Herniated L5-S1 Disk -- how long to recover?

[Arrgh]

I wouldn't go overboard on the exercise. It's like a crash diet versus changing your eating habits; you want to make changes you can stick with. There really is nothing you can do to make a disc heal faster, other than to avoid re-injuring it. I would stay away from anything that comes from McKenzie, old outdated info that imho does more harm than good. (If the Kaiser PT's are still pushing this, I would run, walk, limp or even crawl away as fast as I could.) If you continue to have long term, recurrent sciatica from that disc, don't rule out a microdiscectomy.

[cptn_picard]

Hi Justin,

Sorry to hear about your disc. I popped L4/L5, the one right above L5/S1 approximately 5 years ago. Careful about McKenzie technique, depending on how your particular nerve roots branch, extensions in McKenzie can be problematic. I spent one year bouncing around to orthos and PT's with limited results. Finally, I was referred to Dr. Joel Press of the Rehabilitation Institute of Chicago, the #1 rehabilitation clinic in US, and he subsequently referred me to a certified functional manual therapist (CFMT). The benefit of the manual therapist is they can do some readjustment on the table in tandem with your exercise regiment. Do not take the PT decision lightly - not all therapists are created equal, quality and training matter. Find a PT who you get better under (you'll know in 3-4 weeks). Do your physical therapy daily, religiously - plan on 1 hour a day split up into 2 or 3 sessions in addition to your additional general exercise. Learn all about your multifidus - this muscle will a critical key to recovery. The recovery horizon for me (after starting with a good PT - everything is predicated on this) was significant improvement in 4 weeks, ability to 'reset' the spine through a series of muscle exercises at 6-8 weeks and windsurfing at about 4 months. I have had a near perfect recovery, the only thing I do not do is the full cobra in Yoga (very similar to a McKenzie stretch). Stay on the ibuprofen PRN , if you can tolerate it, to keep the swelling down under control.

Good luck on the rehab road. Though the injury was devastating at the time, my L4/L5 journey has been exceptional - I have a stronger core than anytime in my life, extended control over general movements and all the PT strengthening has protected me from all of the stupid things I have done since.

[3-phase]

Dead Bug exercise worked best for me. SUP as well when windsurfing where a belt to keep your lower back warm.

http://exercise.about.com/cs/abs/l/blbeginnerabs.htm

Aloha

Jurg

www.kasail.com
www.a-h-d.com
www.windsurfdeal.com

[isobars]

Don't forget that recovery time is highly variable. My recoveries from virtually identical surgeries on my right and left sides, a year apart, were dramatically different.

Mike \m/

[csr7]

L5/S1 wasn't any fun. I've been there a few too many times. They have that scale of #1-10 thing for pain rating. I had a #3 sciatica that seemed to be really bothering me for some weeks so I went to seek treatment. Too much aggressive PT just aggrevated it even more. I awakened one morning all sore and then I tried to stretch it out but it wasn't good as the pain suddenly soared up to an 11 in an instant. It felt like someone took a piece of rebar off of hot coals and stabbed it into my hip and then drove it all the way down my leg and then kept on moving it around violently. The bulging L5/S1 disk had finally bursted and totally strangled the root of a very large nerve that controls the leg. They shot me with a very potent painkiller in the emergency room that was supposed to work in seconds but my nervous system and brain was in just too much shock to accept it. I dealt with that xtreme pain for many hours until the meds finally kicked in.

While I was agonizingly awaiting for that shot to work the Dr. advised me to start a walking program immediately after the 3 day pharmacuetical straight jacket period he was prescribing too. I was to eventually walk every day for 30 min for the rest of my life. He said he had a similar event happen to him recently and that's what's helping him. That was the gospel I needed to hear at that time. That was about a dozen years ago and I had a couple of mild aggrevations afterwards but they were many years ago. No surgeries for me and I was back on the water in 3 or 4 months but it takes a while longer to heal even more and regain more strength. I remember doing alot of hamstring stretches along with several other stretches back then too. Now I just try to SUP, windsurf, surf and walk alot.

