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MRI lower back scan result: disc between L5 and S1 gone....
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Hi again...its been a very long time since I've come on the forum as im going through back issues that have kept me away from the sport for a long long time......so, to cut a long story short I had an MRI done and they tell me the disc between L5 and S1 is gone...."obliterated" my doctor said rather dramatically....so it grinds and thus the inflammation I feel......

.......so what now....he reckoned its up to me to decide how much it affects my daily life and thus the course to follow will be determined by that.......

so how does it affect me you will ask.....well, i wake up in the mornings like really really stiff.....I dont have pain as such but like the feeling that im stuck down there and I need to be pulled apart so to speak.....the main symptom is my right hip i would say.....

so anyone have any advice to offer me????? looks like running is out.....I cycled in this morning and its there nagging at me all the time but not painful if you see what I mean.....swimming....well, I guess thats the only one that i can do really......what about yoga will that help?????? or will i make it worse by trying to bend the spine...as stupid as that sounds.....dunno....im in limbo here......

Stephen Perera
Gibraltar, Europe
graphics@gibraltar.gi
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Re: MRI lower back scan result: disc between L5 and S1 gone.... [sperera] [ In reply to ]
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Ah, a fellow bone-on-bone! I found out just a year ago that I had no disc left between S1 and L5 and seriously degenerated vertebrae. I never had back pain, but stabbing pains in my left hip, glute and hamstring........it felt like my hamstring was just going to rip apart. Ortho and spine docs in DFW told me I was done and that runnning was not an option. After 13 years in the sport, I was devastated. I did Memphis in May '08 as my retirement race.

However, I searched around and found Doc V......Alan Villavicenzio (http://www.bnasurg.com/villa.html) who did Simon Lessing's back surgery. After several phone calls and records sent back and forth, I went to Boulder and had a two level microdiscectomy on Aug 4th. V is a sub-10 IM guy who told me that "of course I could run again".

I followed a very slow build-up and took my time getting back, but am pretty much pain-free both in everyday life and training. I still have some weakness in my left leg and definitely more back pain, but nothing compared to before.

I just did my first race since all this started, Memphis in May (of course), and was shocked to win my AG another time. :-D I am told a fusion is inevitable, but when is dependent on my pain tolerance........for now, I am good!

I have a friend who had V do her fusion surgery a month before mine and she just PR'd by 4 minutes at the FL 70.3.

We call ourselves Team V!

Let me know if you need further info or just a pep talk!!

G


It's a little like wrestling a gorilla.........you don't stop when you're tired.........you stop when the gorilla is tired.
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Re: MRI lower back scan result: disc between L5 and S1 gone.... [gleveq] [ In reply to ]
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thanks for this......

the thing with me is not pain but discomfort....like a feeeling of needing to be unjammed.....and the major symptom is being really really stiff in the mornings or if im on the sofa too long or whatever.....

the stage Im at with local doctors is they referring me to some specialist who will give me his opinion....they were quite open to the fact diff people will have diff opinions on it.....

so till then i guess I have to live with it......you say eventually the L5 and S1 will fuse?

Stephen Perera
Gibraltar, Europe
graphics@gibraltar.gi
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Re: MRI lower back scan result: disc between L5 and S1 gone.... [sperera] [ In reply to ]
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Your spine will eventually fuse itself once the disc is gone. My Mom had this condition and didn't even know it until she had x-rays and was told...We think it began in her 20s during her 2nd pregnancy when she experienced a lot of ongoing backpain.

Don't give up hope for your athletic career. You will lose some lower back flexibility but it doesn't need to slow you down in triathlon. You may end up being a bit more rotated forward on your seat than before, so more of a challenge getting comfortable on the soft parts.

If you don't already you will now need to transition to being a forefoot runner. See 'Pose' running and as you are able to begin running again this is the way you need to do it. I'm a degenerative disc patient (since the tender age of 20...22 years going now) and the difference between my old heel striking and my current forefoot striking is...well--striking!

