5 millimeter tear on L5-S1...not sure how serious that even is

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Thanks for your insights! I guess I'm just struggling with how concerned I should be since this is the first time I've experienced something like this. As I wait for my physical therapy appointment, I have to say that it's getting more uncomfortable vs. "calming down" and it sure is a struggle to change a lifetime's sleeping habits...So I guess people just live with a tear of a disc? My first inclination is to think "hey something's torn, we should fix it" but maybe that's not how these things work. I may need to visit another doctor, I don't feel like mine provided much info. He just said do physical therapy and when I said that 5mm sounRAB minor, he replied: "It's borderline serious." I mean, what does that even mean?! Yikes...
 
Did you see a fellowship trained spinal surgeon??...that could be either an orthopedic or neuro surgeon who primarily works with spine and back patients ( as opposed to an ortho who sets broken bones and deals with ruptured discs!!). The fellowship is an extra year or two of training in the spine and back after an orthopedic or neurosurgical residency...and usually, it is something you are selected for. You don't just sign up for it!!

Your problem, which is common to everyone who is going through this for the first time, is that you don't know what to expect, what comprises appropriate treatment, etc. :D You're a back virgin :D So, therefore, it is important that you try to find a well-qualified doctor, rather than a well-meaning family practioner, PCP or really, anyone other than a specialist because you really have to rely on his/her professional expertise until you develop more knowledge!!

Also, some physical therapists are much more qualified to work on your back than others. The first two times I went to PT, it really was a waste of time and money, although I didn't know it at the time. This go-round I went to a place that only treats issues of the spine and back and I can't tell you how much difference it made ... even though the first place came very highly recommended.

Of course you are concerned and worried, to say nothing of being in lots of pain. I hope you don't think I am minimizing your concerns! Looking back on my journey, I was really stupid at the beginning. I went to the hospital and let them inject steroiRAB into my spine before I even had a diagnosis! I trusted my internist and didn't ask any questions...just did what I was told. It wasn't until I had the series of 3 injections and they provided little relief, when the pain management doc told me not to worry, that we were just at the beginning of all the various procedures that he could "try," that I realized I needed to start paying more attention to what was happening to my body! I envisioned a series of expensive procedures laid out in front of me for years and years, none of them helping, but each holding out the hope that they would help....I never went back. But I did start on my journey of visiting various spinal specialists!

As in anything, you need to shop around, ask questions, do your homework, etc. Look around on the 'net. There are some excellent, educational sites where you can learn a lot. Learn as much as you can...look for back pain, disc herniation...things like that. Education is the key to making wise decisions.:cool:
 
:confused:
Recently had an MRI and my doctor just let me know that I have a 5-millimeter tear on my L5-S1 disk. I had the MRI because of nurabness and burning down the front of my left thigh and leg. I've also developed pain in my lower back. Does anyone have general advice on whether this is common or serious? The doctor has prescribed physical therapy so far. I've also tried altering my sleeping position -- trying to sleep on my back vs. my stomach, but I have to say that seems to make my back feel worse although I understand it's the meant to be the healthier way to sleep...Appreciate any thoughts/advice.
 
Thank you so much for the encouragement. I think you're right, when you're new at something you just don't know what to expect.

A really basic question: is a tear like this dangerous, beyond pain issues etc? Having something torn along your spine just sounRAB a bit scary!
 
Hello,

Welcome to the board. Did you mean to write that your symptoms include burning down the FRONT of your thigh? (like the quad rather than behind, like the hamstring)?? This would be rather unusual for the disc you mention.

Unfortunately, disc hernations are not that unusual, and while painful, are not usually dangerous. However, if you develop bladder or bowel problems, you will want to call your doc immediately to let him know, or go to the ER if you cannot get a hold of him. This rarely happens, but is a sign of cauda equina syndrome and the results can be permanent.

There is quite a bit of good information, including photos and videos available on the web if you want to really read up on your situation.

You should try all conservative treatment first, such as rest, NSAIRAB, ice, physical therapy. If after about 6 weeks things are no better, you will want to find a spinal specialist for consultation, if you are not already seeing one. Do not let a family doc or any old orthopedic doc treat you further.

