I’ve been struggling with some “moderate to severe” low back issues for over two years now. It flared up in a major way most recently five days before Ironman Canada and I’ve spent every day since trying to get a handle on whats going on and how to appropriately treat it (and i’ve done everything - PT, massage, acupuncture, prescription meds, etc). The MRI revealed that I have a moderate bulge in the area of my L4/L5 and an excessively curved sacrum (congenital or so my ortho believes). The symptoms/side affects of this are numbness/tingling down the back of my leg and into my foot as well as general tightness in my low back area (primarily on the side of the bulge). Sitting all day at a desk doesnt help all of this. I’ve been doing physical therapy as well as work on my own all while taking Celebrex as an attempt to bring down the inflammation in the area. I’ve not been SBRing since after Canada until recently when I was cleared to ride and swim again as long as no acute pain was associated with either activity.
The problem is, things arent getting any better. The celebrex doesnt seem to be working. PT, which I know isnt an overnight thing, isn’t providing any relief. Just had a follow up with my ortho today and he said that we should now consider an epidural of cortisone directly to the area of issue.
Does anyone have similar experience? I’m concerned that this will become a routine thing - having to get multiple injections a year. And I dont necessarily want that. I’d like to get this “figured out” without the use of injections. Thought thats seeming to be near impossible. I still plan to continue PT and slowly inch back in to SBRing. But just wondering if anyone else has went through a similar issue, has any opinions on epidural injections, etc. Thanks in advance…
I had similar issues but at L5-S1. I did have the cortisone injection, which had absolutely no affect. I experienced sever pain/numbness in lower leg and foot. I also started to “trip” due to the foot numbness.
That lasted for 8 months. I had traction 1x per week for 2 months ( felt great afterwards but within an hour the pain was back). I religiously did the McKenzie abdominal strengthening as well as stretches aimed at getting the herniation to slip back into place. All with no luck.
I was able to run and my Ortho supported that (I actually did an 8 mile run the day before surgery). The only time during the day that I was pain free was during my runs. Could not bike, and swimming also caused pain.
After 8 months of sever pain I could no longer tolerate we decided on surgery. I had an arthroscopic “discectomy”, basically the protruding portion of the disc is trimmed and the disc then recedes back where it belongs. When I woke from the procedure I was totally pain free, as if a switch had been turned off. I had the surgery almost 10 years ago now.
I have had no occurrence and my back feels great. My doctor had me wait the 8 months as he felt that it was a much better situation if the disc receded on it’s own.
Wow. Very interesting. Thats essentially the same thing I experience - though I’ve not lost any strength in my affected leg. And similar to you, while running/walking, is when I feel best. Almost unnoticeable. Its the worst while seated actually.
I’m really hoping that surgery is not needed. Needles and continuous injections are enough for concern - let alone surgery. I wonder how a herniation differs from a bulge as far as treatments go? Meaning, could you even operate on a bulge in the way that was done for your herniation?
The surgery was not bad at all for me. The procedure was just about an hour (or less). I stayed overnight in the hospital and was home the following morning. I was encouraged to walk as soon as I could by the Dr.
Surgery was on a Thursday and I was back at work by the middle of the next week. I started running 4 weeks afterwards. I did spin easily for maybe 30 minutes at a time by 3 weeks.
The surgery was not bad at all for me. The procedure was just about an hour (or less). I stayed overnight in the hospital and was home the following morning. I was encouraged to walk as soon as I could by the Dr.
Surgery was on a Thursday and I was back at work by the middle of the next week. I started running 4 weeks afterwards. I did spin easily for maybe 30 minutes at a time by 3 weeks.
Good luck to you!
I’m not so certain that part bolded above is true. But regardless, it sounds like if I get to a point where the injections arent working that a surgery such as the one you received might not be as bad of an option as I previously thought.
Yes it’s true; herniated, bulging, pinched nerve, sciatica, all the same thing. I’ve had the injections about three times and it worked like a charm. It’s painless. The doc numbed my back and the next thing he was finished. It doesn’t mark for everyone but if it does its wonderful. It also doesn’t heal anything, it just removes all the inflation. My doc told me “you should feel relief in 36 hours”. I could have set my watch, right on time the pain went away.
Yes it’s true; herniated, bulging, pinched nerve, sciatica, all the same thing. I’ve had the injections about three times and it worked like a charm. It’s painless. The doc numbed my back and the next thing he was finished. It doesn’t mark for everyone but if it does its wonderful. It also doesn’t heal anything, it just removes all the inflation. My doc told me “you should feel relief in 36 hours”. I could have set my watch, right on time the pain went away.
This is one of the primary points I’m struggling with. There doesnt appear to be a clear path to “healing” what ails me. Only managing the symptoms. I want to fix the root problem. But apart from PT and general strengthening/lengthening exercises, there doesnt seem to be much else I can do in that regard.
I’m not a fan of injections to remedy lower back issues. I’ve had numerous epidurals which provide temporary relief, but are paid for at a later date. I’ve been able to successfully manage pain through core strengthening and flexibility.
