# Herniated disc experience and recovery?



## tahoegold (Aug 20, 2007)

So I have a pretty bad herniated disc, L5 S1, looking for some hope that in may still ride this summer. Had an MRI, now have to decide how to treat it. Surgery or not?? Every situation is different of course. I can do a lumbar microdisectomy which may take care of it quickly but I fear starting an endless cycle of surgeries. 

Anyone want to share their experiences with similar injuries? Recovery time? Treatment? Thanks in advance!!!


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## fishwrinkle (Jul 11, 2012)

are they ballooned out and ready to rupture? mine have looked like a mating frogs throat and have got them to return to as "normal" as possible and have remained that way for 2 decades. yes, daily i'm reminded by the mild sciatica pinch, but i can live with that versus the dreaded possibilities. i've been battling l4, l5 and s1 herniations, sciatica and spasms for 26 yrs now and no surgery and i'm 41 (bad car accident). what really helps me is stretching 2-3x's a day on a yoga ball, weekly chiro visits since the accident, keep core as fit as possible, eat healthy and ride. drink beer and be happy. YMMV

that worked for years, but now that i'm getting older, old injuries are starting to reappear and new injuries are taking forever to subside. i'm looking into a supplement called mk-677, do diligent research if you decide to go this route


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## Prophet Julio (May 8, 2008)

I blew out the disc between L5 and S1. It was a good rupture. Fortunately for me, I have a wide nerve canal. My Dr. a teaching surgeon at Harvard Medical School, told me that my body would heal without surgery. He was right. I was able to make a full recovery, though I do still have a numb area on my left leg on the front of the calf area. But I am 3 or 4 years post injury.

I have 2 brothers who also ruptured discs and they both had surgery. They have both recovered completely as well. The key to recovery is physical therapy and core strength exercises like planks, side planks, dog, etc.. 

Start moving as soon as you can and don't stop. Good luck!


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## alh (Aug 9, 2016)

I have a herniated disc, maybe 20 years now. I can't walk 20 minutes wo my back aching or getting tired, but I can bike for 3-4 hours (road cycle at least) for some reason! Took PT to avoid the dreaded surgeon. While not perfect, it's working thus far and has not interfered w my cycling (or skiing).


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## Miker J (Nov 4, 2003)

See your doc. If there are no "red flags" I'd highly suggest waiting on it and keep sensibly active.


A year and a half ago, at 46 I had my first low back injury. Deadlifting. Classic herniated disk. Sever pain for 4 months. Less pain for much longer. Lost about 10 pounds of good muscle weight. Since I practice medicine I know the red flags, and had none, but the pain was bad. Couldn't sit at work for months. Despite that I kept active, did not pursue any imaging/mri as I knew without red flags I would not pursue surgical intervention.

Pain is now completely gone. Back to deadlifting, albeit more carefully with less weight (though funny thing is I wasn't even lifting heavy when I injured myself), trail work, trail and DH mountain biking.

An active, healthy body has the remarkable ability to heal itself.

So, unless you've got red flags, avoid surgery.


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## tahoegold (Aug 20, 2007)

Thanks for all the advice! This gives me some hope as the orthopedic surgeon I saw recommended surgery (he is a surgeon so I guess he sees things through that lens). Wasn't pushy about it, but seemed unsure if this would heal on its own. 
I'm only 2 weeks out from the peak of the injury ( had very mild pain/soreness mid winter, but it didn't really get bad til 2 weeks ago). Stil have numbness in my foot and some mild nerve pain in leg (Lyrica is masking some of it, on a side note, anyone ever take the stuff? Wondering how coming off it will be?). Pain and numbness is slowly going so I guess I'm on the right track. Gonna go with PT and see what happens!


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## minimusprime (May 26, 2009)

Funny timing on this thread. I just had my first (hopefully last) back surgery on 5/9. 

I had an initial back injury in 2011 of my L4-L5 and L5-S1 discs. They were fairly severe of 5 and 7mm. I also had "disc degeneration disease" which is an official sounding name for, your discs are just old and busted. I had two MRIs within a 2 year period, 1 round of 3 epidural steroid injections and copious PT visits of all kinds over that same 2 year period. 

Pain for me was severe but localized to my lower back. The pain eventually dulled but weakness remained and it would manifest itself with severe stiffness on longer rides. I elected to not have surgery at the advice of 2/4 surgeons I saw. 

Over the years the pain lessened and my methods for treating it got better. The most key piece of the puzzle was constant home PT usage and maintenance. 

Flash forward to 2017. I now ride (or did ride) more often and longer distances and longer ride durations. I did my typical saturday ride then my sunday easy ride... got home and felt fine. That day while doing chores around the house, my back and right leg started to seize. By monday morning I was incapacitated and in bed. I had moderate to severe foot drop in my right foot along with severe weakness and numbness in my right leg. In one day I went from some one that easily plowed through 35 miles and 5k ft of climbing to not even be able to get up a flight of stairs. Terrifying...

After 6 weeks of imaging, PT, chiro etc I had settled on a decision to have a microdisectomy of my L5-S1 disk. The disk had "torn" or "ruptured" and a chunk of it was lodged in my nerve canal causing pinching of my sciatic nerve. The decision to have surgery was a huge one. I spent 6 years fighting surgery and avoiding opiates and here I was facing that same reality right in the face. Ultimately I had to make a decision based on what was the best chance for strength recovery in my right leg. 

I had actually improved over the 6 weeks from injury to surgery, but not significantly enough to chance not intervening. I had at best 30% strength in my right leg (which is my dominant btw) and still had no feeling in my foot except for 24/7 pins and needles. 