Don't let a Dr. convince you that your running days are over.
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Re: MRI lower back scan result: disc between L5 and S1 gone.... [sperera] [ In reply to ]
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Yes, I understand the stiffness, and I have that, but it is nothing compared to the previous pain I had. I couldn't sit or drive for any length of time without pain and running, especially, caused the stabbing pains in my glute and hamstring. I tried ART, chiro, steroid injections, massage......all of it......with no results.

I never had back pain, but was told that it was probably masked by the other pains. Now that they are gone, I do notice more stiffness and achiness in my lower back. But that is very tolerable.

I have been told that I will eventually need surgery to fuse the vertebrae which will provide some space between the bones for the nerves to run through (at least that is how I understand it works). Right now it is virtually bone against bone at L5/S1 and there isn't much to be done about that except fusion. If and when that time comes, I will go to see Dr V. I guess my tolerance for pain will be the determining factor and I am not even close to that yet.

V said that I was not a classic case, as I didn't have a simple herniated disc, just a real mess of crap going on and a degenerative condition. It was not just a take out the part that is hitting the nerve, more a general clean-up of the entire area. I don't really care......it worked and I am training and racing again!

I was pretty discouraged when I was diagnosed and I thought my time as an athlete was over, fortunately, I found a Dr who was able to help me.

G


It's a little like wrestling a gorilla.........you don't stop when you're tired.........you stop when the gorilla is tired.
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Re: MRI lower back scan result: disc between L5 and S1 gone.... [gleveq] [ In reply to ]
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thanks guys appreciate it......Im feeling really despondent at the moment and I'm moping around here when i should be working....i'm in like a purgatory......I don't have any pain that id associate with nerve issues so at least....but the discomfort is there and getting outta bed im way stiff......the problem is not present sitting down on my Aeron chair working (im a designer) so at least its not like its stopping me from work.....but gardening.....WOW that really really aggravates it!!!!!! In general i find the less i do the worse it gets though.....meaning is im sat around at home as opposed to doing things on my feet etc etc......but running (we only have concrete around here really....running on the beach is not comfortable) is uncomfortable as i feel really tight down there.....it kind of feels like that pressure you get when you have a toothache but its not like pain but pressure.....its like i ant someone to pinch me and let the pressure out to get relief.....

Stephen Perera
Gibraltar, Europe
graphics@gibraltar.gi
Last edited by: sperera: May 21, 09 6:41
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Re: MRI lower back scan result: disc between L5 and S1 gone.... [sperera] [ In reply to ]
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Since you're only talking one level, if it comes to surgery consider an artificial disk
instead of fusion.

Pros:
No loss of flexibility
Doesn't just transfer the load to the adjacent disks

Cons:
Newer technology
Not proven to be better for pain than fusion or therapy (I think, haven't read
all the studies recently)

Good luck.

-Jot
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Re: MRI lower back scan result: disc between L5 and S1 gone.... [gamebofh] [ In reply to ]
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thanks for the information everyone....much appreciated...Im sure there will be more people commenting as the days goes by.....hopefully.....yesterday i did a Forrest Gump in frustration, I told my wife i was walking down to her, she was going to the supermarket, and i ended up walking into Spain and about 11 kms later she picked me up in the car.....we're in Gibraltar and we go through a frontier (passport checks etc) to go into Spain.....

Stephen Perera
Gibraltar, Europe
graphics@gibraltar.gi
Last edited by: sperera: May 21, 09 23:39
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Re: MRI lower back scan result: disc between L5 and S1 gone.... [sperera] [ In reply to ]
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sorry to bump this up but id like as many people to comment as possible.....

Stephen Perera
Gibraltar, Europe
graphics@gibraltar.gi
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Re: MRI lower back scan result: disc between L5 and S1 gone.... [sperera] [ In reply to ]
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hey Stephen..my wife is really curious to see this..can you post a picture of your MRI or send it to kentiger at hotmail.com
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Re: MRI lower back scan result: disc between L5 and S1 gone.... [Kentiger] [ In reply to ]
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thats a very nice offer thanks so much....I will speak to the doctor and get hold of the MRI's......this forum is amazing...it really is.....it'll be some time next week when I can get them UNLESS he's already passed them on to a spinal specialist I'm being referred to as the next step.....

