Herniated disk: 'Should I wait?' | Doctor Answers

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  • Опубликовано: 20 ноя 2022
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Комментарии • 183

  • @Lisa-jt6pn
    @Lisa-jt6pn 8 месяцев назад +2

    The doctor explained everything so clearly. Thanks for the information.

  • @lisabillings2176
    @lisabillings2176 4 месяца назад +3

    Hope you’re healing Jen ❤️‍🩹✝️✝️🙏🏼

  • @annev1516
    @annev1516 Год назад +6

    What an excellent explanation! You explained what to look for and that video if the herniation made it so much easier to understand what happened!

    • @BestPracticeHealth
      @BestPracticeHealth  Год назад +1

      Thanks a lot! I'm so glad it helped. There is a lot of confusion about herniated discs, and they are wicked painful. What about you? Are you OK?

    • @michaelbowley7584
      @michaelbowley7584 Год назад

      I have a question about this also. I have a large herniated disc in between L4, L5 left side starts same issues but I detail cars for a living. Have been off of that job for 7 weeks. I took on a part time job light duty delivering sandwiches at a sandwich return to. Might have me do dishes here and there but always wear my back brace. Would spinal decompression therapy work before surgery?

  • @alfredocalzadilla7251
    @alfredocalzadilla7251 Месяц назад +3

    I am in the same exact situation. I am scheduled for microdiscectomy surgery tomorrow morning. Thanks for posting this video; it reassures my decision.

    • @BestPracticeHealth
      @BestPracticeHealth  Месяц назад +1

      Good luck. I hope you do well and I'm wishing you a speedy recovery.

    • @alfredocalzadilla7251
      @alfredocalzadilla7251 Месяц назад +1

      @@BestPracticeHealth Thanks! According to my doctor, the surgery went very well, but I still feel pain and numbness. It is slowly getting better though. What really alarmed me and prompted me to get the surgery asap was that I was starting to feel tightness and numbness in my groin area (cauda equina most likely). It was a massive l5s1 disc extrusion in my left paracentral area. I am so glad that is over and can't wait to fully recover to go back to my normal life, of course minus the heavy lifting!

  • @johnmitchell2741
    @johnmitchell2741 12 дней назад

    She sounds supper exited about your findings

  • @brendamyers6320
    @brendamyers6320 Год назад +3

    Good explanation--I had severe herination in c-spine { severe pushing on spinal cord causing real issues }, had operation. Went back to work re-injury.. This Dr was correct..

    • @nanwill2786
      @nanwill2786 9 месяцев назад +1

      So what happened? When you reinjured what happened?

  • @claudiacorrea9598
    @claudiacorrea9598 7 месяцев назад

    Thanks for this very good and enlightening explanation! Unfortunately, not living in the US to visit your clinic.

    • @BestPracticeHealth
      @BestPracticeHealth  7 месяцев назад

      Thanks for the comment! I am actually retired... disabled by essential tremor. But I hope so much you are getting the care you need wherever you are.

  • @davila3989
    @davila3989 Год назад

    Awesome video! Thank you

  • @artboy789
    @artboy789 11 месяцев назад +8

    Thank you Doctor for doing such an amazing RUclips channel about all of this!

  • @jeffcalderon2107
    @jeffcalderon2107 2 месяца назад

    Great explanation !! Is there a risk or nerv damage of you wait it out to long.

  • @justjessy0115
    @justjessy0115 2 дня назад

    In 2017 or if nowhere i herniated a discussion, had to rush to the e.r, was admitted, next day had a laminectomy (L3-L5). Went home, 21days later i lost balance, slipped & fell (thought it was my fault being a bit clumsy idk) rushed back in to hospital, new mri showed a massive amount of fluid build up along with a blood flour, rushed into a 2nd lamenectomy AND facetectomy (sorry for misspelling) haven't been the same since. Still experience pain but went from wheelchair to walker to came to walking in my own. No physical therapy or help due to no health ins. Fast forward to 2024, I've been in pain for atleast a month nonstop (just assumed it was sciatica) but it's now all mostly my left side (everything prior had all been in right side only) went to hosp this past sun, Dr said i need another lamenectomy but now on left side as what happened to my right side is now just happening to my left. I don't feel the shooting as much as before BUT very bad sharp stabbing pain when i get up, sit dwn, walk, can't hold upper body without pain. Everything triggers the sharp stabbing pains. It's it true that it's herniated & lamenectomy is necessary? Tingling & numbness under left toes on & off. Shooting dwn back if lewd bit as often, just severe pain in mid to left lower back, very close to old lamenectomy scar area. I'm my mom's care give so i can't go on like this much longer, I've suffered & waited it out over a month but it's only getting worse with the pain. Please ANY advice will be helpful. Thank you in advance

  • @johnmitchell2741
    @johnmitchell2741 12 дней назад

    thanks for the video showing how to read the MRI. Unfortunatly my pain specialist wouldn't look at my MRI let alone explain it to me so I had to figure out how to open and read the MRI even though I'm not sure how to read and understand some parts

  • @SmileyTheAxolotl
    @SmileyTheAxolotl Год назад +1

    Great video! Thank you!

    • @BestPracticeHealth
      @BestPracticeHealth  Год назад

      Glad you liked it!

    • @jaygee6606
      @jaygee6606 Месяц назад

      My wife is 66, has bad osteoporosis and has had 2 total hip replacements. She has had the ESI and very little relieve. She has a bulging L5 disk and we are getting many different options. Is this just a case of one surgery or continual repeated surgeries. It seems as you get older, Drs give up on you faster and treatment is more for experimenting than cure. And I have been working in Emergency Medicine for over 24 year, but I am now 3 years from 70 and it appears the caring has steadily decreased

  • @lisabillings2176
    @lisabillings2176 4 месяца назад +4

    I was an ICU nurse for 25 years and I moved many heavy patients and probably ruined my back.

  • @aprilflontek
    @aprilflontek 25 дней назад

    Do you offer virtual consultations like this with mris ?

  • @katygirl9221
    @katygirl9221 Год назад +4

    Dr. Lieberman, can I please come to Phoenix to get treated? I sent in my MRI to the lovely miss Phebe. God bless you Dr. Lieberman and I pray for all that are suffering from there spines. 🙏🏾 💕

    • @BestPracticeHealth
      @BestPracticeHealth  Год назад +2

      Yes! Of course! I'll get with Phebe and check your MRI then get you squared away with the right doctor. OK?

