Pain has gone away! (But I still have a tiny bit of occasional numbness in foot) I was OK to workout before the shot even with all the other symptoms.
Just curious what others have experienced as far as when to return to workouts. The Dr that did the shot said “take it easy” slowly return to normal activity, he has no concept of my “normal activity” even injured includes 6-8 hours of cycling and 3-4 hours of swimming! He didn’t seem to grasp that
I’m a STer/Anesthesiologist/Pain Physician (order depends on time of day) and take care of people with disk herniations everyday. Interestingly, I have only a few runners or triathletes with back pain bad enough to see me.
As for you it really depends on the details of your disk herniation. Is it a true herniated nucleus pulposus? just a bulging annulus? maybe another cause of back pain and a coincidental finding of degenerative disk disease? There is no real data dictating best practice here. In general I tell my patients that they can do what doesn’t hurt. Running and weight training can be problematic in theory because the increased spinal load can squeeze more of the nucleus pulposus out of the disk. I would definitely avoid heavy weight training for 3-6 months. By heavy I mean things like deadlift, squats, military press, heavy bench press, leg press etc. Swimming should be fine once the puncture wound heals after injection, IF IT DOESN’T HURT. Same for cycling. Running I would suggest 4-6 weeks rest, then a gradual resumption of running. If it hurts it probably isn’t good for you.
I just got a caudal epidural for a herniation of my l4-l5 to reduce the swelling/pain.
What was your experience with returning to training? My doctor treats athletes and mentioned that as long as I don’t do much intensity (no LT training), I could swim tomorrow and bike Saturday but not run off the bike until day 5. My main problem is that I go into severe spasm when I transition off the bike and it shuts my legs down completely.
Pain has gone away! (But I still have a tiny bit of occasional numbness in foot) I was OK to workout before the shot even with all the other symptoms.
Just curious what others have experienced as far as when to return to workouts. The Dr that did the shot said “take it easy” slowly return to normal activity, he has no concept of my “normal activity” even injured includes 6-8 hours of cycling and 3-4 hours of swimming! He didn’t seem to grasp that
I am seeing my PT tomorrow and my doc next week.
What did you do?
If the pain has gone away then I would ramp it up slowly and see what happens. I have done thousands of these and there is no magic number. If the pain is gone, it is gone. If you are better and your pathology is mild you will probably not have any further problems unless you do something stupid. If the problem keeps coming back regularly, then you will probably need some kind of surgery.
Well, as you know Tiger, I ended up with the surgery. Microdiscectomy 2 levels… THE BEST THING I EVER DID!
I am two months now post op, I was walking around next day. Walking 3-5 miles by first week. I have been swimming and cycling since about 4 weeks out. I started running about two weeks ago, NO ISSUES. I ran four mile today, nirvana I have been going slowly, I am at only 10-12 miles a week now and I will stay there for a week or two more and keep ramping up. I run 3x a week.
I started with just light cycling and then swimming, then I mixed in 1 hour sessions on the stairmachine to replace where I would normally run. At first 10 minutes run/ 50 minutes stairs. Now I am at 10 minutes warm up Stairs/ 40 minutes run/ 10 minutes stairs cool down.
I am careful not to get to far ahead of myself, I have a ways to go, but I am so glad to be training again. My doc and PT are crazy happy for me, and say that they are very impressed with my progress.
My Dr have agreed that I am cleared to do a fall marathon if training permits. I am doing about 8 hours a week training right now, with running taking up the smallest portion.
THERE IS HOPE.
I am actually going to repost this as an update for those who are hurting.
i’m 60 had a facet block couple of months ago and it worked great on side of spine shot was given ( no increase in range of motion…i can flex all day but cannot extend very well).
however the other sideof spine is still sore and painful…
i have a question or two…how much of an area is the facet block supposed to help…just the side administered or the entire plane of joint…
what’s difference between epidural steriod injection and a facet block
Uhhhhh, I had to have surgery Mr. Not trying to be a Jerk. I was never able to return to workouts.
That is the nature of the shots, they do work for some, but not others. If you notice, I didnt exactly get a ton of responces to my original post.
I am not trying to be a jerk either, I just figured since I didnt have anything kind to say…
Ohhh, see I didn’t realize that. I did remember that you had surgery but thought maybe you gave it a shot first (pun intended) and could offer some feedback. Sorry for the misunderstanding, that was my mistake. Glad to hear you’re doing better, another reason I bumped the thread instead of going with a PM was to see if anyone else had experience, but I guess not.
The first shot (I had two) worked for a week. I never really had a chance to do much though because I “re-herniated” a second disc that was bulging, causing me to experience the most horrible three weeks of my life waiting for surgery.
