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1izalluneed
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I had been having some pain in my left buttock for several months and got an MRI that showed a herniated disc L5,S1. The Physiatrist diagnosed me with sciatica and reccomended an epdidural for the pain along with physical therapy. I recieved the epidural and have been in PT for two weeks.

The strange thing about my pain was it didn't hurt when I rode unless I was really pushing it on long rides and then not much at all. The most pain primarily was in the morning when I woke and after sitting for a while, like at my desk or in a car. I don't have a desk job but have been at my desk more lately because of the weather.

I was told by my Physiatrist if it didn't hurt to ride I could ride but just don't lift anything heavy. The Physical Therapist said pretty mush the same thing, if it didn't hurt to ride it was "probably o.k". So I have been riding my road bike, 20 to 30 miles three times a week with rolling terrain and short hills. I feel good while riding.

After the epidural and physical therapy I seem to be getting worse. The pain in the morning when I get out of bed is very intense and lasts for over an hour. After about an hour the pain subsides and then only really bothers me when I sit for a time during the day, or bend the wrong way. The pain then comes back around 7 or 8 o'clock at night. I also have a tingling pins and needles feeling in my leg down to my foot at infrequent times during the day, this did not start until after the epidural.

I seem to feel a little better when I ride mentally and physically, but for now I have not ridden in over a week and seem to be the same if not worse. I thought that riding might be interfering with getting better.

Has anyone else experienced a similar condition? What did you do to recover and how did you recover? Is continuing to ride helping or hurting?

Thank you for any comments or advice.
 

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I think if you do a search for herniated disc on this site you'll find a fair amount of previous discussion.

I went through a very similar type of experience. Herniated L3-4, L4-5, and L5-S1. The most important thing to do is to break the cycle of trauma. I don't have any experience with an epidural, but I would assume that it could be masking some pain? I would go ahead and get off the bike for a couple of weeks. Spend as little time sitting as you possibly can and get up frequently to walk around. Walking is really good...lots of time walking.

Otherwise, stick with the PT, but ultimately you have to kind of "walk on eggshells" with this thing for a while. Get the inflammation down and let it heal before you get back on the bike. I tried to rush things and it turned into a good 6 months of getting slightly better and then significantly worse.
 

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For many people most of their pain from a herniated disc is due to inflammation and reflexive muscle spasm. So I'm not surprised that the pain increased some with the PT. That's why they give you the epidural, to decrease the inflammation and allow you to do the PT with less pain. If that isn't the case, then you are one of the unlucky ones, where the epidural did not work. Sorry for that news. But all is not lost.

First of all, you need to accept the fact that disc herniations take a long time to heal, and you won't feel awesome for close to a year. That doesn't mean you will feel like this for that long, but it takes a while for the tisses to heal really nice. This is due to the nature of disc material and the low blood supply discs have.

Secondly, unless the PT is doing traction, you may not get the good result you are looking for. Traction for disc herniations does wonders, and a dynamic traction, like Flexion/Distraction or decompression is best. This type takes into account that the traction may cause muscle spasm, and adjusts accordingly.

The last thing I have to add is about your riding. Riding your mtb may not be causing you pain now. However, lord help you if you crash. So I would take ebaker's advice and take some time off. Until the muscles are no longer gaurding the area, and the disc materal is healed enough to take a mild fall. Then you can ride and avoid the large jumps. Make sure the doc knows what kind of riding you are talking about. He might think you're just doing a gravel trail.
 

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I'm still recovering from a herniation diagnosed last summer. The symptoms are much like yours. The severe pain is gone now but my back constantly reminds me it is not alright. During bad days I found swimming, walking and inversion to be the best remedies for the pain. Now I do daily core exercises to keep it under control. I took 5 months off my bike and I think it did help the tissues to heal up even though I usually feel better after riding.
 

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Herniated L4-5 and L5-S1. Surgeries in Sept 06 and January 09. Still in recovery mode after surgery #2.

Epidurals are only short term fixes. Occasionally they will reduce the inflammation and your disk will naturally recede back to "normal", but like others said, it will just temporarily reduce pain levels.

There are many diagnosis and treatment methods for herniated disks. What works for one person might make things worse for another. One of the few generally accepted treatment options is to strengthen your core. If your pain level permits it, do plenty of core excercises, not just sit-ups or crunches.

Take your time in recovery and get second opinions if you feel at all uncomfortable or unsure of your diagnosis or treatment.

Back pain is a *****.
 

