Been in agony for a week or so due to a slipped disc. Was in A&E for 4 days now home on all nice meds.

MRI below, discharge notes say no op needed just pain relief and physio. Saw a private guy today who says operate (cut out areas in red)….who to believe as back op isnt something to jump into without maybe giving enough time to settle naturally? Going to get another opinion to be on the safe side. Anyone found anything that works with out op? Trying all sorts of stretching, McKenzine

Currently on Diazapan, Diclofenac,Dihydrocodine, Gabapentin, Paracetmol, Omeprazole. Takes the edge of it but still a 24/7 ache in the buttock area,

Apologies for any english, too high and drowsy.

That’s a lot of drugs, I never get that amount, jealous.

Had an op on a herniated disc, I had to lay off the meds the day of the op and to my shame I caused a bit of a stir trying to knock myself out on the gurney thing as I was smarting a bit.

Myself if my sciatica flares up, (I have another disc making itself known) it’s best to simply avoid anything that aggravates it.  Could take a month, then continue with physio when it calms down a bit. Starting small is the key.

Blimey that is a lot of drugs.

Sorry I was on morphine (shed loads), diazapan, ibuprofen, paracetemol, and anti co-agulent injections when I broke my spine.

I’m on duloxetine now for the pain (similar to gabapentin).

I’d first see if they settle down as spinal surgery is not to be sniffed at – I opted to lie on my back for over 6 weeks.

I’m fortunate, my disks are all fine, except the one that was squashed between my L1 and T12 (broke both those vertebrae).  Certainly see how they settle and see what physio can do.

Take some time, see how things go, and do the physio! It might be that surgery is the option for you, but don’t rush into it. Some people get benefit from disc surgery, some don’t, and some even get a bit worse, but once you’ve done it you can’t undo it!

Beware of private opinions, you’ll always be able to find a surgeon who will offer surgery. If the patient wants it, and has the means/insurance who will pay then why not!!!

As a physio working in a musculoskeletal clinic it is difficult to say without seeing you and assessing you both subjectively (lots of questions) and objectively looking at how you move and completing a neurological screen to ensure the thinking chamber up top is sending information to and from your legs muscles, sensory components and reflexes what would be the best course of action.

Certainly an MRI scan although can highlight things such as disc bulges as seen in your pictures they also been shown in a great deal of research to highlight that disc bulges are often a natural part of the ageing processes of our spines along with reduced disc heights.

Much like any other part of our body that goes through ageing processes such as wrinkles and grey hair they don’t necessarily = pain.

Low back pain and radicular pattern pain is something that in many many cases will certainly improve and resolve without spinal surgery which should only really be considered in the presence of what is known as red flag signs which I would hope you have been asked about at your previous appointments. Anything unusual going on in terms of bladder and bowel control, any weakness in the lower limbs, loss of sensation down between your front and back passage and extra pain with a cough or sneeze which are know as cauda equina symptoms.

If there aren’t any strange goings on then I would certainly be looking at seeing a physiotherapist in the interim stages rather than surgery ( I know, I’m biased!) for a in depth assessment to look at your symptoms, things that aggravate them, things that ease them and aim to build a plan of action for treatment. This may involve exercises specifically tailored to your symptoms, positions of ease and possibly some manual therapy if needed. They may also be able to advise you after assessing you about other medication options.

Your doing the right thing using medication up to now as many people I see try and manage without thus leading to a lack of mobility, deconditioning  of the body holistically and develop antalgic (bizarre, non useful) movement patterns that will often put further stress on strains on the tissues, joints and nervous system.

Regular well paced low intensity movement, and physical activity will also help de-sensitse your nervous system that is known with pain that lasts for any more than a few hours becomes over analytical and hypersensitive to any stimuli. Particularly things that previously wouldn’t have caused a painful response. This is known as central and perhipheral sensitisation and is a massive part of pain.

Over recent years we have started to understand that pain isn’t necessarily representative of damage or harm but merely the brains response to what the tissues receptors (sensors) are telling it. Many of these things being amplified by how long we have had pain for, our emotions, stress, previous injuries and such like.  A nice way to think of this is that pain isn’t made in our backs or legs but our brain decides to tell you that your in pain when the sensors tell it enough information and processing time to think about and reflect on. Massively interesting and a crucial thing to think about when building a treatment plan with a patient.

