Herniated Disc - anyone else had one?

[Dick Little]

I'm trying to suffer through a herniated disc. Luckily cross is over for the year and I won't start really training again until Jan. 1. Anyone else ever have this problem? What kind of treatment did you get? Stretching, bed rest...?

[Dick Little]

My mistake.

[bulliedawg]

I've never had disk problems to my knowledge; just general back pain and soreness from muscle strain and lack of flexibility.

You certainly should check with a doctor before you take my suggestion, but I have been doing inversion therapy (hanging upside down) for the past six weeks and it has really helped. My back doesn't ache anymore; I can sit and stand longer; I can ride longer and more stretched on my bike. You might mention it to your doctor and see what he/she thinks.

sic'em

[larryp2]

don't have surgery unless you can't function. rest, anti inflammatory meds (ibuprofen) and if your doctor recommends, a course of steroid medication. if surgery is recommended get a second or third opinion before you go that route....ljp

[lithiapark]

You didn't specify neck or back, but most of the treatments are similar. Having the problem described as a "bulging disk" suggests that you have pain mostly in the spinal area and not down in an arm or leg. The latter would be evidence of a nerve in the spine being compromised, and the treatment for this category of problem will be somewhat different from back or neck pain alone. An intervertebral disk is made up a circular ligament, the annulus fibrosis, which connects to the rim of the vertebra above and below. Contained within is the nucleus pulposis, which is gristle like in a younger person and more like crab meat in an older person, just from age alone. When a disk bulges, it is a ligamentous injury, occaisonally abrupt from trauma, but can be from fatigue and deterioration of age. The hydraulic pressure within the nucleus can no longer be withstood, and the disk "bulges" A torn ligament hurts no matter where in the body it is, so you get a dull to sharp, deep midline pain typically. Occaisionally muscles of the back go into spasm, a protective reflex. Caring for this problem begins much like caring for a badly sprained ankle, which is also a ligamentous injury. Reduced activity, but not bedrest unless that is the only comfortable activity, is the first step. There is nothing to be gained by suffering severe pain with activities, and you may injure yourself further. Lifting, bending, twisting should be moderated, your level of comfort is a pretty good guide. Anti inflammatory medications such as ibuprofen, and mild analgesics like Tylenol are the basic treatments for pain. More severe pain or muscle spasms can usually be managed with prescription medications, but they just treat the symptoms too. Physical therapy for traction is helpful often for the neck, but not ususally in the low back except temporarily. Physical therapy ultrasound and other treatments for muscle spasm can be quite helpful. As long as you do not have major pains in your arms or legs, then Chiropractic treatment can be considered (at least this is my view, our Chiropractor members will have to speak up). Ligamentous injuries come in all degrees of course, but many can take 6 months to reach a plateau of healing. Advice specific to your situation regarding return to activities is something your physician can help with, but of course predicting one individuals course of healing is not possible, fundamental principles apply but statistical studies, the best information we have, are not perfectly applicable to individuals. If, after a couple of months you are not seeing some ability to increase activities without immediately worsening the pain, the next level of intervention can be pursued. Epidural steroid injection is a common next step, and indeed can sometimes be appropriate in the first few weeks. The risk here is very low. If these treatments aren't successful, further diagnostic measure such as diskography, a somewhat uncomfortable test where needles are placed in the disks and they are injected with X-ray contrast dye, should be considered. Further major interventions short of surgery are available-nucleoplasty/annuloplasty/IDET-but a very focused and accurate diagnosis is a must. MRI scans may show an abnormal disk but diskography can show that a less abnormal disk is actually the source of the pain. The success of these treatments, and in fact surgery, depends greatly on the accuracy of the diagnosis. If all of this fails, then a surgical fusion can be considered. A bulging painful disk is essentiall a failing joint, but unlike knee or hip joints they are not routinely replaced. Artificial disk are being used in clinical trials for FDA approval here in the US, but I think the indication for their use will be limited, and I don't believe the technology is well developed yet. A surgical fusion essentially obliterates the joint, takes two vertebra seperated by the disk, and makes them one bone. This is obviously a large undertaking, but it does have its place in the appropriate situation.