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According to S. McGill sit ups is a particularly bad exercise for troubled backs which I find to be consistent with my observations. According to him core conditioning exercises should be chosen wisely so that they do not create an excessive compression force on the spine. In particular, disk herniations do not go well with exercises that impose load at the ends of spine range of motion.
 

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Agreed. Everyone hears "strengthen core" and thinks "sit-ups". I would highly suggest planks and side planks as an alternative. There are plenty of other good exercises as well, but, in my opinion, those should be at the center of a core strengthening routine, especially for someone with back problems, especially for someone who rides. Remember, the function of the core is to form a stable platform...not to create motion and so your training should reflect this.
 

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ebarker9 said:
Agreed. Everyone hears "strengthen core" and thinks "sit-ups". I would highly suggest planks and side planks as an alternative. There are plenty of other good exercises as well, but, in my opinion, those should be at the center of a core strengthening routine, especially for someone with back problems, especially for someone who rides. Remember, the function of the core is to form a stable platform...not to create motion and so your training should reflect this.
Yup, planks do work really well for me. If I don't do a set in the morning it is pretty much a given I'll have a bad day with my back.
 

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Valdemar said:
Yup, planks do work really well for me. If I don't do a set in the morning it is pretty much a given I'll have a bad day with my back.
Wow. I usually do them post-work, with just a little loosening up stuff in the morning.

What does a "set" consist of for you? I saw one recommendation that nobody should be doing a strength training routine until they can do 3 minute planks and a couple of other things. 3 minutes is...a long time. I'll do 2 sets of 2 minutes or 3 sets of 1.5 minutes, but even that is brutal.
 

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ebarker9 said:
Wow. I usually do them post-work, with just a little loosening up stuff in the morning.

What does a "set" consist of for you? I saw one recommendation that nobody should be doing a strength training routine until they can do 3 minute planks and a couple of other things. 3 minutes is...a long time. I'll do 2 sets of 2 minutes or 3 sets of 1.5 minutes, but even that is brutal.
When I say morning it is 40-60 mins after waking up, before that I'm usually too stiff to do anything safely. I start with a short careful cat-camel with 10 repetitions max to loosen up the spine, continuing with leg raises from the same position, and finally planks, my set is something like side-straight-side-straight-side-straight-side, hold 30 seconds in each position, so it is not as strenuous as yours but enough to get muscle activated for the rest of the day. The whole thing takes 10min max but makes a big difference, to me anyway.
 

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Valdemar said:
When I say morning it is 40-60 mins after waking up, before that I'm usually too stiff to do anything safely. I start with a short careful cat-camel with 10 repetitions max to loosen up the spine, continuing with leg raises from the same position, and finally planks, my set is something like side-straight-side-straight-side-straight-side, hold 30 seconds in each position, so it is not as strenuous as yours but enough to get muscle activated for the rest of the day. The whole thing takes 10min max but makes a big difference, to me anyway.
That makes a lot of sense to me. Like you, I'm much too stiff to do anything when I first wake up. I like the idea of getting the muscles activated for the day. The idea of getting up even 40 minutes before leaving for work though...awful!
 

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Bad disc

I was hurting from before New years. 2 weeks ago it really started to hurt. Had a mri last week and have a herniated disc. I see another doc next week and think the shots will be the next fix. I am interested in what exercises I can do and how long it will take to heal. Are the shots only to mask the pain? What are the plank exersise talk about above. Is riding my mtb in rough rocky grounds out of the question for the summer? Thanks
 

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There are no definite answers to your questions. I'm not a doctor but I'd only do the shots if the pain is very severe, e.g. unable to walk. There are different types shots, some are to block the pain, others are for reducing inflammation (steroids). Perhaps they can give you both at the same time but oral NSAIDs should be tried first. As for exercises I'd also wait until the pain is more or less under control. Google for "side plank exercise", there will be plenty of hits. Try inversion for temporary pain relief, there are many reports on positive effects, my case including. Healing duration is of course individual. Literature suggests that about 40% of disk herniations will heal by themselves in ~2 months frame with proper care, the remaining 60% is unclear, and chronic cases are not unheard of. In my case it took me about a year to get to a mostly ok shape with mild sciatic symptoms. As for riding rocky grounds you will have to see for yourself, definitely get a FS bike if not yet done so.
 