    • @katygirl9221
      @katygirl9221 Год назад +1

      @BestPracticeHealth Thank you so much Dr. Lieberman. It's been since August of 2020 in backpain.

    • @katygirl9221
      @katygirl9221 Год назад

      @@BestPracticeHealth Thank you. 🐐 👍🏼

  • @johnmitchell2741
    @johnmitchell2741 12 дней назад

    When i had my latest MRI done and went to my pain specialist I gave him the radiogist and disc report of the MRI he read the report and said you have a multitude of issues with your spine according to the report. I said aren't you gonna look at the MRI I brought to you and he said no need to we will just give you some epidural shots to try and isolate where your pain is coming from. So I had the first round and it messed me up so bad I could barely drive home cause I couldn't feel my legs and for the last two weeks I haven't been able to walk more the a couple hundred yards without dying in pain. Folks be careful before letting anyone cut on you or give you an injection

  • @connormusic9274
    @connormusic9274 7 месяцев назад +5

    Jen, please consider spinal decompression treatments using a DRX9000 or any IDD computer controlled traction table. No surgery, just an outpatient treatment 2-3 times a week. However it's very expensive and not many insurance companies pay for it. However there is a 95% success rate in healing the herniations after approximately a 10-12 week regimen. I was quoted $5500 by the first doctor, and $3600 + by the second doctor. Have not been able to afford it since the symptoms increased in severity in the last 3 months. managed to live OK with it and work part-time as an electrican for almost 2 years. Now I'm worried I may go paralyzed if I don't start it soon. God bless you and me to find a way to start this decompression treatment!

    • @Circe-wz3kg
      @Circe-wz3kg 5 месяцев назад +1

      According to research, this method is not good promising

    • @amberashley7559
      @amberashley7559 4 месяца назад +2

      I did a traction machine at the chiropractor and it was very painful. Right afterwards I felt horrible pain.

    • @KyDairyGoats
      @KyDairyGoats Месяц назад +1

      I did the decompression treatment before Lumbar TLIF L4-5 for stenosis, unstable spondylolisthesis and did PRP the decompression table made the pain much worse. The PRP and compression was expensive. I was slow to heal from surgery but had a secondary issue with cervical unstable spondylolisthesis C4-5 and had severe stenosis in cervical in other areas. 3 years since Lumbar surgery, one year after C3-7 surgery. I have had weight loss despite Lipedema and Lymphadema. I am walking over 10,000 steps a day. My husband saw me walking up steps recently and commented I no longer walk like an elderly person. The two spine surgeries gave me back my life.

  • @fatmonk2034
    @fatmonk2034 Год назад +2

    Thanks very informative video, can you please create videos on microdisktomy recovery

  • @mjvovola2557
    @mjvovola2557 6 месяцев назад +1

    Hi docter is sciatica temporary? I have mild sciatica only feeling a tingling sensation on my hamstrings and lower back pain on my left side but its been a month and ive just started doing decompression excersizes daily. Im only 21 so I'm concerned it might affect my quality of life later on. THANKS

  • @user-lj3gx6rs4t
    @user-lj3gx6rs4t 8 месяцев назад +1

    Hi doctor,
    I'm from India and I have been dealing with low back pain and nerve irritation down to the left leg from the past 3 years yearly twice I had to bed ridden then I can able to return to normal regular day activities with fear of back always for all these 3 years now I'm getting frequent symptoms regularly and now left thigh starting to lose Mobility (not fully) but I can able to walk and sit but I could sense the weakness ( I couldn't do action on the left leg as much right leg can- could not lift the left leg straight while lying down) my doctor suggested the endoscopy surgery
    Pls tell me can I go ahead and take surgery

  • @NiccBlacc-NCBC
    @NiccBlacc-NCBC 3 месяца назад

    Hey Doc when I get my MRI how can I send you mine to review ?

  • @kebatshabilengoni9774
    @kebatshabilengoni9774 Месяц назад +1

    Hello Dr. your videos are great. You explain everything very clearly. I am struggling with chronic lower back pain since June 2023. I did my MRI in July 2023 and at that time I had pain radiating to my left leg, I could't sit or stand for more than a minute. The spine surgeon recommended Physiotherapy rehabilitation and pain medications, it helped because I can now sit even though it requires a specific type of chair. Almost a year later, I still can't stand for more than a minute...the pain is still excruciating and now radiating to both legs. The funny part is that with no activity I am fine, I can also walk just fine but I can't clean, I can't cook or even go to a grocery store because I cannot stand for more than a minute. When in pain, that is when I have a difficulty walking because the back is painful, and both legs are painful too. So I don't know if the condition is getting worse or my physchology is playing tricks on me. I sent my MRI report to a different surgeon for a 2nd opinion and he suggested lumbar decompression surgery. See my MRI report below and let me know what you think, but that was done almost a year ago. Also whats the difference between lumbar decompression and discectomy?
    MRI REPORT:
    L3-L4: Disc bulge compressing the thecal sac
    L4-L5: Left foraminal annular tears: Disc bulge causing mild to moderate right and severe left neuroforaminal narrowing.
    L5-S1: Assymmetric disc bulge causing mild left neuroforaminal narrowing. Mild bilateral chronic sacroilitis.

    • @BestPracticeHealth
      @BestPracticeHealth  Месяц назад +2

      It sounds like you have been experiencing back pain radiating to your legs for over a year. Initially, the pain was in your left leg, but it has now spread to both legs. Your pain worsens with standing but is relieved by rest and is not exacerbated by walking. You've consulted two surgeons: the first recommended conservative measures, while the second is now suggesting a laminectomy. Your follow-up MRI report indicates severe foraminal stenosis on the left at L4/5. You are asking about the difference between a laminectomy and a discectomy.
      Great question. A laminectomy involves "raising the roof" of the spinal canal and is a surgical treatment for spinal narrowing (stenosis). It is highly effective and is often the best treatment for severe spinal stenosis, which can affect the central canal, lateral recess, or the foramen (the opening where the nerve root exits the spinal canal). Your MRI indicates you have L4/5 foraminal stenosis, and your surgeon has recommended a laminectomy. Technically, this procedure can also be called a foraminotomy, which involves opening up the severe stenosis in the foramen.
      On the other hand, a discectomy involves removing the herniated portion of a disc and is appropriate when the pain is severe, there is a neurological deficit, or recovery is not progressing as needed. Since your MRI does not mention a herniated disc, a discectomy does not seem like a suitable option for you, which explains why your surgeon recommended a laminectomy instead.
      While a left L4/5 foraminotomy might be a good option for you, it's not certain. The L4 nerve root, which is being compressed in the L4/5 foramen, is notoriously difficult to localize. Typically, you should experience pain radiating to the left inner ankle. However, your pain is in both legs and doesn't follow the typical L4 distribution pattern.
      Therefore, I recommend a diagnostic left L4/5 transforaminal epidural steroid injection (TFESI) block first to ensure the correct source of pain is identified. If this block does not provide temporary relief to both legs and significantly reduce your pain, then you will need to consider an alternative plan.