Sorry for the long geeky reply but hopefully useful.

There is also the nerve block injection, was offered it 5 years ago after the last mri but my back had calmed down of its own accord by the time it was offered (6 weeks ish that time).

Thanks all great advice all round, please keep it coming.

I think I have clearly had a bad back for ages looking at the scans.

What I think had a complicating or addition factor is back in June I broke my clavicle another thread covers that. It’s still not healed so basically since mid June I have done nothing bar sit on the sofa and a few zwift sessions so my muscles have wasted away, I have none. I thought it was zwift that may have kicked it off but I already had some degree of leg pain before I set that up. The physio and osteopath thought piriformus or a disc issue, so at least we have the answer. I now need to find someone I believe in, my collarbone experience was bad, 4 docs all different advice ie no lifting…do lift and now this on my back.

Thing is when is too soon, when I am not asleep due to drugs I am trying McKenzie movements,leg rolls. I really want to try spinal compression after reading about it but don’t want to over do it.

As someone who has back issues and tried variuos things over the years, accupuncture is what gives me the best relief. Try finding a good one and have 3-5 sessions and see how you feel. I was on meds/ physio etc with no improvement and in desperation gave accupuncture a shot. I thought it was nonsense but they were also a GP and said to try it, i did and was amazed at the improvement after about 3 sessions. If i ever have a flair up i go back for a couple of sessions and it really helps me. Worth a shot i say.

Had a similar problem 10 yrs ago due to too much cycling and sitting in an office with no core or stability stuff, ended up off the bike for over a year (had to go swimming and wallking instead) this combined with physio and pilates sorted it out (after MRIs, chiropracters, osteopaths, applied kinesiology, acupuncture and strong medication, quite a lot of ££ and then more successfully physio), still flares up regularly when i get lazy on the exercises but i can spot the signs and act accordingly. You mentioned since June you’ve done nothing but sit on the sofa and zwift all of which would not help your back at all and probably increased the issues you’re having. I’d explore all other avenues before going down the surgery route and be honest about your whole body stability strength etc as others have said start slow and find a good physio like the chap above as they deal with the whole body and can help you manage pain and make a real difference.

I have actually had accupunture for around 6 weeks on the disc and leg, it gave short term relief. Maybe I can try again.

I think the clear and good advice out of this thread is small steps, find a good physio(in South London if anyone can recommend) and also start small and start with the core as I have just lost everything.

Tried the plank this morning, as couldn’t do that for months due to collarbone, but managed a minute. So positive thinking also. If all else fails I didn’t mention the liquid Morphine 😉 Even tried CBD oil.

I think I know what I need to do but I need that decent wingman/woman physio, my NHS one for collarbone was useless.

Oh and make sure my wife doesn’t know zwifting might have made it worse. I ride a gravel bike in it, Giant Revolt 3 but I made the stem a lot shorter due to collarbone, 100cm down to 70cm but on it had 2 rides before it kicked off.

to quote Ian

“Anything unusual going on in terms of bladder and bowel control, any weakness in the lower limbs, loss of sensation down between your front and back passage and extra pain with a cough or sneeze which are know as cauda equina symptoms.”

All checked OK, only they comment on now is the sensation / reaction when then tap your legs, joints/knees with the stick/mallet thing, right side is less sensitive.

I would also echo what has already been said regarding physio, strengthening, and exercise. My own sciatic problems came about after  a spell of no real physical activity and regularly driving for several hours without taking a break. The above has helped me hugely, especially work on strengthening the core, hip flexors, and hamstrings.

I’d really consider surgery as a last resort, you owe it to yourself to give yourself the best chance of recovery without undergoing surgery.

I’ve suffered from pretty much exactly what you’ve got. I tried everything above. The cocktail of drugs, the acupuncture, the spinal injections, the physio. Unfortunately for me, nothing worked so I had to have the surgery. the relief in pain was unbelievable, I managed to walk upright for the first time in 4 months. However, looking back, I’d go through all of the pain and trials to try to resolve prior to surgery. It took over a year before I could mountain bike again, nearly 2 until I skied. I wasn’t a happy chap!

No advice to offer better than has already been given but, be very careful, whatever you do! These things can easily escalate.

