UPDATE ---Back pain procedure , numbing injections , anybody have this done ?

[CRJR45]

When I went to physical therapy the therapist showed me some stretching exercises to take away any tightness. I got on the floor for the first one and pulled my leg up and over the other one with my knee all the way down to the floor on the other side. He said "Wow, I guess tightness isn't an issue for you". I've always been very limber.

See , thats me too , I can palm the floor no problem . But , since this thread I have found out my hamstrings are very tight . I will try the video above and the stretches .

 

[Steve from GA]

See , thats me too , I can palm the floor no problem . But , since this thread I have found out my hamstrings are very tight . I will try the video above and the stretches .

I can't manage to find a video of the hamstring stretch that my ortho gave me, but it's super easy, isolates the hamstring, and has worked wonders with fairly minimal effort and zero strain on my back.

Sit on the edge of a table (or something similar), back straight. Press your palms into the table and engage your core - you don't need to put a lot into this part - maybe 30% effort. You are simply stabilizing your upper body so that your hamstrings are isolated during the exercise.

Now alternate between each leg bringing it into full extension straight out in front of you and hold it for a couple of seconds each. This is a dynamic exercise with you constantly going back and forth so as to warm up and stretch your hamstrings without agitating your back. Set a timer and do this for 5 minutes every day - listen to music, a podcast, or just chill while you do this.

Stick with this exercise and it will pay dividends. I have done hamstring exercises many times in my life, and this is the only one that can have me touching my toes, and it's by far the easiest exercise I have found.

 

[RickH]

I went through all of the above mentioned, I'm 59. My issue was my L4-L5 vertebrae had slipped and was putting a kink in my spinal cord. This was causing severe pain and numbness in my left leg. My job for 30 years was pretty physical as well as many years of backpacking and packing heavy loads of meat etc. I'm sure all that played a role in my back. I started with physical therapy, then steroid injections (which hurt like hell, I think I levitated off the table), to no avail. I ended up getting a fusion surgery from a well known orthopedic spine surgeon and it was successful. That was in March 2020, just before the pandemic shut down elective surgeries for a while. At 8 weeks the doc lifted all restrictions. Since then I've done a lot of backpacking. As stated above I now use an external frame ultralight pack(Seek Outside) and have invested in ultralight gear to get my pack weight way down from what it was before surgery. Last year I shot a cow elk about a mile from the road and boned out the meat and made a few extra trips to get her out, just common sense stuff. I still have some pain going on at the L5-S1 joint occasionally. I recently had an MRI to see what was going on there and it's basically arthritis that I can manage with daily strength training and stretching for the rest of my life.
Everyone's situation is different and from what I can tell spine treatments are basically a crapshoot. The injections may work great for you. For me the injections weren't going to move the vertebrae back in place and they didn't work, but insurance required them before surgery. I hope you can figure it out without fusion surgery. Good Luck!

 

[CRJR45]

I was on the back pain merry go round for a good while and had a hemilaminectomy on L4/L5, which helped considerably. I will say this - I think there is a very good chance that you can manage your back pack pain without any injections or additional surgeries. I still have flare ups on ocassion, and I now know how to move past them and get back to normal. You just need to find the routine that works for you.

Do not underestimate the need to stretch, particularly your hamstrings. I have figured out that tight hamstrings are the #1 culprit for my back pain.

I recommend you do the McGill Big 3 back strength exercises religiously:

If you don't know who Stuart McGill is, you owe it to yourself to read "Back Mechanic". The guy has been a leader in scientific research on back pain.

So I would say, try stretching your hamstrings, IT bands, and hips every day. Do the McGill Big 3 every day. Stick to it for at least a couple of weeks, and I would be surprised if you don't notice a difference.

I have been there. Good luck!

I'm reviving this thread , I've been doing these just a couple times a week and it does help , I can feel a difference in my back .
I need to get a better routine going , and get in the gym maybe .
The pain management Dr said I wasn't a good candidate for the injections , yet . Same on the fusion , he said I wasn't in enough pain for either .
He did give me a topical ointment , it seems to help , but I hardly use it . My first issue is my mid chest area of my back will go out , for lack of a better term , causing muscle spasms for days .
My second issue is just aching pain in my L5 area , which he said was a combo of arthritis and degenerating disc .
He did offer to write a prescription for a steroid pack he called it , before I went on a hunt or anything else that would be strenuous . I passed on that , for now . I've not had good luck with steroids in the past . And I don't want to take opiods , even though it's in the ointment .
I'm not in a lot of pain in my lower back , until I do something stupid , like using shovel , LOL , the wife wanted to put in flower beds around the pool this weekend , I was feeling it Sunday night . I used the ointment , it helped .
But , I think you guys are right , just making an effort to get into better shape is my best option , just wanted to say thank you for the inputs .
Thank you !