    • @kebatshabilengoni9774
      @kebatshabilengoni9774 Месяц назад +1

      Thank you so much doctor this is very insightful. I haven't done any follow up MRI, the one I shared with you is the initial MRI. That is why I am now concerned because I do not know if the condition has worsened because now I am experiencing a lot of pain in both legs. I will ask my doctor about the injection and take it from there.

    • @aprilflontek
      @aprilflontek 25 дней назад

      Following, I have the same symptoms 😢

  • @patriciaortiz1683
    @patriciaortiz1683 8 месяцев назад

    Hi doctor my name is paty and I desperately need your help/advice I have a bulge on l4l5.I got it when I delivered my baby girl on July 18th. My pain got a better ,I can sleep , and don’t need heavy drugs which they don’t work anyway . My neurologist told me to do the surgery. I’m just so scared everyone around me says not to do it. The pain subsided but I walk like an old person and have no social life because after some time my knee and calf starts to hurt. I have a question does the bulge ever heal on its own and go back in? If I don’t do surgery would it mean that I would have to be careful the rest of my life and not pick up my daughter? As Jen cus I am feeling better I am second guessing the surgery. Thank you

  • @emanuelailie748
    @emanuelailie748 Год назад +1

    I need a 1-1 session Like this tooooo😮

    • @BestPracticeHealth
      @BestPracticeHealth  Год назад +2

      Come on the show! We'd love to have you. Fill out the contact form on this page and the team will set you up... phoenixspineandjoint.com/resources/best-practice/

  • @ninastapleton803
    @ninastapleton803 2 месяца назад

    Right now, this minute. I'm in agony.
    I've been trying to get a MRI for months. I've been in this state for more than a year. I desperately need your export advice. A year. I've had medicine after medicine. I believe I a herniated disc. I believe this has caused sciatica. I had to learn this by going to the ER. I was giving a CAT Scan and told I definitely have sciatica. There is much back story to my case. I'm terrified frightened. How can I correspond with you.

  • @leeleeirv1270
    @leeleeirv1270 Год назад +3

    Can you do a video about spinal cord stimulator implant surgery?

    • @BestPracticeHealth
      @BestPracticeHealth  Год назад

      I'm sorry this is taking so long. But yes. It's on our list.

  • @offhandheadshot
    @offhandheadshot 11 месяцев назад +5

    Hello, I recently saw my neuro after 5 months of initial L5-S1 injury. He says I’m a candidate but also says I should consider accepting the new way of life as they do get better. I have very low pain that only really goes up to a two and it’s very sporadic. Calf, butt, hamstring on right side. I’m just unable to run and mobility is limited but it’s improved. I’m only 26 making it hard to do the things I love. It’s a large right herniated disc with significant compression of s1 nerve root. MRI was done at 2 months. What would you suggest?

    • @BestPracticeHealth
      @BestPracticeHealth  9 месяцев назад +8

      The 3 treatments for a herniated disc are epidural injection, waiting it out, and microdiscectomy. So far you've chosen to wait it out. Epidural does not make sense as it provides only temporary pain relief. So, your decision is whether you want to change from waiting it out to microdiscectomy. We know from the NIH-sponsored SPORT trial that after 2 years the outcome is the same whether you have surgery or not. So, if you have bearable pain and normal neurological function, seems like you made the right choice.

  • @johnmitchell2741
    @johnmitchell2741 12 дней назад

    been there done that 2015 Surgeon said I need a fusion no disc left gave me no other options. now 9 years later I have adjacent disc dieses at L3 and L5 with a herniated disc at L5 and L4 on top of that I now have severe arthritis in my L4 facet joint because of L4 . Im in agony every day but going thru a 3rd fusion at this point is the last thing I wont to do . Im male 63 🤢🤮🥵😵

  • @pinal151
    @pinal151 11 месяцев назад +1

    Hello Dr. Lieberman, can I please schedule an online consult? I have MRI and am miserable :(

    • @BestPracticeHealth
      @BestPracticeHealth  11 месяцев назад

      Hello! I"m not in practice but I'd be happy to see you on the show! Call Phebe at 602 256 2525. I will look forward to meeting you.

  • @Rdot3423
    @Rdot3423 Месяц назад +1

    Good evening. What happens if the IME tried to say, "I was fine with little to only minor injuries", but I still ended up needing to have an perc discectomy on lumber L5-S1 ( one bilateral epidural) & cervical discectomy c4-c5/c5-c6 (3 epidurals overall). I can't sleep at night, had to quit and change my field of work (was painting/power washing/constrution) to doing office work now smh, can no longer play basketball, pick up my niece or go paint balling at this time. All because I was sideswiped on the highway by another vehicle. 250k/500 primary insurance policy. Bergen county New Jersey

    • @BestPracticeHealth
      @BestPracticeHealth  Месяц назад

      IME are highly variable. Some are great doctors who are doing the right thing. Others seem to lack integrity. Overall, I don't trust an IME without knowing the doctor who did it.

  • @user-vu3os4by5p
    @user-vu3os4by5p 8 месяцев назад

    The exercises seem good and the video would have been even better if it was a routine that I could just follow

  • @blakemoore666
    @blakemoore666 9 месяцев назад +1

    I’m 61 yo, ruptured l4l5 39 years ago, recently re aggravated it and it’s pretty unbearable, just based on what I’m telling you what do you think about a fusion for me? Also, what about artificial disc replacement?

    • @BestPracticeHealth
      @BestPracticeHealth  9 месяцев назад +1

      Wait, what? It seems like you've had a history of a herniated disc in the past, and recently, you've been experiencing recurrent pain. However, the cause of this recent pain remains uncertain. If it turns out to be a repeat herniated disc, then fusion is not the appropriate treatment. Lumbar fusion is indicated for three specific problems:
      Spondylolisthesis with stenosis.
      Scoliosis.
      Spinal instability.
      Unless you have one of these conditions, lumbar fusion is generally not recommended as the best course of treatment.

