16 y/o with L5-S1 protrusion. Help!

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Al Kyder

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Hey everyone,
First off, I had initial pain on my lower-right back that had stopped me from bending over, on 19 Aug 2010. The cause was from batting in the sport of cricket at school. At first it wasn't strong pain, but noticable. Soon after about 1-2 weeks, I could feel a very slight pain down half-way on the under-side of the right of my thigh. It slowly developed down to the knee, and now it's down to bottom of the calf.

I've had neurological testing and it didn't reveal neurological deficiency. After two weeks of this 'neurological' testing, I was finally prescribed an MRI. Here are the results of the MRI that took place on Tues 5 Oct 2010.

Findings: Normal lurabar segmentation and alignment. Proximal lurabar discs unremarkable. Conus at the T1/2 Level. It and the cauda equina are unremarkable.

At the L3/4 disc level, some minor disc bulge. No central canal, lateral recess or foraminal narrowing.

At L4/5, there is mild diffuse disc bulge and a clearly identified small central disc protrusion. This mildly indents the anterior aspect of the thecal sac without abutting or displacing traversing roots. No foraminal narrowing.

At L5/S1, there is a more broad central disc protrusion on the background of disc bulge. Again, clear indentation of the anterior aspect of the thecal sac. There does appear to be abutment without compression of the traversing S1 nerve roots above the lateral recesses. No definitive foraminal narrowing.

Interpretation: small broad central disc protrusion at L5/S1, with some minor abutment of the traversing S1 roots, either of which may be irritated.
Also, a smaller focal central disc protrusion at L4/5 mildly indenting the thecal sac but not causing definitive neural irritation.

Sorry for the long post, but those are the details. Again, I'm a 16 year old male, and at this stage surgery is a last resort.

I'm particularly concerned that there are problems at 3 levels on the back, I'm very worried. I'm wondering what sorts of hydrotherapy, physiotherapy, excercises, etc, you would recommend for someone with these problems & age.

Thanks!
 
Hey Al Kyder-

I am 20 and going for surgery tomorrow for my herniated disks. I know what its like to feel this disabled at young age. I actually don't know why my disks have herniated, but your MRI findings sound a lot like mine, except mine said 4mm herniation and 8mm herniation for L4/L5 and S1 I believe. (I am not too sure, I don't have my MRI findings with me)

If you are able to sit, walk and go about your daily business, I say continue to do so and perhaps ask for antiinflammatory (if u arent taking them already) and look for epidural injections to block out pain. I had to resort to surgery because i cannot sit, walk or stand for more than a minute and am living off tylenol 3s.

I had a sharp pain in my back that totally disabled me and had to go to the ER in an arabulance, and slowly got better in the next 3 weeks and was actually able to walk/sit but it all the sudden got worse again, so had to book for surgery.

If you are not as bad as I am, do be REALLY CAREFUL of moving and using your back, and go to physiotherapy to learn how to move. It is supposed to go away on its own over time. till then, make sure you save your back, or you will need surgery like me-

i hope you get better!
 
Hi Al. I can certainly understand why you are worried. You are very young to have bulging discs. Can I ask what kind of dr. you saw who ordered the MRI? Did he have any suggestions for you? Did he prescribe any kind of treatment?
If the dr. was not an orthopedic or a neurosurgeon, then you might need to see one of them in order to be referred for proper treatment which I will go into next.

Right now, those discs are not causing a lot of trouble, tho the L5-S1 nerve roots may be irritated by the protrusion. So you are a long way from surgery.

Physical therapy can help but it should be ordered by the kind of dr. I described so that the right exercises are prescribed. Perhaps an injection into the L5-S1 area is needed but that's where the surgeon can guide you. Do not, I repeat, do not entertain the idea of surgery and if the dr. suggests it, find someone else. Once you have back surgery, you are prone to more discs developing problems, and in your case there is no need to operate. There are many other options, including the pt I mentioned, or pain management by a qualified specialist.

I do think that playing sports, especially the very physical ones, should be avoided as you could cause more problems. I know that is not something you want to hear, but you do need to be careful now and protect your back from heavy straining, including lifting heavy weights. Again, a good spine specialist can guide you better than I.

I hope you find someone who will lead you down the right path and keep you out of surgery. Please stay in touch and let us know.

Carol
 
Hi anna, all the very best! I hope everything goes okay with your surgery!

I am able to sit, walk, and stand, but sometimes I have to bear with intense pain. And of course, sometimes I feel no pain at all. It is very on & off.

I just went to hydro yesterday, and my leg was aching like anything. It was crazy, I couldn't even lie on the beRAB without the pain. Pain continued after coming home. Then, towarRAB night, the pain went away, and today it seems fine too. I hopefully believe that hydro/physio will help relieve the condition.

