Disc Herniation and Surgery Dilemma

Pain & Rehab Forum [Moderated]
1

Hi everyone,

Sorry in advance for the essay.

Three months ago I herniated my L4-L5 disc. At the first the pain was crazy and completely incapacitated me for about 2 weeks, and my left leg went numb and I was dragging my foot when I walked. Since then I made a lot of improvement following the usual medical advice - doing daily physio and staying as active as possible without overdoing it. I’m 31 and in good shape and generally eat well. I did a lot of sports before the injury (bouldering, swimming, cycling, tennis, yoga), and all of my holidays involve something like hiking or cycling.

However the pain has gradually started to get worse again. Following an active vacation involving some hiking and swimming, the pain intensified to the point where even standing or walking became excruciating, and few nights ago, my pain levels were at a 9 - even a massive dose of opioids (which I’ve been trying to avoid) didn’t touch it. Fortunately, the pain has been on a slow decline since then, but I’m still unable to walk or stand for longer than a minute.

I have scheduled discectomy at the end of next week. The surgeon (from a very reputable hospital in Berlin) said that long term outcomes are similar for surgery vs no surgery, but it would enable me to return to my hobbies much sooner. Also, he was worried about how little my pain had reduced.

However I have just seen my physio who generally leans away from recommending surgery, who said my pain might have become chronic. This suspicion arose from the fact that activities which used to trigger discomfort or stiffness—like back bending or sitting with poor posture—no longer bother me at all. Furthermore, the pain has changed quite a lot - it used be primarily in my hip and butt but is now mostly radiating down to my shin. She recommended Dr John. Sarno’s book ‘The mind body prescription’, and encouraged me to look into programs like BBM.

I guess I’m looking for advice or opinions on what to do. I’m worried that the surgery isn’t going help if the pain is now psychosomatic and not directly caused by the herniation, but at the same time it is really ruining my life and I will do whatever it takes to start improving.

I was thinking of getting a PT and starting BBM’s rehab course after surgery, but am now considering delaying surgery and trying it first. A friend who does powerlifting used BBM to solve chronic knee pain that was ruining his life, so I have good feelings towards it.

Has anyone here have similar experienced something similar or have any advice/ opinions?

2

Hi @pshp ,

I’m sorry to hear about your back injury. This is something I’m very familiar with after sustaining a similar injury in May of 2020. Here is the very condensed version of the story:

On May 18, 2020 I hit a new paused squat PR of 625lbs x 3.The next morning I woke up with debilitating pain in my lower back that radiated down to my feet. I could barely sit up out of bed, my right shin was numb, and I couldn’t fully contract my right calf similar to what you’re describing.

Fast forward 5 months later, I had made significant progress in my recovery through conservative management up until October 21st. I was doing a normal ‘run of the mill’ squat session when I started to feel a ‘twinge’ in my left quad, so I stopped the session early. When I woke up the next morning, there were ‘electric shocks’ going down my left thigh whenever I would sit up, I couldn’t fully contract my quad, my knee would buckle when I would walk, & I was back to square one.

I never got imaging done as I had no intentions of getting surgery. Instead I began to focus more on bodybuilding, boxing, and other forms of physical activity I could tolerate without exacerbating symptoms as much. As I began to stack small wins in training, my confidence grew and I slowly started to feel better. There were lots of ups and downs along the way, which I’m in the process of writing a 2-part article series on this exact topic that should be released soon. Two weekends ago I competed at USAPL Raw Nationals and was able to squat an all time meet PR of 689lbs post injury, and this is the best I’ve felt in a very long time.

It is entirely possible to recover from this setback without going through with surgery. If you have not read our article on pain in training, that would be my first recommendation as it lays out our general approach to managing these types of issues. If you would like to schedule a consultation for more specific guidance, here is our intake paperwork.

Wishing you a speedy recovery, stay strong.
Charlie
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