  • @sandracrawford9813
    @sandracrawford9813 5 месяцев назад +3

    I was working in the garden November 2023, had leg pain soon after. A week later I went to the doctor with excrutiating sciatica. Had and MRI 5th January 2024. 18mm disc protrusion at L4. I found that the pain went by December 2023. I did have partial foot drop but could walk. My leg felt heavy walking upstairs and had a bit of numbness down front of leg on soft part - not bony shin. This is resolving with Physiotherapy ( I was sent for Physio from December). It is very slow and incremental and I am finding that my walking is improving, but there is still a little numbness. I am wondering if the improvement is a sign that it will get better completely or if I will need surgery? -And How long should I give this?

    • @BestPracticeHealth
      @BestPracticeHealth  4 месяца назад +1

      Since you have a herniated disc with functional weakness, you’re already a good candidate for microdiscectomy surgery. If you are not well enough for surgery, or just don’t want to have it, then you do risk permanent damage. Physical therapy is not generally helpful for the underlying problem, but may help you regain some Power in the ankle as it recovers. If you have the option of surgery, I would really recommend it. The longer the nerve is compressed in the nerve damage the more likely it is to become permanent.

  • @l2r777
    @l2r777 9 месяцев назад

    Hi Dr.
    Can you please help me to decide what to do.
    L4-L5: Diffuse disc bulge and bilateral facet hypertrophy resulting in mild
    bilateral neural foraminal stenosis.
    L5-S1: Grade 1 anterior listhesis of L4 on L5. Fatty degenerative endplate
    signal changes and degenerative endplate irregularity at L5-$1. Chronic
    appearing anterior wedging and $1. Disc space narrowing at L5-S1. There is
    unroofing of the disc with diffuse disc bulge, central disc protrusion, and
    pilateral facet hypertrophy. There is resulting severe canal stenosis with
    compression of the cauda equina, and moderate-severe bilateral neural foraminal
    stenosis.
    IMPRESSION:
    Listhesis at L5-S1 with chronic degenerative changes resulting in severe canal
    stenosis with cauda equina compression and moderate-severe bilateral neural foraminal stenosis.

    • @BestPracticeHealth
      @BestPracticeHealth  9 месяцев назад +1

      I don’t know your symptoms, but based on the MRI report, the most pressing issue is the severe stenosis at L5/S1. Even though you have a grade 1 spondylolisthesis, most surgeons today would treat this with laminectomy at L5/S1. I suspect that is the next step for you.

  • @johnmitchell2741
    @johnmitchell2741 12 дней назад

    Im going on ten years

  • @leannemcknight3338
    @leannemcknight3338 Год назад +1

    Wow your Amazing Dr Lieberman I cried when I watched your video. Am in England and been left to suffer like a dog! The level of care here is non-Existent. Jan 18 2023 I started with severe back pain & sciatica! 6 months on and am still in severe pain. I can’t lean forward I can’t sit to eat I have to stand up. I can’t drive my life as been taken away from me. Took 6 months before the NHS pulled their finger out and give me a MRI. I get my results 1st week of July. I think I have a herniated disc. Please advise me if you can. I would appreciate it. Thank you Leanne

    • @BestPracticeHealth
      @BestPracticeHealth  Год назад

      Thanks, Leanne. I am so sorry you are going through all this. I just posted a video answer for you. You can see it on my page bestpracticehealth.tv/ or here on youtube.

    • @kennethrayeady
      @kennethrayeady 9 месяцев назад

      Wow so sorry!! I don’t know how you are handling this.

    • @johnmitchell2741
      @johnmitchell2741 12 дней назад

      Dont feel bad the health care system sucks in the United States as well

  • @happybabe4life734
    @happybabe4life734 7 месяцев назад +1

    What is the best surgery for a herniated disk? I am scheduled for a fusion. I have a herniated disk at L4, or L5 and several bulging disk. My surgery is scheduled for December 22, 2023. I have been in a lot of pain for 18 months. I cannot take it anymore. Pain goes down my butt into t my right hip and down my left leg into my foot. My leg and right foot is numb and tingling. I have a large herniated disk. What surgery should I have?

    • @BestPracticeHealth
      @BestPracticeHealth  7 месяцев назад

      I’m confused. Spinal fusion is a great treatment for scoliosis, moderate or high grade spondylolisthesis with stenosis, and instability. Spinal fusion is not a treatment for disc herniation. The surgical treatment for disc herniation is microdiscectomy. Either there’s more I don’t know, or you are scheduled for the wrong surgery.

  • @pkaronis1
    @pkaronis1 Год назад

    Hi Dr. Is it possible for you to take a quick look at my MRI for a second opinion? I am getting confliction info.......

    • @BestPracticeHealth
      @BestPracticeHealth  Год назад

      Totally. Come on the show and we can review it together. phoenixspineandjoint.com/resources/best-practice/.

  • @vzeller
    @vzeller Год назад +1

    Hey Doctor! I was told a Microdiscectomy isn't a great option for my L5-S1 herniation because I have grade 1 Spondy. Have you ever done a Microdiscectomy on someone with Spondy?

    • @BestPracticeHealth
      @BestPracticeHealth  Год назад +2

      No. I have not. The concern is that the decompressive microdiscectomy surgery would make the spondy unstable and then require a fusion to fix. No doctor wants to make a bad problem worse. I'd really exhaust epidural injection and time before considering surgery for that one.

    • @johnmitchell2741
      @johnmitchell2741 12 дней назад

      Thanks im in the same boat except I'm already fused at the vertaba below the one that has now blown and slipped

  • @jnatividad
    @jnatividad Год назад +1

    I hope my doctor explained herniated disc the way you did. How is Jen doing now?

  • @hegotaspare
    @hegotaspare 3 месяца назад

    I’ve had prolapse disc for almost a year now and have had chiropractor and stretches and pain killers. Couple weeks ago it’s been twitching down in the toilet area so the bulge is hitting those nerves I would guess but the sciatic pain has decreased. I haven’t taken pain killers for nearly three weeks now. I’m just worried I’ll get CES. Will I need surgery?