......regardless I WILL take you up on your offer as I want your opinion of course!!!!!!!!!

......the main thing I'm looking at now is how to get round it and do some sports....running is definitely out cos it is uncomfortable as I said.....pushing off the wall in the pool is not good either......biking seems ok when i dont have to push hills i guess......

so can anyone advise me on what to avoid specifically in order not to grind the L5 and S1.....gardening, as i said is a killer....bending down etc like taking out weeds and stuff is a no-no.....funny that, as im not applying much force, its just the position.....thankfully, sitting down at work is fine, no discomfort at all.....almost like its in the perfect no-contact position or something......

what i cant get my head round is how can it be possible I have no disc left and at no point in time have I keeled over in pain etc.....could it be like the analogy of the fish in the goldfish bowl who's water temp is turned up and up over a long period of time and they don't notice it and get used to it.....new goldfish is inserted and he goes "what the f***k, this water's too hot"....well, thats what they'd say if they could talk....hahahahahhahaha....yes I am losing it......when the doctor told be my disc has been "obliterated" I even felt nausea......

Stephen Perera
Gibraltar, Europe
graphics@gibraltar.gi
Last edited by: sperera: May 22, 09 5:12
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Re: MRI lower back scan result: disc between L5 and S1 gone.... [sperera] [ In reply to ]
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For me, I went in for hamstring pain and hearing the doctor say "I don't see anything there, but let's talk about your back pain" was a complete and total shock. I had NO back pain. Then he proceeded to show me the bone-on-bone at S1/L5 and the herniation at L4/5. Who knew?

I still do not have what I would consider to be significant back pain.......more a sense of tightness or stiffness.

I do think of the "grinding" aspect of it and wonder what the long-term affects of continuing to S/B/R will be, but for now, thanks to a great surgeon, I am doing 100% better than pre-surg.

I have done some yoga and pretty inventive core work with no issues. What bothers me most is riding in strong winds and swimming with a pull buoy.

I know what you mean about visualizing what is going on back there........kind of like driving a car you know is ready to fall apart and wondering when, not if, it's all going to hell. ;-)

G


It's a little like wrestling a gorilla.........you don't stop when you're tired.........you stop when the gorilla is tired.
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Re: MRI lower back scan result: disc between L5 and S1 gone.... [gleveq] [ In reply to ]
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It's funny you say that about riding in strong winds, that makes my back flare up too.

I have a compression fracture of my L3 vertbrae (I think that's the one). The fracture is pretty symetrical and healed well, the discs on both sides seem fine as well. I ride a pretty low position on the tri bike and honestly, being stretched out in the aerobars feels very comfortable. But anytime I am grinding, either up a hill seated, or particularly into strong winds, the tightness/pain flares up.

My pain really isn't symmetrical, it's on my right side, I don't think it's my glutes, but not my lower lats either. It's my lower back, to the right of my spain, just above my glute.



Portside Athletics Blog
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Re: MRI lower back scan result: disc between L5 and S1 gone.... [sperera] [ In reply to ]
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I don't think running is out and don't buy the you need to run pose stuff either.

I have a disc herniation and it's no worse with running. In fact it's better to keep moving. Don't stop. Swimming helps. Use a kick board and kick a lot. It strengthens the core.

Try yoga but be very careful with forward and back bends. Finding a skilled teacher is key. Don't give up on triathlon just find more balance in what you are doing. Your back is telling you something. Time to listen.
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Re: MRI lower back scan result: disc between L5 and S1 gone.... [SwBkRn44] [ In reply to ]
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From what the docs tell me, that is referred pain. Mine is worst on the left side just above my glutes as well. It can be annoying, but is nothing like the hamstring/glute pain before surgery.

The consensus was that I didn't notice the back pain before because the other stuff was worse and took precedence.

Riding in strong winds is the worst!

