BACK INJURY QUESTION FOR ALL MADJACK DR'S or BACK EXPERTS

TJ72

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I had an MRI on Friday and was called by my Dr. today saying I have a herniated disc at the L4-L5 level with "large extruded fragment into the extra-arachnoid space." He is referring me to a Neuro-Surgeon. My question to anybody that might know is..can jogging make this any worse?
I have continued running for about the last two weeks and have been pain free. I couldn't get my Dr. to speculate and I don't expect a call from the N/surgeon's office for about another week. Anyone know the seriousness of this injury? Thanks in advance for any info. I'm only 29 so bed rest just doesn't cut it!
 

ozball

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TJ72,

remember free advice is often worth what you pay for it...I'm a family doc up here in Canada.

If you are pain free and able to go jogging, and if you have no paralysis or weakness or numbness, then the neurosurgeon will treat you and not the MRI and likely leave you alone. Having those MRI findings would only lead you to surgery if you had corresponding physical findings as well.

As to jogging, etc, I would follow the neurosurgeons advice, whatever that will be. That being said,jogging is not likely to cause you major problems. Your flare-up, if it comes, will most likely occur from lifting and twisting, lifting improperly, etc. The most important thing you can do is learn proper lifting techniques, and keep your supporting back muscles strong through focused exercises.

Azrusty and others here will chime in hopefully. Az is a chiropractor, and there are several other MD's watching too.

cheers

ozball
 

1837

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I was going to tell you to ask for Az Rusty advice but ozball was faster than me!
wink.gif
Glad to see we have another doc around Ozball
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JohnWise

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My wife has had two herniated disk surgeries. Neck and lower back. She is mid 40's and is now into yoga. Does a lot of stretching and it really seems to help.
I too run. Actually jog. Know how hard it is to take time off. Good luck to you.
 

TJ72

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Thanks a lot guys. I think at this point I will continue to do some light jogging until I'm seen by the N/surgeon. Yoga sounds like something in my future too. TJ
 

jng

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TJ, I'm a doc myself and happen to have an identical injury including the extruded disc fragment which causes some numbness even after the herniated disk pain resolves. I'm also an avid soccer player and a runner.

You need great physical therapy and a thorough evaluation by the neurosurgeon. It's highly unlikely that surgery is a good option. Surgery is a 3rd or 4th best choice

You need to maintain ideal weight, changes habits which are hard on your back (twisting and bending and so on) and stick to the pain in the butt abdominal/back program you'll be given.

I got better. You will too.

If you ever need to reach me, Jack has my number.

J
 

SixFive

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I think think your body will tell you if you should be running or not, and I don't think you will cause more damage by running. My story and experieces below.

I had this same injury last year, except mine was a little bit worse. I had pretty bad pain, and numbness down my left leg extending all the way down to the top of my foot. My injury was at the same level as yours, and my disk was "ruptured" with multiple fragments.

I woke up one morning to find that I couldn't do something as simple as putting on my shorts secondary to the pain. My back had hurt pretty bad for about 3 weeks before this, and although I don't know this, I think that I probably had a herniation for quite some time. My back has hurt since I was 16 and running on the Track and CC teams at school, and I guess with my size, I am prone to these sorts of problems. I am tall, but not overweight.

The big difference in our injuries, though, is probably the extent of pain, numbness, and tingling I was having down my leg. Because of the dysfunction and on the advice of my neurosurgeon and several personal MD friends, I decided to have the surgery as I felt I really didn't have any other choice. My job requires some heavy lifting of patients, and I didn't want to let this thing linger and be off work hurt all the time. I also have young children, and I am very active in the outdoors and with playing sports, so I wanted to get "fixed."

I had an L4/L5 discectomy the end of June last year. Recovery is no fun, but with therapy and time, I can do everything I could do pre surgery. I still have pain, but really, it's nothing more that I have been used to, and I just tolerate it without narcotics to kill the pain. I take Celebrex 200 bid which imo is a wonder drug, not only for me, but for many of the patients I have as well.

Before I had this happen to me, I would have told anyone to not have back surgery until the pain or disfunction interferes with your activities of daily living and/or wakes you up at night, and I still tell people that.

I have played competitive basketball, and I have run since my injury. The running does not bother me at all. I also play golf as frequently as I can. Someone above mentioned good thorough stretching, and I will agree that is very important. Back exercises are also useful.

