fortunately quite rare) it's "just" the fibrous ring tearing but there's nothing to escape - no herniation. Symptoms are very severe but lasts days to a couple of week rather than months.
The context I heard it in was from the spine specialist I see at Duke Health when I said something about getting a newer MRI because the one I had that showed a herniated disc was about 20 years old. He told me that they don't get better and that I needed a new one to see if it was worse and/or there was other stuff going on. The answers were yes and yes. I didn't press him about exactly what he meant by not getting better. I have not been pain free in the low back in about 30 years; I have just become conditioned to a low level of it.1 -
So sorry to hear about that! I had a microdiscectomy in May 2017 for my herniated disc at L4/L5. Unfortunately I was unable to try to wait it out with PT because body was crooked and I was in too much pain. I’m doing much better a year and a half post op but still have to be careful. Every situation is different and I definitely suggest talking to a professional who specializes in neurology.
Walking is great and really just listen to your body and take things slow. You don’t want to hurt yourself more. Best of luck! I remember the horrible pain and surgery was the best thing for me! I have my life back for the most part!3 -
MommyLifts3 wrote: »I think it's different for each person and each injury. I had herniations in L4/L5 and L5/S1. I injured myself about eight years ago while pregnant and not using proper body mechanics to lift patients. My main symptoms were back pain and shooting pain down the back of my right leg. Rest is really what helped me. I got pregnant again about five years ago and had the same symptoms. Finally having my last baby and losing weight was also a big help. I still have to be really careful because even now of I'm not mindful of form it's easy to exacerbate.
This is what I am afraid of, wanted to have a baby this year and this injury is very intimidating to do so.0 -
CarvedTones wrote: »I notice a couple of posts using past tense - "had herniated discs". If they were herniated, they still are. Adaptation in how you sit, stand and move plus strengthening muscles around it is what makes it better. I think we also get conditioned to some pain there; if I think about it and pay attention to how my lower back feels, there is always a little pain but I just subconsciously ignore it unless it spikes higher.
Definitely getting used to having some pain, and so far you're right about adaptation and movement. Walking, mild strength training and ROM are what seems to make it better. I guess I just need to come to the understanding that it may always hurt a little, and a pain of "0" might not be a reality for me anymore.0 -
GrowlingCupcake wrote: »Has an lumbar epidural shot been suggested? I have juvenile disc degeneration disease (so several herniated discs + sciatica), and the shot does wonders for me. Since mine is a progressive disease, I have to keep taking it, but if it's a single injury, one shot might be sufficient.
Yes, actually had one a month ago that offered no relief. I'm going to switch doctors for injections and see if it's their technique that makes the difference. I was an OR nurse before this injury, and I've seen the differnce a skilled doc can make, especially in these type of injections.0 -
Leslierussell4134 wrote: »MommyLifts3 wrote: »I think it's different for each person and each injury. I had herniations in L4/L5 and L5/S1. I injured myself about eight years ago while pregnant and not using proper body mechanics to lift patients. My main symptoms were back pain and shooting pain down the back of my right leg. Rest is really what helped me. I got pregnant again about five years ago and had the same symptoms. Finally having my last baby and losing weight was also a big help. I still have to be really careful because even now of I'm not mindful of form it's easy to exacerbate.
This is what I am afraid of, wanted to have a baby this year and this injury is very intimidating to do so.
I would talk to your OB about it. I didn't know that I had a herniation until after having kids. I just procrastinate about going to the doctor and my OB thought it was the baby's position putting pressure on my sciatic nerve. I had an MRI after my third which confirmed the herniations. The pain/symptoms were definitely worse during pregnancy but they may be able to manage it for you.2 -
Leslierussell4134 wrote: »GrowlingCupcake wrote: »Has an lumbar epidural shot been suggested? I have juvenile disc degeneration disease (so several herniated discs + sciatica), and the shot does wonders for me. Since mine is a progressive disease, I have to keep taking it, but if it's a single injury, one shot might be sufficient.
Yes, actually had one a month ago that offered no relief. I'm going to switch doctors for injections and see if it's their technique that makes the difference. I was an OR nurse before this injury, and I've seen the differnce a skilled doc can make, especially in these type of injections.
Yeah, I got the four shots of cortisone with numbing medicine at the "corners" of L5 with live imaging so that he could carefully get the needle as close as he felt was safe. He mentioned that it didn't take much distance off the mark to get to where little to none of the medicine would actually make its way to the joint.1
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