[Barnett]

The good news is, no matter what approach you take, the natural history of disc herniations and back pain in general is that they get better, but they can take time, and the amount of time is very individual- can be slow. As others have stated, surgery is only a last resort, and studies have showed similar long-term outcomes for any number of treatment (or lack of) options. Proper exercises can certainly help the recovery process, and it may be useful to get a physical therapy referral- a good PT can tailor your exercises to your lifestyle. Exercise is very good- strengthens supporting muscles - as long as it is not triggering pain, and this too is quite individual. I can stay on a treadmill for hours but five minutes on an exercise bike triggers back pain....for others it is the opposite. You have to figure out what works for you. Good PT exercises for back pain include "pelvic tilt" exercises, ab crunches, bent leg lifts (hamstring stretches), "the lizard" (I think that is what that yoga posture is called, but maybe not...might just be what I call it), and others that I don't know the names of. Just stop whatever you are doing if it triggers the back pain, as this will add to the inflammation and make things worse. In other words, use your head and listen to your body.

An aside- I had 2 herniations nearly 20 years ago (L4-5 and L5-S1), and though I still have certain back pain triggers (fortunately usually mild nowadays), windsurfing has never been one of them. In fact, when I do experience back pain (very infrequent now), it is usually worst when driving, and in these cases I have found that wearing my windsurfing waist harness (without the bar/hook of course hehehe) cinched tight works wonders for long drives!

[justingordon]

[windsurfmama]

Hi Justin,

I PM'd you a few days ago. I'm hoping you tell your PT the symptoms you get from the Cobra pose, which means, you are still impinging on the disc and nerve area. Likely, other parts of your spine are not going into extension with your pose. That can be as a result of not letting your belly 'out', not letting your rib cage loose, as well as letting your sternum slide upwards during the Cobra pose. I'm hoping that you check out the 2 specialists that I suggested. I told my PT of my recommendations for you. She knows the Feldenkrais' person's reputation and says she is one of the BEST. Also, she also encourages the aquacranial sacral work from the other person that I recommended. You are fortunate to have those 2 specialists living in Maui.

As I said in the past, I've experienced remarkable improvements despite the fact that my back is nicknamed, 'Hwy 17', lots of curves, all banked in the wrong way AND despite the 6 knee surgeries on one knee. Windsurfing is my top recovery sport thanks to the Feldenkrais and Anat Baniel method treatment that I received. Other things like walking are more difficult because you've added other biomechanical requirements into the equation (feet, ankles, knees)...which are not necessarily as much of a demand in windsurfing or even kiting for that matter.

You will learn to move the rest of your body in concert with all of your vertebrae...that you will get you out of pain. Even your swimming will improve in ways you never realized (REALLY).

Another suggestion is to find a good osteopath to work with your spine as well.

I think you'll realize over time that it is important to work with other forms of therapy once you feel that you've hit a plateau. If I had stayed with just one form of therapy, I would still be laying flat on my back.

Good luck!

[wavecat]

For the tingling/numbness due to siatic injury trya good B-complex vitamin. After loss of feeling in my foot for 2 years I had noticeable improvement in a matter of days after taking them. It has been a couple of months since I began and the feeling in my foot and toes is still improving.

[Barnett]

If the cobra is reproducing your sciatica, my guess would be that you should not do it for now, though I am not a PT. You might discuss it with your physical therapist, and, again, listen to what your body is telling you.

You didn't do anything stupid. Disc herniations happen. You seem to be approaching it very intelligently. Just don't blindly take advice from random, though well-meaning, people on a windsurfing site (like me- I may or may not have the credentials- online how would you know?). Speak to professionals, follow their advice but not blindly (listen to your body as well). You will likely get better and be back on the water. It's the natural history of the injury, which takes time to heal.