    • @abhinavheya6289
      @abhinavheya6289 Месяц назад

      Did you get an mri, if it is a big herniation then of course you should consider it otherwise I guess conventional way is best

  • @user-vj8qm3qc2k
    @user-vj8qm3qc2k Год назад +2

    Hello doctor, as a physio a lot of patients ask me if there herniated disc can get worse while they wait it out. Knowing that cauda equina syndrome is one rare but serious complication, I would love to know:
    if even small herniated disk can lead to this complication? (I heard from a spine surgeon that once nucleus pulposus herniation happens, even a sneeze can make it way worse or even lead to cauda equina, is that true? )

    • @BestPracticeHealth
      @BestPracticeHealth  Год назад +4

      Hey! Thanks for the comment. Not to mention all the good you do as a physical therapist!
      With regard to the cauda equina syndrome, in my 25 years of training and practice I didn't see anyone go from a small disc herniation to cauda equina syndrome. In theory it's possible, but on a practical level the risk is really low. The force that is required to produce a giant disc herniation is usually pretty large. The keys issues in my mind are whether the pain is bearable, and if there is an neurological deficit.

    • @user-vj8qm3qc2k
      @user-vj8qm3qc2k Год назад +1

      @@BestPracticeHealth Thanks for taking the time to reply doc!
      I will use your words to reassure, comfort and empower my patients (sometimes that is the only thing a patient needs)

    • @Preeti-lw9jc
      @Preeti-lw9jc 7 месяцев назад

      ​@@BestPracticeHealthhello doctor this is Ranjana from India. I have a question i had a back injury 2 month back and i started having back pain and then after getting some jerks while traveling, i started having weird sensation in private area,i really thought that i had cuada equina. But after visiting the doctor and having a MRI it shows a mild left paracentral disc bulge causing mild narrowing of left lateral recess.
      Now my question is that I am afraid of doing any movement, just last night I cleaned my room just arranged some stuff although I paid attention to my position i squat to pick to things up and sqaut and lifted a mini table it's weight will be just 2 kg now the thing is that I am scared that movements like this or walking, traveling by bus going back to college I'm scared that my disc will herniate and cause cuada equina.
      Will my disc ever heal or it will get worse?? please reply

  • @johnmitchell2741
    @johnmitchell2741 12 дней назад

    GOOD TIMES

  • @drd6893
    @drd6893 10 месяцев назад +3

    I didn’t think anything hurt worse than kidney stones or labor. Until this …. I’m a mess in pain i can’t sleep cant walk. Its pretty bad
    Do you know a doctor in Maine that’s great like you?

  • @lisabillings2176
    @lisabillings2176 3 месяца назад

    Yes urination issues and dark yellow but I’m doing. Cijjccbbb by

  • @shinderkaur8781
    @shinderkaur8781 Год назад +2

    Omg you explained this so good..I went into the ER 2 days ago via ambulance the pain started will mild back pain did nothing throughout Xmas and then about few days after Xmas pain got worse and now I have right buttocks severe pain radiating down to my calf leg and foot buckles out...and cramps up this pain is so unbearable and I’ve been crying for days ..at the ER no scans done sent home at
    After 6 hours for doc to say it’s back pain I was horrified ...now symptoms are so bad just getting out of bed to the bathroom takes me literally 20 min ...the way you showed the video is exactly how that spilling out is hitting my nerve on my leg is why it knocks me out..I’m on 50 mg prednisone and pain med ( btw not even touching the pain) muscle relaxants and that’s it..They is terrible I can’t walk without help from spouse and I’m shuffling my left foot to move the right and with each step the pain out of 10 is 100 that’s how bad this ..I have all the symptoms of a herniated disc..so thank you so much 🙏🏻 for your video I pretty much knew it but now actually seeing it confirms my diagnosis again thank you 🙏🏻And happy new year ...and I even told the doc of my symptoms that it feels like a herniated disc and sciatica forgot to mention when I do any movement runs down my right leg like electric shocks and still doc dismissed everything I said ..what are your thoughts on my description of the symptoms? I’ve had herniated disc back in 2016 but that was very mild and I healed but this one is out of this world never endured pain that much ever..sorry doctor about long message I see my PCP tomorrow and hopefully I get reply back from you today..I just watched so many utube videos and you were so accurate 🙏🏻

    • @BestPracticeHealth
      @BestPracticeHealth  Год назад

      Oh, NO! I'm so sorry this is happening to you! Hang in there. AS horrible as sciatica feels, it's temporary. Time will heal. Have you had your Mri yet? Come on my show if you want to talk through the options. Fill out the form on this page. It's free! phoenixspineandjoint.com/resources/best-practice/

    • @Preeti-lw9jc
      @Preeti-lw9jc 8 месяцев назад +1

      How are you now??

  • @Billy-cw4kr
    @Billy-cw4kr 6 месяцев назад +1

    Im Having pain in both my glutes and legs down my foot from past 1.6 yrs .unable to sit walk or stand for more than 5 minutes. My mri shows l4 l5 mild disc bulge without nerve root compression 5 s1 mild disc buldge with minimally compromising the nueral formania l
    How long will it take to heal

    • @BestPracticeHealth
      @BestPracticeHealth  6 месяцев назад

      Your MRI reports does not explain your symptoms. The most common cause of this in my experience is that they misread the MRI. Request a secondary reading of the MRI by a radiologist who is board certified in neuroradiology.

  • @lisabillings2176
    @lisabillings2176 4 месяца назад +1

    I had 9 different neurosurgeon consultations the 9th one fixed the previous 2 FBSS. I’m finally getting better Praise God. I am fused from T10 - S1 rods to correct adjacent vertebrae shifting disease. The “severe” pain is intolerable. Going in 2 weeks for 4th surgery to fuse T10-T8 dang it will it ever end?

    • @BestPracticeHealth
      @BestPracticeHealth  3 месяца назад +1

      my heart goes out to you. I’m so sorry you’re suffering after caring for so many who I’m sure needed you so much. It sounds like you’re in a marathon back surgery situation. Hang in there. It may not seem like it, but there’s always the beginning, middle, and end to the pain. I hope yours come sooner rather than later. Good luck with your surgery. Please let me know how it goes.

    • @HolySpiritchild777
      @HolySpiritchild777 3 месяца назад

      Thank you and God bless you ❤

  • @anitachery6693
    @anitachery6693 11 месяцев назад +1

    After a major surgery Laminectomy i started having very sharp pain in my left leg burning stabbed pain, and very week mussels..

    • @BestPracticeHealth
      @BestPracticeHealth  11 месяцев назад

      Nerve root pain after laminectomy can be normal, but it's never welcome. Check with your surgeon to make sure you are all right.

  • @joseare96
    @joseare96 6 месяцев назад

    Hello doctor I got an MRI on August and it show I have L5/S1 herniated disc I been dealing with this for a year when it first started I couldn’t walk for longer then 5min or stand for no longer then 5min I have a epidural injection and it help for couple weeks but the pain comes on and off. It’s not bad like when it first start I can take this pain but should I wait and have my body fight this herniated disc naturally or not?

