Hello! I posted earlier about my partner and now have some updates after an MRI.
My partner has had hermitic L4/L5 discs in the past and has not necessarily noticed. He began having intense back pain about 6 months ago, was completely incapacitated for 2-3 days (unable to walk) and then it suddenly went away. This has happened twice in the last six months.
After a week of squatting, a 3000feet of elevation winter mountain half marathon, and regular training, his back slowly started seizing up. Every day it got worse and worse and worse until today, where he can no longer get himself to the bathroom or move at all.
We ended up going to the best spinal doctors in our city and got an MRI. We’ve just gotten the message that he has a severely herniated disc and will likely need surgery.
My boyfriend is already panicking about not being able to ever train again, not being able to push himself in the gym, never being able to be strong ever again, etc.
Even in “severe” cases, does surgery have better outcomes than non-serious? There is still a possibility of building oneself back up again, even if he has surgery, right?
We are planning to do the lower back rehab program, but I am desperate for ways to help him relax right now, so any words of wisdom would be helpful…
Hi there,
Sorry to hear about this challenging situation.
It’s important to point out that in our world, a truly “severe” case of acute disc herniation involves paralysis or other severe neurological problems and is a surgical emergency. If you saw spinal doctors and they felt you had time to get an outpatient MRI, and consider elective surgery for this, it is not one of these emergencies. While he may be experiencing severe pain, that is not the same thing as a “severe” case.
So, in this case, I would first reiterate the advice that was given by Charlie Dickson in the other thread where you replied. Surgery in these situations can lead to more rapid relief of pain in the short term, but patients often have similar longer-term outcomes at 1 year out or beyond. I would expect him to be able to remain active and train in the future either way.
Finally, the last thing that stood out to me was your description:
After a week of squatting, a 3000feet of elevation winter mountain half marathon, and regular training, his back slowly started seizing up. Every day it got worse and worse and worse until today, where he can no longer get himself to the bathroom or move at all.
It does not sound like there was a significant acute traumatic incident that precipitated this, but rather that his training load was very, very high – and clearly higher than he was ready for. Given that he has had prior episodes that resolved on their own, I suspect that with smarter management of his programming & training loads, the risk of these sorts of episodes can be mitigated in the future. This would benefit from individual consultation and guidance, ideally from Charlie or one of our other BBM Rehab clinicians.
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Thank you so much for your response Austin! He ended up spending the week in the hospital because of his pain and inability to move. He’s now gotten an epidural and cortisone IVS (not pushed for by the doctor, but requested by him), as time and inter-venal pain medicine was not helping him become mobile again.
He is, of course, going to train in the future 
His doctor is the spine expert in our province and works primarily with athletes (and is also of the opinion that his training future will be bright and is also important). His S1/L5 and L5/L4 discs are currently completely black with S1/L5 being completely herniated and the doctor says - if his pain does not improve - that he is a good candidate for artificial discs.
Do you know if these sorts of issues also resolve themselves? I do not think the disc is completely collapsed but seems to be on its way. My boyfriend is afraid that a surgery would cause his facet-join arthritis to get worse… He is unsure if surgery would be the right move forward.
He has been training heavily for the past 16 years, is a strength and conditioning coach himself and thinks that his disc degeneration comes from 10 years in the military.
I’m glad he’s working with an expert you feel you can trust.
I don’t have much more to add, because we there just isn’t enough clear information here to comment. I don’t know what exactly is meant by the discs are “completely black” or “completely herniated” – these are also separate considerations from facet joint arthritis.
As mentioned above, further information/input from us would need to come from an individual consult with our rehab team. We’d be happy to help however we can.