Shit! Ruptured disc?

I've spent the last few days on the couch as a result of re-injuring my back. I hurt it in late August and thought I had it felt back to normal by the start of ski season. Well, this time I've got pain in my back that radiates all the way down my right leg, my toes tingle and I have pain in my abdomen. I visited my PT on Monday and he seems to think it is a ruptured disc around L4. I can't get in to my doctor until Friday. I'm in my mid thirties and thought until now that I was pretty fit. This shit really humbles a guy. It hurts too much to even take the dog for a walk around the block.

Anyone else have experience with this injury?

I had a procedure late spring to fix a herniated disk.

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BTW I Deadlifted 435# last week for 2 reps.

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Originally Posted by GoBig1776

Anyone else have experience with this injury?

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Too much experience. I've had two decompression surgeries. You will have to get an MRI to determine what happened. Tingling and numbness could be a sign that a hernia is causing nerve damage (possibly permanent) so take it seriously. If you are experiencing progressive neural deficit, you are a likely candidate for surgery. I lost quite a bit of leg function the second time this happened to me. It's returning very slowly but after 7 months since surgery, my leg is still too gimpy for me to consider going back to snowboarding. Can't tell if it will ever fully heal, to be honest. Don't let yourself get talked into a fusion; there's estimates that as much as half of all fusion surgeries are unneccessary. The fusion is around five times more profitable for the surgeon and hospital, so be skeptical.

Here's a basic test. Sit upright in a hard chair with your chin tucked down on your chest. Lift the affected leg with your leg straightened. If that sent pain shooting down your leg, it is probably a herniated disc pressing a sciatic nerve root. If the pain seems to go to the big toe, that is the L4-L5 sciatic nerve root. If it goes to the ankle, heel and little toe, that is the S1-L5 root.

Going in to the Doc on Friday and hopefully will get the MRI that should have done in the fall if not for the stupid government shutdown. This injury was sustained while working for the USFS, so they should pay for continued treatment. Everything got fucked up with billing during the shutdown, but my physical therapy was progressing well and I elected to continue the non-invasive treatment.
I was still skiing and working until Sunday, but commuting to the hill and riding on the chairlift caused much pain.

Skiing through the pain is not a good idea. You can easily turn a PT manageable hernia into something serious where it hurts so bad that you can't stand without a cane and there is no resting position that gives you any relief for sleeping. I did that twice, so beware, mon frere.

After almost two weeks of couch time, things are getting somewhat better. Doc prescribed a steroid that was supposed to reduce inflammation. I can now walk the dog down to the park and I even went for a short road bike ride yesterday. I still get pain from my back down my leg and numbness in my foot after walking around or standing for a while.
I had an MRI on Thursday and will visit the doc tomorrow for results. It is an early appointment, so I plan on skiing in the afternoon unless the news or pain is dire.
I have not missed more this many days in a row of skiing in ten years, so I'm getting a bit stir crazy.
Wish me Luck!

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Originally Posted by Tuckerman

BTW I Deadlifted 435# last week for 2 reps.

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Did you have a discectomy or the rounds of epidural injections? I'm on round two of three injections, and have gotten noticeable relief but still have tingling in toes, foot, with occasional heel pain. The VA docs want ya a to go this route first before cutting.

Ouch.
I blew L5-S1 disc in June, 2012. I did P.T. narco dope, acupuncture, chiro, ESI (epidural steroid injection) for a year. Docs said leg pain, numbness, weakness, etc. down to foot often ends up with surgery. So, I had a Micro-discectomy in July.

6 months out, all back pain is totally gone, but my left leg still has numbness and a weak sensation...no pain, tho. May or may not be permanent...fingers crossed it's not. I can ski about 80%, but if I hit it too hard, my leg pays the next day.

I agree with Neckdeep about avoiding a fusion. If that is recommended, get a 2nd...and 3rd...opinion. Hope that PT and ESI works, but if not, Micro-discectomy is pretty non-invasive (for surgery), about 80% effective, and you recover quick. I was walking to the end of the block and back the very next day.

