Lower back - Dr. in the house?

[victork]

Couldn't sleep on Friday due to an unbearable amount of pain in my left hip and thigh. Dr. says I have Lumbar Spondylosis with Myelopathy...(herniated disk with spine damage?)

On serious pain meds now and dying to know if I can still ride. Anyone else out there have some experience to share? I'll be talking to a neurosurgeon tomorrow.

[gasman]

If you do have a herniated disc ( that's not clear from what you said) you can get good pain relief from surgery to remove the disc. Everyone over the age of 40 or so has back abnormalities on MRI or CT scan. The question is do the abnormalities explain your pain and can surgery help. You may find that physical therapy or a chiropractor can help. I have seen surgery really help and seen it not be so successful. See what the neurosurgeon says, if they are conservative that is a good sign.
Best of luck. Can you add ibuprofen or another NSAID to your regime to decrease inflammation ?

[victork]

My Dr. was great in prescribing both pain medication, muscle relaxant, and inflammation help. It's scary how great these meds are at masking the pain. I was two hours long in taking my next dose and definitely noticed. I'm wondering if riding will exacerbate the injury?


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[rnhood]

Spondylosis can mean many things, as its not a specific ailment. You will likely need an evaluation (by a real doctor, not a chiropractor) and only this doctor can advise you on riding. I ride with pain in my lower back every day. It only goes away when I lay down at night to go to bed. Mine comes from normal degeneration and some facet joint arthritis. There is no leg, hip or thigh pain. Your condition will be different. If you are young then they will figure out a way to treat it. If you're like me, well, those disc just can't be pumped up again. We have to live with it. Unless you have numbness, the doc very well might prefer you live with it too. There is always risk associated with spine surgery.

Having said this, I am not an expert or a doctor. Just a rider.

[buddybikes]

Have it, l4/l5 most common place. Unless you have serious issues going on in there, probably they will need to advise you PT perhaps steroid shot and start from there. Know 2 people had surgery, one is back to full blown heavy work at his house and another not so well. Find the best neurosurgeon in your area for advice.

[victork]

Thanks. MRI hopefully this week.


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[bcroslin]

Best thing is lots of rest in whatever position you can get comfortable in. Don't ride until you get an all clear from your doctor. I've been in your shoes and rest is the only thing that consistently works unfortunately.

[victork]

Thanks,
The strange part about this is it hurts to lay down or sit down. I have to keep moving.....unless i'm on these meds. I'll know more tomorrow.

[professerr]

Couldn't sleep on Friday due to an unbearable amount of pain in my left hip and thigh. Dr. says I have Lumbar Spondylosis with Myelopathy...(herniated disk with spine damage?)

On serious pain meds now and dying to know if I can still ride. Anyone else out there have some experience to share? I'll be talking to a neurosurgeon tomorrow.

I'm no doctor but had a significant herniated disc years ago with a very scary looking MRI. Sure, talk to a neurosurgeon (or two or three), but don't stop there. Even the best neurosurgeons, e.g. head of neurosurgery at Stanford, can have strong opinions and biases that what they know how to do (surgery) is the solution. Back pain is very poorly understood, and last time I looked at this the outcomes from surgery were no better than no surgery.

[gasman]

Thanks,
The strange part about this is it hurts to lay down or sit down. I have to keep moving.....unless i'm on these meds. I'll know more tomorrow.

This is consistent with studies on low back pain. Your best long term recover is to stay moving, laying in bed makes your overall recovery slower for the vast majority of people.

[Rekalcitrant]

I have recurring congenital lower back problems. I get a flair up every now and then and spend a week or two in pain and have trouble doing basic things—shaving at a sink is impossible. The main thing I have learned is that keeping my hamstrings very well stretched out makes a big difference. From talking to an MD, the explanation seems to be that a lot of back pain is caused by a muscular response to some or another deeper problem; so if muscles that have an effect on the overall dynamics of the region—especially big muscle groups like hamstrings—are tight, it makes things a lot worse. It took me years to figure out that stretching my legs helped a lot, in part because an MD I saw early on told me that stretching would only make things worse. What eventually clued me in was the realization that while my back problems are always triggered by something else (hard physical labor, a fall rock climbing, etc.) they almost always happen at times when I am worn out and my hamstrings are tight.

[CNY rider]

I AM a Doctor, have been through what you've been through and will tell you the most important person you need right now is a great Physical Therapist.
You don't really need an MRI.
You don't need surgery.
Until you have tried non-surgical management for a couple of months.

[biker72]

I AM a Doctor, have been through what you've been through and will tell you the most important person you need right now is a great Physical Therapist.
You don't really need an MRI.
You don't need surgery.
Until you have tried non-surgical management for a couple of months.

This is great advice.
Most good surgeons use surgery only as a last resort.
With similar back problems my internist recommended pain medication and stretching. Took a while but I'm now totally painless.

