Low Back problem L5 S1

[Jersey mike]

If anyone feels like sharing their experience with back surgery I’m all ears, especially the low back area.

Ok so for many many years I’ve had a recurring issue with the low back mainly L4/L5/S1.

Surgical repair has been on my mind for a long time but heard many times wait until you really need it done, surgical techniques and science constantly change.

The latest flair up has been just over a week now running its typical course. Saw my chiropractor twice last week and finally went for X-rays yesterday.

The disc at L5/S1 is pretty much gone, chiropractor did a quick sizing on his computer and it showed about 3.1mm (probably less if he had to be exact) and the radiology report was written as moderate degeneration, chiro commented the disc is probably boarder line severe degeneration but the hips and pelvis look to be in excellent condition for the mileage.

So the next step is to see about some type of surgical relief. My understanding is low back, especially in this area is low risk for spinal cord or nerve damage from surgery.

Not sure how I feel about a cage, I’ve heard good and bad results and especially since my L4/L5 isn’t that terrific as well.

So anyone who feels like dropping a some comments I’d like to hear what anyone has to say and how long it’s been since any procedure, results and any recurring issues and any recommendations you may have.

Thanks, appreciate any feedback.

Mike

Edited to include; there has not been an MRI done yet. Going to let the orthopedic handle that.

[trout dude]

The Right Dr makes all the difference in this matter. I had back surgery on July 15th 2022   It was my second time for surgery on my back the first time was in 2004   This time I had a new Dr and he removed L4 and L5 and caged and fused my back    90% of the work he done was thru my belly and a small cut on my back to put some screws.  8 weeks later I was in North Carolina on the bike for the FCR that is a 625 mile ride and we did it in one day also rode all week and when we came home that day was 690 miles in one day from clover SC    It never felt so good to be pain free and I’m still there and I’m so thankful for my Dr.   My Dr stays up with new techniques and technology. So picking the right Dr is key   If you were close to Louisiana I would tell you to see  Dr Justin Owen Good luck and I hope this helps your decision and if you need to talk pm me and I will send you my number
Dennis AKA Trout Dude

[scooperhsd]

I've just finished my first year of herniated disc down there. I go to the chiropratic college health center 1-2 times  / week to stretch my muscles that parallel the spinal column - they are as tight as my string bass strings ! CHiropractic care got me moving again much faster than PT - it was amazing after that first adjustment (and I have an incredibly loose skeletal system - almost every joint is hyper-extended). I also have #10 rib with an unhealed fracture - that doesn't bother me much and is ever so slowly beginning to heal. Inspite of the chiro - I live on 2-3 doses of 1000 mg of Tylenol / day to keep the pain down to about .5 on the scale. The pain is ALWAYS there, and I can't slouch any more - it can be painful to straighten back up. I asked my current intern about surgery and his advice was wait as long as you can.

[robin]

i have had 3 back surgeries and the right Dr. makes all the difference and get away from the chiropractor at this point he might do more damage.
You need a good doc PM me mine is great but you would have to come up to north jersey.

[Serk]

Badly herniated L5-S1 and L5-L4 around 20 years ago. I could barely get off the floor for the better part of a month, most excruciating pain I've ever experienced.

Went to multiple doctors, some wanted to go straight so surgery, some wanted more conservative treatment.

Being in my early 30's helped as well.

What worked for me was massive amounts of Ibuprofen, physical therapy (The best was get on the ground face down, and do "girly pushup". Keep your hips on the ground, and push up and arch as far as you can and hold it, basically bending the spine back as far as it can.)

Also I got an inversion table which although the FDA says they're useless, I beg to disagree. When I have a flare up now I'll get on it for a bit, and pulling the spine apart gives things some time to "rest" and readjust; has done wonders for me.

Might still need surgery some day, but it's been managed with PT and basic stuff for the last two decades, so I'm hopeful.

[Valker Jr.]

So, February 13th I had a L5-S1 fusion done on my back because of intense daily pain due to a 5mm herniation and the disc being declared "dead" by my doctor. All I knew was either the pain had to end, or I was gonna make it end. After the surgery, the first thing I remember is only shadows and tunnel vision, but I could feel that the intense pain was gone.

 Now, almost exactly a month afterwards, the worst part is not being able to ride, or not being able to lift 1000 pounds and bend over, but the pain is gone. I had the after surgery pain, and my body getting used to the cuts and staples(43, btw) and having a stiffer back now. NOTHING COMPARED TO WHAT WAS BEFORE.

