Ruptured a disk in late 1994. The pain quickly became acute enough that I could not drive or tie my showlaces. I went to the Dr. and started a program of physical therapy and 30 days of steroids. This changed the situation from acute pain to mild discomfort by early 1995. I slowly got back into shape and raced for a few months before I realized I was not going to be able to train/race as aggressively as I did in the past.

So in May of 1995 I had surgery to shave the disk. The surgery went well with no complications. I still have a little weird sciatica in the rigth leg that rears its head from time to time, but the surgery worked wonders. I've done many sprint tris, 2 marathons, and 4 ironmans since. Needless to say, I am a big advocate of surgery.

If you decide on surgery, take your recovery from it slowly and don't do anything stupid. I believe most people who have bad experiences from surgery bring the problems on themselves.

Merv, bummer about your back. About four years ago I had a herniated disk on the L4. Started with drugs..no effect. Next came the epidural, no effect. Finally after two pain-ridden weeks where I could no longer walk or stand up, I had surgery to shave the herniated section. Pain immediately gone. Have done many triathlons since then including two ironmans. However, just recently I got another slighter herniation two disks up from the last one (MRI confirmed what I suspected, but ER doctor didn't). Fortunately this one is not as bad or debilitating. Drugs brought it down somewhat, then I tried the "rack," a machine that stretches the spinal cord to relieve pressure at the herniation. It's a fairly new procedure here and you basically lie on a table with harnesses strapped to your hips and ribcage. These are pulled apart by a computerized machine in slow increments. I was scheduled for about 20 of these 30 minute sessions but was able to only do about 12 because of scheduling conflicts. They will make your back somewhat sore but nothing major. I do believe it's a great alternative to surgery. It has helped me, though I don't feel I'm 100% cured. Perhaps more sessions would have done the job. Also, from what I've learned, many minor herniated discs fix themselves if you take it easy and use anti-inflamitory drugs. Do a google search on herniated discs for some great info. Good luck and keep up with preventative measures like I should have been doing.

I have to agree with the traction. This worked with me.

---

"Your limits are self imposed"

Get a second opinion from someone who is in no way associated with your current physician. Too many knife jockeys see 'Mercedes payment" when someone comes in with a protruding or herniated disc. And btw...lots of people have bulging discs....most aren't symptomatic. Many discs that protrude will eventually shrink and dessicate if given time. Unless there is a large fragment which has extruded into the spinal canal and extended to the other level surgery is not the first step...conservative therapy is. Without knowing exactly how bad the disc is it would be hard to say, but based on your described symptoms it doesn't sound like it is causing you anything more than discomfort. Unless you meet the criteria for immediate surgery such as progressive neurological deterioration or incontinence, I would run, not walk, from somebody who suggested surgery as the first alternative. As for the "you'll need surgery to be competitive"...horseshit. As someone who recovered from a thoracic disc injury the only reason I am not competitive is poor training and an inability to swim. The only symptons I have it is that chipseal aggravates my back (which is why I am having a Titanflex built).

Bottom line go get a second opinion. Preferably from someone who has an objective opinion.



Lance

---

_________________________________________________
That is just one more group of people that should be thrown screaming from a helicopter- George Carlin

I've got a slight herniation at L4-L5, but it doesn't keep me from doing anything. It doesn't bother me one bit when running or swimming; only on the bike will it begin to get sore on longer rides. My pain is just a dull soreness/tightness/ache around my low back--it could be worse. The recommendation of my doctor was to give it time (as Dr. Doom suggested, sometimes they just heal themselves), and throw some PT and core strengthening exercises at it. A very weak core, combined with a lack of hamstring/hip flexibility hasn't helped, and may have even been one of the contributors. But I'm working on it....slowly but surely it has begun to improve. Back surgery, as I've been told by many, should be considered a LAST LAST LAST resort. Good luck.

