Herniated Disc

Stephanie Stevens

I somehow managed to herniated a disc in my lower back one week ago.  I'm not sure how it happened, I don't remember a movement or anything that happened in particular.  But, it started hurting through the day last Sunday, and by Monday morning, I got up early to run and had excruciating pain with every step.  It continued to get worse over the next few days, so I had a doctor visit and MRI on Tuesday.  

I started PT on Wednesday and had a followup visit on Friday.  I've canned all my workouts except my physical therapy.  Part of the problem this week is that we have had an influenza explosion in our town and I have had one of my busiest weeks at work (I'm a pediatrician), and it was my weekend to work, so I had a full day on my feet yesterday and today as well.  It seemed to be getting a little better through the day on Friday, but today it is back to being horrible.  Hurts to walk, hurts to sit, hurts to stand up and sit down.  I just can't seem to find many comfortable positions.  

I am doing naproxen every 12 hours, ice every 2-3 hours, and trying to take it easy.  The inactivity is absolutely driving me crazy.  I have PT tomorrow morning again before I have to work a full day.  

Any thoughts on the future?  I was feeling a little hopeful a few days ago, but I'm back to being depressed about it.  

Carrie Chavez

Right now all you can do is heal your back. The future is depending on it. You can't really predict your racing and training future until the back is calmed down. A herniated disc is no joke. It usually does not occur because of one specific erroneous or traumatic movement but is most often a cumulative thing. Poor or suboptimal body mechanics coupled with possibly tight hamstrings or weakness over and over and then one day you pick up a piece of paper off the floor and them whammo- it goes.

What treatments in PT seem to help? Are you being taught proper body mechanics with how you do your job, get in and out of the car, in and out of bed etc? Sometimes those tips can help you a lot right now. Does laying flat on the floor with legs up on couch or ottoman feel better? Or sidelying?
Sitting is the most compression on a disc only made worse if you sit with a bent over posture- Eek!!

My heart goes out to you. The pain is wicked. Watch for LE weakness like foot drop etc. a huge red flag. You don't want that. If so emergent back to MD.

Praying you don't get the flu also. Yikes.

Once you are pain free and have some mobility back we can address returning to exercise. Lots of folks here can help you start back up.


Carrie

tim cronk

Stephanie, I'm no doctor but I have lived with a bad back for over 20 years now.... I never believed in back pain until it happened to me... When it did I was crippled on the floor crying for a week , totally almost unable to move.... When I finally got the MRI it was 2 herniated disc's 1 was major and 1 was minor.... For me PT or activity was the absolute worst thing to do.... I became a believer of doing nothing and laying down was best for me....It slowly got better but its never gone away, I have what I call episodes , something tweaks it.... The first couple episodes after the first where the worst but NOWHERE near the initial pain I experienced. I've tried all kinds of PT , Yoga , stretching, core strengthening , chiropractic, etc and none of it helped and most of it just irritated it....I've learned to live with what I can do and what I can't... Very paranoid about bending over, picking up anything , all sorts of manual labor with shovels, rakes, brooms which provide a twisting motion... Some injuries require active recovery and some require none or very light , my experience is to favor the light side of everything... The disc is bulging and needs to shrink back down in order to alleviate the pain its causing.... Listen to the Doc's but be really careful with PT!

Stephanie Stevens

So far, the PT has been education and active release therapy of my hamstrings, psoas, ITB, and just a bit of the paraspinal muscles. I've been told no to running, biking, swimming, yoga, etc. I hope to be able to do some short walks on level surface this week.

One of the biggest things right now is that work is killing me. My days are about 10-12 hours, with a one hour commute on either end. I couldn't pick up kids this week and that was so hard for me. But, I know I do that way to often and I need to stop.

Sleeping is becoming a problem as well. I don't think I've been able to sleep for more than about 1-2 hours at a time, and I have not been able to stay "in bed" for more than about 4 hours due to the pain. Currently, that "bed" is a yoga mat on the floor with my legs propped up. It is about the most comfortable that I have been able to get.

Glad I'm not the only one....

Robert Sabo

Remember everyone is different and different activities will be better and worse per individual. Rest and PT. The hour commute sucks. The good thing is that most patients (85-90%) are better within 6 weeks no matter what treatments are used. Good luck. Let me know if you have any other questions.

steve Beyer

The disc herniates when the "annular" fibers (cartilage) tear enough to allow the gelatinous center part of the disc to protrude. The annular fibers are poorly supplied with blood, and require a pumping motion to draw/push surrounding fluid in and out ("imbibition") to keep it healthy. I'm bothering to explain this to a physician to emphasize the following.....poor joint mechanics(ie..locked up vertebral segments) always underlie disc herniations, and usually poor muscle balance usually underlies the poor joint mechanics.

Soooo this means that......the poor joint mechanics is why some form of joint mobilization/manipulation work often is a useful part of a treatment plan. The poor muscle balance is why some form of PT work is likewise often an important part of a treatment plan. I say "some form" because, like Tim implied and Robert said....everyone is different. AND the timing of when anything is implemented is important because....

In addition to the above issues is the inflammation in the the torn annular fibers that needs to be addressed. So what I've found to be the best approach is to start out very cautiously, primarily addressing the inflammation/muscle spasming with things like what you're doing.... rest, NSAIDS, passive PT modalities like electric muscle stim., cold/heat, light stretching. Many people have the response Tim had because they have someone try to do too much too soon. But having said that I strongly feel that the right TYPE of some combo of joint/muscle work, done at the right TIME has a very important place in a more successful outcome.

Good luck!!