I’ve had disc trouble since early twenties(55 now). All the regular symptoms, back spasms, sciatica, unable to straighten up etc. Would probably flare up every six months or so and gradually settle again over a few weeks. Around seven years ago I had a twisting fall that set it off again but I carried on working and a couple of days later my left knee gave way while getting out of the van. After that I couldn’t support any weight on my left leg for the best part of a year during which time my thigh muscles virtually disapeared. MRI showed pretty much same results as yours and nerve conduction tests showed there to be nerve damage. Have never been offered surgery but would probably take it if offered. It took the best part of two years before I could walk anything like normally again and riding was impossible at first. After four years I was able to ride gently while seated all the time. This year has been the first year since then that I have been able to ride properly again. It’s been a very long road and I still feel like it could go again at any time.

The only plus side is that since it happened I have had no more sciatica. I guess the nerve is completely defunct.

Hello, Sciatica sufferer here too. L5 disc bulge and smashed L4 endplate. I was off work for 3 months earlier this year as I couldn’t sit for longer than 30 minutes. The GP told te they wouldn’t operate as they often do more damage going in.

I managed to find a fantastic physio who has now got me back to (almost) full fitness. A series of simple exercises and stretches have transformed my pain. I was on ibuprofen, dyhydrocodene all-sorts. Now the occasional ibuprofen.

My advice would be to find a decent physio with experience in dealing with back problems.

Oh, I also swapped to a hip pack and ditched the camelback as any pressure on the spine could irritate.

Good luck. You have my sympathy in regards to the pain.

The Quacks will promise all sorts. One of my friends is a surgeon and says that back surgery is really something to avoid if reasonably possible. It’s risky and can make things worse, maybe even much worse. I’d avoid any elective back surgery myself.

Hi,

Ive has bulging disks around 9 years ago. Cause was a lot of rugby, working with tools for a living and a car accident. I was off work for 8 months and sleeping on the floor – not great when self employed.

I had various scans and conflicting advice from different professionals. The operation route offered no easy fix and a risk of other back issues so I was very hestient. Thankfully I was offered a 4 week intensive Physio course with the nhs. It was 8 hours a day / 5 days a week! We only had an hour or so physio a day and mainly focused on relaxation, posture, core strength and addressing the mental side of back pain. There was also hydro therapy and a lot of stretching that I still do today. 8 years now without a day off work with my back however I did take their advice and took a career change.

Once you feel slightly more together I would exhaust all natural treatments before the operation.

I too had/have a ‘large central disk bulge at L-5’, did it back in May and had to get an MRI done privately to get any sort of diagnosis. Sounds like I got off lightly (so far) compared to some of the stories above, but my message would be that there is definitely hope!

I wasn’t given anything like that list of drugs – basically just ibuprofen – but there was a time when I couldn’t walk with the pain, and I was getting quite scared.

But now, 6 months later, things are MUCH MUCH better. I even went out on my bike for the first time last week, and will be out again tomorrow.

Things that helped me are below. Sorry if some of these are obvious, but they’re things I wouldn’t have known, and are mostly things my doctor didn’t tell me. (My doctor was useless, by the way.)

• Get a back brace. About £20 on Amazon. Wear it nice and tight.

• Don’t drive a car. The driving position is massively aggravating for it. I was lucky, I could work from home.  I stopped driving altogether for 2 weeks, and only when essential for a couple of months. Looking back, I should have been stricter about not driving.

• After around 4 months, I had enough movement to start pilates. I can’t recommend this highly enough – I see an instructor once a week 1-1 at the moment, and will keep doing that for a few more weeks at least.

• Cranial osteopathy – perhaps not for everyone, but seems to work for me. 2 visits seemed to sort out a few weird bits of tension.

• Breathing, relaxing, positive thinking (see notes above – there is science to this, it’s not just hippy shit)

• The surgeon I visited explained that the body can do a good job of healing this itself – the protruding disk matter reduces in size (from a large grape to a raisin, I was told) and what’s left continues to reduce very slowly over time. I didn’t know that – I assumed I’d have the bulge for life.

• I ordered a sit/stand desk and HAG Capisco seat from the Back In Action shop in Bristol.

• If there is one thing I would recommend, when you’re ready, it’s pilates.

