My husband has a herniated disc in lower back (I think L5). He has been in pain for about 6 months. Physical Therapy did not help. He had two of the three scheduled steroid injections and he actually got worse after the third. Right now he is on bed rest. He takes Flexaril, Hydrocodine, Tramadol and an antiflammitory (don’t remember which one). It just seems to keep getting worse.
#1 by Lindsay on September 4th, 2010
Quote
If the steroid injections are not working then unfortunately there is very little else he can do. Some people don’t respond to the steroid injections. The surgery is actually not that bad, I had it at L5S1 and the surgery and recovery are fairly straight forward. It’s better to get it fixed permanently and get to you life. I hope this helps good luck!
#2 by I_am_AWESOME on September 4th, 2010
Quote
The longer he stays on the pain meds, the greater chance he has of getting seriously hooked on them. Go for the surgery.
#3 by Richard C on September 4th, 2010
Quote
Gwen, don’t be in any rush to have your husband undergo any surgical procedure. Statistics show that only around fifty percent of those procedures are successful and once done there is little that can be done to correct for any problems that arise. I am sorry that the physical therapy that was done was not successful but try again. Find a therapist that does hands on work and not the use of modalities coupled with some exercises. You want hands on work! I am going to give you some movements to have your husband try. Some of them may not seem related to the problem but trust me that they are. All that is needed is a straight chair. Have him sit in the chair and do these movements. Raise the left arm up as high as it can go and then return it to the side. Note how high it went and then do the right arm. One arm will have gone up further so start with that arm. Raise that arm up as high as you can for thirty seconds and then rest it for fifteen seconds. Now repeat that procedure exactly the same way twice more. Then do the opposite arm exactly the same way for three times. Next turn the head to the left as far as it will go and note the movement. Turn to the right and note how far it went. One direction will have gone further so start in that direction. Turn the head in that direction as far as you can for thirty seconds and then rest for fifteen seconds. Repeat that process twice more on that side and then go to the opposite side and repeat that process three times. He should now get up and move around. There should be a decrease in pain and a little bit more mobility in the lower back. Return to the chair and follow these instructions carefully. Do not ever enter into an area of pain but stop short of it! The feet and hips should be planted firmly and since he all ready knows which side has more mobility turn in that direction as far as possible without pain for thirty seconds and then rest for fifteen seconds. Repeat that twice more on that side. Now do the opposite direction. Do not enter into any painful areas! Turn in that direction as far as possible for thirty seconds and then rest for fifteen seconds. Repeat that twice more and after the last movement get up and walk around. There should be a lessening of symptoms with more mobility. Hopefully that has worked. It should be done at least once a day and if possible twice. Get to a therapist that specializes in backs and does one on one work. The muscles of the legs from the feet on up to the head have to be strengthened and brought back into balance to control the problem. Good luck!
#4 by mistify on September 4th, 2010
Quote
Without seeing him clinically, it’s difficult and dangerous to give him specific treatment advice. What is also tricky is the term “herniated disc.” Radiologists and other medical practicioners commonly use this term haphazardly. In it’s true sense, a herniated disc differs from that of a “bulge” or a “protrusion” in that in a herniation, the wall of the annulus (the outer layer of the disc) remains intact, but it is incompetent. This means that the material that has been displaced in the disc is unable to be restored to a normalized position. The clinical presentation is typically one that pain (and possibly numbness and tingling) usually radiates to the foot, and is constant. Some relief may occur with lying down or specific exercises, but the second the patient returns the standing, the symptoms return. In the incompetent annulus, recovery with physical therapy…whether manual therapy, traction, direction specific exercises, or “stabilization” exercises is a moot point. Many of these patients will get better with time as the disc firms up again, or they may need surgery.
The fact that you say he was worse after injection is worrisome. Was it done under flouroscopic guidance? If not, I’ve seen a handful of cases where people were worse after injection done in the physician’s office. Typcially, these patients will, after injection, have a progression of their leg pain, which may have been intermittent before, but is now constant and worse than the back pain. If this is the case, this correlates highly with an extruded fragment…presumably because the injection went into the disc instead of the epidural space and subsequently ruptured the disc. Not a whole lot can be done in these cases other than surgery or time.
However, in cases where the disc is only protruding or bulging, these frequently respond to physical therapy. Yet, I would have expected a much greater recovery at this point…should have occured in days to weeks, not months. The next thing to discuss is that the quality of physical therapy varies greatly between practicioner. Having spent literally hundreds of hours of continuing education and residency in spine care, the best advice I can give you, as opposed to specific exercises is to have your husband follow up with a physical therapist who is at least certified, but preferrably a diplomate in Mechanical Diagnosis and Therapy. If he did not receive care from such a PT, I would HIGHLY recommend it, as an easy and simple solution may have been grossly overlooked. Or, if it does appear to be an incompetent annulus or an extruded fragement, this becomes very apparent during assessment, and they will relay this information to you.
Find a certified or Diplomate in MDT at: http://www.mckenziemdt.org
Best wishes