A long while back (Thu, 12 Aug 1993) I posted the following to various
newsgroups and mailing lists on the net:
——–+++++++++++——–
If anyone has any information that may help me learn about the following
situation and make a decision, I would be very appreciative if you could email
me, or mail to the list.
I recently had a CT (Computed Tomography, ie: catscan) done on my lumbar
spine (from L1 -> S1) since x-rays show a "rudimentary disc space" between
L5 and S1.
The CT shows that my L5-S1 disc has "slipped" and is impinging on the spinal
cord. This is the apparent cause for pain shooting down my left buttock and
thigh.
The CT also shows that the L4-L5 disc is on its way out, and there is a
"disc fragment" between L5 and the spinal cord. This fragment could have come
from the L5-S1 disc, or it could have come from the L4-L5 disc.
There is an operative procedure that removes the defective L5-S1 disc and
fuses L5-S1. If L4-L5 "slips" as well, such an operation could also be
performed to fuse L4-L5.
The doctor (he’s also an acupuncturist) says not to operate, but to see a
physio and treat the problem "conservatively". He says I’m too young for such
an operation (I’m 27). He is of the opinion that I must avoid all forms of
movement that place strain on the lumbar spine, for the rest of my life.
A friend who is a neurosurgeon looked at the CT and immediately said "you need
an operation". He is of the opinion that after a while I would be able to move
"normally", and need not "watch what I do with my back".
Over the last couple of days the pain has somewhat decreased, and the
L5-S1 and L4-L5 joints have been "cracking" occasionally.
Any information about similar cases and experiences would be very helpful.
Thanks.
——–+++++++++++——–
I received several very helpful responses, and I promised that a summary would
be forthcoming.
Due to a rushed overseas trip and heavy workload since then I did not fulfil
this promise. Today is my last day at work for a while and I have some spare
time. I have chosen not to summarise but to list each response. I feel that
this will give readers a clearer picture of the issues involved in the
above-mentioned case and ones similar to it.
I also mentioned in my replies to people that I would anonymise all responses
in any summary that I post. However, on second thought it will be more helpful
to readers to be able to contact people who may be in similar situations. I
don’t think I am doing anyone a disservice by identifying people below, since
none of the information below came from people who requested to remain
anonymous. If I have inadvertently offended someone, then please accept my
apologies.
First of all, I would like to describe my current situation:
Probably no change in prolapsed disc at L4-L5.
Once every couple of weeks lots of "cracking" in the lumbar joints but no
discomfort.
Sciatica ranging from mild to extremely painful at non-regular intervals
it’s only really uncomfortable after work that requires shock-absorbing in
the spine, eg: jumping, riding a motorbike or horse.
I bought a "kneeling chair", one made by Balans. I can sit in it for hours
without moving and feel no discomfort at the end of the day. Using a normal
chair I find I have to change position every couple of minutes, and at the
end of the day the sciatica is very bad.
I swim at least once every two days, 1km each time. In the pool there is
absolutely no pain, and I am extremely mobile. I stick to freestyle, but
other types of stroke are no problem for my back.
I walk 8km once a week without a break and then another 4km that same
afternoon. I wear normal dress shoes with a heavy leather sole and no
inner-sole. My back is fine after this. I can stand for hours at a time and
feel no extreme discomfort.
Cycling provides no problem, which is strange, since sitting on a motorbike
can be really painful after a while. I suppose it is due to the angle of the
back against the hips.
I cannot bend from my waist much more than 15 degrees without getting severe
pain down my left leg (sciatica).
In conclusion, the only thing that I have had to do since the original
nightmare is swim instead of skip (ie: jump rope) and cut out running. So I
suppose I’ve managed to adapt to a reasonable extent.
So that’s my story. Here is a list (ordered chronologically) of responses I
received to my original query and related articles from news and mailing-lists
that I’ve pulled off the net. I’ve seperated responses by a single line
containing the pattern ——–+++++++++++——–. I hope this makes it easy
for people to decipher what’s below.
Since this is my last day at work, and since I have unsubscribed from lots of
lists, would someone please post this to relevant lists (eg: HOLISTIC,
SOREHAND, etc.). Better still, if anyone thinks it worthwhile, perhaps this
post can be archived somewhere and a note sent to the relevant lists.
Thanks once again to everyone who sent such helpful responses.