Had it on three different occasions. First time I had all three injections. Second time I only needed two. Last time I needed just one injection. Started tri training as well and haven’t had a problem since. Probably five years now. If I don’t SBR my back kills me. Go figure since the doc said I should not run. I feel for you. Good luck.
After 8 months of sever pain I could no longer tolerate we decided on surgery. I had an arthroscopic “discectomy”, basically the protruding portion of the disc is trimmed and the disc then recedes back where it belongs. When I woke from the procedure I was totally pain free, as if a switch had been turned off. I had the surgery almost 10 years ago now.
I have had no occurrence and my back feels great.
I could have written this same exact thing.
@wsrobert - IIRC you are in NY, correct? While surgery is different for everyone, like rayman, it gave me my life back 10 years ago. I’m forever in the debt of this man: http://weillcornell.org/physician/eelowitz/
If you need surgery (and only you will know) he’s the man in NYC. Good luck. I know your pain.
First round of cortisone shots, ineffective. It was very discouraging. Next round, the sciatic pain in my lower leg went from pain to numbness to gone. Thank God. It was 4 months and 600mg of Advil 3x per day.
I’m pretty certain I did it from piling on too much weight doing barbell squats. Then what do I do? Oh, let’s go for a run. Let’s run the snowmobile and groomer to ski. Ooof. too much clumsy lifting for a skinny kid…make that skinny old man.
I’m 6 feet tall and walked around at 5-6 for 8 months and wanted to die.
Each shot helped a bit until the 5th and it was much better and after 4 weeks took the 6th and was 95% and remain there other than if I do something stupid like lift 60 pounds.
I am in NYC. I’ll give him a look. I’m seeing Dr. Neely at NY Sports Med right now. And have been happy thus far. We havent had a convo about surgery yet. He’s been very conservative in terms of the treatment approach which I appreciate. I guess we’ll see how these injections fair and go from there.
I’m 6 feet tall and walked around at 5-6 for 8 months and wanted to die.
Each shot helped a bit until the 5th and it was much better and after 4 weeks took the 6th and was 95% and remain there other than if I do something stupid like lift 60 pounds.
This is encouraging actually. And sort of what I’m hoping for. Though preferably back to 98% before 6 rounds!
my many years of desk job combined with lots of biking for IM distances really made havoc of low back. i went to chiros and pts and really they never explained the true problem of the anterior pelvic tilt. despite cortisone shots (even tried prolotherapy) which helped temporarily i never really got on top of it until i worked on the tilt. many things on internet for it. best website for me is mobility wod. you can subscribe for one month at under 10 bucks and review tons of material. the best for me is using an elastic band from pole to around my leg and working extension of leg. the psoas and tight hip muscles are my main culprits and at it requires constant vigilence. and with back pain your glutes can shut down too. so you have to get those suckers firing again.
i had mris that showed bulge in l4-5. over time it subsided and the facets were causing some sharp pains until i got the tilt mitigated. i had honest doc that wasn’t very high on surgery for my issues. i was tempted to try the surgery route and now am glad i followed his advice. but it took several years before i hit on the routines that best addressed my issue. i tended to early on overdue it trying many different exercises and stretches. had PTs that really weren’t that good despite good credentials. good at trying to milk it though.
most of my pain was horizontal along the iliac crest. had brief spell where it did hurt down one thigh in the front.
my issues started at age 55 and now at 65 my back is much better though as one ages you naturally get some disc degeneration.
Had back issues for years (herniated disc). Did the PT thing, did the injections then finally surgery. The injection did help for about 9 months and then the pain started again. Surgery was a success. As soon as I woke up from surgery the pain was gone. I was hesitant about the surgery as well, but it was the best decision I could have made, no regrets so far. It has been one year since the surgery and besides a little stiffness at times the lower back is good.
To op, it might help you if you can consider treating possible muscle imbalance. Tight psoas, hip flexor, erector muscle and weak ab and glute can contribute to anterior tilting of pelvis. I would find reputable PT in your area and fix postural deficiencies due to muscle imbalance.
L4-L5 and two others as well. Ten years ago Orthopaedic surgeon gave me one shot. Worked like magic. Then he died. 4 years later I reaggrivated it. Found new orthopedic surgeon. He gave me two shots. Not working. I went to pain mgmt guy, one shot worked like magic.
Been about 90% since. Pain comes n goes but as long as I SBR (especially B) I feel good. I guess I’m like a shark-gotta keep moving. My cross to bear!
Moral of my story: make sure you get shots by a medic for whom it’s NOT in their best interest for shot NOT to work!
I’m going through a similar ordeal at the moment although the affected nerve in my back is affecting my left foot and impairing my ability to run. I’m also taking Celebrex, but the next step after that will be a round of high dose oral steroids. Then if those don’t work will be the steroid injections directly into the affected disc(s). I’m surprised your doctor doesn’t want to try oral steroids first, especially as you are not enthusiastic about the injections. Of course oral steroids come with their own list of side effects but it might be something to ask about.
