Disc herniation? Why surgery is being suggested?
I have a disc herniation in L4/L5 area. It has been categorized as a large herniation.
Facts
1)Lower back pain for a very long time now.
2)Starting January 2010 left buttock pain radiating to left leg resting relaxes it.
3)No side effects like numbness, or loss of control in left leg.
4)Tried physical therapy based on xray, not MRI and disc herniation not yet revealed.
5)No effect of physical therapy.
Recommendations
1)General doctor : Get it fixed with a neurosurgeon after seeing MRI.
2)Orthopedic surgeon : Remove disc and fuse vertebrae after seeing MRI.
3)Neurosurgeon : Laminectomy after seeing MRI.
4)Neurologist : Clinically no issues with nerves did not even conduct nerve test said not needed, suggestion was to still get fusion done after seeing MRI..
5)Neurosurgeon : Microdiscectomy after seeing MRI.
Now on the web suggestions are
1)Surgery is last resort.
2)Physical therapy, how will it help?
3)Cortizone shots how will they help?
Thanks
If your PT was not certified in mechanical diagnosis and therapy, I would start there. They will be able to give you a really honest interpretation if you are likely to recover with physical therapy…there are several clinical signs that can predict your outcome. You can find such a therapist at www.mckenziemdt.org. If you do have, upon examination, what is thought to be a reducible derangement, a set of very simple exericses will the pain generator to be relieved of the pain.
However, if it’s a full blown herniation to the point where the disc has lost it’s elastic ability to contain the nucleus, there is often little that can be done conservatively. In the short term, those who’ve had a microdiscectomy tend to feel significantly better within a few short weeks after surgery. If there is no significant disc degeneration or foramenal narrowing, I would opt for the microdiscectomy. It’s minimally invasive, and should you ever need the other procedures, you can always have that done later…but lamis and fusions are highly invasive, have longer recoveries and offer no advantage in the cases where there is simply a herniation…and they can’t be undone.
Based on what you said, however, that it is relieved with rest, it does sound like you are the typical person to respond well to a microdiscectomy. These people often complain of leg pain that eases upon sitting or resting but comes back the instant you stand up…these people often have more leg pain than back pain.
However, one thing that cautions me is the location of the herniation, research shows that L4/L5 problems are little harder to treat than L5/S1 problems…no matter what procedure you have.
The other option is time…you can wait it out, and chances are, it will subside…the disc may firm up over time.
Standing frame for Kids, Physical Therapist’s Perspective
|
|
NEW Guide to Evidence-based Physical Therapy Practice - $66.68 |
|
|
Guide to Evidence-Based Physical Therapy Practice by… $39.95 |
|
|
Guide to Evidence-Based Physical Therapy Practice (2007, Paperback) $24.95 |
|
|
Evidence-Based Physical Therapy for the Pelvic Floor: B $93.09 |
|
|
Evidence-Based Physical Therapy for the Pelvic Floor: Bridging Science and Cl… $81.72 |
|
|
Evidence-Based Physical Therapy for the Pelvic Floor: B $84.00 |
|
|
Guide to Evidence-Based Physical Therapy Practice by Dianne V. Jewell $9.95 |
|
|
Cardiovascular and Pulmonary Physical Therapy : An Evidence-based Approach $47.65 |
|
|
Guide to Evidence-Based Physical Therapy Practice 2nd Edition New $84.95 |
|
|
Guide to Evidence-Based Physical Therapy Practice By Jewell, Dianne V., Ph.D. $82.74 |
|
|
Evidence-Based Physical Therapy for the Pelvic Floor: Bridging Science and Clini $60.79 |
|
|
Stronger Seniors® Chair Exercise Program- 2 disc Chair Exercise Program- Stretching, Aerobics, Strength Training, and Balance. Improve flexibility, muscle and bone strength, circulation, heart health, and stability. Developed by Anne Pringle Burnell $17.85 The Stronger Seniors Workout Program is designed by Certified Fitness Instructor Anne Pringle Burnell to help seniors develop strength and to enhance the ability to function in daily life. These two fitness DVDs work together to improve your ability to be stable and balanced, to stay mobile, to go up and down stairs, to squat and pick something up, and to play with your grandchildren!… |
|
|
ThermiPaq Therapeutic Hot & Cold Pad Therapeutic Hot & Cold Pad for soothing pain reliefContouring Theramics® Radiant/Thermal Ceramic Therapy6″ x 12″ pad Reusable/portable Cools in Freezer Heats in Microwave Flexible at any temperatureMaintains optimum therapeutic temperatures better than gels! Designed in consultation with physicians, chiropractors & physical therapists.Theramics technology uses radiant energy to bring soothing rel… |
|
|
Flower Essence FES Quintessentials Self Heal Skin Creme — 1.7 oz $8.80 The Self-Heal Creme is based on the remarkable properties of the Self-Heal herb (Prunella vulgaris). A truly universal plant which can be found growing wild in many parts of the world, it belongs to the Mint family. Every member of this plant family exhibits medicinal, culinary, or aromatic qualities, and it includes such plants as the mints, basil, rosemary, thyme, and lavender. Prunella has been… |
|
|
Breo IDream 1260 Head and Eye Massager included AA Batteries $149.98 Introduction:The Breo IDream 1260 head and eye massager is designed computer-based according to structure of head region and distribution of different cure points. It uses the principles of channel acupuncture from Chinese Medicine to apply massage, and vibrations to your head and eye, and temple to increases oxygen supply and blood circulation in the head. With music therapy, it can help you redu… |