There are a wide range of disk injuries, and beyond some of the very early treatments you can do yourself, you should see you physician for specific advice, which it seems you have. A significant majority of disk injuries heal on their own if you don't get in the way of mother nature. Pain in your arms or legs or weakness would be signals that you should contact your physician, nerves could be compromised. Hope this helps. Paul

[dnovo]

I have had lower back and disc issues since 1969. Surgery should ALWAYS be a last resort. First, see a good, repeat, good doctor. If the first thing he or she recommends is surgery, find a different doctor. Second, proper exercise, only AFTER the disc heals up, and as your doctor directs. That will help the muscles in your back compensate for what will always be a fragile disc if it has 'bulged' -- and may do that again. Third, any reinjury or aggravation, stop exercising and see your doctor before resuming exercise. Four, remember, once you injure your back it may be more prone to happen again. So always be a bit careful in how you lift, etc. Learn to lift more carefully, squat and lift with your legs, not you back. Avoid lifting things by holding them out suspended away from your body.

And, keep in mind that there is a light at the end of the tunnel. I had some fool tell me nearly 35 years ago that I would never walk at more than a slow pace and then with a lot of pain after I got wracked up. I may not be the fastest guy at 56, and I need to ride with my bars higher than fashionable (that is an issue you may have to deal with yourself depending on what the healing process brings) but I am up, about and around, even if I may be a pedantic pain in the a** from time to time. If a lout like me can ride, no reason you can't too. Dave N.

[Marco]

Dick:

First of all, I speak as a "user" of the medical system and have no medical, chiropractic, physical therapy or other qualifications. I know there are a number of members from the old board that practice in those areas (including, presumably LithiaPark with his very substantive and detailed response) who can perhaps point you in the right direction.

About 4 1/2 year ago I suffered from intense pain in my left leg that made it very painful to walk. It was a time when our third child was born, professional life was very demanding, and there was essentially no time (or units of energy) left for bicycling or other exercise.

After having a CT and MRI, I consulted with a neurologist who suggested an operation "if it didn't get better within two weeks of physical therapy". I knew that wasn't going to happen so I looked around and came upon a different approach to physical therepy that was successful for my needs.

The therepy begins with the premise that many back related issues are due to a lack of strengh in the back muscles which itself is caused from a lack of movement in our daily lives that actually strengthens the back muscles. As such, the therepy utilizes a set of very specialized machines (made by the parent of Nautilus I believe) that isolate the back muscles (i.e. no cheating by using hip, leg, or stomach muscles) and work on strengthening the back muscles. It also employed a regimine of daily stretching.

After going twice/week for six months I was cured of my issues and have not had a relapse. The ongoing maintenance has been a course of simple stretches and use of a roman chair several times a week to maintain strength.

Good luck.

[bags27]

Many people with herniated disks have been helped (or even fully cured) by reading a remarkable book: John E. Sarno's Healing Back Pain: The Mind-Body Connection. Sarno is a NY physician who believes that herniated disks are something that most of us have (studies have, indeed, shown that fluids begin to leak in our 20s, and only later, when a particular person complains of the pain, does the MRI confirm it: MRIs done on random people indicate that the loss of fluids and compression goes on all the time, with or without symptoms). According to Sarno, we should consider most back and neck pain as we do headaches: often the result of constricted bloodveins caused by tension. The pain only increases as we focus on in. Put it aside and get active, ASAP, according to Sarno (and even according to most other doctors these days who do believe in the traditional aetiology). I know soooo many people, including some doctors, who are convinced he's right. In my case, the pain went away the day after reading the book: I went from bedridden to riding a brevet within a few months, though I do still have a bit of numbness in my leg.

What Sarno's suggesting isn't risky or dangerous. All you have to risk is the $14.00 to buy the book, and, if you don't begin to feel better just by changing your beliefs, nothing's lost.

