Dealing with herniated disk

[Cookerhiker]

As far I can tell, this hasn't been discussed in any WB forums yet.

About 6 weeks ago I awoke with shooting pain down my right hip, thigh, and leg. After bearing it for 2 days, I checked into the emergency room, received shots and steroids, subsequently visited the ortho, got x-rays and an MRI. Bottom line: it's official - I've got a herniated disk in my lower back. Per the doc, the cause isn't a sudden event like bending the wrong way or even backpacking several hundred miles. Over time, disks can deteriorate. I suppose if I sat with better posture and hadn't jogged (which I don't do anymore) this may not have happened but who knows?

Surgery is a last resort. For now, I'm taking strong prescription-level Vitamin I. If this fails to reduce the inflamation, the next step is a shot. As the doc explained, the problem isn't the bulging disk itself but its impingement on the nerve. There's no pain now - the only sensation is numbness in my right little toe and the adjacent areas of the foot. I've done one 3-day backpack (50 miles in VT & NH about 2 weeks ago) and continue to work out on the stair climber and elliptical.

Surely I'm not the only WBer out there with this problem. I'd appreciate any insight, advice, experience from WBers on this, especially how it affected your hiking.

[hammock engineer]

I'll see your herniated disk, and raise you a ruptured disk. In 2000 I ruptured my L4/L5 disk and herniated one in the S region. I didn't see the signs early enough and go to the doctor. I had the surgery. If you do have it, get a good doctor. I was lucky with mine. I talked to other people who said they were never the same.

I will always have some problems with it, unfortunately you will too. Go to physical theropy. It is one of the best things you can do. Do the streches they give you daily. I try to do mine in the morning and in the evening. They make a big difference.

In terms of hiking, dropping the pack weight and using trekking poles are a big help. I would talk to your doctor about this. He might want you to take it easy for a while. I also switched to a hammock. It is the only way I can sleep while hiking. I do not think I could through without it.

Feel free to PM or email me with you want to. 6 years later I can do just about anything I could before. Once a year or 2 my back decides that it has been forgotten about and likes to remind me that it is still there. Usually after I do something stupid. Then I am laid out for a week or 2.

[orangebug]

Avoid any temptation to be bipedal. That is probably the only way to avoid risk of recurrence.

Disc herniation/extrusion is a chronic condition, caused by our tendency to walk upright. While many of us have had back pain related to overexertion, this is an entirely different matter, and will recur - perhaps in months, years or decades.

The best/first treatment is watchful waiting, just as you have done. If you had further pain or muscle weakness, other decisions would be made, including pain blocks, opiates, and possibly surgery. Depending on where you live, a neurosurgeon or orthopod will be involved in your care. If you are very lucky, this will go away - until the next event. You may have lost a reflex.

If you are unlucky, you may require surgery. Depending on the skills of your surgeon and your anatomy, you may be filleted or might have a microsurgery procedure performed. Success rates vary. I know more disappointed back surgery patients than happy ones.

I am a happy one. I had L4-5 blow on me while driving, suddenly finding it very hard to push on the accelerator pedal. After about 2 months of hobbling and taking opiates, I had a microsurgery procedure to remove the glob of disc (essentially the consistency of tooth paste) by suctioning - much like an arthroscopic procedure. The frame they draped me on looked pretty extreme. I was out of pain within two hours of anesthesia initiation, walking by 6 hours and home in 24 hours.

It was great to get out day hiking with in a week to regain strength. My personal Physical Therapy was to be talked into better lifting and posture. No driving for 2 weeks. "Imagine you are in a miniskirt and high heels, without skivies, Pick things up while maintaining some level of decency." I also lost 40 pounds.

Have fun, and be glad you have a painless paresthesia - for now.

[Tim Rich]

As far I can tell, this hasn't been discussed in any WB forums yet.

About 6 weeks ago I awoke with shooting pain down my right hip, thigh, and leg. After bearing it for 2 days, I checked into the emergency room, received shots and steroids, subsequently visited the ortho, got x-rays and an MRI. Bottom line: it's official - I've got a herniated disk in my lower back. Per the doc, the cause isn't a sudden event like bending the wrong way or even backpacking several hundred miles. Over time, disks can deteriorate. I suppose if I sat with better posture and hadn't jogged (which I don't do anymore) this may not have happened but who knows?

Surgery is a last resort. For now, I'm taking strong prescription-level Vitamin I. If this fails to reduce the inflamation, the next step is a shot. As the doc explained, the problem isn't the bulging disk itself but its impingement on the nerve. There's no pain now - the only sensation is numbness in my right little toe and the adjacent areas of the foot. I've done one 3-day backpack (50 miles in VT & NH about 2 weeks ago) and continue to work out on the stair climber and elliptical.

Surely I'm not the only WBer out there with this problem. I'd appreciate any insight, advice, experience from WBers on this, especially how it affected your hiking.

