Post Herniated Disc Worry

I did chiropractors, traction, multiple injections for several years then finally had the surgery. If you have good surgeon(s) I highly recommend it. The sooner the better. Less permanent damage and more likely to recover some lost nerve function. And the only way to prevent further damage IMO.

+1 to what David said.

It sounds like it has only been 4 or so months and you are not really pursuing a course of conservative treatment. (Life style changes, physical therapy, disk decompression exercises like swimming, standing desk, accupuncture, etc.).  I

If you only have issues with one disk, I am surprised that you have not gotten better with conservative treatment. The younger the patient is the more likely the chances of success with conservative since as the patient ages the discs can become “desiccated.”

I assume that  you are not referring disk fusion surgery. The goal of micro decompression surgery is to reduce nerve compression with the goal of the nerve healing. The healing takes time and there are no guarantees.

I had issues with multiple disks on both sides for over a decade and finally had surgery. But as my neurosurgeon said: “the surgery will not make your back any stronger.” Sounds like you need to find a good physical therapist before and after surgery.

In reference to blisters, even with post surgical neuropathy, the management is the same: low pack weight, properly fitted footwear, nightly inspection of your feet.

+1 to what’s already been said, and…
assuming you’ve already had an MRI, your next stop should be a second opinion. As I’m navigating my path of dealing with a herniated disc, with associated sciatica, I’m finding there is great variability in the quality of care available. From what I’ve learned, if you can get by with a microdiscectomy you should consider it. A surgeon I’m talking to is on the fence about whether that will work on me. but he is consulting with some colleagues. I wish you luck. This is no fun.

Some people get over those problems with a good physical therapist. Others don’t. Disc problems are very personal. Your problems are different than your cousin’s. If PT didn’t work, you’re still having serious symptoms, and you have a good doc who thinks a microdiscectomy will help, I would probably do it. A microdiscectomy is typically not a horribly invasive surgery.  I would want a neurosurgeon or ortho who does only spinal surgeries.

+1 to the above, particularly the need to keep up with PT whether or not you get surgery.

My HMO (Kaiser) said I did not meet their criteria for surgery (foot drop or incontinence) so I did PT.  My numbness on the right foot did not go away, and in fact has increased, but it doesn’t seem to affect me.  The skin on the toes and sole are where most of it is, as well as somewhat up the ankle in the back.  But my footing does not seem to be affected.

I’ll add my two cents for what that is worth. I have had three procedures, and the first provided immediate relief. Afterward, it became apparent several weeks later that there was still some pressure on the nerve, so I had a second. The third occurred because of a bike accident. I have also broken my back at T7, and this makes pack fit very problematic. I use a heavier, more supportive pack, and doing so has resolved the issues caused by the fracture. The more supportive hip belt has also helped with the lingering sciatica. Additionally, I generally use a hammock, but I get get by for a few nights using a large mattress such as a large XTherm.

For me the foot numbness has never gone away. I cannot feel my outermost two toes. I do worry about sores and blisters, so I examine my feet frequently, and I am very particular with shoe and sock fit. Consequently, I have had no serious issues, but again, I check my foot frequently. More troublesome is that my calf on the affected side remains mostly numb, and the phantom pain can be annoying.

With regards to hiking the numbness gives me less feel for the ground, but physically I have no problem hiking or rucking. I keep my loads under 30′ and shoot for far lighter. I just hiked and rucked 41 miles over the weekend in the Colorado mountains, and while I am a bit sore I had no real issues.

For me the breakthrough came when I embraced yoga; it has really helped with my back, and it helps with the balance and nerve issues. I also learned that I am an individual and that one treatment does not fit all. You often know your body better than your doctor or PT; ask hard questions and determine for yourself what treatment is best for you. Do take the time to heal.

I would have the surgery(ies) again, and while I sometimes have flareups I have mostly limited my pain management to Yoga and Motrin, but I will be candid in that sometimes I need something stronger. I would work with a pain management specialist. In my case because of some other health issues I am largely limited to opioids, but…the bottle of 90 pills I got two years ago still has three left.

Bottom line: My only real limitations are the ones I have accepted.  Our bodies are much stronger than we realize. I am not advocating enduring pointless pain, but on occasion embracing the suck can teach us wonders about who we are. We can function through discomfort and less than ideal physical circumstances. I still love and enjoy the outdoors. I am sure you will be able to do the same.

After getting a diagnosis, get a second one, then the MRI and surgery if all indicators are present. Sometimes a sciatica can be treated with drugs (steroids and pain killers.) Pressure on the nerve means more and more permanent damage will occur. So, do not wait. 1) You will be limited to about 20-30 pounds after the surgery. 2) No problems with blisters on your feet, they are NOT painless. You will know to look. 3) Fortunately, most muscles are in your calf, anyway, so you should be able to walk, hike as well as ever.

I chose surgery. I still get occasional pain, but I also help out at Lean2Rescue work, meaning I move an occasional log or two that weighs 300-400 pounds. Be careful, though, set yourself for any lifting over 20 pounds. And, you really shouldn’t do a lot of it. Generally, you need a LOT of exercise in recovery. two or three hikes of a mile long per day is good. After 4-5 weeks, you can combine them into one hike. Start with an empty pack. Every week, add a 5 pound dumbbell or sandbag. When you get to around 30 pounds, stop adding. I also used ankle weights of 5 pounds. These were free according to the doctor. I could carry these all the time.