If you have a good doctor, and you're in as much pain as I was, I'd say do it. I'm also 31, and can't wait to go on many more rides in 5 months.

[Valkorado]

I'll be watching this thread.  Chronic lower back issues here, but stubborn as hell re: pursuing surgery.  A Grand Junction ortho saw me literally decades ago and after diagnosing that I have the gamut of deteriorating disks, bone spurs and arthritis in my lower back, he said putting off a surgery until later in life would be best.  He said I'm a likely candidate, and I'll know when.

It's getting to be later in life...  The rear ender I took on the bike a few years back hasn't helped matters and has incorporated my neck and shoulders into the mix.  The heavy snows this winter have gotten my attention.  Speaking of which, more big 'uns coming for us starting tomorrow.  Suckalablah.

Regarding inversion tables.  Like Serk mentioned they work wonders for many.  Years ago I invested in one, and it definitely did not agree with the mesh I'd had "installed" in a double hernia surgery years earlier.  I was not happy with the surgery to begin with, lots of pain and cramping since.  The pulling and stretching of the mesh from the inversion table was immediately noticable.  It hurt!  Just my experience and a FYI if you've had a hernia surgery in the past.

[Jess from VA]

Short of surgery is hydorcortizone shots.  And they can go in there and kill certain nerves (though I hear they grow back in time).

Walking helps low back trouble, with the steady left right bending the spine to and fro with each step.

I had a periodically symptomatic painful low back for many years.  It also gave me tingling in my right lower leg from time to time (from sitting in chairs too much).  But exercise, and not doing stupid lifting, bending, twisting has me symptom free for about 15 years.   

[cookiedough]

although no lower back pain,  I say if the pain cannot be relieved by exercises/stretching/meds, etc. and gets to be too painful to bear near daily, get surgery done regardless of age. 

One of these days (or years) I will get both hips replaced.  6 to 8 doses of acetaminophen per day takes the edge off for me, but just barely.  Long walks or heavy lifting or bending over is pretty much out though which annoys me.

[98valk]

high dose 4k mgs, 2 to 4 times a day will rebuild cartilage. add liposomal vitamin c and msm, along with the membrane that is along the inside of an egg shell.
avoid chondroitin, save your money, the molecule is too large to pass through the small intestine, provide nutrients so the body can make it itself.

https://draxe.com/nutrition/glucosamine/

Dr Bookspan for posture, building up back muscles etc. see is at temple

http://drbookspan.com/clinical.html

https://www.afpafitness.com/blog/bad-discs-and-sciatica

Dr Bookspan is a military researcher. Harvard School of Medicine clinicians have named her “The St. Jude of the Joints.” A degenerating disc, or one that is slipped (herniated) can be painful and frightening. Despite the fact that discs usually can heal quickly and easily, people are commonly told that a disc problem is a difficult and long-term condition.They are told to accept and “live with” pain and reduced ability. They may stay on pain and anti-inflammatory drugs for long periods. Recent news reports from Time Magazine and The New York Times quote spine specialists as saying that back pain is mysterious, and that commonly used modalities like acupuncture, strengthening, surgery, massage, chiropractic just aren’t working. However, the case is that back pain is usually simple to understand, and simple to fix without surgery or special beds or equipment.

God Bless.

Jeremiah 17:14
Heal me, Lord, and I will be healed;
Save me and I will be saved,
For You are my praise.

[scooperhsd]

although no lower back pain,  I say if the pain cannot be relieved by exercises/stretching/meds, etc. and gets to be too painful to bear near daily, get surgery done regardless of age. 

One of these days (or years) I will get both hips replaced.  6 to 8 doses of acetaminophen per day takes the edge off for me, but just barely.  Long walks or heavy lifting or bending over is pretty much out though which annoys me.

Ahem - the bottles I get from Sam's Club on the acetaminophen say no more than 4000 mg / day. I hope for your health you are not exceeding that without talking to your primary care / pain management specialist. You should certainly not be partaking of adult beverages with large amounts of acetaminophen .

[98valk]

although no lower back pain,  I say if the pain cannot be relieved by exercises/stretching/meds, etc. and gets to be too painful to bear near daily, get surgery done regardless of age. 

One of these days (or years) I will get both hips replaced.  6 to 8 doses of acetaminophen per day takes the edge off for me, but just barely.  Long walks or heavy lifting or bending over is pretty much out though which annoys me.