I think if I had just the one disc issue, the shot would have been great. After the surgery the Doc said the first one had pretty much cleared up on its own.
i’m 60 had a facet block couple of months ago and it worked great on side of spine shot was given ( no increase in range of motion…i can flex all day but cannot extend very well).
however the other sideof spine is still sore and painful…
i have a question or two…how much of an area is the facet block supposed to help…just the side administered or the entire plane of joint…
what’s difference between epidural steriod injection and a facet block
thanks
Facet blocks are more “focused”. I never liked them because I didn’t feel I was smart enough to know exactly where the problem was nor good enough to put the medicine exactly where the problem was, if i thought I did know. I know of zero data to suggest facet blocks more efficacious or offer less risk than epidural steroid injection in solving these problems. The need for x-ray/flouro does allow everyone to charge more though and puts everyone (including the doctor) at slightly more risk from the radiation. (can you tell I have some pretty strong feelings on the subject?) Epidural steroid is sort of like taking a shot gun to the situation. sort of gets everything with something that is very easy to do technically. Plus, you can do a couple of other things at the same time if you need to.
I had the injection in early April and was told I could resume “normal” activities the next day, but to delay running for 3 days.
I had no pain for about a week, but then it came back and now it is a bad as ever.
I tried running only on grass, now am reduced to water jogging only. Swimming a lot and biking enough, but at low intensity. I was able to run enough to do MIM, but was 30 sec off my pace from last year.
Now I am seeing a very aggressive ART/chiro (also an IM) and getting 2-3 treatments a week for the past 3 weeks. Still hurts.
Is it worth trying another injection? The pain is only bad when I push on the bike, try to run or sit for long periods…it wasn’t so much the pain that got me to the Doc, it was the weakness in my leg.
I am soooooo confused. Nobody seems to give me a conclusive plan of treatment…is it just that there isn’t one?
My understanding is that in a facet block the nerve there is “burned” to deaden it. Facet blocks supposedly work in 2 out of 3 people and last from 3-6 months. Unlike nerve root blocks that are more permanent, the nerves in the facet joints are small and will “grow back”—to put it in very “simple” terms. Cortisone shots do not “attack” nerves—more to reduce inflammation.
The facet block should just be helping in the specific joint–so just on one side.
Your range of motion should not increase necessarily, just that movement should be less painful.
Facet blocks can be used to treat arthritic symptoms–so when the pieces and parts of your spine start to get calcifications on them and the joints narrow and put pressure on nerves.
I think most of the people in this thread are talking about using epidural cortisone treatment for disc bulges and herniations that are affecting the nerves in their arms (C discs) and legs (lumbar discs).
Maybe there is a anaesthesiologist that can jump in here and provide a much more informed answer than me!
-Danielle
I had the injection in early April and was told I could resume “normal” activities the next day, but to delay running for 3 days.
I had no pain for about a week, but then it came back and now it is a bad as ever.
I tried running only on grass, now am reduced to water jogging only. Swimming a lot and biking enough, but at low intensity. I was able to run enough to do MIM, but was 30 sec off my pace from last year.
Now I am seeing a very aggressive ART/chiro (also an IM) and getting 2-3 treatments a week for the past 3 weeks. Still hurts.
Is it worth trying another injection? The pain is only bad when I push on the bike, try to run or sit for long periods…it wasn’t so much the pain that got me to the Doc, it was the weakness in my leg.
I am soooooo confused. Nobody seems to give me a conclusive plan of treatment…is it just that there isn’t one?
G
I would do a series of three injections, usually about a week apart. If the patient was better but not “cured” I would extend the series up to 6 or so as long as improvement was being seen. (you can’t do them forever because of the risk associated with chronic steroid use, short term use is pretty benign).
Weakness is a more serious sign than pain. If you got improvement in the weakness after the steroid injection then I would try some more. If you didn’t, you might try one or two more but surgery is probably in your future. Don’t delay too much until the weakness/nerve damage becomes permanent. You need to see a doctor experienced dealing with this stuff.
I am soooooo confused. Nobody seems to give me a conclusive plan of treatment…is it just that there isn’t one?
G
I might add. There is no conclusive plan of treatment. What will happen will depend a lot upon your symptoms, how you respond to what is tried, your long-term goals (not every patient is trying to get back to running) and the experience/bias of your doctor. Even if you end up needing surgery, there are about 10 different surgeries that might be done for this kind of problem. You need a doctor you can talk to and that you trust. If your doctor does not seem to be responding to your needs be sure to ask for a second opinion or, even, third opinion.
thanks for response and tip of hat to pedergraham too.
frank, i do own powercranks and they have helped my pedal stroke and i believe have helped me keep some running form despite bad back. keeps both legs, hip flexors, etc honest.
my facets are acting up again. not major pain compared with past episodes, but don’t want to make worse. how many epidural shots can one take before there is a corrosive reaction? you mentioned a shot every week for 3 or so and maybe more. or did i misunterstand? the reason i ask is my podiatrist many years ago gave me injections for mortons neuroma, but said he could only do a few before more damage than benefit.
anyway, going to chiro to see if he can help. if that does not work, then back to doc for maybe some more shots? i got one on left side dec 07 and one on right side in jun 08 so they are pretty widely dispersed time wise.
any other approaches to facet joint problems?
ps i know you take a lot of grief about PCs, but after last jun08 injection i competed in sprint distance tri and finished 3rd in age group at fairly large race in aug08. and in october finished 1st (ag)in 5k in decent size race. all this with very low mileage running max 10 miles/wk but supplemented by using lemond revmaster with pcs 3-4 times a week.