Good Luck with it no matter how you get it resolved. Back pain sucks.

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Originally Posted by GoBig1776

After almost two weeks of couch time, things are getting somewhat better. Doc prescribed a steroid that was supposed to reduce inflammation. I can now walk the dog down to the park and I even went for a short road bike ride yesterday. I still get pain from my back down my leg and numbness in my foot after walking around or standing for a while.
I had an MRI on Thursday and will visit the doc tomorrow for results. It is an early appointment, so I plan on skiing in the afternoon unless the news or pain is dire.
I have not missed more this many days in a row of skiing in ten years, so I'm getting a bit stir crazy.
Wish me Luck!

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It takes an average of 2-4 months for these things to heal up without surgery so going skiing (or heavy lifting) now is a bit premature. Steroids don't heal you but they can mask the inflamation enough for you to get out and hurt yourself some more. The recurrent numbness in your foot is a major red flag warning you to ease up until that stops. I'm telling you, you should fear that numbness more than the pain because after numbness comes paralysis. Remember, a hernia is an open tear in the disc membrane. Trust me on this: the last thing you want to do is tear that sucker open any further. There is always a next season.

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Originally Posted by neckdeep

Trust me on this: the last thing you want to do is tear that sucker open any further. There is always a next season.

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^^Thanks for that.

Just came back from the Doc. MRI clearly shows bad stuff at L5-S1. We scheduled an injection for Wednesday.
Doc did clear me to return to work next week with no lifting >25lb and ok'd me for 1 careful, slow groomer run per day. Until then I guess it's more Netflix and TGR.

It's not just skiing/sports you have to think about now.

Be really careful when you sneeze, be careful getting out of bed, careful with sex... You have to re-learn how to live your life without stressing your spine.

Sorry, but this injury is a motherfucker and you have to take it pretty seriously.

Listen to yetiman.

I had a herniated disc. I can't remember the exact location, but it was between C4 and C7. My doc simply said not to do anything that caused pain and don't do any jarring activities, eg. running, skiing, etc. "If it hurts, stop. Do not work through the pain."

On a related note. I've been dealing with a pretty bad sciatica episode since Christmas. There was no injury per se but a general straining of my back loading shit into my car then it got really bad after a half day of skiing on Christmas day (no falls in fact just some groomers). Classic major pain down my right leg and a bit of numbness in my big toe. Had a similar attack 10 years ago that just sort of went away after a month and a half. I went into the doc for this one and he sent me to get x-rays. The results he said only showed some minor issues but he said there were no major issues and that an MRI was not needed (just gave me naproxen and send me on my way). The thing is this guy is older than dirt and is partially retired. Do I trust the guy? I've been told x-rays really don't show shit and you need an MRI to diagnose disc issues.

P.S. Went to a chiro on Friday and he did some thing where he practically yanked my leg off and popped the hip in a way that unlocked my piriformis. Cleared things up a lot but not totally. Still enough pain where I would not walk more than a half mile without pain and still some numbness in big toe.

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Originally Posted by YetiMan

It's not just skiing/sports you have to think about now.

Be really careful when you sneeze, be careful getting out of bed, careful with sex... You have to re-learn how to live your life without stressing your spine.

Sorry, but this injury is a motherfucker and you have to take it pretty seriously.

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Too true. I nursed my last hernia for 3 years of riding, hiking, fishing and firewood only to have a catastrophic blowout pitching horseshoes, of all things. I went from feeling solid to total agony in one week without overdoing anything physically. Fucker was just so worn out from years of toughing out the pain that it just fell apart. Toughing out the pain gives you scar tissue and beat up discs. To be honest, I'm just so glad to be walking without a severe limp that I don't know if I even want to risk going back to the board next season. There are much worse things than missing out on some pow days with your friends. Losing nerve function in your leg is one of them.