[BigMac]

I'm not an MD and I would never advocate surgery w/o seeking a 2nd or even 3rd opinion. That said, if surgery is required, it will likely not end your cycling aspirations. I had my L3,L4,L5 fused several years ago and have no problem cycling. I can compete in DC's, have logged 15k miles in a single year on several occasions since surgery and really have no special fitting requirements. For me, I actually prefer a more stretched out position than I formerly employed, albeit with a bit less saddle-bar drop. I would highly recommend yoga, swimming and kayaking all as effective means of improving torso strength while maintaining maximum flexibility. I would suggest you perhaps address our resident yoga guru, dbrk, he is highly regraded in field, a highly experienced cyclist and one heck of alot smarter than I. Best of luck with your recovery, set reasonable goals and never, ever give up.

Ride on!

[Spectrum Bob]

I have a herniated disc in my neck where I got considerable pain in my right arm especially when riding as well as greatly restricted movement. I had a great doctor that but me on a program of basic exercise to strengthen my core neck muscles and traction. I have a home traction unit that hangs on a door. It took time but my neck is greatly improved. I only seam to have problems now when I let my neck muscles loose there fitness or if I ride in the drops for too long. I do have my bar a little higher than my saddle to put me in a position that I can ride all day pain free. This is as much a result of a long torso and short arms as my neck issues. Good luck!
Spectrum Bob

[dohearne]

As others have stated, surgery should be an intervention of last resort. But let me add my agreement with BigMac. Labor Day weekend of 2001, I did a header off my bike causing an unstable fracture of T8 and fractures to T9, T6 and T7. Surgery 2 days later fused T3-T11 and I now carry two nice Ti rods to complement my Legend that has been ordered. Within 3.5 months I was downhill skiing and I am biking as well as I ever did (not that great actually compared to what I read on this forum).

As BigMac points out, there is great biking to be enjoyed after backsurgery.

[Bruce H.]

I was diagnosed with one total and two partial herniated discs in the lumbar region of my back in the 1980's. Was constanly having problems. Two things yhat helped me were:
1- losing weight and strengthening my abs and back muscles.
2- Started using orthotics in my shoes.

Since that was done about 1985 I have only had perhaps 2-3 episodes of lower back problems and the discomfort disappeared in 2 days or less vs. 1-2 weeks or more previous to that time.
I am not an MD and do not suggest anyone do anything their physician does not approve of. I am only stating what worked for me.
I also am a nut about activity, teaching 3-4 spinning classes per week, riding outdoors at least 200 miles a week in season and spending time with weights for tone ans strength conditioning.
Good luck for the future!
Bruce H.

[BarryG]

Huge difference between a lumbar and cervical disc herniation. Which is it Dick? Also, what are your symptoms?

Happy Holidays,
Barry

[Bicycle Tailor]

Being brief...
Flexion of your spine WILL continue to push the disc out. Flexion and rotation will most likely tear the fibers of the annulus fibrosis making your problem worse (careful w/ your golf). If it's a lumbar disc try this, stand in neutral spine, pinch some skin in the lower lumbar area, bend down to pick something up off the floor. As soon as the skin pulls, you’re loosing your lumbar extension and your pushing your disc out. Try this in your riding position. If you can't maintain a lordosis on your bike, stop riding! until fully healed. (500 days)
A fully herniated disc will clear itself up (never, ever fix itself) in about 30 days, so surgical clean up is an option if extreme pain continues after that time. But it takes about 500 days to end the risk of re injury.
drink lots of H20, 75% of their load bearing is from the water in the discs (even though discs are not really there to bear load...)
Train your multifidus muscles and Transverus ab.
Do not flex! Don't sit.... not taking care of it now will lead to excessive scaring and most likely conditions of Stenosis later in life.
The ONLY way to FIX this is to learn how to activate the muscles that support the spine! Get a good trainer to guide you through chiros, Dr.s and P.T.s.
Chekinstitute.com will lead you to someone not afraid to work with your issues.
josh

[jerk]

dick-
the only effective remedy for back pain the jerk has ever found effective is copious amounts of alchohol.
merry christmas,
the jerk


lemme know if you or anyone who sorta looks like you needs any tiso junk....i'm gong to put together an order next week.)