All, thanks again each morning I wake up in pain as the over night meds dont quite make it to 7-8am…might have to take them later. At least its not waking over night. But each time I read the thread it inspires me not to give up even though I have pain whilst on the meds. I have booked another private appointment for Monday for an other opinion. I am covered for that so no issues. I have a list of questions.  I am liking the 4 weeks physio type approach.  To be honest of it works and I dont get paid for 4 weeks or 6wk in the long term its not a worry.

I mean how long can you take diclofenac, Diazepam,Hydrocodone and Gabapentin for. Nearly 3 weeks now and I do notice them work when I am actually awake.

Which back brace was it so I can ask as at the moment getting upright for any amount of seconds isnt good and also walking inaided for 30secs is sore. I can furniture walk around the house and up the stairs but I feel movement does flare it up. I iced it last night seemed to work. Haven’t figured out if its ice or heat at this point and reading I am not sure anyone does?

All I can do now is keep hydrated and keep the small movements going…leg sides to sides and some pelvic tilts and planks.   Was reading about back decompression and like the sound of that.

I’ve had a bulging disc for years that has caused a great deal of pain. But this has vastly improved in the last 4 months. What I’ve been doing is taking vitamin D tablets, and doing the “lying on your front and arching your back” exercise.

And I’d advise sleeping on the floor, on your back, or sides, but never on your front.

Not sure what make mine is, but it’s this sort of thing:

https://www.amazon.co.uk/d/Back-Braces/Proworks-Support-Lumbar-Exercise-Sports/B01MS501ZB/ref=sr_1_10_s_it?s=drugstore&ie=UTF8&qid=1540633035&sr=1-10&keywords=back+brace

Presumably at least one of those sets of painkiller is actually an anti-inflammatory? Stupid question, but I was prescribed something by my GP which my physio told me actually has no effect on the pain systems triggered by our type of injury. So I stopped taking it and stuck with ibus morning and night.

Inflammation gets worse during the night, my physio told me, so I took ibus at bedtime which got me through.

Get as many second opinions as you can – it was my physio who got me on the right track with diagnosis and crisis-relief, I only found her by chance after trying a few different medical routes (went private in the end).

From what you’re saying up there, it sounds to me like you need to give yourself a good long break, and rest. I know how hard it is, what with real life and everything. But you need to give your back a chance to recover and let the inflammation settle. I was told that’s a 3 to 6 month wait.

Good luck with it.

(I am no flipping expert and certainly not a medical one, but I do wonder about those drugs. Especially as you say they don’t seem to do much anyway. Find a physio 🙂 )

You have my sympathies, the pain is ridiculous isn’t it. Only thing that provided any sort of relief for me was the Entonox in the ambulance and the hospital.

I had a annular tear of L4 and L5, the spinal consultant said it was the largest he had ever seen.

Luckily no Cauda Equina symptoms but given a letter explaining I’d need urgent decompression surgery if I experience any issues down below.

Left leg did stop working properly for a while though. Had to force myself to walk which made a hugh difference. One day I’d got 100 yards down the road, the pain flared up and I had to lie on the pavement, on old bloke came out of his house (wanting to ring an ambulance) anyway he lent me his walking stick so I could get home. Eventually I was walking 2-3 miles a day.

Opted not to have surgery as the pain had subsided quite considerably. Think I am lucky that the discs ruptured rather than bulged as the body removes the stuff that comes out.

18 months on and the MRI showed the area to be clear, completely healed up. Pretty much pain free now apart from the odd tinge or ache, just use Volterol or Ibuprofen gel. Left foot is a little numb, particulary the big toe but I’m happy with the foot and leg strength.

Couple of other thoughts, I didn’t use a back brace and the Mckenzie exercises also didn’t do much. I found the exercises given to me by the Physio felt and worked better, these were basically, humping and hollowing on all fours and wagging the tail for want of a better description. Plus some others using a rubber band.

<span style=”text-decoration: underline;”>meds</span>

Dihydrocodeine tablets belong to a group of medicines
called analgesics.
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including the pain of sciatica (nerve pain of the leg/back),
joint and bone pain (osteoarthritis, rheumatoid arthritis
and arthritis of the spine), nerve pain, pain following
blood vessel disease, cancer or after operations.