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Originally Posted by LegoSkier

On a related note. I've been dealing with a pretty bad sciatica episode since Christmas. There was no injury per se but a general straining of my back loading shit into my car then it got really bad after a half day of skiing on Christmas day (no falls in fact just some groomers). Classic major pain down my right leg and a bit of numbness in my big toe. Had a similar attack 10 years ago that just sort of went away after a month and a half. I went into the doc for this one and he sent me to get x-rays. The results he said only showed some minor issues but he said there were no major issues and that an MRI was not needed (just gave me naproxen and send me on my way). The thing is this guy is older than dirt and is partially retired. Do I trust the guy? I've been told x-rays really don't show shit and you need an MRI to diagnose disc issues.

P.S. Went to a chiro on Friday and he did some thing where he practically yanked my leg off and popped the hip in a way that unlocked my piriformis. Cleared things up a lot but not totally. Still enough pain where I would not walk more than a half mile without pain and still some numbness in big toe.

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Chiros are ok for muscle problems. If you actually have an open hernia and the chiro "adjusts" you hard enough to tear open that disc, you'll be shit out of luck when the quack tries to act like it wasn't his fault that you are suddenly in agony and need a $35,000 decompression surgery. You described symptoms of a L4-L5 hernia but your chiro decided fuck an MRI, guessing is good enough for this guy, I'll just give him an adjustment for piriformis syndrome and collect my fee. Caveat emptor. General Mds can't do much for you either besides a referral. Spines are the realm of specialized orthos, neuros and radiologists. Your general practitioner can only tell you numbness in the big toe indicates a L4-L5 hernia. This muscle group holds the foot up to keep it flat when striding. You should be on the lookout for "drop toe" which you will notice as the repeated, accidental stubbing of the tip of the foot. If you get drop toe, go directly to the best spine surgeon you can find because the nerve is pressured enough to cause nerve damage. If the Md did not tell you that then, yes, you should seriously question whether to trust his knowledge. Same for the chiro; if he didn't mention drop toe then he is a quack. A tight piriformis or psaos muscle can aggravate a back problem but there is usually an underlying injury being aggravated. If you have chronic pain without any specific trigger event, yeah, maybe tight muscles are to blame. That's fat person, too much sitting, couch potato back pain fit for the chiro. If you got an injury, stay the fuck away from a chiro.

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Originally Posted by neckdeep

It takes an average of 2-4 months for these things to heal up without surgery

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That is an optimistic "average" from what i've been told. My understanding is that the discs shrink as you age and through this shrinkage, the back pain will eventually subside due to less impingement on the nerve in the joint. This is one of the reasons surgery is often not suggested immediately: because it will likely go away over time.

But none of us here is willing to waste years of our lives not being active.


I had a microdiscectomy and laminectomy on my L4-L5 back in 2004. It got me back to being active shortly before my son was born (2mos). [full recovery was more like 6mos]

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Originally Posted by acinpdx

That is an optimistic "average" from what i've been told. My understanding is that the discs shrink as you age and through this shrinkage, the back pain will eventually subside due to less impingement on the nerve in the joint. This is one of the reasons surgery is often not suggested immediately: because it will likely go away over time.

But none of us here is willing to waste years of our lives not being active.


I had a microdiscectomy and laminectomy on my L4-L5 back in 2004. It got me back to being active shortly before my son was born (2mos). [full recovery was more like 6mos]

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Surgery is not indicated for pain alone. Most episodes of pain resolve themselves. Numbness and tingling, however, are a warning that neural deficit could be next. So, pain plus significant numbness needs to be evaluated differently; i.e., an MRI might be a good investment if you are experiencing more than just pain. Loss of nerve motor function is an indicator for surgery as soon as possible, even without significant pain. Damage to the peripheral part of the nerve root can heal gradually, over a few years. Damage to the root on the cord is permanent. Unless you are Peyton Manning and can afford being flown to an elite foreign clinic to have ground up babies injected into your neck. For the rest of us, tho...take it easy until it stops hurting!