Ahem - the bottles I get from Sam's Club on the acetaminophen say no more than 4000 mg / day. I hope for your health you are not exceeding that without talking to your primary care / pain management specialist. You should certainly not be partaking of adult beverages with large amounts of acetaminophen .

aspirin is the safest to use

https://chriskresser.com/the-dangers-of-acetaminophen/

[svsteve]

I had l5 s1 surgery done in 1996 after herniating disc at work. I was 37 at the time. They went in through the back and just cut away the herniation to relieve pressure off the nerve that was pinched. 27 years later and no issues. It does let me know when I overdo things and starts hurting, but nothing like the extreme pain that comes from such an injury. I'm glad I had it done. No regrets. Good luck .

[Bret SD]

Had lower back problems on and off my whole life.. chiros.. weight training.. tried many things. Had to take Ibuprofin @800 mg daily when working at times, ( I do construction work as self employed). Nothing I tried helped long term.

Did barbell work through my 20's and phased that out mid thirties, concentrating on dumbbell work. It was more joint friendly and worked for many years. Even dumbbell work was starting to irritate joints that I needed healthy for karate practice, that was when I decided to try the kettlebell route.

Enter the two hand kettlebell swing.. in late 2014 my best pal introduced me to kettlebells. After learning the 2 hand swing and Turkish getup, I was hooked. It took a few months of swings and getups with a moderate weight to start seeing some serious results.. my low back problems disappeared and have remained gone today.

I started with a 52lb (24k) bell which I do not recommend for most. A 35lb (16k) bell is a good size for men to start with, 12k for most women. I self taught after getting an initial primer from my friend, after some time training I became a level 1 instructor through Strongfirst. I highly recommend getting instruction from a competent instructor and being cleared by your doctor to partake. Strongfirst has instructors all over the world, you can find one through their website at Strongfirst.com.

It takes about a year for tendons and ligaments to strengthen up when doing kettlebell work. Start slowly and build up slowly.. the pulsing, dynamic loading of the swing will strengthen the lower back to become near bullet proof. Since starting I have not been down once with LB problems.. they are gone.. for real.

There is gold inside those iron spheres. This video is from 4 yrs ago, I could not have dreamed of doing this before, even in my strongest years.

https://youtu.be/MvMuhuALArA Pardon the music  .. was messing with a new format.

I would be happy to help you, please PM me if you want help and guidance. This stuff is real and it works.

[TTG53#1717]

I have used a device called “Spine-Worxs” for a couple decades and recently had good results with another tool called “Low Back Trax”. They should NOT be used together but I’ve developed a routine for myself that helps my lower back when it slips out of plumb.

I hope you find a solution to your situation.

[Jersey mike]

Thanks to everyone for all the feedback, I greatly appreciate the time you each took to drop a comment.

In our historical files I found X-rays from 1993 and an MRI film from 2006, there’s been obvious reduction over the years with the disc at L5/S1 over the years when compared to the recent X-rays taken.

Ortho appointment today, we’ll see what he has to say.

Again thanks for the feedback and feel free to continue to leave more. 

[Bret SD]

Probably the world's premier lower back/spinal expert is Stuart McGill, his work is worth studying in depth. Look at his 'Big 3' for core stability. Part of the reason for KB swings and most other movements working so well on low back problems is from core stability required to perform the movements.

What Is the McGill Big 3?

Stuart McGill, PhD, has extensively studied spinal biomechanics and performed clinical studies to narrow down the best three exercises for a stable core to prevent back injuries and to improve function in your everyday activities. His method develops core stability and, most importantly, muscle endurance.

https://www.livestrong.com/article/392341-stuart-mcgills-big-three-back-exercises/

[98valk]

Probably the world's premier lower back/spinal expert is Stuart McGill, his work is worth studying in depth. Look at his 'Big 3' for core stability. Part of the reason for KB swings and most other movements working so well on low back problems is from core stability required to perform the movements.

What Is the McGill Big 3?

Stuart McGill, PhD, has extensively studied spinal biomechanics and performed clinical studies to narrow down the best three exercises for a stable core to prevent back injuries and to improve function in your everyday activities. His method develops core stability and, most importantly, muscle endurance.

https://www.livestrong.com/article/392341-stuart-mcgills-big-three-back-exercises/

I like doing the farmer's walk with dumbbells. that always straightens up the back for me helps keep great posture.

[Bret SD]

Probably the world's premier lower back/spinal expert is Stuart McGill, his work is worth studying in depth. Look at his 'Big 3' for core stability. Part of the reason for KB swings and most other movements working so well on low back problems is from core stability required to perform the movements.

What Is the McGill Big 3?