——–+++++++++++——–
From s…@kiwi.rasna.com Thu Aug 12 01:43:11 1993
Jonathon –
I sympathize completely. I have a similar problem (sciatica). I see a
chiropractor reguarly and went to a physical therapist for several
months after the diagnosis. I still do the therapist-recommended
exercises when the pain flares up, and get occadional massages (which
help relax me in general).
I was just diagnosed as having CTS, too, and noticed that the sciatica
flared up at the same time. I’m trying to reduce my overall stress
level in the hopes that both problems will get better. So anything to
reduce stress should help as well.
My best advice is to avoid surgery at any cost. I thought I was "too
young" to get sciatica at 31, but it turns out bad backs can come at
any age. But you are too young to permanently debilitated from
still-risky back surgery.
Thanks,
Sue Jackson
sue@kiwi
——–+++++++++++——–
From mich…@resonex.com Thu Aug 12 16:05:05 1993
> The doctor (he’s also an acupuncturist) says not to operate, but to see a
> physio and treat the problem "conservatively". He says I’m too young for such
> an operation (I’m 27). He is of the opinion that I must avoid all forms of
> movement that place strain on the lumbar spine, for the rest of my life.
> A friend who is a neurosurgeon looked at the CT and immediately said "you
> need an operation". He is of the opinion that after a while I would be
> able to move "normally", and need not "watch what I do with my back".
Personally, I’d be more inclined to trust the neurosurgeon. Degenerating
disks would not be treatable via physical therapy, as they are physically
decomposing (in a sense, anyway). If it was just a matter of slippage
caused by muscles and bones getting out of whack, then I’d say go ahead
and try PT or a chiropractor. But with the disks actually degenerating,
an operation is almost mandatory.
Age has nothing to do with whether the operation is necessary. Being 27,
you’re certainly a rare case for spinal problems of this nature, but that
doesn’t mean you shouldn’t have the operation. How would you react if
you were told you had lung cancer, and said "Oh, you’re only 27, that’s
too young for this sort of treatment." I would hope you’d run away
screaming from such a doctor, and you should probably do likewise with
your current doctor.
Spinal problems of this nature are *serious*. If you let them persist,
you could easily develop severe problems in the spinal cord, quite likely
leading to paralysis. Get the operation!
Caveat — I am not a medical doctor.
–
Michael Bryan mich…@resonex.com +1 510 249 9600 Ext 325
Resonex, Inc. ____ ____
47911 Westinghouse Dr. \ / \ /
Fremont, CA 94539 \/ Hate is not a family value. \/
——–+++++++++++——–
From E…@psulias.psu.edu Thu Aug 12 12:19:31 1993
I have a "partially herniated" disk at L5/S1 too; I’ve had pain in my left
hip and thigh for about a year and a half now. I’ve gone through
conservative therapy (anti-inflammatories and physical therapy), but
haven’t had any success. I’ve heard cortisone injections into the disk
area can help, but I haven’t had that done. If you get any email on
your back problem, could you forward it to me? Thanks.
–Lee Newman, e…@psulias.psu.edu
——–+++++++++++——–
From SOREHAND%UCSFVM.BIT…@CMSA.BERKELEY.EDU Thu Aug 12 14:00:16 1993
For Johnathan Goldstein on his back problems:
Don’t get surgery! I saw a presentation by a company called Save-A-Back in
the US. They mentioned that there is a group of Phyiscal Therapists who
use "McKenzie" techniques to treat backs conservatively and successfully.
The McKenzie technique is so simple it is revolutionary. The therapist
fits you with a corset so that your back is swayed back. This allows the
body to heal itself, much like stitching a cut on your hand together.
It has been a while since I took the class, but they tell you about the
back and possible injuries. There is no way to "slip a disc" without
major trauma (i.e. auto accident or fall). Disks are fused to spine bones
and they don’t really move. They do, however, tear, which probably
happened in your case.
The other thing that we learned is that when they fuse a back joint, they
remove the disk. Disks are natural shock absorbers for the spine, so
just think about driving your car around without shocks. I think that
anyone is too young for this kind of trauma and you would be paying for
the rest of your life.
Just my $0.02,
Daniel
mccro…@saifr00.ateng.az.honeywell.com
——–+++++++++++——–
From SOREHAND%UCSFVM.BIT…@CMSA.BERKELEY.EDU Thu Aug 12 22:31:22 1993
The general principle is:
There is only one back operation to avoid – the first one.
My back injury goes to 1979, I have learned to self manage, and to listen
to the
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