My husband has similar issues- degenerated disc between L5/S1, and FIA in both hips. He’s had surgery on both hips but refuses surgery on his back (for now). So not the same, but we’ve run the gamut of therapies. We also both have a sports and training background.

if you’re concerned about foot issues, my first recommendation is to find a gait specialist. Even if you aren’t concerned about foot issues, I’d still recommend a gait specialist as back problems are closely linked to our gait. Gaithappens.com is who we respect and follow.

A few other recommended resources are the book “Healing Back Pain” by Dr. John Sarno (any thing by him, really), and Move U https://fys.moveu.com/

I’d recommend to check those out before you commit to surgery.

Thank you all for the positive comments and good information. Embracing the suck is part of our sport and creeps into our daily lives more than I realized. I think it made these past 6 months of pain easier and had a positive impact on my attitude. I am grateful to know that any permanent nerve damage should not stop me from pursuing this sport. I definitely will look into the gait specialist. I can easy see how this can make a huge difference.

Good luck Worth!! That’s a great attitude to have, I wish you the best

Everyone’s story is different I guess, but here’s mine, in case it helps. I’d been having back problems for years, but then about 10 years ago it reached a crisis point. I crawled into an emergency room on my hands and knees. I lost the use of my left leg completely and couldn’t uncoil my right, I couldn’t straighten. I couldn’t walk at all for a few weeks, was out of work for months, and on a walker and a cane for two-three months after.

I assumed surgery was in my future but we started with rehab. The therapy I was assigned and did wasn’t super helpful, but I went on a yoga retreat with my then-fiancé and ended up getting a viniyoga back therapy dvd in the gift shop. I found it transformative.

It’s on Amazon for like $15, viniyoga for lower back health by Gary Kraftshow. It’s largely free of any new agey apparatus and just straightforwardly guides you through a simple series of expansions and contractions. You don’t need to be flexible or in good shape to do it — it’s geared at injured people basically.

I play golf, split firewood, go hiking — I rarely feel limited now. When I have pain, I do my viniyoga stretches for a while and things get better.

It worked for me, so I recommend it to others. But HYOH.

For those of you with the disc issues, what backpacks (or types of backpacks) do you find most beneficial?  I’ve had recurring problems with my disc since a car accident about 6 years ago.  In January I had another episode from bending over and standing back up.  MRI showed a desiccated disc at L5-S1. The result is part of my foot and lower calf are numb and results in weakness preventing my foot from being able to lift my heel much with all my weight on that foot.

I’m retooling my gear setup (obviously lighter will be better), but trying to figure out a new pack. I was thinking of going with a pack that is designed to carry heavier weight, such as a Seek Outside, with the idea that it may take more stress off of my back.  Not sure if my logic proves out.  I recently picked up a Granite Gear Blaze 60.  All the reviews I find say that it can carry heavier weights (up to 50 lbs.) comfortably.  Have not used it yet, but seems comfortable, but it does weigh a little over 3 lbs.

And for those suffering from back issues, I will throw out another book that has some great advice and exercises, The Permanent Pain Cure by Ming Chew  https://www.amazon.com/Permanent-Pain-Cure-Breakthrough-PERMANENT/dp/B001TI1E6G/ref=sr_1_3?s=books&ie=UTF8&qid=1476572239&sr=1-3&keywords=the+permanent+pain+cure

I was recently turned on to the work of Dr. Stuart McGill. I highly recommend his book “Back Mechanic” for anyone having back issues. You can see what he’s about on Youtube, but the book is very enlightening and I wish I’d discovered it years ago. Long story short; a great deal of the back treatment advice we’re receiving is wrong.

Nobody has mentioned this yet, so I will.

Lose weight.  Single best thing you can do to improve your back.  I have managed mine with a series of exercises, and avoided surgery, but nothing made a difference like losing 25 pounds.

@PaulW, can you comment on what specific back issue you have and how did the Stuart McGill book help?

Well, call me a skunk at the garden party, but I wonder if backpacking is the right activity for someone with disc issues-at least, for now.

I’m sure people will jump in and dispute this, and that’s fine. But I feel like it needs to be said.

Back issues affect every part of your life, 24/7. I wouldn’t want to ‘accept’ permanent numbness in my feet in order to continue backpacking for a few years. Or other, more painful consequences.

Sometimes in life we’re forced to bow to reality. Moving on to other activities can be rewarding and exciting too. Swimming, anyone? How about guitar, or cello? Seriously.

At least, ask your doctors their opinion.

Brad W. – My main, but not only, back issue is an impinged nerve due to a disc herniation. This causes both pain and numbness. Coming from a technical/engineering background I really appreciate a science-based approach to things and this is what “Back Mechanic” has going for it. Dr. Mcgill was a professor of spine biomechanics and it shows in the content of the book. He explains how the spine is supposed to work, injury mechanisms, how to assess what’s wrong, and then what you can do about it. My only gripe with the book is that he didn’t go deep enough, but as he explains, this book was written for the layman and so he had to leave some things out. My back is already improving by simply NOT doing some of the things he warns against.

jscott – You are absolutely correct. In my case, until I get this under control, my backpacking is on hold. Luckily, I can still hike all day and do just fine, but I’m wearing a lumbar pack, counter-weighted with water bottles, to avoid straining my back with a pack.
BTW, swimming is not necessarily a good exercise for those with back problems. Neither is cycling. Both were recommended to me by PTs and they both caused me pain. Back issues can be very unique to an individual. There is definitely not a “one size fits all” therapy for back injuries.

@PaulW Thanks. I will check this out. I have some some sciatica type pain-hip soreness, some calf numbness and would like to be able to remedy some of the numbness without surgery.