It's good to know I'm not the only young'un going through this stuff. Once again, I hope everything's okay for you, because I know for myself, I wouldn't take surgery unless it was the absolute last solution/last resort.
 
Just an update;
The pain's pretty much gotten worse. After sitting for a while & then getting up, I feel mild tingling & pins & needles. So now my neurosurgeon has recommended a microdiscectomy on my lower back, L5-S1 area. I don't even know if my disc has ruptured or not, or whether it is just only the disc protruding onto my nerve, so how can he perform a micro-discectomy?

So yeah, basically I am leaning towarRAB surgery now anyways, I've had the pain still there for more than 1.5 months, no physio/hydro is helping very much. I haven't tried injections yet because they are just temporary pain relievers, so I believe that the discectomy is the way to go, what are your thoughts???
 
Carol is right. YOu need to see a good back doctor so you can get a treatment plan that will help with your issues and also help you to develop good core strength to protect and support your back.

As far as surgery goes. If you have it at this age, you won't be going out and playing sports or running or overexerting yourself. Once you have had surgery you protect your back on daily basis so you don't undo the work that the surgeon did. BUT you are far too young to have that thought when there are so many other things that can be done to take care of your issues.

Keep us posted.
 
Hi, thank you both for your responses.
The doctor who prescribed the MRI was my family general practitioner. He suggested a few light back excerices, which admittedly I wasn't doing very much, and also light swimming. I did go swimming a few times, in heated water, although after that I didn't really notice much relievement of the pain down the leg. Maybe I swam too hard.

Around a couple of days ago, my GP prescribed me with Mobic Capsules, 7.5mg Meloxicam. I take two each day. So far, decent pain relief has been noticed, although it is still there sometimes, sometimes striking randomly & very painfully at times. These are non-steroidal anti-inflammatory capsules. GP said that these would slowly help the discs to recede & relieve pain.

In a few days will get my GP to refer me to a hydro/physiotherapist, who will then refer me to the right treatment. I will keep you posted on this.

If an injection is required, I'll consider. But what bothers me the most is that there are 3 disc-levels with problems, even minor.

What do you think about swimming? I want to start light/moderate swimming on a daily basis for around 30 minutes or so to help strengthen the core. Hopefully after that, I can return to the gym like I used to when I was 15. Believe me though, I've never sustained an injury from gym/weightlifting, because I was always observant & cautious about my form & amount of weight.

Thanks, very much..
 
Hmm... No replies?

Anyway, I'm booked in for a microdiscectomy on Monday. Pain has been there for almost 3 months so I don't want any permanent nerve damage... Physio & Hydro didn't work very much for my nerve.

I will keep updating this thread post-surgery.
 
Glad its working well for you. I saw you posted in my other thread where I discussed my own surgery. Don't get discouraged if it doesn't go away completely in a week. I am a month and a half post-op and am 90% pain free. I get some aching down my leg when I do something physical for too long. Yesterday I was fixing some stuff around the house, I spent about 3 hours working on things and today I have that aching again. Tomorrow it'll be gone. Each time I get the aching its a little less than the time before. Nerves take a long time to heal, luckily yours was not compressed for too long. Mine was painful for about 8 months and I couldn't walk normally for 2 (I stand upright 6 feet tall, I was hunched over walking, shorter than my wife who is 5'4"). Even so, from stories on this board, that's a short time too. Long story short, it's going to take time. Be patient and take it easy.
 
There are classes for back people in the water. It's not the swimming so much as you do alot of leg work in the water where there is less resisitance but a good gentle workout.

Your GP is probabaly a very good doctor but he isn't a back specialist. Please get a referral to a good back doc, take your films with you and see what he has to say. You have but one back to live with and you are wwaaayyyy to young to have to suffer....

hang in there.
 
1 week update, post surgery.

Overall microdiscectomy surgery has worked well. I am able to stand and walk for much longer. The pain is not as bad as I experienced before the surgery but slowly, I am recovering. I am still experiencing some pain, almost as bad prior to the surgery in my thigh but I'm hoping this will go away in the next week.
 
Hey Mr. Fergy, those worRAB of encouragement are great. Thanks for the heaRAB up, I guess this will take longer to heal than my entire family was expecting...
So far though my microdiscectomy has worked well overall... The pain I had yesterday has gone because I think some specific activities trigger the nerve aggravation & pain starts, and takes about a day to go away, like you said...

Just wondering, what kind of pain meRAB are you on? Do you ever still feel the need to take a strong pain killer if you (ever) get excruciating pains? I was thinking just take basic pain relievers for about 1-2 weeks, then stop them.
 
I'm not on any meRAB regularly anymore. I stopped taking Vicodin about a week after my surgery, and stopped taking Lyrica about a week after that. If my leg gets pretty sore, I might take 600mg naproxen (aka Aleve), but that's it. If its just a little achy/sore I just deal with it and it goes away.
 
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