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Valdemar said:
There are no definite answers to your questions. I'm not a doctor but I'd only do the shots if the pain is very severe, e.g. unable to walk. There are different types shots, some are to block the pain, others are for reducing inflammation (steroids). Perhaps they can give you both at the same time but oral NSAIDs should be tried first. As for exercises I'd also wait until the pain is more or less under control. Google for "side plank exercise", there will be plenty of hits. Try inversion for temporary pain relief, there are many reports on positive effects, my case including. Healing duration is of course individual. Literature suggests that about 40% of disk herniations will heal by themselves in ~2 months frame with proper care, the remaining 60% is unclear, and chronic cases are not unheard of. In my case it took me about a year to get to a mostly ok shape with mild sciatic symptoms. As for riding rocky grounds you will have to see for yourself, definitely get a FS bike if not yet done so.
The sounds about what I would suggest and what my recovery process was like. It's been about 2 years now since my initial injury and it's still something that I have to manage every day. That's not to say that it's painful every day...most of the time it's fine, but it's something you always have to manage with posture, stretching, and strengthening exercises.

Planks are an exercise that resemble push-ups, but you are placing your weight on your elbows and forearms rather than your hands. You want to keep your midsection stable and your entire body parallel to the ground. There's probably a lot of information out there on exactly what to focus on with this exercise, but you want to make sure that your symptoms are well under control before attempting, because you don't want to aggravate things further. Your doctor and/or physical therapist should be able to help with that.

As far as significant riding this summer...hard to say. Wait until you feel you're ready and then give it another couple of weeks. I will say that rocky trails weren't any worse than anything else. Sustained climbing and staying in the same position seems to be the hardest for me.
 

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ebarker9 said:
As far as significant riding this summer...hard to say. Wait until you feel you're ready and then give it another couple of weeks. I will say that rocky trails weren't any worse than anything else. Sustained climbing and staying in the same position seems to be the hardest for me.
+1. In fact rocky terrain implies keeping your butt off the saddle and moving around which I find less stressful for my troubled back than staying seated in the same position for long time.
 

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I herniated a disc a couple of years ago, so badly that I had to work standing up for several weeks, watch TV lying on the floor, and some days couldn't walk.

I managed the pain with Advil and beer. I'm not kidding about the beer. It worked wonders as a muscle relaxant. Just one or two made all the difference.

It was a big day when I could finally come off the Advil.

I'm still on the beer. Don't want to chance anything.

Seriously, though, riding turned out to be a lifesaver. I agree that trails that force you to stand may actually be better for your back... I've certainly never had a problem with my back riding tech stuff, anyway.

I did change my riding position, and went to wide riser handlebars, which I actually like better anyway. The open-shoulder position is MUCH better for your back. As soon as you feel your shoulders rounding, you're in trouble.

The only issue I've had has been on long singlespeed rides where I've been doing a lot of climbing. This can start my back cramping. I have occasional foot cramps but nothing that stops me riding for more than a couple of minutes.

The most annoying thing is that when I fall off, I inevitably have a severe foot cramp, which makes spills more painful than they need to be.

Overall I'm riding harder and better than I did before the herniation.

I even got onto a road bike this week, which I thought would be much too hard on my back, but with some tweaking of the position it was fine.

Straight back in everything you do. That's really the key.
 

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Based on experience from my mother and wife

My mother has had several and my wife just had one. Both have had excellent results from the minimally invasive surgery that is now available.

My wife had symptoms similar to what you described - constant nagging pain down the leg. She tried all of the usual non-surgical approaches, and finally went for the surgery. She woke up with all of the pain (except for the surgical pain of course) GONE. Instant relief.

The downside of course is the 6 weeks of no "lifting, twisting or bending"...

I'm not advocating moving to surgery without trying everything else, but just saying if you're the right candidate, it can work.
 

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Do what you must to save your back........... get second, third and fourth opinions if you don't feel right

I had surgery after gutting it out at the ripe old age of 26 thinking there was nothing wrong and finally after not being able to push in the clutch of my car or walk properly went in and had "emergency" lumbar discectomy the next morning.

I feel great as does my back MOST days but riding is only one thing that will now and again bother it even Hmm.... 13 years (yeah I am old now I guess) later.

Take very good care of your back regardless and take it serious. It hurts and will lay you flat out for months, forget about weeks if not treated as a real problem.

My usual worthless 2cents probably but Good Luck:cool:
 

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Disc Decompression Therapy

It's now been a month since the really bad pain started in my left leg. The docs do seem to try out other methods first. I have been to a Pain Managment doctor and was in for my second visit for Axial Spinal Disc Decompression Therapy. Tracion for the lower back. Then a crack and push on the table. I really hope this helps out. Anyone else have this done to them?
 

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I go in tomorrow morning for surgery, same place L5/S1. Evidently the worst place to do surgery on a herniated disk according to the surgeon. He has to drill through some bone to get to the disk; maybe I should ask if he can drill a few extra holes to lighten me up a little.:thumbsup:
 
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