Stuart McGill, PhD, has extensively studied spinal biomechanics and performed clinical studies to narrow down the best three exercises for a stable core to prevent back injuries and to improve function in your everyday activities. His method develops core stability and, most importantly, muscle endurance.

https://www.livestrong.com/article/392341-stuart-mcgills-big-three-back-exercises/

I like doing the farmer's walk with dumbbells. that always straightens up the back for me helps keep great posture.

Very good.. carries are great for many things!

[scooperhsd]

I'll start out just walking at first, if you don't mind. 1/2 mile (to park and back), 1 mile( add 1 lap in the park walking trail), 1.5 mile (add another lap).

[Bret SD]

Walking is one of the best things we can do to stay fit and strong, a friend of mine walks 5 miles every day for 30 years now.. he does it in an eye popping 60 mins.. I asked if he was kinda running and he said no, over the years he's gotten very fast.
At 64 yrs old he looks healthy, young and vibrant.

[Jersey mike]

On Thursday ortho gave me a 6 day cycle of Prednisone (4mg).

We had to then leave for a 3 hour trip to attend a wake Thursday night and funeral Friday morning and returned home last night. Today will be day 3 of the cycle and currently have some relief, I can actually move this morning, was able to stand up out of bed normally and move around with considerable ease and slept pretty well too.

Ortho wants an MRI, gave me the script for MRI and will plead my case should insurance put up fight so we’ll see what next week brings in that regard.

FYI, I’m not against the exercises but I’m not the gym type, I never was. I’ve done PT for the low back many times. I know all the exercises and stretching but they were never really that helpful. We also have the big rubber exercise ball in the living room which I use for relief and to stretch. I also have the inversion table which never really seemed to do much for extended periods.

The work I do it pretty tough on the low back. It keeps me standing, lifting and carrying, bending while holding weight for extended periods, twisting and turning along with a bit of repetitive kneeling to standing as well.

[98valk]

On Thursday ortho gave me a 6 day cycle of Prednisone (4mg).

We had to then leave for a 3 hour trip to attend a wake Thursday night and funeral Friday morning and returned home last night. Today will be day 3 of the cycle and currently have some relief, I can actually move this morning, was able to stand up out of bed normally and move around with considerable ease and slept pretty well too.

Ortho wants an MRI, gave me the script for MRI and will plead my case should insurance put up fight so we’ll see what next week brings in that regard.

FYI, I’m not against the exercises but I’m not the gym type, I never was. I’ve done PT for the low back many times. I know all the exercises and stretching but they were never really that helpful. We also have the big rubber exercise ball in the living room which I use for relief and to stretch. I also have the inversion table which never really seemed to do much for extended periods.

The work I do it pretty tough on the low back. It keeps me standing, lifting and carrying, bending while holding weight for extended periods, twisting and turning along with a bit of repetitive kneeling to standing as well.

Prednisone is catabolic aka muscle wasting aka less muscle and strength u will have to support your spine. there are other pain/inflamation drugs that could be given that are not catabolic.

still amazing doctors don't prescribe prednisolone which avoids the conversion by the liver of prednisone to prednisolone which is only what the body can use. this always results in the higher water intake and then urination.  amazing prednisolone only costs a few cents more than prednisone.  too many doctors today are just puppets of the drug companies.

 all of this can be looked up.

God Bless.

Jeremiah 17:14
Heal me, Lord, and I will be healed;
    save me and I will be saved,
    for you are the one I praise.

[Jersey mike]

On Thursday ortho gave me a 6 day cycle of Prednisone (4mg).

We had to then leave for a 3 hour trip to attend a wake Thursday night and funeral Friday morning and returned home last night. Today will be day 3 of the cycle and currently have some relief, I can actually move this morning, was able to stand up out of bed normally and move around with considerable ease and slept pretty well too.

Ortho wants an MRI, gave me the script for MRI and will plead my case should insurance put up fight so we’ll see what next week brings in that regard.

FYI, I’m not against the exercises but I’m not the gym type, I never was. I’ve done PT for the low back many times. I know all the exercises and stretching but they were never really that helpful. We also have the big rubber exercise ball in the living room which I use for relief and to stretch. I also have the inversion table which never really seemed to do much for extended periods.

The work I do it pretty tough on the low back. It keeps me standing, lifting and carrying, bending while holding weight for extended periods, twisting and turning along with a bit of repetitive kneeling to standing as well.