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inflammation and pain treat to used also are They
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Ice on the area seems to give it most relief.

I have rest, 3months of nothing after collarbone now this doing my head in. No sleep last night couldnt get comfy. Day on the bed with ice and watching the footy.

Hoping tomorrow is productive.

I googled all fours and wagging tail like a dog….those people are more expensive than physio 😂. Maybe I could sideline in that to relive the pain and earn money while off 😀

My biggest issue when all this settles is time….hectic life, 2 kids, travel a lot with work, probably why I am here.

I had a few others like amitriptyline and tramadol, waste of time. It was the gentle movement of walking that really helped with the pain, although at first I was just lying on the floor unable to move, I’ve seen every episode of How its Made.

haha yeah you don’t wan that in your search history

The nearest thing I can find is the cat/cow yoga pose, was pretty much that but also moving the hips from side to side.

Not sure if it is the same thing but, I have a herniated disk at L5/S1 and have had for about 12 years (47 now)

After years of on and off back pain where the GP said I had a low tolerance to pain and it was always muscular, I went private. Within 10 minutes he’d identified the problem and an MRI the next day proved it as above.

Mine might not be as bad as I don’t get much if any sciatica, just sharp stabbing pain that takes my breath away when it ‘goes’. When it does, usually as a result of me bending forwards and twisting too far, the only thing that takes the edge off is diclophenac and industrial strength co codamol. A few days later and it eases back into normal life.

After the initial private consultation I had a general in the area injection that did nothing and then 8 X-ray guided nerve blockers into each side of my spine. That did the trick and I’ve been pain free for years – unless I tweak it by bending silly. Even then it’s a few days annoyance then back to normal.

Surgery was mentioned but strongly advised against by the private consultant, even though he was a specialist in the op.

Another L5/S1 sufferer here though mines slightly different as the fluid is gone/going with aging. Occasionally I get very nasty sciatic pains and nervous sensations in both legs. Been ongoing for 8 years. I had nerve blocks which were ok initially but by the 3rd were just aggravating the area. The spinal surgeon was against surgery.

This was compounded by being knocked off my bike last year and breaking L3 and L1. Get more pain from that now than the disc issue.

Things that worked for me; yoga, swimming, giving up the singlespeed for a while. I am back to cycling regularly and racing.

The painkillers, anti-inflammatory and neuropathics you’ve  been prescribed are a mixed bunch.

Mind how you go on the opiates; codeine and diazepam, and if you start to get serious mood swings then can the Gabapentin.

Similar tale here. Gardening and boiling kids in and out of cots did for me. For weeks I slept on the floor, on my side with towels wrapped around my waist to keep my spine straight. Woke in the morning knowing that the first movement I made would cause cramp to make you weep. Refused surgery and it slowly got better – luckily I could ride after a few months, as it helped. Osteopathy worked for me. I had a 50% loss of function in my right leg for months (couldn’t lift onto my toes). My leg was pretty numb and as it improved pain moved slowly up into my butt before clearing up – good sign for you if that’s where it is now? Stick with Pilates/core work and it’ll get better. What doesn’t kill you…….. Oh, and ease off the pills dude!

So update

Saw 1st private consultant last week. All he was bothered about was operation operation operation. He may well be right but my discharge notes said no op needed. So I went for a 2nd opinion as back ops not something I want to jump into.

2nd guy was like no op. May gel injections. So we came to a compromise,  2 weeks physio then review if no progress then injections as he thinks I am coming out the back end of this. Also need to get in at the docs as these pills are making me sleepy and well just feeling a bit weird, nothing major for now but don’t want it to escalate although I still have pain when taking all of them.

The pills will only take edge off, when I was in enough pain to need those sorts of meds unconsciousness was the only thing that worked.

Spot on with that comment James. I want to try and back off them a bit as overall pain is less but when it goes then I am screaming. Let’s see how next two weeks go.

So in the last couple of weeks I have seen 2x Neurosurgeon and an Orthopaedic surgeon via NHS and privately. Two neurosurgeons say operate and Orthopaedic says wait.

I am off most meds now only Gabapentin and Diclofenac now. I still have numbness in right smallest toes and a constant butt ache. I can walk for 10mins now but the tip toe lift test shows right side is defo weaker.