Lots of good discussion here. Never thought I'd get this much.
I will heed the advice about not trying to work through the pain and make it worse, but the real hard thing for me to wrap my head around now is what I do for work.
I've built myself a pretty cool seasonal lifestyle, firefighting for the USFS in the summer and ski patrolling in the winter. I've dedicated pretty much my whole adult life to trying to become decent enough at both jobs to consider it a career. In essence, ski patrolling and firefighting are just manual labor. I can go back to the ski hill soon as a dispatcher and I'm willing to write off this season, but what about down the line? I've been doing some serious thinking about finding new lines of work.
Anybody still do manual labor after this injury?

"The flame that burns twice as bright, burns half as long" - Lao Tzu

I don't know about your USFS job, but I would imagine forest firefighting is out with a blown disc. They must have lighter-duty gigs, like dispatching, shuttle driving, or something like that.

I'll second being cautious about you activity, as ESI's and pain meds will make you feel like it's not so bad and that you can do quite a bit. Like has been said, though, that's just due to meds covering up the pain. The injury is still there, and too much strain (even though it doesn't feel like it) will just make it worse.

I'd suggest seeing a PT also. They can make up what they call a "home program" for you of exercises to do at home that will strengthen your core, maintain nerve elasticity in your spine, yet not aggravate your disc injury.

I also agree with staying away from the chiro. I saw an Anesthesiologist for the ESI's and a Neurosurgeon for the surgery.

LegoSkier, to the best of my knowledge, you need an MRI to accurately diagnose disc issues. I don't believe an X-Ray will cut it. I'm not a Doc, tho. I do know the Doc who did my ESI's wouldn't do shit without an MRI...so there's that.

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Originally Posted by GoBig1776

Lots of good discussion here. Never thought I'd get this much.
I will heed the advice about not trying to work through the pain and make it worse, but the real hard thing for me to wrap my head around now is what I do for work.
I've built myself a pretty cool seasonal lifestyle, firefighting for the USFS in the summer and ski patrolling in the winter. I've dedicated pretty much my whole adult life to trying to become decent enough at both jobs to consider it a career. In essence, ski patrolling and firefighting are just manual labor. I can go back to the ski hill soon as a dispatcher and I'm willing to write off this season, but what about down the line? I've been doing some serious thinking about finding new lines of work.
Anybody still do manual labor after this injury?

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I did 14 fire seasons. IMHO it's undoable with a bad back.

Hang on tight...I pulled the plug in 2008 and life has been dog shit since then. I had that dream life, helitack in the summer, took winters off. Owned a home. It all went away until I was down to nothing. I'm just now finally sort of maybe getting it together again working as a bus driver. It's been a long, hard road reworking everything. Get ready for people to have no idea what wildland firefighters do, get ready for everyone to assume since some structure firefighter they know is obese that you don't need to be in shape to be a firefighter.

Honestly, I wish you the best. It's been extraordinarily difficult for me.

edit: also re: dispatching wildland. I would STRONGLY CAUTION AGAINST THIS. Unless you're desperate. It's the worst job I ever had. It was life-changingly bad.

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Originally Posted by YetiMan

I did 14 fire seasons. IMHO it's undoable with a bad back.

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I agree. Stoop work with a pulaski and shovel is the sort of repetitive motion wear and tear that will probably lead to recurrent problems and a life of chronic pain. Shovelling dirt or snow, either is a killer on the lower back and should be avoided, if you are thinking for the long term. There are acute spine injuries and then there are chronic problems. Wear and tear tends to beget the chronic issues that lead to degenrative disc disease. On the plus side, degenerative disc disease is a legitmate diagnosis for a med card for weed, if that's your thing. Won't make it any better but you'll care less, I guess. Better than oxy. It only takes about two or three weeks on oxy or hydro before your brain is scrambled to mush and you get withdrawal. I was on oxy for a month and couldn't think my way out of a paper bag.