Prednisone is catabolic aka muscle wasting aka less muscle and strength u will have to support your spine. there are other pain/inflamation drugs that could be given that are not catabolic.

still amazing doctors don't prescribe prednisolone which avoids the conversion by the liver of prednisone to prednisolone which is only what the body can use. this always results in the higher water intake and then urination.  amazing prednisolone only costs a few cents more than prednisone.  too many doctors today are just puppets of the drug companies.

for the naysayers who like to attack me all of that can be looked up.

God Bless.

Jeremiah 17:14
Heal me, Lord, and I will be healed;
    save me and I will be saved,
    for you are the one I praise.

After reading your text I went to look more closely at the box of medicine.

Apparently the box is not Prednisone but MethylPREDNISolone 4mg…as printed on the box. I just assumed it was Prednisone, did not know there is a difference.

Thanks for the info.

[scooperhsd]

I was laying awake in my bed this morning, and noticed that I wasn't feeling any lower back pain. Now, I'm sure this will not be a permanent thing, but it sure made me feel happier. I expect it will come roaring back since I'm now up and moving.

[Kiwitex]

I have had 4 back surgeries so far and I'm sure I'll need more in future, so there's that to start with.
One thing many surgeons forget to mention is that once you fuse the spine you transfer the 'workload' to the next joint in line, which adds to it's wear and tear. Just something to be aware of, not a negative as long as you know in advance. So you need to do more 'maintenance' to keep your back in shape.

Strongly advise you to investigate a surgeon who has knowledge of, and practice with, replacement disc technology. It's not suitable for everyone, but the results are significantly better than fusions.
They have been used in Europe for over 20 years now, so there's lots of data and great techniques for surgeries have been developed, most insurance will cover it now too. Best to let your surgeons describe the procedure and the limits of who can have them, but if you have a choice, go with the replacement. The results are very impressive and last much longer than fusions.

[henry 008]

I had lower back surgery in 2003 for a herniated disc. Doc said I'm to old (42) to be jumping dirt bikes with my son. FF to 2013 and I was in Hocking Hills Ohio on my Valk. I was packing up 1st thing in the morning to head out (everyone else was still asleep) I was putting the last tie down on and the bike fell over. I tuned off the gas and the key and tried righting the bike. It was completely on its side in the grass, on a hill. It started to move and then CRUNCH I felt my back let go. Got my 1st ride in an ambulance. It was a Compression fracture and it was so splintered they wouldn't do surgery, even thought about bone glue, but was worried it my go thru the bone and end up in my nerves. Spent the summer in a body brace. In this past year my hands started shaking and my feet and legs got numb and I'm off balance often. Dr. is saying that its the past nerve damage that's starting to show up. I'm not looking forward to  whats next. 

[Jess from VA]

When you get old, it's time to act old..... meaning to be very deliberate and careful with heavy weights (and really all out of the ordinary lifting, bending, stooping, pulling, pushing, yada). 

And tone down the acrobatic coitus too.   

Otherwise you can act as young as you feel. 

[Jersey mike]

Just to keep an update, MRI was approved but soonest appointment was for 3/30.

The steroid pack helped some, last pill was yesterday. Went into work Monday, spent an hour kneeling, bending and turning to repair an edging machine and all the good the steroids did went out the window.

Sitting, standing, walking, turning and rotating at the waist is quite difficult. I’ve been down this road many times, it just takes time to go away but each time it’s gets a little longer and now the number of symptoms seem to have increased, especially the right leg. Sometimes I have to stand and support myself on a desk, table or counter with my leg out to the side like a dog doing its business.

[semo97]

Look up dry needle therapy. I had it done at the VA physical therapy clinic on my syatic nerve. It can be a little uncomfortable but no more problem in 24 hours.

[Jess from VA]

Wear a back belt.  They keep you in a better upright posture, provide heat, support, and every time you're going to bend, stoop or twist, they remind you to be careful. 

I did not have one with harsh metal stays, I used one like the big box store guys use, with elastic, velcro and suspenders. 

[Jersey mike]

Wear a back belt.  They keep you in a better upright posture, provide heat, support, and every time you're going to bend, stoop or twist, they remind you to be careful. 

I did not have one with harsh metal stays, I used one like the big box store guys use, with elastic, velcro and suspenders. 

I’ve had several through the years, ones like you described annd ones w/o the suspenders and they do help to an extent. I’ve even ridden the bikes with it on which is kind of uncomfortable. I did like the one with the metal supports but the Velcro and elastic doesn’t really last that long with constant use.

[Jess from VA]

.. the Velcro and elastic doesn’t really last that long with constant use. 

Then you buy another.