    • @BestPracticeHealth
      @BestPracticeHealth  6 месяцев назад

      I am so sorry to hear you have been suffering for a year! That's a lot of pain and would make anyone miserable. Hang in there. Unfortunately, this is a common situation. The NIH-sponsored SPORT trials showed that herniated discs fare the same with or without microdiscectomy surgery after two years. At this point if you do not have a neurological deficit your options are to wait it out or give in and have surgery. The decision depends on your life and how you are feeling. Everyone is different. A good pain management doctor or surgeon will work with you to find the best solution for you.

  • @Its-Broke
    @Its-Broke 7 месяцев назад +1

    So are you saying it should go away after 2 years? I’m 1 year in hopefully I’ll start getting better soon

    • @johnmitchell2741
      @johnmitchell2741 12 дней назад

      I wouldn't hold my breath on it completely getting better and one wrong move you can blow out the disc even more its a vicious cycle of re-injury. But if you can deal with it I would. Because fusion is no picnic the recovery is hell then after a few years the rest of your disc start to go.Im going thru it now

  • @user-gc2pl4gn1n
    @user-gc2pl4gn1n 9 месяцев назад

    Dealing with a L4-L4 \ L5-S1 disc bulges no sciatic pain but a very intense back ache. It’s been 3 months. Can’t stand for more than 2 hours and can’t sit for more than 30 mins. Currently unable to work what do you suggest I do? Had an injection and it lasted 6 days. Now in worse condition then before it

    • @BestPracticeHealth
      @BestPracticeHealth  9 месяцев назад

      I'm sorry to hear about your persistent back pain and the challenges you are facing. The fact that your pain is localized in your back and not radiating down your leg suggests the possibility of a facet joint pain or an annular tear. Annular tears, often caused by a specific incident (although not mentioned in your comment), tend to worsen over time, contributing to intense back discomfort.
      Given this context, it's crucial to consult with a Board Certified Pain Management specialist for a comprehensive evaluation. They can review your imaging studies (MRI, CT scans) and conduct a physical examination to better which facet joint is hurting.
      Based on this evaluation, the specialist can do a diagnostic medial branch block. If the pain is relieved more than 80% of a few hours, then you would be a good candidate for radiofrequency ablation. The RFA (Radiofrequency Ablation) procedure relieves pain 80% in 60% of those treated for an average of 10 months.

    • @user-gc2pl4gn1n
      @user-gc2pl4gn1n 9 месяцев назад

      I have burning in both feet mostly right side legs are a bit shakey. l5-S1 Disc bulge is central

  • @drhotchkiss
    @drhotchkiss Год назад +2

    I have 3 ruptured discs grinding away,
    I've had 2 stem cell treatments in Costa Rica with minimal results.
    I have an orthopedic doctor and MRI
    But so far I just take anti inflamatory meds. I've dismissed disc replacement, looking for another solution.

    • @BestPracticeHealth
      @BestPracticeHealth  Год назад

      Oh, Man! That sounds terrible. So sorry you are going through this. Costa Rica sounds interesting. I would love to hear more about how that went and the cost. As far as the next step, I think you need to back up and consider the cause. Ruptured discs may cause either discogenic (4%) or facet mediated (40%) low back pain. Discogenic low back pain and facet-mediated low back pain are two different types of conditions that can cause low back pain. Here is an overview of the differences between the two:
      Discogenic low back pain: This type of low back pain is caused by damage or degeneration of the spinal discs in the lumbar region of the spine. The spinal discs are located between the vertebrae and act as shock absorbers. Discogenic low back pain can occur when the discs become compressed or irritated, leading to pain and inflammation. Discogenic low back pain feels like a knife in the middle of the low back, buttocks, and upper thighs, as well as stiffness and limited mobility in the lower back. The pain may be worse with bending, twisting, or sitting for long periods of time.
      Facet-mediated low back pain: This type of low back pain is caused by irritation or damage to the facet joints, which are located on either side of the vertebrae in the spine. The facet joints help to stabilize the spine and facilitate movement. Facet-mediated low back pain can occur when the joints become inflamed or irritated due to wear and tear, injury, or other conditions. Symptoms can include pain that is felt in the low back and buttocks, as well as stiffness and limited mobility in the lower back. The pain may be worse with certain movements, such as twisting or bending backward.
      In some cases, low back pain may be caused by a combination of discogenic and facet-mediated factors. It is important to consult with a healthcare professional to determine the underlying cause of low back pain and develop an appropriate treatment plan. Treatment options depend on the cause.
      You next step is to see a pain management doctor who will use blocks to figure out the cause of your back pain. You can learn more about your options here: bestpracticehealth.tv/spine/#SpineLumbarLaminectomy

    • @drhotchkiss
      @drhotchkiss Год назад +1

      @@BestPracticeHealth I live in rural Costa Rica, retired.
      My two stem cell treatments cost 8k.
      I can plainly see the ruptured discs on the MRI, @500 USD.
      I have tramadol for occasionally rough times , but if I take it easy and stay stretched out alieve and Tylenol do ok
      Thanks for getting back to me.
      Pura Vida

    • @goldieadeline1228
      @goldieadeline1228 Год назад

      😅I’m 😅

    • @goldieadeline1228
      @goldieadeline1228 Год назад

      You 😮

  • @vonpena3237
    @vonpena3237 9 месяцев назад

    I have herniated disc L5/S1, started to have a tingling sensation in my right leg last June i thought this is normal for someone who is at her 40’s, then last July 25 out of nowhere i could not walk nor stand because the pain in my back and shooting pain from buttocks down my feet is excruciating. I was literally crawling at that time, The pain is just unbelievable, post MRI i decided to have an operation, my discectomy happened last week, post operation the pain has subsided but there is still residual pain left in my right leg which I am trying to work on with a physical therapist. Hoping to get back to my normal state in a few months. Just one question, its been 7 days post my surgery, the mild residual pain i am still feeling (2 to 3 out of 10) will this go away doc? Please help me as I am paranoid right now.

    • @BestPracticeHealth
      @BestPracticeHealth  9 месяцев назад +1

      In my experience there is a greater than 90% chance the pain you have after microdiscectomy surgery will go away. If you still have pain 6 weeks after surgery then a repeat MRI is appropriate. That will need to be done with contrast.

