herniated L5 and corresponding leg problems. ARRRRRRR!!!!!!

[andy mac]

Not unlike the middle-east peace process my injury seems to be never ending.

The latest finding is that I have a herniated L5. The thinking is that this could be causing my neck and major left leg pains esp in the vastus medialis and sartorius on the front and calf/hammy on the back side.

My left side consistently tightens up, I end up with a ton of trigger points etc. So I stop, get them beaten out of me for a few months, start exercising and it happens all over again.

Has anyone else experienced anything similar?

What to do? Any advice, insights etc much appreciated.

It’s been 3 years now and the kid’s taper is long enough.

:beer:

[Frog Hair]

L5 was the first one that went on my dad. The process from there was that like dominos falling, as the pressure was re-distributed to other discs that could not bear the load. He is now about 4" shorter now than he was in 1990. 5 discs are now all but totally gone. He's had just about every surgery short of fusing his spine (he won't go there). 2 other friends, who were athletes went through similar. My brother and I are in line for "genetic failure" on this, so I pay close attention on this topic. Here is what I know.

Cortezone shots are popular but only temporary and they only block the pain.Cortezone stores up in your body and is bad for you. Unless you are in chronic, untreatble pain, avoid the cortezone.

Therapy is king. Of that, water therapy is the "best" thing you can do. The weightless effect that water offers allows the muscles to be strengthened around the affected area, while taking the strain off the structure. Of course you know, strong muscle around the spine will aid in supporting it, thus reducing the load to the disc.

Sitting is a bad thing. Sit on a stool, or use a "stand-up" desk and avoid "traditional" chairs.

Never ever lift anything again. (well, not really) But be very careful and always "bend at the knees".

Use a "therapy ball" for your abdominal work. Look for exercises that you can do that will strengthen your core, without loading your spine in the process.

Stretch, stretch, stretch.

Make sure your walking/ daily shoes are in good shape. Standing support starts at the feet. The lumbar region is particularly sensative to this. You may consider orthotics for your street shoes.

There are newer surgical procedures that have been presented to my Dad. The future is looking toward the route of the synthetic replacement or bio-replacement (where they grow new parts in you - they are doing this with the meniscus (sp) in the knee now).

The thing I live by, to beat this myself, is life-style. As much as I hate core body exercise, going to the pool, etc, I can tell when I have not been doing it. Now that you have "broken the seal" on this disc, there is no turning back. You are now chasing the symptoms via conditioning and deterring it from getting any worse. Don't be a hero and try to "beat the pain." You'll be in worse shape than you can imagine in a very short period of time.

See you doctor for new medical treatments that can aid in the process. Until then - be healthy, and be smart.

[Climb01742]

serious suggestion: come to beantown and see my A.R.T. trained chiro. the guy is damn good. i've seen a tons of sports medicine dudes over the years, and he's helped me the most.

[Ti-Boy]

I agree with Climb, A.R.T. is the way to go. In one week I went from barely being able to do 20 miles without debilitating knee pain, to my fastest century to date.

[telenick]

Good posts about core work, stretching and getting a good "body" specialist to perform analysis and provide correction.

Brother, I feel your pain ...literally. I herniated (extruded, as they call it) my L5/S1 8 years ago.

Rossiter has been a very effective treatment for me.

[Mikej]

No M.D., but I've had plenty-o-pain in all the same places. Do try to keep an accurate journal of what works and doesn't work - I found that leaning over the sink to get my ugly mug up close to the mirror when shaving aggrivates the crap out of my back which in two days ends up in my glutes and VMO / groin. Get a book called "TRIGGER POINT THERAPY" its like 20$ at BORDER'S BOOKS. Beats the knife and paying for some guys sports car.

[andy mac]

Thanks for the replies everyone. Love this forum.

I’m finally working with a chiro who actually cares and we seem to be making some progress. When I first went in there my lower back and sacrum were totally locked up. They are now releasing and starting to move more.

Frog Hair:

Thanks for the detailed response. This is all new to me and there was a lot of helpful info in there. Before I moved to NYC I did a lot of swimming for triathlons and when surfing and really miss it. Luckily we are bailing on the city and will be able to get back in the water more easily.

I do sit all day and just purchased an aeron chair which seems to help.

One of the few things I like about NYC is the walking and I do most of it in good shoes with orthotics – makes a big difference.