I had my first decompression 15 years ago and got in around 800 more days of riding afterwards until a DIFFERENT level blew out last may. I also worked, cut my own firewood and rowed a drift boat like there was no tomorrow. Basically, I got away with it for another 15 years. But now, I'm middle-aged with a bum leg and I am a candidate for a three level spinal fusion if it happens again. Yeti makes the case that things can get worse than that. I wouldn't argue that. I'm relatively pain free, so I've got that to be thankful for. So, the answer to your question might be, "where do you want to be in another 15 years." Getting back to snowboarding was really important to me, a decade ago. Right now, I'd trade in my pride for a leg that worked better, kapiche?

Yetiman, Ouch. That's quite a tale of woe. Glad things are finally starting to come back together. I'd raise a beer with you and trade stories if you are ever in Montana.
I've also done 14 seasons with the USFS. From trail crew foreman to Wilderness ranger and horse packer to hotshot to heli-rappel. I thought the heli gig was pretty easy on the body compared to rest.
I had been thinking it was time for a change for a year or so, but the money and excitement is pretty hard to pass up. I'm just having a hard time coming up with alternatives. My education and experience are totally invested in forestry or ski patrol stuff. At least people here in Montana seem to know what wildland firefighters do.
And No, I'm not considering wildland dispatch, but doing ski patrol dispatch till I can get back to full duty. I think I would hate doing it for the USFS, but it is pretty fun at the ski hill.

Between the discussion here, talking to my PT, and several friends and family members in medicine, I decided to go for the injection.
The whole procedure was pretty quick and didn't hurt too bad. I got relief right away. I know I still have a long road of rehab, but at least the pain is drastically reduced.

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Originally Posted by YetiMan

I did 14 fire seasons. IMHO it's undoable with a bad back.

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This.

13 years in myself. Back is "bad" but not herniated. I have sciatica come and go. Makes life fucking miserable when you are eating muscle relaxers at night so you can go back and do it all over again in the morning.

Look around at the old guys, most are beat up or have moved on the desk jobs.

If you are going to stick it out, do Physical Therapy like crazy.

Edit- I'm in helirappel as well. It isn't easier on the back.

Attachment 149233
So, here is what a fucked up spinal disc looks like on MRI. I should also edit the title of this thread. My disc is herniated not ruptured.
Any of you medical people, help me out here, but this is how things have been explained to me and might help others with this injury:
The best analogy is that spinal discs are like jelly doughnuts. They have a tough fibrous outside with squishy crap in the middle. A herniated disc like the jelly doughnut that you put into your ski pack to eat as a mid morning snack. After getting smooshed between your water bottle and shovel handle, the doughnut is a deformed, but the jelly is still inside. The ruptured disc is similar, but your ski partner's husky laid on your pack in the car, then you took a fall before your morning snack. There was more force on the doughnut and this time when you grab the it from your pack, the jelly has squirted out and made a mess. Hopefully you put the doughnut in a bag before you put it in your pack.
Here is what happens with the shot. They numb you up, probably with lydocaine. Then they do a series of x-rays as the doc maneuvers the needle into position. The x-rays allow the doc to see the needle and determine when it is in the right spot. This hurts but not terribly bad. The shot is a mixture of lydocaine and cortisone. Lydocaine is an anesthetic and has two purposes in this application. First, it numbs the space near the disc when the fluid is pumped in, without this the shot might be very painful. Second, it helps the doc determine if he put the shot in the right place. If the patient reports that the injured spot goes numb, the doc knows he hit the target. The cortisone is a very powerful anti-inflammatory. It is supposed to shrink the disc and reduce the pressure on the nerve.
About five days out from my first shot, my pain is reduced considerably. The leg pain is mostly in my calf, not the whole leg. My right foot is still tingly, but much less so. My lower back actually hurts worse. The PT told me to expect this. She said pain at the injury site is better than pain and tingling in an extremity. I can walk a bit farther, my range of motion is slightly increased, and I can tolerate sitting and standing slightly longer than before the shot.
All in all, the shot was minimally invasive and did some good. I got to go do my exercises now.