The reality is that the surgery was a gamble. Microdisectomies are a silver bullet for curing sciatic pain. They are not an effective or guarenteed solution for leg weakness or low back pain. The nuclear option would be to perform a spinal fusion... but that has consequences and it can cause you to pass the load up your back to the next weak link. For me, I have two weak links next to each other so they would have to be fused together, and load up the one above/below.

This brings me to my current state... The surgery was a huge success. I woke up from surgery and 90% of the weirdness, muscle spasms and numbness in my right leg were gone. The surgery was performed with cutting edge minimally invasive techniques and from a rockstar of a surgeon. I feel so fortunate that this worked for me...

And that's the problem with back injuries... They are so much a horses for courses scenario. That being said, there are some things you can look for as triggers or "flags" as they were called above:
1) is the pain back pain or sciatic or both
2) is it persistent or can you find positions and/or periods of relief
3) do you have incontinence issues, leg strength or numbness issues
4) can you live with the pain without pills

For me, the surgery made sense. I asked myself, and my doctor, what would I do about this if I were a professional athlete. And the answer from all 3 of the surgeons I saw about this agreed, surgery provided the best chances of full recovery. I know that a spinal fusion is potentially in my future in my life time, the game is to avoid it as long as possible and hope the technology gets better.

A few notes from my saga:
1) fitness, PT and constant maintenance is your hobby now. It's a hobby we share and I can tell you it's not always fun. Basic stretching with a foam roller with a warm up before will pay off huge. I do this every day before work and after work. Core strength is huge but even bigger is learning or re-learning proper bio-mechanics. This injured back of mine didn't just happen, I did this from years of abuse and proper bio-mechanics. Simple things such as reviewing the firing order of your muscles with your physical therapist is huge. Reviewing the firing order for things such as leg lifts etc was an eye opener for me. Making sure you engage your glutes, quads hamstrings and core muscles in the proper order will not only help cure your back pain, it will make you a way stronger rider
2) Imaging... I get the imaging comments above regarding not getting it. And if you have a medical education or you have a ton of experience with an injury like this... I'm iffy on that. The medical imaging that I saw and researched when i first had this injury was terrifying and overwhelming. The reality is that you should not look at your own imaging unless you're in such a bad state that you really think you need surgery. The reality is that all of our backs look like hammered dog **** in an MRI after 35 years of life. The spine is an imperfect organ. For my case... what I did get a huge amount of usage out of was being able to compare 4 different MRI's for 4 different points in time with this injury. 

What was interesting to see is that obviously one of my disc's got worse and tore needing intervention... however other one has healed slightly and hardened as the fluid has gone away over time. 

The body does have a funny way of healing itself, for that reason even though I just had surgery, I'm a huge proponent of changing the input before going under the knife. You should only go to surgery as an absolute last resort. And do not, whatever you do start weighing missing the riding season as something that weighs in on this decision. I for example, am going to be staying off the bike for 5 months. The doctors say I could get back on the bike at 3 months, but I have a feeling that their idea of what biking is and what mine is, is pretty different.

One last thing to consider... You are significantly more likely or susceptible of a re-herniation or re-injury after surgery. In the case of my surgery, 20% of patients re-injured the disk in the same way within the first year. Once you're through the first year the chances drop significantly, but you're still not "right" for 12-18 months. 
You need to treat the PT you do daily, as seriously as you would treat a recovery from surgery. 

I think I let out a bit more then my .02 on this. I guess that's what happens when you can't work for 2 weeks and you have nothing to do. :madman:

P.S. I consider myself a beast for pain and it's due to this and many other motorcycle injuries. I think most people around me would agree, I am not a pain meds guy by any means... That being said, the pain the first two days of my disctectomy was immense. A new level of shitty. I'm now way better 7 days after op, but it's still sore. The recovery from this surgery is going to be one of the hardest things I've ever done. I know I'll be able to get back on the bike, that's a given after how i feel, but to get back to the performance I was at before this surgery, is going to take a whole heap of effort. I'm up to the task... but if you're considering surgery, be forewarned, it will not be easy and you're going to have to really want it.


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## tahoegold (Aug 20, 2007)

Wow! Thanks for the advice and ideas! Lumbar microsdiscetomy is what my surgeon recommended, but your situation sounds a little more severe/ complicated than mine. Glad to hear the surgery has been successful for you!
I wan to ride, but I am realistic and don't want to push it with an injury like this, so riding is not a factor in whatever I decide. It can wait (not easy though!!)
I have sciatic pain still but it's diminishing (knock knock)
Some numbness but also diminishing. 

It's still fresh so i guess time will telll a lot. 

How quickly do you think I should be in PT? (Probably now I suppose?). I'm just starting to walk normally without a limp. It's been 2 weeks like mentioned. 

Thanks again for the .02!!


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## ridetheridge (Mar 7, 2009)

I once had a PT tell me. "The body will eventually heal, given enough time". That's true with one big caveat. That your symptoms aren't causing more permanent damage like weakness developing in your leg or foot. That's a big red flag. You don't want nerve damage. 

Two weeks is not very long. If your symptoms are getting better that's a good sign. Most doctors will try the non-surgery route for a while; PT, injections if necessary, rest etc. How long you give it depends on your symptoms. Most people can deal with intermittent pain here and there, and how to avoid it. You may also consider going to a Neurosurgeon (not orthopedic) for a 2nd opinion.

Most people don't realize this but a lot of common exercises and in fact common movements we all do are very bad for the spine. When you are young, it doesn't manifest itself.. until you get older. When you do get older there is no margin for error. If you have the opportunity to get with a good PT have them explain all this to you what to avoid and what you can do. Avoiding injury is the #1 thing.


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