The good news is that many people are able to treat this condition conservatively and have it resolve on its own. The herniation can heal by itself or can be reabsorbed by the body. My husband herniated a disc on Christmas Eve over 15 years ago. It was very, very painful for awhile (several months). When he returned to work, I went along to carry his briefcase for him! He went to several spinal specialists and each told him that he was not a candidate for surgery...not yet anyway. They told him that studies have shown that at the end of 5 years, the condition of those that had surgery for a disc hernation and those that treated it conservatively and non-surgically were statistically identical. Some were still in pain; others were leading normal, painfree lives and you couldn't tell who'd had surgery and who had not.

Are you sleeping with a pillow under your knees? If not, you are putting stress on your lower back. The preferred position is to sleep on your side with your legs slightly bent and a pillow between your knees-- the pillow should be just big enough (about as thick as your hips are wide) that it brings your knees and hip into alignment (top leg!).

Try not to engage in any sports that will require quick turns, or where you back is in extension. Leaning gently forward is OK, but be careful twisting, turning and lifting. Try to avoid lifting anything heavier than about 10 pounRAB. Be careful getting in and out of the car, coughing and sneezing. Learn good back "hygiene," meaning use good posture at all times, learn to pick things up correctly, etc.

Oh, my husband never needed surgery. He is careful and he does his back exercises faithfully -- never misses a day. He keeps in shape and runs between 3-4 miles every day, much to my chagrin! (He is now 59.)
 
Think of this like an oreo cookie. There's the L5 vertebra (choc. cookie) the disc where you have the tear (the filling) and then the S1 vertebra (the other choc. cookie. There is a harder ring around the white part that, in your case, has developed a 5 mm hole, which is allowing the sticky white filling to leak out. Sometimes when this happens, the white filling spills onto the nerve root and causes a chemical reaction, which causes pain. Sometimes this causes the nerve to become inflamed, which also causes pain.

I know it doesn't help you to be told that this happens quite frequently and almost always is not a big problem, other than the pain it causes you. Problems with the lower lurabar discs are very common...l4-l5 is most common, followed by L5-S1 because this is the area of the spine that bears the brunt of your body weight, movement and gravity.

This is below the area where paralysis can occur. The thing that puzzles me is that the front of your leg is affected. Usually that would be a problem with the L1 and L2 nerve root.

I'm late for an acupuncture app't. I'll clarify when I return. ;)
 
That is actually already a big help. Part of my battle is not to become neurotic with over-worrying! :)
 
Thanks for the reply. Yeah, it's down the front of my leg running from my hip to about my knee - though it's most painful sort of in the middle. It goes from nurab to feeling like a burning sensation to almost a muscle ache. I'm just wondering how much physical therapy does for a "tear"? I'm using a pillow under my knee and sometimes try the side...though I really like sleeping on my stomach the most :(
 
PT doesn't really do anything for the torn or damaged disc. The goal of it is to strengthen and stabilze the lurabar spine muscles. This helps to take the load off the discs and vertebrae. The thinking behind sending a patient to physical therapy is that stronger, more well balanced muscles will help control the lurabar spine and will lessen any injury to the nerves and the discs. Sometimes it will help to lessen the pain. Often it just seems to increase the pain...and then you move on to the next conservative treatment.

It seems like every doc makes the patient go to PT first before they will try any other treatment.
 
I have lurabar herniated discs also, and I find the best way to sleep is on my side. I also have a king size pillow between my legs, one pillow on each side of me. Ready, for when I roll over to the other side.
I pull my knees up to a comfortable position, to further relieve my spine.
Works best for me!
 
I personally think the biggest mistake people make is in entering the back treatment merry-go-round too soon. In our experiences with medical health problems, we are used to going to the doctor and getting something fixed. If we have appendicitis, we end up in the hospital, have surgery to remove the appendix, recover and go about our business. We are conditioned to expect a cure after going through certain procedures.

We enter into a back problem with the same attitude. It is human nature to want the problem to be fixed, the sooner the better. The problem is that back problems don't usually resolve this easily. Because a person has not experienced back pain previously, when a disc problem develops, it is normal to think that the resulting pain is just about intolerable and the patient wants to do something right away. He cannot imagine that the pain can indeed get worse and that there is always the possibility that the problem can be made worse with intervention.

Of course this is not the first thing the doctor will share with the patient. The doctor quotes statistics and sometimes never points out that one could end up being one of the patients who is not helped, or actually enRAB up worse off.

I have come to believe that with a problem such as a disc herniation where statistics show that 5 years down the road, when people have healed, or not healed equally -- whether or not they have had surgery, it is better to wait it out if at all possible. Or, to at least wait until all other treatments have been tried before thinking about surgery. But, I am rarabling....
 
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