There are plenty of folks out there with worse looking MRI's and no pain. The latest study I read stated that 88% of us have a disc bulge or worse and the vast majority of us don't hurt. The disc that is bulging is also dessicated (darker color than the others) which means that this disc is aging faster than the others. The technical term is disc degeneration, but the truth is that everyone's discs degenerage as we age and the process starts around age 10. It becomes a problem when one disc degerates much faster than the others and its no surprise that this was the disc that bulged. It's also possible that this disc may continue to give you problems down the road. Core strength and good body mechanics are your friend.

Its a really good sign that you responded to the cortisone injection. Many people recover with the injections and PT. Actually, some people think that time is the biggest variable since most people are back to normal after 3-6 months regardless what they do. Sometimes on repeat MRI's the bulge shrinks overtime but sometimes it stays the same size but the pain is gone. The key factor seems to be local inflamation of the nerve root...something undetectable with MRI.

Surgery is often indicated with intractable pain or if some muscles exhibit neurological weakness. Your PT knows to look out for weakness and there is a test called an EMG that can confirm it. In my case the weakness was in my glut max and was not detected for several years (the EMG didn't test that specific muscle). All of my problems since my back surgery are related to damage done to my glut max from the years of partial denervation. In my case, I wish the weakness was detected sooner and I had opted for surgery sooner. There are probably many more people who wish they never had back surgery and just gave it more time to resolve. Every case is different.

Good luck and heal fast. One last note, the PT routine that helped me the most was McKenzie style back extensions (you can youtube it...its like the cobra position in yoga) and dry needling. If you plateau with your current PT you can try another certified in either of those things....they both have websites with a list of providers.

My spinal cortisone shots were awesome



for two weeks

(I hope yours are more effective for you - back issues suck!!)

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Originally Posted by YetiMan

It's not just skiing/sports you have to think about now.

Be really careful when you sneeze, be careful getting out of bed, careful with sex... You have to re-learn how to live your life without stressing your spine.

Sorry, but this injury is a motherfucker and you have to take it pretty seriously.

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This is the truth. And anyone with real back injuries understands exactly what Yeti is talking about.

I've had two blown disks. The first was L4/L5. I had surgery 2 years after the injury and was able to get back to about 90 percent and continued all of my pre injury activities.

3 years later i blew L5/S1. The steroid pack got me out of the acute crisis and after 3 or 4 months I was doing alright. However, I had to give up running and basketball, as the jarring would irritate the injury and I would end up with another 2-4 week flare up. I did the PT path for about 3 years.

After years of OTHER, Chiropractic care, and meds I suggest you pay attention to what makes you feel better. Does laying on one side feel better than the other? Can you tilt your car seat back to reduce the pain while sitting?

The PTs seemed to focus on core core core - which translated to abs abs abs. For years I followed the about routine but found myself having fairly consistent set backs.

After having a set of twins I quit working out and doing abs - and my set backs all but vanished. I put on 30 pounds and developed a bit of a launch and the set backs disappeared. I still ski 30 + days a year with few back problems (an occasional muscle strain). What I believe is that a lot of us have overworked our abs and have thrown our cores out of balance. If your quads, glutes, back, abs or other muscles are overpowering the other groups you end up with your pelvis feeling "tilted".

My experience is antedoctal but is offered to suggest you pay attention to how your body responds to different exercise, rehab protocols, and excercise. Backs are as much art as science. It seems that every treatment has between a 40-60 percent of working - so pay attention to what works for you.

Good luck.
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Originally Posted by jma233

All of my problems since my back surgery are related to damage done to my glut max from the years of partial denervation. In my case, I wish the weakness was detected sooner and I had opted for surgery sooner. .