[Avincent52]

I've had long term l4-l5 back issues, so let me say this loud and clear
DON'T HAVE SURGERY.

At least not this week.*

*Unless you've literally lost control of your bowels and bladder and/or simply can't move your leg/legs. That's a very rare condition that might require immediate surgery and honestly your doctor would have checked you into the hospital by now.

And now for some good news. If you've got a herniated disc, there's a 92 percent chance that it will get better largely on its own through a process called resorption.

A back problem isn't orthopedic, it's neurological. The disc is like a jelly donut between your discs. A blob of jelly leaked out and it's pressing on the nerve.

Most of the time, your body will simply take care of that blob. It'll make it disappear the same way that it deals with, say, road rash.

But it does so in a way that's kind of strange. It's not like a knee ligament where you make slow grudging progress every day after lots of serious physical therapy.

Your back pain acts like its on an on/off switch. Once that piece of disc material moves a fraction of a millimeter, it's no longer touching the nerve, and you feel better.

The problem is that your body may take its sweet time about this. It can take 3-4 months with no real progress before, one day, you wake up and your back is "better."

That time frame is one of the reasons you get people swearing by accupuncture/yoga/copper belts/chriopractors/surgery. They get fed up, they start trying things and the thing that they're trying at the moment the disc finally resorbs enough to alleviate their symptoms gets the credit as a miracle cure.

A year ago this time, I was in misery. My back hurt like hell--above and beyond its normal pain--and worse, I was getting numbness in my left leg. A year later? I'm feeling better than I have in years, and I'm thinking about getting back on my bike. No surgery. No miracle cure. Just PT and Mother Nature.

There are a few things like epidural steroid injections that help some in the short term, by alleviating pain and restoring function until Mother Nature takes its course.

I've argued for the Pork Rinds and Pro Wrestling Cure. Take 100 back patients and sit them down with fried snacks and WWE and within 4 months, 92 of them will be all better due to the miracle of Funyions and Sleeper Holds.

As for that other 8 percent (me,) we'll talk about that some other time.
Good luck with your back, and yes, I know how much it sucks.

[Avincent52]

What's likely to happen at your doctor's visit.

He'll/She'll probably order an MRI to see exactly what's wrong with your back. Hopefully, you've got one very clear, visible blob of disc material in an otherwise clean scan, so that if it doesn't get better on its own in several months, the surgeon knows exactly what to do.

My own back surgeon agrees with CNYRider, except about the MRI. Although I do think they'll want to do a scan just to get a sense of what they're dealing with, and also to have a baseline to be able to track the "changes" in your back, to get a sense of what's just normal/congenital and what's a result of this injury. Assuming your insurance will pay for it, there's no real downside to having an MRI now.

Totally agree about finding the best therapist at the best Physical Therapy place you can. Your PT guy will make a huge difference. A McKenzie certification is a good thing but not absolutely necessary. Find a place that specializes in sports medicine and works with athletes, but also a place that works with back patients.

No pain no gain works great on a blown out knee. But overworking a back can literally make it worse. You might want a guy who's got some experience rather than the enthusiastic therapist just out of school.

Depending on how bad your symptoms are, your doctor might give you a variety of prescriptions. Oral prednisone. A very strong anti-inflammatory like Toradol. These are short term that will just help reduce the acute inflammation. But boy do they kick arse.

Again good luck.

[weisan]

Yep, echo my pals....rest, sleeping posture, PT, wait for that out of the blue "miracle" cure.

[cnighbor1]

If in the CA Bay Area try info@n8chiropractic.com
I have had great success using them
charles

[Seramount]

ruptured L4/L5.

at the time the herniation happened, it was pain of almost unbearable intensity.

went with microdiscectomy surgery and PT. pleased with the results and was riding only a few weeks after surgery (well, actually I tried it 2 days afterwards and that was a very bad idea).

currently in the 3rd week of hassling with L5/S1 pain issues.

trying non-surgical approaches, chiro, yoga, etc. can still swim and ride with little to no pain. trying to sleep is horrid tho.

making progress, hopefully things will resolve soon.

[pdmtong]

You have two choices

1) get a MRI. After which the doc will say go to PT. Only after PT for a few months will the doc move to the next decision on meds, injection, or surgery.

2) go to PT for a few months. if it works, lucky you. if it doesnt, now get the MRI

in both cases you will start off with PT, so spend your copay there first.
if PT doesn't help, now you are into the MRI, which will be required before any injection let alone surgery happens.

[victork]

Had an MRI today and am meeting with a Neurosurgeon on Monday. I agree that PT and something to help with pain is the route to go. Feel great now due to some hydrocodone help. Curious and nervous to see what happens when this is gone. Great advice everyone. Thanks.