 

[velvet muley]

From all the people I know that have taken the shots ended up having the surgery and wish they would have done it earlier.

 

[Rob960]

My wife gets a procedure in which they use a fluoroscope guided catheter and basically singe the nerves responsible for her pain. It is a progressive procedure. At first it lasts 6 months and then increases. Right now she is at about 2.5 years between procedures.

 

[mitchellmountain]

After battling sciatica and herniated disk:

This stretch really helped me; after doing this for a while, my disk looked completely different on MRI

View attachment 466659

If your main issue is deteriorating disc, not bulging or herniated, this is exactly what you should not do. Not being rude to ETtikka but not all stretches are beneficial for all types back pain.
I would look up routines for stenosis, hyper lordosis or anterior pelvic tilt. Those type of stretching and strengthening routines tend to help people with deteriorating discs. I've seen inversion tables help certain individuals too. The main thing with this condition is it takes a lot of work, stretching and strengthening everyday, multiple times a day for months and months to make an actual long term difference.
BTW this is how I earn a living.

 

[CRJR45]

If your main issue is deteriorating disc, not bulging or herniated, this is exactly what you should not do. Not being rude to ETtikka but not all stretches are beneficial for all types back pain.
I would look up routines for stenosis, hyper lordosis or anterior pelvic tilt. Those type of stretching and strengthening routines tend to help people with deteriorating discs. I've seen inversion tables help certain individuals too. The main thing with this condition is it takes a lot of work, stretching and strengthening everyday, multiple times a day for months and months to make an actual long term difference.
BTW this is how I earn a living.

Yeah , I ruled that one out too . Although , when my lower back is flaring up , laying on my stomach , flat , for a length of time , does help .
My main problem is DDD , my last disc (L5) is two thirds gone . And , yeah , I suck at maintaining a routine or sticking to a program . I am my own worst enemy , always have been , LOL . I tried the inversion table , it helped at first , but then I started to get headaches from it , had to quit .
Thanks for the input though .

 

[ETtikka]

If your main issue is deteriorating disc, not bulging or herniated, this is exactly what you should not do. Not being rude to ETtikka but not all stretches are beneficial for all types back pain.
I would look up routines for stenosis, hyper lordosis or anterior pelvic tilt. Those type of stretching and strengthening routines tend to help people with deteriorating discs. I've seen inversion tables help certain individuals too. The main thing with this condition is it takes a lot of work, stretching and strengthening everyday, multiple times a day for months and months to make an actual long term difference.
BTW this is how I earn a living.

You are absolutely correct, my misunderstanding

 

[CRJR45]

You are absolutely correct, my misunderstanding

It's the thought that counts , LOL , thank you !

 

[30338]

This may be a dumb idea but if you're having trouble sleeping after 5 or 6 hours, do you think it may be worth also exploring a different type of mattress? Maybe that would help also.

If the exercises are helping, that seems like the best route. Good luck. I have more aches and pains the less I work out so need to get back in the gym now that hunting season is winding down.

 

[CRJR45]

This may be a dumb idea but if you're having trouble sleeping after 5 or 6 hours, do you think it may be worth also exploring a different type of mattress? Maybe that would help also.

If the exercises are helping, that seems like the best route. Good luck. I have more aches and pains the less I work out so need to get back in the gym now that hunting season is winding down.

Not a dumb idea , we did buy a new mattress . It's a Puffy and we love it . My problem is I'm a side sleeper and I end up contorted , hips and shoulders out of line , and it strains my mid back . I wake up in pain , but after setting in my chair for 20 minutes , it's gone . But I can't go back to sleep .

 

[dutch_henry]

Get a second opinion. Your doc is smart to suggest a non-surgical path first. Dedication to PT can work wonders and you owe it to your body. Even if it comes to surgery, it will make the outcome so much more successful.

But if you doc is giving spinal fusion a hard no, it could mean he's obstinate to the point of being close-minded, or he's not considering what's in the patient's best interest. Let me share my family's experience with that.

My Mom (72) just had three spinal fusion surgeries. This was after two years of very intense, debilitating pain, throughout which her ortho insisting all she needed was PT and cortisone injections. After getting nowhere with her pleading, she finally ended up taking her MRI scan to another (better) doc at a research hospital, who saw incredible bone degradation and multiple issues. The outcome? A T12 to L5 fusion. How did the first doc miss something that extreme? Dogma. Lousy judgement. Bias.