  • @Preeti-lw9jc
    @Preeti-lw9jc 7 месяцев назад

    Hey doctor, i have a left paracentral disc bulge which is causing mild narrowing of left lateral recess. And all other 4 lumber disc are normal. The report does not mention which disc is bulged i tried seeing on MRI but I can't find it.
    Right now, I'm having low back pain which is mild on scale of 1 to 10 its 1 -2 and i have on and off legs pain which is very minor that sometimes I won't notice it if i pay attention to it. And I have tingling in bottom of my both feet. Now I want to ask will i ever get better.
    Actually I have a fear of doing any movement that it will cause my disc to rupture and it will create cuada equina syndrome.
    Now could you please tell me is my condition serious should I consider surgery?? My doctor said that this is very minor issue and heal itself and i should do spinal extension excercise and pay attention to my posture. Can i please send you my MRI . PLEASE reply doctor I'm 21 and really scared i have my parents who are sick and i don't want to be a burden??
    .

    • @BestPracticeHealth
      @BestPracticeHealth  7 месяцев назад +1

      It sounds like your doctor is on top of your care! That is great news. The MRI report is very reassuring and sounds normal for age. Cauda equina syndrome is so rare! I know it's scary, but you should worry about it as much as being hit by lightning. Which is to say not at all. You should not consider surgery for the things mentioned here. I don't think it will help for me to review your MRI when you have a great doctor already. Do not fear being a burden for your parents! I'm sure they love you and care for you, just like you would for them.

    • @Preeti-lw9jc
      @Preeti-lw9jc 7 месяцев назад

      @@BestPracticeHealth thanks for replying doctor. Actually I even consulted a spine surgeon yesterday and he told me to do spine extension excercise for 1 month and then report him about my progress. He also told me to avoid forward bending, prolonged sitting and standing . And i really really want to ask how much time will it take for me to heal and get better and be like before?? Any idea please reply i would be really thankful of you.I also have buttocks pain which is 3-4 on scale of 10 and my back hurts and also sometimes my bottom of feet both pains , so when will i get better how much time will it take?? Do I wait it out or go for surgery by the way i can walk well i even walked 9km yesterday and approximately i walk 7 km daily. Do i really need not to get my MRI reviewed by you??

  • @jcgolf159
    @jcgolf159 Год назад +1

    This is very interesting. I'm in Canada and recovering from a 3rd (2013ish, 2018, Dec 2023) disc herniation/protrusion L4-L5 with severe narrowing of the spinal canal which is progressed slightly since the last (2018) MRI. I just had an appointment with my surgeon and he said no surgery is necessary. He went on to say they'd only consider surgery if i was experiencing ongoing numbness in my foot.I am experiencing ongoing thigh (both thighs) numbness for years but now have healed to the point where after four months of inactivity due to pain I'm able to walk (walking stops the thigh numbness 99% of the time) and play golf (easy swing golf buy unable to walk the course due to increased pain 'stiffness' on the lower back. I was very surprised the surgeon did not offer surgery as an options. This is my third disc protrusion as noted above and my GP even suggested i consider surgery. I concurred as my DDD isn't getting better and I know I'm also getting older :) I also have a shallow disc bulge L3-L4 that's approaching the traversing L4 nerve roots. I watched this vlog and recommendations to Jen and I simply do NOT understand why surgery isn't being offered. I am on Lyrica 3 x's a day and take naproxen. My pain is localised to my L4-L5 region at this time but had the usual radiating pain down my leg focusing more at my knee, and numbness of the big toe region. All my recoveries looked like: 4+ months of excruciating pain and inactivity, followed by 3 months of working thru and with the pain to begin activity again and work on returning to my normal of low grade chronic back pain that's managed with T3s up to 12 months post injury. I'm in my late 50s and will go thru this again. It was five years in between the last protrusions. Guess I'm in the wrong country. I'll keep playing my lotto numbers lol to hopefully win a nice sum of cashola so I can come on down and see you or another clinic for a consult. Fingers crossed doc! I'm off to my next tee time :)

    • @BestPracticeHealth
      @BestPracticeHealth  Год назад

      Hmm. It does sound strange. Send me your MRI if you want and we can talk about it.

    • @Preeti-lw9jc
      @Preeti-lw9jc 8 месяцев назад

      How are you now?? Did you had surgery?? Or your pain got better on its own

  • @wejdanamer8935
    @wejdanamer8935 Год назад

    Would I be able to get pregnant if I have a herniated disc (extruded 6mm) ? Or should I first do the surgery Microdiscectomy 6 months -1 year before pregnancy?

    • @wejdanamer8935
      @wejdanamer8935 Год назад

      L5-s1 extruded disc

    • @BestPracticeHealth
      @BestPracticeHealth  Год назад

      Great question! It’s very difficult to manage disc herniation and pregnancy occurring at the same time. The combination can lead to a ton of suffering. However, it’s actually good that you have an extruded fragment, and that that should resolve within a few months. I’d love to learn more about your history. I’m also going to put together a small panel of experts to get a stronger answer to your question. I’d like to get the opinions of some doctors who have dealt with herniated discs in pregnancy more than I have.

  • @albertbrooklyn
    @albertbrooklyn Год назад +1

    How long to recover from the microdiscectomy surgery? How quickly after surgery can can you get back into the gym?

    • @erikaerigo4626
      @erikaerigo4626 Год назад +2

      My question exactly! My impression is that surgery will remove the exuded material but then what? If, after surgery, one goes back to their sports, I think that the annulus can still rupture again. A healed annulus is still not as strong as the original healthy one. If, after surgery, the annulus tears again and the remaining "jelly" material squirts out again, one is back to square one. No? And add to that the risk of surgery. They shave off bone to get to and clean out the exuded material. Shaving bone sounds serious intervention with possible long term effects (like arthritis pain in the back). Surgeons always downplay the risks of surgery. I know this from experience.

    • @albertbrooklyn
      @albertbrooklyn Год назад +2

      @@erikaerigo4626 What has become abundantly clear to me having read everything I can find the answer is somewhat illusive but the timeline I have been given by the neurologist I saw was about 4-weeks post-surgical healing and roughly at the 12 week mark you can gradually get back to exercising. My imperfect understanding is that ~ 94% heal in about 12 weeks without surgery, that is, in the absence if neurological symptoms, i.e., cauda quina syndrome, saddle distribution anesthesia or drop foot. I am approximately at 6 weeks out from a large herniation at L3 with radiculopathy and am starting to see noticeable improvement/progress, I say noticeable because the first 5 weeks my recovery was moving at glacial speed. I tried a few sessions of physical therapy but those "sessions" set my recovery back at least a week. It appears some physical therapist have a one-size fits all approach which can be detrimental to proper healing. In any event, good luck with your recovery!