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What are the long term issues with this? My whole S1-L5 myotome is messed up, especially below the knee. My glute has a numb patch but seems to have lost less muscle strength than the calf and ankle. You mentioned "dry needling"? Did accupuncture help stimulate the nerve to heal? Seems like the damage is sort of healing, though very, very slowly. Eight months post surgery, I have recovered some strength and I get tingling, itching, burning sensations in the numb areas sometimes that, I hope, is the nerve trying to "relearn" sensory info through the lesion. Haven't taken an EMG test yet. I can walk 5 miles now and no longer have a noticable limp. One month after surgery, it was a real chore to limp along for half a mile. My leg is way too weak for winter sports and my back feels fragile, but I'm not in pain, so things are better. Advice?

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Originally Posted by HansJob

Did you have a discectomy or the rounds of epidural injections?

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Discectomy, but I just just re herniated it 2 weeks ago. Fuk I my surgeon says its a 1:10 on having to get the discectomy done a 2nd time. I asked for 3 weeks to fix it myself with TB500 and chiropractor.

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Originally Posted by neckdeep

What are the long term issues with this? My whole S1-L5 myotome is messed up, especially below the knee. My glute has a numb patch but seems to have lost less muscle strength than the calf and ankle. You mentioned "dry needling"? Did accupuncture help stimulate the nerve to heal? Seems like the damage is sort of healing, though very, very slowly. Eight months post surgery, I have recovered some strength and I get tingling, itching, burning sensations in the numb areas sometimes that, I hope, is the nerve trying to "relearn" sensory info through the lesion. Haven't taken an EMG test yet. I can walk 5 miles now and no longer have a noticable limp. One month after surgery, it was a real chore to limp along for half a mile. My leg is way too weak for winter sports and my back feels fragile, but I'm not in pain, so things are better. Advice?

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Shit, I wrote a novel but my computer crashed. I'll try and hit the highlights:

1. Dry needling has been key for me in order to regain function. My gmax was the only denervated muscle but pretty much every other muscle in my pelvis and thigh became dysfunctional since my mechanics of gait and weightbearing were so 'off'. My rectus femoris, vastus lateralis, and tensor fascia lata responded quickly to needling and my glut med, glut min, and vmo are responding slowly. The gmax is responding very slowly but I'm definitely seeing improvement. It has become obvious that everything has to be treated in order allow my mechanics to be restored. Trying to strengthen with faulty mechanics wasn't working. The dry needling group I like the best are the Intramuscular Stimulation (IMS) group. I also like the Kinetacore group. They both have websites with a list of providers. Some states like CA don't allow dry needling so acupuncture is the only alternative.
2. Stetching the gmax was/is key but I've found that with denervation it can be tricky. I have to hold the stretch much longer than with a healthy muscle and sometimes stretching just causes my gmax to spasm and I have to hold off. Stretching after needling is a big no no for me because it always causes spasming. The stretch that works the best is the figure 4 stretch aka piriformis stretch.
3. Strengthening is also really trickly. Honestly, simply walking with perfect mechanics is probably my best exercise. My body wants to compensate around my weak gmax and some of the compensations are incredibly subtle. However if I'm able to eliminate the compensations then my gmax becomes incredibly sore and achy afterwards which i take as a good sign. If you read the literature about exercising partially denervated muscle it warns you to not overdo it, so I'm always walking the tight rope between doing too much and too little.

I'll shoot you a pm with my contact info in case I can be of further help. There is hope. Its been 3 years since my surgery and I've improved more in the last month than any other time.

Neck Deep and JMA are right on target. I had l4/l5 suegery in 2001, back on snow in 6 weeks. Had drop foot and no feeling in my foot either. Surgery 100% successful.

2007 had quada euqina syndrum, meregency back surgery and once again skiing 6 weeks later, Heli skied in Alaska for 8 days 2 months out.

Be careful of the shots, they mask pain. I had one, raced in the 24 hours aspen then blew my back up at last chance qualifier for x games skier cross.