As a result of the fusions, she is now pain free for the first time in more than two years. She's like a different person. She has a long road ahead, but went through two years of needless suffering because some callous doc insisted it's a PT problem, not a structural problem

 

[307]

Thank you .
But , how do you rehab a disc that is gone ? My L5 is only one third the size of the rest of them . I'm as strong as I ever was , still working and very active . I went through rehab several times and it did nothing for me , for my back . I've torn tendons in my shoulder and just let them heal , after rehab did nothing . Physical activity makes my pain worse , so how can rehab help ? Seems like if it was going to get better , it would by now , naturally ?
I know what you mean about the botched surgeries , my BIL is going through hell after his , he had a pain medicine pump or something implanted .
Not trying to argue and I appreciate your input , really I do , thank you .

L5-S1 disc is always smaller/thinner than those above it even without pain/injury. Normal anatomy.

 

[CRJR45]

Get a second opinion. Your doc is smart to suggest a non-surgical path first. Dedication to PT can work wonders and you owe it to your body. Even if it comes to surgery, it will make the outcome so much more successful.

But if you doc is giving spinal fusion a hard no, it could mean he's obstinate to the point of being close-minded, or he's not considering what's in the patient's best interest. Let me share my family's experience with that.

My Mom (72) just had three spinal fusion surgeries. This was after two years of very intense, debilitating pain, throughout which her ortho insisting all she needed was PT and cortisone injections. After getting nowhere with her pleading, she finally ended up taking her MRI scan to another (better) doc at a research hospital, who saw incredible bone degradation and multiple issues. The outcome? A T12 to L5 fusion. How did the first doc miss something that extreme? Dogma. Lousy judgement. Bias.

As a result of the fusions, she is now pain free for the first time in more than two years. She's like a different person. She has a long road ahead, but went through two years of needless suffering because some callous doc insisted it's a PT problem, not a structural problem

Sorry to hear about your mother going through that . My pain is not debilitating , at it's worse it's a 4 or a 5 on the pain scale , most times a 2 . I was merely trying to be proactive , if I need the surgery , I want to have it now so I can still have five or so more years hunting . Whats happened in the past is just before I go on a hunt , my back goes out , limiting what I can do .
I don't want to book a hunt and then be miserable during the whole thing , again . I'm going to try and get into a better workout routine and hope that helps . Here is the Dr I am seeing , seems legit to me ?

Dr Anuj Prasher | Spine Surgeon Stuart | Spine Surgery Port St Lucie, Fort Pierce

Dr Anuj Prasher is a board certified orthopaedic spine surgeon who offers minimally invasive spine surgery in Stuart, Port St Lucie and Fort Pierce, Florida.

www.anujprashermd.com

 

[CRJR45]

L5-S1 disc is always smaller/thinner than those above it even without pain/injury. Normal anatomy.

Hmmm , not what the Dr told me , I'll check that out .

 

[mitchellmountain]

L5-S1 disc is always smaller/thinner than those above it even without pain/injury. Normal anatomy.

Although that may be true in some circumstances, it is not true as a general rule. I will agree that if one of the lumbar discs is going to be smaller on a fully healthy young adult it will be the L5/S1 disc, but the majority are not as part of normal anatomy minus any disease or damage.

 

[dutch_henry]

Sorry to hear about your mother going through that . My pain is not debilitating , at it's worse it's a 4 or a 5 on the pain scale , most times a 2 . I was merely trying to be proactive , if I need the surgery , I want to have it now so I can still have five or so more years hunting . Whats happened in the past is just before I go on a hunt , my back goes out , limiting what I can do .
I don't want to book a hunt and then be miserable during the whole thing , again . I'm going to try and get into a better workout routine and hope that helps . Here is the Dr I am seeing , seems legit to me ?

Dr Anuj Prasher | Spine Surgeon Stuart | Spine Surgery Port St Lucie, Fort Pierce

Dr Anuj Prasher is a board certified orthopaedic spine surgeon who offers minimally invasive spine surgery in Stuart, Port St Lucie and Fort Pierce, Florida.

www.anujprashermd.com

I hear you. A few thoughts.

I think second opinions are always important, even when dealing with docs in whom you have a ton of faith. Even the best-intentioned docs may over-rely on the law of averages, bias based on age or health, perception regarding activity levels and merit of those activities, standard protocol vs detailed reviews, etc. At worst, a second opinion will do nothing more than confirm the original diagnosis and treatment protocol, in which case you eliminate some of your uncertainty. At best, it could resolve a potential oversight. These days, self-advocacy in medicine is more and more important. Think of a second opinion as no different from shopping trucks at different dealerships, getting different quotes on a roof, pushing back on what a financial planner suggests, etc.