I too was only 29 when this happened, so it's not the end of the world if u do have to have surgery. I would recommend that you do follow up with the neurosurgeon like planned and see what he has to say. I also think you are wise seeing a neurosurgeon as opposed to an orthopedic surgeon. If the injury is not painful, and you do not have effect in your legs though, I would consider not having the surgery until that point. Good luck!
 

JohnWise

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That yoga my wife does. It is a tape called AM Yoga For Beginners. No idea how to get it but she swears by it. If anyone is interested, I will find out.
 

TJ72

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Thanks a lot for all the advice and first-hand knowledge you guys provided me!

Wow, MadJack's is great for everything.

I actually had some major leg pain about 4 weeks ago after I felt somewhat of a re-aggravation of the injury. That night and for the next few days I had some real bad leg pain in one of my legs. Sort of a "phantom" pain that felt like it was behind my knee. I think this is caused by the fragment. I have ran and even played softball since then and have not had any of the leg numbness or pain since then.

JNG-If you see this. You stated that you had/have the same fragments in the "sub-arachnoid space". Are they still there? What happens to them if surgery is not performed?

Thanks again for all this info. I realize none of you had to reply. Thanks again for the knowledge. TJ
 

SixFive

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If the fragments are impinging on a nerve root causing pain and numbness in your leg, this will damage the nerve and it will deteriorate. I read a lot about this and my Doctor confirmed that if I went on with the pain and numbness I could potentially develop permanent loss of function including foot drop. Again, it sounds like my injury was a little more severe, but that's what I learned.

I have also had patients in the past who had similar injuries and never did anything about it who had this permanent loss of function.
 

TJ72

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Now THAT is scary. Thanks for the info 65. I've now got an appt on Thursday w/the n/surgeon. They must think it's pretty serious if they're going to see me this quick, HMO and all. Thanks again. TJ
 

Mike Foreman

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TJ72,

Just curious, if you're not feeling pain, why'd you get the MRI?

I had a similar injury that led to a real nasty bout w/ sciatica. I'd felt just a little pain in my back for a while & thought I simply needed a new mattress.

I was jogging daily & felt fine while doing so... just kinda felt like I couldn't stretch out my hammy quite enough.

Then, one day I woke up & could barely even move. I can't ever remember pain like that before.

I tried everything... I went to the Kerlan-Jobe Clinic (very well-respected in SoCal) & they told me I would need sugery. I went to chiropractors, had electric stimulation, etc.

Everything seemed to make me feel a little better but never really got rid of all the pain.

I even went to a sports doctor that gave me two epidurals (boy, did that hurt).

I've always heard nightmare stories about back surgery & didn't want to go that route.

Finally, after close to a year of suffering, I devised my own plan. I decided to try a combination of the different methods I'd tried separately all at once.

I found a chiropractor I like & started going weekly. I'd been going off & on to an accupressure specialist, & started going every 2 or 3 weeks. Then I started mixing in deep tissue massages every 2 or 3 weeks.

Sounds like a bunch of quacks? You're probably right. None of these on their own really helped me out. But the combination did!!

I think the general idea that worked for me was combining the skeletal therapy with muscular therapy.

IMHO, a disk injury has to do with both & won't be repaired unless you try to fix both.

I've heard many horror stories of people who've had multiple disk surgeries. Be careful!!

Regards,

Mike



[This message has been edited by Mike Foreman (edited 08-28-2001).]
 

TJ72

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Mike- I did get pain at the onset of my injury. It was originally just back pain, mainly spasms that wouldn't quit. Then about 3 months after this, while playing softball, I was running and went to stop suddenly. This is when I felt I HUGE spasm in my back and a pain down my leg. This was approx 4-5 weeks ago. The next couple of days were full of leg pain. This is when I started to see a Dr. about it. It took a couple of weeks of insurance crap to get everything started.

The weird thing is that I had the MRI Friday, and played 8 games of softball over the weekend and didn't have any real pain. This is why the MRI results shocked me. Thanks all. TJ
 

Mike Foreman

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TJ,

Another short story.... the inner maniscus in both of my knees are torn (my body's a mess, eh?). Every now & then, my knees stiffen up if I sit in one place to long or I get pain if I put too much pressure on them.

I went to a dr. & asked him if I need sugery. He asked, "Does it hurt when you walk?" I said no. "Is the pain unbearable?" I said no.

He told me to come back when the answer to either of my questions is "no".

My advice to you.... avoid sugery at all costs!

Mike Foreman
 
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