I blew the disc at L4-L5 eight years ago at 33, a cumulative result of being a basketball gym rat and abusing my body with football. Symptoms started slowly, with a numb big toe and aching hip. The numbness spread, the pain intensified and I started losing strength in my foot lift (raising your foot with your heel still on the floor). I had a microdiscectomy, with a small incision, a drilling through my vertebrae the size of a first grade pencil, and carving out the ruptured portion of the disc. My neurosurgeon, Tariq Javed, Kennestone Hospital, Marietta, GA, has my highest recommendation. Overnight in the hospital, two weeks off work. His counsel was to do anything I wanted to do except basketball, and to keep my pack weight down. There's about a 10% chance of rerupture, and my L5-S1 is deteriorated but not bulging or blown. I'm hoping the technology of artificial discs will improve so I'll not have a fusion.

Before surgery, I had sectioned a little more than half of the AT. The following seven years, I finished the northern half. Dr. Javed said that now that he's cut on it, I'll have a bad joint the rest of my life. It's stiff sometimes, hurts a little sometimes and, like my knees, is a nice indicator of when I'm dehydrated. Good hydration helps the comfort level significantly.

I wish you the best. If you do get two surgery recommendations, I'd have it. Waiting too long will affect how much the strength comes back, and numbness diminishes, in your leg.

Take Care,

Tim

[Alligator]

Hey Cookerhiker,

One more in the boat here. I herniated my disk, L5-S1 (not positive, there was some ambiguity between two disks), three years ago. I was laying in bed and sneezed tremendously with my head turned. That's all it took. I had some problems through the years with the back previously though nothing serious. There wasn't much to see on the MRI but my nuerologist suspected a small piece of disk pushing on the nerves. He suggested that it would reabsorb. I did two courses (3 doses each) of IV steroids which helped some. I had a lot of pain running down my leg (sciatica) for several months, the pain was only when seated.

Eventually, the pain stopped. I read a lot about others' cases and don't recommend surgery right away. It takes some time to heal these things. What finally calmed things down for me was Celebrex, 200mg. Recognize there is some controversary in terms of potential heart trouble with this drug, but it really worked well for me. I stopped taking it regularly after I think it was several weeks. Now I only take it if there is some soreness from lifting/yardwork. Maybe once or twice a month.

I went back to backpacking about 8 months later. My nuerologist gave me the all clear. He only suggested against horseback riding and downhill skiing. Not a big loss there. I keep my pack weight low, but still take heavy winter trips. In fact, I have not had any back problems while packing, and still sleep on the ground.

I seriously recommend getting off the Vitamin I it will kill your stomach. I was taking maximum dosage ibuprofen for weeks. I was in so much pain and my d***head regular doctor wouldn't prescribe pain medicine. [He's no longer my doctor.] It was so bad I had to have my wife help me lay down, I couldn't do it alone for the pain. I had to walk around with my hiking staff for about two weeks. My sympathies go out to you. I highly recommend the Celebrex bearing in mind the above caveat.

[Blissful]

My dh has that right now - got two injections at the spot at the pain clinic and it helped tremendously. Also went to PT for strengthening exercises, though he's not real good at following through on them.

He got an REI UL 45 pack and likes it very much. Much lighter than his old Lowes. No pain or numbness as far as I know.

[Seeker]

no one's mentioned the cervical manipulation technique of chiropractic... (it's where the doc only moves the atlas bone in your skull/neck. no cracking or popping of anything... just a gentle push on the base of your skull.) i was in an accident involving a horse (long story, but briefly, i was thrown across a barn and into a stall by a horse), knocked out for a few seconds, and kinked my neck badly... after a few weeks of pain, someone convinced me to see a chiropractor... he healed the neck, and a secondary effect was and end to some toe numbness i'd had for years, as well as a lot of the lower back pain i was simply chalking up to 'getting older'.... it was amazing... best of all, no drugs or surgery...

[Alligator]

I went to the chiropractor also Seeker while waiting to get an appt with the nuerologist [only two in the area and I couldn't tolerate more than 30 minutes in the car]. It helped some, but once he found out it was a herniated disc, he discontinued treatment.

[Deb]

In terms of hiking, dropping the pack weight and using trekking poles are a big help.

Does this mean that on our next winter hike you'll be leaving the frying pan home?
Because if pancakes aren't on the menu, I might not be able to make it...

[SideWedge]

I'll share a little info too....last August doing trail work I felt a pop and sharp pain when moving a rock, at the wonderful age of 18. Its part of the job to be stubborn about pain, so I took a few days off and then went back to school. A few months later I was getting such severe sciatic pain that I could no longer sit and lectures, and finally sucked it up and went and saw a doctor. She touched my back once and pinned it: herniated disk at L4-5. A CT scan confirmed that and a slighly bulging disk, and in January I finally start PT. That did little so I had a nerve block...which also proved futlie. I finally had diskectomy on March 9th (a little over 2 months ago), and felt great within 2 weeks. It was the first time in months I didn't have pains going from my back to my legs...AMAZING! I have a few inch incision, but absolutely no pain. And the best part...2 months post op I started my thru-hike of the Long Trail!!! Last week I did 60 miles and go back tomorrow to do 70 more. I've kept my pack weight low, as well as pretty small daily mileages, and with a zero or two every week I have no worries about not finishing. My advice is to work work work those abs! That way when you're carrying weight (or even just supporting your own body) your back has to do less work. And know when to push it, but also when to lay off. Its easier to take an easy day every now and then, rather than having to lay down for a week while you wait for sciatica to subside.