Discs don't heal, but surgery can clean up the offending bits and buy you time. Even less invasive, PT can alleviate issues we all have by augmenting our strength, flexibility, and in turn alignment and amount of strain we place on our discs. Meanwhile, surgery carries risks, the most common being infection.

I'd ask questions like

• In your opinion, what was the mechanism of injury?
• How is my bone density and integrity of my vertebrae?
• What needs to happen for me to begin running again? Carry a heavy pack again?
• My life takes me deep into the backcountry, where helicopter rescue may be the only option if I'm incapacitated and can't self-rescue. Knowing that, does your treatment plan change?
• What metrics do we use to determine if current treatment is/is not working, and what is the next step?
• How do I get from a 4/5 on the pain scale to a 1/2?
• Under what circumstances would you recommend surgery? What type? Who performs it, and at what hospital?
• What specific improvements have you seen re: discs and fusions in the last, say, five years? How do they impact your diagnoses and treatment plans?

Surgeries get better and better each year. So there's merit to waiting. BUT if you feel like this is a career-ending injury and there are surgical alternatives that could restore you to the things you love, I think it's worth pursuing...

 

[CRJR45]

I hear you. A few thoughts.

I think second opinions are always important, even when dealing with docs in whom you have a ton of faith. Even the best-intentioned docs may over-rely on the law of averages, bias based on age or health, perception regarding activity levels and merit of those activities, standard protocol vs detailed reviews, etc. At worst, a second opinion will do nothing more than confirm the original diagnosis and treatment protocol, in which case you eliminate some of your uncertainty. At best, it could resolve a potential oversight. These days, self-advocacy in medicine is more and more important. Think of a second opinion as no different from shopping trucks at different dealerships, getting different quotes on a roof, pushing back on what a financial planner suggests, etc.

Discs don't heal, but surgery can clean up the offending bits and buy you time. Even less invasive, PT can alleviate issues we all have by augmenting our strength, flexibility, and in turn alignment and amount of strain we place on our discs. Meanwhile, surgery carries risks, the most common being infection.

I'd ask questions like

• In your opinion, what was the mechanism of injury?
• How is my bone density and integrity of my vertebrae?
• What needs to happen for me to begin running again? Carry a heavy pack again?
• My life takes me deep into the backcountry, where helicopter rescue may be the only option if I'm incapacitated and can't self-rescue. Knowing that, does your treatment plan change?
• What metrics do we use to determine if current treatment is/is not working, and what is the next step?
• How do I get from a 4/5 on the pain scale to a 1/2?
• Under what circumstances would you recommend surgery? What type? Who performs it, and at what hospital?
• What specific improvements have you seen re: discs and fusions in the last, say, five years? How do they impact your diagnoses and treatment plans?

Surgeries get better and better each year. So there's merit to waiting. BUT if you feel like this is a career-ending injury and there are surgical alternatives that could restore you to the things you love, I think it's worth pursuing...

I hear you about the risks of surgery , they screwed my BIL's back up big time . Those are all good questions , and I've not been able to articulate it in that form when talking to the dr , I printed them off , thank you .
I wonder two things -
1 - Is the Dr just going through the "steps" required by the insurance companies ? Does he know what they will and will not approve ? It seemed like the pain doc was defending Dr Prasher's decision , and wanted to establish a plan of action , starting with the cream . Maybe to appease the insurance companies ?
2-Do I have to be in a lot more pain than I am in to be taken seriously ? I get that I'm old and can't expect to feel like a kid again , but it would be nice not to hurt and have some confidence that I can do the things I want . Maybe I'm using this as a crutch , but it's hard to work out when it just causes more pain .

 

[Weldor]

I hear you about the risks of surgery , they screwed my BIL's back up big time . Those are all good questions , and I've not been able to articulate it in that form when talking to the dr , I printed them off , thank you .
I wonder two things -
1 - Is the Dr just going through the "steps" required by the insurance companies ? Does he know what they will and will not approve ? It seemed like the pain doc was defending Dr Prasher's decision , and wanted to establish a plan of action , starting with the cream . Maybe to appease the insurance companies ?
2-Do I have to be in a lot more pain than I am in to be taken seriously ? I get that I'm old and can't expect to feel like a kid again , but it would be nice not to hurt and have some confidence that I can do the things I want . Maybe I'm using this as a crutch , but it's hard to work out when it just causes more pain .

Same here surgeon trashed my nerves during surgery 22 years ago. Not a days rest from the lower back pain. Did all the hoops for about 8 years with minimal results. Just walk and swim plus stretch, worked better then all the other procedures nerve burning, shots , physical therapy etc. I can't pack much more than 15-20 lbs.