G


It's a little like wrestling a gorilla.........you don't stop when you're tired.........you stop when the gorilla is tired.
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Re: MRI lower back scan result: disc between L5 and S1 gone.... [gleveq] [ In reply to ]
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None of the docs I saw suggested surgery because the fracture is pretty clean and the discs on either side seem fine, so I am not sure what surgery would do as there isn't really anything to do surgery on (other than some procedure of using a giant needle to put a bag in the vertbrae, inflate it to restore the height of the vertbrae and then fill it with cement...no thanks).

Any suggestions on what to do for the referred pain? Stretch the area that hurts, or is that useless because it is referred pain? My pain/tightness will radiate down into my right glute if I am riding hard. Running is fine, can run 50+ miles a week with no issues at all, just wish I knew what it was like to ride without back pain. I have a ton of fun riding and was thinking yesterday "Man, this must really be a blast for people whose backs don't feel like they got hit with a baseball bat." Sitting in the car for long periods of time will make that same area, right side, above the glute and then down into the hip, get tight though.



Portside Athletics Blog
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Re: MRI lower back scan result: disc between L5 and S1 gone.... [SwBkRn44] [ In reply to ]
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some people with bad bike back pain have had great results with beam bikes.

something to try perhaps

In Reply To:
None of the docs I saw suggested surgery because the fracture is pretty clean and the discs on either side seem fine, so I am not sure what surgery would do as there isn't really anything to do surgery on (other than some procedure of using a giant needle to put a bag in the vertbrae, inflate it to restore the height of the vertbrae and then fill it with cement...no thanks).

Any suggestions on what to do for the referred pain? Stretch the area that hurts, or is that useless because it is referred pain? My pain/tightness will radiate down into my right glute if I am riding hard. Running is fine, can run 50+ miles a week with no issues at all, just wish I knew what it was like to ride without back pain. I have a ton of fun riding and was thinking yesterday "Man, this must really be a blast for people whose backs don't feel like they got hit with a baseball bat." Sitting in the car for long periods of time will make that same area, right side, above the glute and then down into the hip, get tight though.
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Re: MRI lower back scan result: disc between L5 and S1 gone.... [gamebofh] [ In reply to ]
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If it doesn't transfer the load, what does it do with it? eat it? There is minimal gain in flexibility that isn't proven to last forever and like you said it is new technology, weak at best.

Ride Scoozy Electric Bicycles
http://www.RideScoozy.com
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Re: MRI lower back scan result: disc between L5 and S1 gone.... [sperera] [ In reply to ]
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Same boat L5-S1 and L4-L5 both gone, plus severe arthritic spurring causing irritation of the Foramin. Was told last April and for a while just gave up, gained 20 pounds etc...

Swimming is no problems and I do it almost everyday now.

I found a good chiropractor who does the back decompression, I get it done every 2 weeks now and alternate the other weeks with a modified inversion table at home. I can run 3 to 5 miles now, slow but without pain, I don't speed up or go longer out of fear rather than out of pain.

Biking is still hit or miss if I ride really easy I am fine but if I try to push really hard I will get some pain.

I am going to try a sprint Tri soon just to participate and have fun not to race.
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Re: MRI lower back scan result: disc between L5 and S1 gone.... [msuguy512] [ In reply to ]
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If it doesn't transfer the load, what does it do with it? eat it? There is minimal gain in flexibility that isn't proven to last forever and like you said it is new technology, weak at best.

I wasn't clear.

When you have spinal fusion, you obviously no longer are applying load to that disk. However, the load that was
absorbed by that disk (that is their job after all) now will be absorbed by the disks on either side.

With an artificial disk it can continue to absorb the load, and thus not add load to the adjacent disks.

Does that make more sense? (Not arguing about the merits of the procedures or technology, just
the pro vs. con)

-Jot

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Re: MRI lower back scan result: disc between L5 and S1 gone.... [gamebofh] [ In reply to ]
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I don't think you are using the word absorb properly. Whether or not you go fusion or disc replacement the device isn't going to absorb any load. Metal/metal or metal/UHMWPE isn't going to flex/heat and dissipate energy, it will still transmit it to the adjacent vertebra/discs. I think you mean that a disc replacement should maintain original kinematics. The problem is the disc replacements do not match the original kinematics of the spine so the loads/kinematics will be altered regardless.