Think I have made my mind up with life and other things is to delay surgery and say if its not right by end of January then have surgery in Feb. NHS actually reckon I could get a slot in Dec and private next Friday but for me that’s not giving it long enough to sort itself out.

Physio did some acupuncture on Thursday, one needle in buttock..wow that muscle spasmed. Feels a bit better.

That’s a pretty short wait, My surgery ended up 6 months after diagnosis. In my case I was deteriorating, the surgeon spoke to me afterwards and kept asking how I’d injured the disk so badly.

Good luck to you, my back is great at the moment but the flare up in the spring kind of weed on the endless summer we had.

Good luck OP. I’m no expert and you have had plenty of good advice already but I will say that these things do often resolve over time. I was on the point of surgery about 15y ago but I put it off a bit and have been basically fine for over a decade now.

I have exactly the same thing, thigh went into spasm and the whole thing locked up.

Think I had less pain than you though, I’m about 8 weeks in, I’ve gone from walking round the bungalow, to a bit round the estate we live on, I’ve slowly expanded the walking and can now do 4 miles and today did 11 miles on my ebike.

Doc said it should reduce and didn’t refer me further, it’s hard work but the exercise and physio is helping.

Below is part of the work I’m doing, my physio has seen good results from it, the manual has a disc like ours and compared to one operated on they both look resolved.

Home

I have the same, but not as seriously. It started slowly, and built up over about 6 weeks to being unable to lift anything, unable to turn over in bed or stand for more than 5 min. All the exercises, back extension, etc seem to make it worse. Prescribed Naproxen and told to carry on with life – cycling and canoe/kayak seem to help it, and another 8 weeks in I’m much more mobile, saw the NHS physio last week and will be trying the exercises now. Also been recommended one of those spiky plastic balls to roll on or against to release the trigger points in my buttock..

Isn’t it weird how opinions are so varied across professional’s and experiences. I think that’s why I want to wait as surgery isn’t proven to be a complete success either. At the moment I can function interms of walking for 15mins but its hard work. I think the fact I have numbness is the issue plus it was the NHS neurosurgeon who suggested operation plus a private one. The private guy I just didnt like not just the diagnosis just the experience …was more of more money for the Porsche thing. Whereas the NHS guy I looked him up and he is a top doc, I though being NHS they would probably do as much as possible to add to waiting lists so was surprised when he said Dec. At least its in my hands now.

I have the spikey and normal lacrosse ball but that doesn’t seem to release it for me plus if I massage my back it flares it up. So maybe due to all this surgery is best.

I am trying McKenzie and McGill exercises at the moment, its defo improving but still 24/7 ache.

Time is the key for me I am in no need of instant surgery and will bust my balls to avoid surgery.

You know your improving when you make it to the pub, I can manage 3 pints now, but wearing jeans is like having someone rub rough sandpaper up your thigh at every step.

Ive actually got no pain in my back it all just thigh and knee

Well I was doing so well on physio then last week bang…massive leg pain…burning like the leg was going to explode. Nothing could touch it, morphine in hospital just sent me to sleep. So now got extra numbness and burning sensations in my leg so took the surgery option. 3rd Jan…let’s hope the neurosurgeon hasn’t been on the pop over xmas. Could be a hardly used Canyon Spectral 2018 up for sale soon…..

That’s shit, best of luck with the op.
It felt brilliant when I woke up after my op, yes there was pain but not in my legs and just needed Naproxen for a while after.

Update incase others are in a similar position. Turned up on the 3rd for the op. Over Xmas I did nothing but rest and it had improved a lot.So pre op assessment the surgeon said he would no longer operate due to the improvement and back surgery isn’t something you want. I still have a numb foot and tingling in the leg and tightness in lower back but each week its getting easier. I haven’t driven for months which I think has really helped. Took trains instead. Still on Gabapentin but off everything else. Walking 7000 to 12000 steps a day on average. So next thing is to add in some light weights. I don’t fancy the indoor bike trainer for a zwift just yet.

I have found that I have something like this (I think) – prolapsed disc between L2 and L3 if I remember what the physio said right. Exercises from her and yoga are helping, and I am “only” on Co-Codamol for pain at the moment. Damn car crash in November!

I have been warned to sort it now, and properly, otherwise it is liable to get a lot worse… so this is making interesting reading!