Andy

I have had long time issues with my L5/S1 disc. Herniated it several times, the original injury coming from doing squats in my muscle head days. I also herniated the L5/L4 disc two summers ago while training for a 1/2IM. I have had some miserable months/weeks/days and the L5/S1 continues to annoy me daily with sciatic pain down my left leg. That said, I have to agree with Dr. D and stay away from surgery. I have increased my core strengthening and that helps tremendously. Find a good physical therapist and stay away from the knife unless you have loss of control over your muscles or bladder and bowels. Your body will essentially eliminate the bulging portion of the disc on its own, although this takes more time than surgery.

I've been told by some of the best back specialists that disc issues just seem to strike certain people mostly due to genetics. Keep the core strong, watch your posture and listen to your body. Another important piece of advice I keep in mind from my last PT, if you have lots of pain that is localized to the back its ok to work through it, BUT, if the pain radiates down the legs, you need to stop and stretch it out or possibly hang it up for the day.

It's unfortunate but those of us with disc problems have to fight through that discomfort on race day as well as the other more normal discomforts. Hope this helps. Good luck and keep the hammies stretched too!

Merve:

I have suffered from lower back spasms since 1988. I used to have one attack a year. In 2001 I had an attack that resulted in very bad leg pain for a couple of weeks. For some reason, I went from 2001 to 2004 with no attacks. Two weeks ago I had a new attack that was just as you described: hard to walk, hard to sleep, etc. The second day I could barely get out of bed. I suggest that you be very cautious in making a direct link between back spasms/leg pain and disk problems. For the first 10 years I had various medical opinions about my back, including such dire assessments as "you will never run again - I have raced 9 times this year). In all cases for me the attack subsided and I was back to normal. I plan to race this weekend.

I would be very leery of quick diagnoses about herniated disks. I do a lot of stretching and try to recognize when I am overdoing things. If this is your first attack I strongly encourage you to rest, ice, and see what happens. If the main symptom is back spasms my bet is that you will be back on feet soon.

I couldn't agree more with Dr. Doom. I'm a physical therapist, and I see people all the time who come in to my clinic with their eyes bugged out because they were just diagnosed with a "herniated disk/bulging disk/ruptured disk...". What they're not telling you is that studies have shown false positive rates of up to 44% for MRI in the diagnosis of herniated disks. Also we are finding that so many structures in the back can refer symptoms down the legs, that's not always the most accurate measure either. Finally, high quality clinical studies have also shown that long-term benefit of surgery is no greater than conservative treatment.

Basically, what I'm trying to say, is that surgery should always be the LAST option. Unless you have the red-flag symptoms (incontinence, numbness in the groin...), which it doesn't sound like you do, then you really should seek physical therapy first. If that fails, then consider your other options.

BTW, my other favorite is "I was told I have Degenerative joint disease (arthritis)". There is such a stigma placed on this term. Lots and lots of people have arthritis/DJD and never even knew it. They continue to lead healthy, competitive, active lives. Don't let these buzzword bring you down. You are not limited by your "diagnosis".

---

Dan Hollingsworth

Nobody grows old by merely living a number of years. People grow old only by deserting their ideals. Years may wrinkle the skin, but to give up interest wrinkles the soul." - Douglas MacArthur

There is not always relief of the pain from the surgery, and lots of people with little or no problems have bad discs.

Get another opinion.

If surgery, there is an option which I know little about. It involves needling the disc and sucking it out, possibly using enzymes to soften it. Since I'm a pediatrician, my patients don't need these procedures, so I don't keep track of the particulars.

I have had recurrent back pain since 1969. It does much better since I started using suspenders (braces) and better still since I began lifting weights.

---

_________________
Dick

Take everything I say with a grain of salt. I know nothing.

There was a procedure tthat was in vogue in the late 80's that involved using what was essentially a form of hyaluronidase to dissolve the disk. I dont' remember exactly what the compound was however. The big drawback was that it occasionally leaked and you would wind up with 'other things' getting dissolved.

If surgery is necessary, find someone who knows how to do it without having to fuse your back. The best neurosurgeon I ever had the pleasure of scrubbing with (in my surgery residency days) used a microincision and did his discectomies without having to rip out half the posterior stabilizing structures. His patient's did remarkably better than his partners/colleagues too.

All surgeons are not created equal.

---

_________________________________________________
That is just one more group of people that should be thrown screaming from a helicopter- George Carlin