I will add my $.02. If you have pain and no neru muscular deficit i would try and work through the pain with PT. I have a great regiment that I can send anyone who wants. I have it in PDF. I would do this 15-20 minutes a day, 2-3 times a day.

My back has been great every since. I am on the volunterr fire dept, emt and wildland as well. Crossfit 2-4 x a week and ski 4-6 days a week. Deadlift max is around 405

I am 45 and feel stronger and faster than when i was 30. See embedded video taken this sunday (Shameless self promotion)

http://www.youtube.com/watch?feature...be&app=desktop

Deeppow,
Thanks for the encouragement and stoke. I'd love a copy of your workout. I'll send a PM with my email address.

Today, I had my third shot. This one was a double. The Doc had been putting the medicine in at S1, below the herniation, but today he went above and below. The shot at L5 produced a slightly different sensation when it in. The tingling and pain that come when the steroid cocktail was pushed in was more on the side on my thigh and calf and some tingling on top of the foot. The lower shot produces the same sensation, but more on the back of my calf and bottom of my foot.

The shots have done lots of good, but I still may be in line for surgery. I see the doc again on Monday and we will make a plan.

My pain has gone from a near constant 7/10 to a 2/10 with rarer and rarer spikes to 5/10. The tingling in my foot is still there but dramatically decreased. I am still weak in my right leg, but that too has decreased. I've been rocking my PT workouts and taking longer walks.

I went back to work at the ski hill last week and will be there tomorrow. Just as a patrol dispatcher but the folks there are being really cool to me. I can basically stretch and do my workouts, or just lay down to rest my back or whatever as long as I answer the radio and phones when needed. Big props and thanks to my supervisors and coworkers.

Last week was seriously good skiing here and it was great to be part of it again, at least in some way. It was awesome to hear the stoke from my bros and my wife. Not long and I'll be squishing pow again and sharing stoke myself.

I'll send these out this am for those who requested it

Just to add to what GOBIG was referring to on his MRI, and to add to it.

My MRI makes that look like a walk in the park. I currently have l5/s1 bulging and it almost impedes the entire spinal canal. I had pain but no neurological symptoms. I did my pt and started reading a couple of books by Dr John Sarno.

He is a DR in NYC, Jand his view is that all back pain is psychological. Although I do not believe in this 100%, i do think it has some merit. My last bought with back pain occured when I got married. Literally 5 days after the wedding, on my Honeymoon, i woke up and the pain was 95% gone. So i believe that stress does play a role.

Lastly, iceing also helped me and I recently found a great new product called Hyper Ice. They make a great compression belt with an ice pack that is included in it. You can wear it around the house, office etc and it creates some relief. The combination of compression and the ice, make for a very cold pack.

Good luck!

PM sent to skideepow. This has been a very informative and encouraging thread. Many thanks maggots.

i sent out the pdf to all who requested.

Bumping a thread I had hoped to never need to.

Impinged L5 nerve from an L4-L5 bulge. Not my first rodeo (I had a thread on this in ~2008). I have skideeppow's set of exercises -- and add'l ones from my own PT -- have been good about stretching etc but this won't go away.

Missed 2 weeks of work because all I could do was lie on the floor
Haven't been able to touch a bike in 2 months
1st epidural helped, but I'm far from ideal - I can go to my desk-jockey job but am still an immobile limping curmudgeon
Less pain, but getting pins & needles on calf and foot, and the affected big toe and foot are slightly but noticeably weaker (drop-foot test)
2nd epidural scheduled for a week from now, hoping for the best

...but just in case, I'm starting to research and collect recommendations for microdiscectomy docs in Denver/Front Range. I know most of this stuff works itself out over time and I really don't want to go there, but might as well do my research. Whatcha got?

I like my current doc so far as my "back generalist." He has his recommended injection guys and surgeons, but I want to do my homework

Thanks, y'all. Back gimps unite!