[K0OPG]

Been there, done that, twice. Once lower back (l-5/s-1) and then in the neck. after the back surgery, painfree in 2 weeks. wonderful! It took about a month and a half for the neck pain/surgery pain to go away.

I have had zeron problems witht he neck. However, the back was done in 98 and I am now having more problems. Almost dead nerve from lower back to little toe. I was having the steriod injections and man was it wonderful. If you can get the shots, do that first. surgery asx a last resort. as my doctor told me though, once you have it, you will always have it. surgery is a temporary fix. the disk is still herniated/suptured. The only close to permanent fix ia having the disks fused together.

I am still planning a thruhike for next year and hope that my back makes it. I need to lose many pounds and that would help the back.

Good luck and as someone said before, get a second opinion, and know all of your options.

[hammock engineer]

My surgery sounds a little different than everyone else's. On mine, a piece of my disc broke off. 2 different doctors and a PT told me of surgery was the only option. I lucked out and went to the same doctor one of my friends dad's uses for similiar operations.

Mine took a few months and some serious PT to get better. Not very much fun. But in the end, I can do almost anything. Still can't bring myself to bowl again.

[Cookerhiker]

Does this mean that on our next winter hike you'll be leaving the frying pan home?
Because if pancakes aren't on the menu, I might not be able to make it...

Uh, let's compromise. I'll carry the frying pan if you carry the other ingredients including the pure maple syrup. You can carry the oil - it's nice and light. I'll lug the spatula and blueberries.

[Alligator]

I don't think I want anyone hacking on my spinal column, but I thought this was an interesting article.
http://abcnews.go.com/WNT/DrJohnson/story?id=1991281

I figured it would happen, but I didn't think it would be done for some time.

[Cookerhiker]

Thanks Gator for the link (don't think I'm a candidate at my age) and thanks to all who responded for your insight and experience. Something else I'm considering is a new techonology which simulates space weightlessness without surgery or medication to pull the bulging disk material back off the nerve. It's described here http://www.marylandspineanddisccenter.com/HOME.htm
and I may give it a try. Right now, the only physical reminder of my problem is continued numbness in a small area of my right foot around my little toe.

But first things first; tomorrow's my colonoscopy. Ah the joys and pleasures of advancing age!

[hammock engineer]

But first things first; tomorrow's my colonoscopy. Ah the joys and pleasures of advancing age!

I had one of those also. Can't say that was very much fun.

[Sorcerer]

I had one of these too, but mine was from a buildup of trauma from moving and working on a new house.

The best treatment available, according to my doctor, was to walk. So, I ended up hiking 450 miles with it last year and felt like a new man when I got home!

Of course, 2 days after I returned I had a car wreck and was rear-ended and I ended up with a pinched nerve in my back that was almost as bad as the bulging disk that pinched a nerve. Finally, it subsided and I hiked about 100 miles so far this year and I'm feeling much better!

Good luck with that back thing. Time seems to heal most of those and walking/stretching seems to help more than most anything.

[TIDE-HSV]

This is worth adding. My problem is not the herniation or rupture, but all my disks are deteriorated - lots of athletic injuries - lifelong runner, basketball player, etc. It started in the lumbar area, and it is now from tip to tail. I've lost 3.5" in height in the last 15 years. Despite that, my main symptom is lower back pain - no neuro symptoms. I had a full spinal x-ray done three weeks ago, along with a bone density scan (backbone very dense). The spinal ortho told me that he had a lot of patients on total disability with better looking spines than mine. Back pathology credentials established, I've started something new. Around three months ago, I bought an inversion table (hang upside down). I do ten minutes in the morning and evening and it's made an enormous difference. I'm more flexible and pain has decreased. I've regained about an inch in height (I'm sure it'd disappear if I quit), and I've regained around 20 yds on my drive (yep, still golf, somehow). Just one experience...

[Fahrenheit]

I screwed up my back in september playing flag football. After a month or so of pain I went to the doc. He said it was mucsular and would heal. By January I was worse, I wasn't able to run, hike or even sit for my morning lectures. I went back to the doc and he sent me to physical therapy. Physical therapy made a big difference in my mobility and kept me strong enough that I don't keep re-hurting it. Unfortunately after 4 months of therapy with me still not able to run or sit for more than an hour I got sent to a different doc. He thinks I either have a bulging disc or stress fracture. I'm getting an MRI next week. Good times.

[LULU]

Hi,
I have this problem for years and I try everything from 7 pain killer a day, patch,cortizone shots, nerve block (2),massage,physical therapy almost kill me, hothing work. The pain is unreal!!!
Good luck!
E-mail after you are MRI to see how you are!

Lulu