I stretch like a mad man. Core is pretty weak as I’ve been injured and super tight and locked up for awhile. Slowly (on purpose) getting back into it and things are unlocking.

Climb:

Thanks for the suggestion. We are actually leaving your part of the world in a week so that won’t be possible. I did start off seeing an ART guy here in the city. I felt the technique had merit but had some problems with the guy. Firstly he was only treating the symptoms not looking for the cause and even more annoyingly he would often juggle 3 patients in 3 rooms at once. Not great for a hands-on technique. I have since found someone who cares thankfully and now I’m finally making some progress.

Telenick:

I am an old ski bum too. Spent most of my life until the age of 21 racing around the world. Where did I go wrong and how did I end up behind a frickin’ desk?!?! Did some bump comps for fun too. Sounds like that may be where the problems from although I have had some good bike wrecks, car accidents etc.

I would be really interested to hear what you did to correct your back if you have a minute.

Mikej:

That’s funny you should mention leaning over. I totally get pain doing that and never connected the dots – just thought I was desk-jockey wimp. It especially flares up doing the dishes – now I’ll have a great excuse for the mrs!

I actually do have that book and love it. In fact I’ve actually recommended it to a few on this forum including the Climb-master.

:beer:

[mdeeds71]

I have a 2-3mm L5-S1 herniations. It does cause a slight tighting of the left leg since that nerve is being compressed by the vertebrae. My herniation goes to the rear and left thus when on a bike I do not feel it since I am expanding this area. But when it gets a little irritated it can cause pain when sitting straight up. I had an MRI (newest system that is very accurate...only a few in the US and one here in Los Gatos CA. My ortho/sport surg basicaly has stated it may subside on it own using anti-inflamatories...such as a steroid shot. My disc is intact just bulging thus if it were not to subside the next step is where they trim away the part that is portruding and enlarge the area the sciatic nerve is contained in. That procedure is 99% correcting and causes no other problems later on down the road.

Right now I am trying to reduce the stresses on it...still ride/race...just no lower body strength training. That is how I actually injured it doing a weight leg sled that is standing position. I take 600 mg of Motrin with a meal when it is inflammed...I started under Dr's orders doing this 3x a day with each meal...now I am down to it as necessary. Also keep an eye on the curvature (l vs r) of your spine...Your back may start to compensate and cause a curving spine...Excercise seems to keep in from doing this. I have never experienced it rather a good friend of mine has.

Mark

[sirroada]

Andy Mac,
You are doing all the right things. I have treated a zillion patients in your condition and most of them respond with chiropractic care. Those who don't typically respond to other forms of conservative care such as physical therapy. If nothing seems to work in that regard I would then recommend finding the best orthopedist you can and getting an opinion from him/her. Typically, patients who don't respond to conservative care will recieve cortisone shots (which mask the pain and do nothing to fix the problem AND are catabolic, meaning they destroy healthy tissue). If shots do not work surgery may be the last option. However, there is a long road between where you are now and having surgery. Most importantly, it is what you do that will determine your outcome. I would recommend a regular (3-4 times per week) session of core body strengthening. This will strengthen and maintain the other supporting structures of your low back since there is now damage to one of your main supporting structures (L5-S1 disc). Maintaining flexibility is also critical. Additionally, chiropractic manipulations help maintain the range of motion at the affected joint helping to minimize if not stop the arthritic degeneration that often occurs as a result of a degenerative and herniated disc. I recommend seeing your chiropractor once every couple of weeks for the rest of your life. I know it seems like a lot to swallow, however, you can either be adjusted on a regular basis to slow down the arthritic progression or you can take Ibuprofen and other NSAIDS on a daily basis to kill the pain and stiffness caused by the arthritis...your choice. I ride about 150 miles per week and I get adjusted on a weekly basis.
Finally, there is some really interesting research out there on spinal decompression. You see, discs do not have a direct blood supply that helps hydrate and nourish them. They rely on compression and release motion to help pull fluid into them. Much like if you took a sponge and balled it up in your hand and put it in a sink full of water and watched it expand. It would pull fluid into itself. Spinal decompression will accomplish this, even on your torn and dehydrated L5-S1 disc. Some of the research I have seen has even included before and after MRI scans of the the low back and the results are astonishing. Obviously, this does not work for everyone, but you may be a candidate for it. Check it out if you want. If you have any questions, do not hesitate to PM me. Your condition should not be limiting if you manage it appropriately.