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Post Herniated Disc Worry


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  • #3713848
    Worth Donaldson
    BPL Member

    @worth

    I herniated a disc in January, failed physical therapy due to the pain, received a spinal injection with some positive results and a site targeted spinal injection with no improvement. I finally obtained a surgery consult and the recommendation to have a microdiscectomy. I was told waiting prolongs the chance of permanent nerve damage and the muscle weakness I am experiencing. I am concerned that the numbness in my foot may not improve much and the ramifications on hiking. Will I recognize the warning signs of a blister, etc? Any recommendations on how to protect myself?

    #3713850
    David Gardner
    BPL Member

    @gearmaker

    Locale: Northern California

    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.

    #3713852
    Bruce Tolley
    BPL Member

    @btolley

    Locale: San Francisco Bay Area

    +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.

     

    #3713890
    PaulW
    BPL Member

    @peweg8

    Locale: Western Colorado

    +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.

    #3713939
    Ben C
    BPL Member

    @alexdrewreed

    Locale: Kentucky

    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.

    #3713965
    d k
    BPL Member

    @dkramalc

    +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.

    #3716905
    William Moller
    BPL Member

    @whmoller

    Locale: Pikes Peak Region

    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.

    #3716946
    James Marco
    BPL Member

    @jamesdmarco

    Locale: Finger Lakes

    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.

    #3717579
    Bonnie Ackerman
    BPL Member

    @pachamamahikes

    Locale: New Jersey

    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.

    #3717734
    Worth Donaldson
    BPL Member

    @worth

    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.

    #3717996
    Bonnie Ackerman
    BPL Member

    @pachamamahikes

    Locale: New Jersey

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

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