Ride Scoozy Electric Bicycles
http://www.RideScoozy.com
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Re: MRI lower back scan result: disc between L5 and S1 gone.... [mikeran] [ In reply to ]
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I was told, by the chiro that would have made $$ off of me, that decompression was not an option because there was no disc left to decompress. So much for that.

If the pain is radiating into your glute or down your leg, it is most likely nerve (radicular) pain caused by the nerve root being impacted at the point where it leaves the spine (at least that is how I understaind it). This is what I had and it was worse when I ran or rode with any intensity. Finally, I was unable to run without pretty significant pain.

After the surgery, I was swimming in 3 weeks, riding in 6 and running in 12. All easy and slow for a few months. Just started adding intensity about 6 weeks ago and completely understand the fear that comes with that. I finally entered my "decision-making race"......the one after which I would either continue racing or retire. I was very unsure about how it would go as I had only started to push my body into the "scary" zone.

Happily the race went well and I am optimistic about the future. I take Omega-3's and vitamin D religiously and have found that my need for anti-inflammatories has decreased greatly. I didn't even need any post-race or during the 8 hour drive home.......something that would have been unthinkable prior to my surgery. It even seems to help with the referred pain.

I still have some numbness and a little nerve pain in my lower left leg and foot, but it is pretty minor and very tolerable. When I push hard on the bike, my leg will "buzz" or tingle and I definitely notice some weakness in the leg when running. But again, nothing horrible and certainly tolerable.

Everyday life is much less painful as I can sit and drive without issues.......that was not the case before surgery. Compared to where I was last February........things are pretty good. :-)

G


It's a little like wrestling a gorilla.........you don't stop when you're tired.........you stop when the gorilla is tired.
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Re: MRI lower back scan result: disc between L5 and S1 gone.... [AeroWeenie] [ In reply to ]
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Wow, this really hit home for me. I was hit by a car on my bike July 06. Compression fx of L4, multiplt fx of cervical spine, I was very lucky. I wore a back and neck brace for 6 months. Now, 3 yrs later, most of my issues are lower back pain on the bike. I can run/swim pain free, but after about an hour on the bike , I am really uncomfortable. It is much worse in the wind, and I guess I have some company with that. I am competing again in all distances, but needless to say the longer races/ rides are not as much fun as they used to be. I do think yoga helps , I do hot yoga once a week, and pilates 1-2 times a week. I also have an inversion table , which I think helps but I am not real good about using it a lot. I was also told post accident to have the procedure where they inject cement and bone into the spine to give it height, but I also said no thanks to that. So ,I do a lot of strength training, trying to get the back stronger..and keep hoping that the pain will ease up, my goal for my 3rd Ironman ( Florida), is to ride pain free...any advise would be awesome!!! Good Luck!!!!

It could always be worse.....
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Re: MRI lower back scan result: disc between L5 and S1 gone.... [come back kid] [ In reply to ]
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Sounds like you and I are in the exact same spot (I think maybe you meant to reply to me).

My compression fracture is L3 I believe. Running and swimming is fine, but cycling gets uncomfortable after about an hour. I guess there is no magic bullet in terms of a cure, just being diligent about stretching, strengthening, etc.

Being that things get tight after about an hour my desire to do IM distance has kind of faded, have been enjoying training for Half-IM and shorter though as long rides of 2-3 hours are much more comfortable than 5-6 hours. Also, just bought a full-suspension mtn bike and have got into mountain bike a bit and have been enjoying that as well and there is almost no pain there, nice to be able to ride, do some different stuff and have less pain.



Portside Athletics Blog
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Re: MRI lower back scan result: disc between L5 and S1 gone.... [SwBkRn44] [ In reply to ]
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ill bring it up again in case any missed it

but Jurgen Zack actually bought out his quintana roo sponsorship so he could ride a softride because it transformed biking for him and his problematic back

a titanflex or similar might be worth looking into for you guys
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