Low back herniation/bulge and rehab

Leslierussell4134 wrote: »

ellkay2 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.

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.

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.

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!

sijomial wrote: »

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.

@CarvedTones
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.

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.