    • @BestPracticeHealth
      @BestPracticeHealth  Год назад

      After surgery there is a risk of recurrent disc herniation. The annulus heals of 6-8 weeks, so most surgeons restrict your activity to less than 5lbs for that time. Talk to your surgeon about workouts that don't affect your core or low back - like seated biceps curls, while you recover.

    • @BestPracticeHealth
      @BestPracticeHealth  Год назад

      The annulus heals over 6-8 weeks.

    • @BestPracticeHealth
      @BestPracticeHealth  Год назад +1

      Everyone is different. I'm glad to hear you have turned the corner. No wonder you have a big smile!

  • @zaidal-hasani5465
    @zaidal-hasani5465 10 месяцев назад

    What about stem cells?
    really appreciate your opinion.

    • @BestPracticeHealth
      @BestPracticeHealth  10 месяцев назад

      Epidural stem cell injections for herniated discs are considered both an experimental and controversial treatment option. I am not aware of any scientific evidence to support their effectiveness, and their safety and long-term outcomes were not well-established at that time.
      But it is a great idea.
      I will tell you why. In theory herniated discs can cause pain and discomfort due to pressure on nerves in the spine. However, in my experience as a neurosurgeon the real pain from a herniated disc is in cases where there is a lot of inflammation. Growth factor and stem cell injections are about guiding inflammation toward the healing side. So, the approach is both logical and hopeful.
      You cannot help but notice that epidural steroid injections, where corticosteroids are injected into the epidural space, are temporarily effective in managing sciatica pain from herniated discs. In theory growth factors would be even better.
      It is important to note that stem cells do not do anything. The hope of the “stem cell” approach is that the growth factors inside stem cells will have a good effect. We know that because cells lyse (blow up) when they are injected. There are presently amnion derived growth factors for injection available. Any pain management doctor could inject them through the same approached used for transforaminal epidural injection.
      BUT again, the use of stem cells for herniated discs had not been thoroughly studied, and there were concerns about the safety and effectiveness of this approach.
      If you or someone you know is considering epidural stem cell injections for a herniated disc, look online for a pain management doctor who meets Best Practice Certification for epidural injection but is interested in amnion derived growth factor injection. I would not consider interlaminar injection but would try transforaminal as well.

  • @Footballwithbikku
    @Footballwithbikku 17 дней назад

    Hello doctor can I get heal from mild disc Bulge by doing core exercises

    • @BestPracticeHealth
      @BestPracticeHealth  17 дней назад

      A disc bulges when it is unable to absorb the load at its level. While you can't change the structure of your discs, ligaments, bones, or tendons, you can significantly influence your muscles. Muscles play a crucial role in supporting the spine, and by strengthening your core, you can theoretically offload some of the stress from a bulging disc, providing it with additional support. Although there may not be definitive scientific proof of this, it makes common sense and aligns with clinical observations. I've seen many individuals experience reduced back pain as they improved their core strength and overall muscle condition.

  • @user-gs8pf3xd2r
    @user-gs8pf3xd2r 7 месяцев назад

    Mild disc bulge at l4l5 level identation thecal sac please btaye have pain in lower back and right leg calf

  • @sarahduble8822
    @sarahduble8822 Год назад

    Did Jen get surgery and how did it go? Is there a follow up?

    • @BestPracticeHealth
      @BestPracticeHealth  Год назад

      Great question! I will reach out to her today and see if we can get her back on the show.

    • @sarahduble8822
      @sarahduble8822 Год назад

      That would be awesome because I am deciding right now whether or not to have surgery and I have what looks like exactly the same MRI as she does and same kind of story. This interview and your explanation was very helpful, and I would love to know what she ended up doing. Thanks

  • @shrutilahoti7943
    @shrutilahoti7943 9 месяцев назад

    Hello doctor, I am 22 yr old female and a student and it has been 4 months when I fell down resulting in a very severe disc bulge at L4-L5 with the feeling of tingling and radicular pain in my left leg and lower back. My buttocks region hurts all the time even when I change position while sleeping and there is a tingling sensation on the bottom of my left foot for a week. but I am able to do activities like walking and sitting. My doctor said I will need to have microdiscectomy but I have my college final exam soon. So is it okay to wait it out till December ? Can i delay the Surgery to December? Is it safe and wise to do so?

    • @BestPracticeHealth
      @BestPracticeHealth  9 месяцев назад +1

      I understand your situation. You're a 22-year-old woman with a four-month history of L4/5 disc herniation causing sciatic pain in your left leg. Your surgeon recommended microdiscectomy.
      When dealing with a herniated disc and sciatica, you have a few treatment options. Firstly, waiting it out is safe if the pain is bearable and there is no neurological deficit. The second option is epidural injections, which offer temporary relief but do not change the long-term prognosis. Epidurals are suitable for short periods of pain relief and can be repeated up to three times, but they are not advisable if you have a significant neurological deficit, like numbness or weakness in your left leg.
      The third option, microdiscectomy, is what your surgeon suggested. Microdiscectomy is appropriate for patients who have not responded to conservative care or those with a neurological deficit. Here is the key: if you do not have a neurological deficit and the pain is manageable, it's reasonably safe to wait until the end of your finals or even until December. However, if you experience significant numbness or weakness, the longer you wait, the more likely it is to become permanent. This also applies to pain; the longer it persists, the higher the risk of developing chronic pain.
      Considering your age, microdiscectomy may not work as well for young people as it does for older individuals. If you're not in severe pain and don't have a neurological deficit, I would encourage you to wait until December and have a repeat MRI. If the MRI shows improvement or your pain is gone, you might be able to avoid surgery altogether.
      The third option is microdiscectomy, and this is the one a surgeon recommended to you. Microdiscectomy surgery is appropriate for patients with. Failed conservative care, or. A neurological deficit. And here is the real answer to your issue. As long as you don't have a neurological deficit, and the pain is not too bad, it's reasonably safe to wait for the end of finals. And even until December. On the other hand, if you do have significant numbness or weakness, the longer you wait, the more likely it is to become permanent. That also applies to pain. The longer the pain is present, the more likely you are to have chronic pain.
      I think the biggest issue for you is your age. Microdiscectomy surgery really doesn't work as well in young people as it does older ones. If you're not in terrible pain, and you do not have a neurological deficit, I would encourage you to wait until December and repeat the MRI. If the MRI shows improvement, or your pain is gone, then you can avoid surgery altogether.

    • @shrutilahoti7943
      @shrutilahoti7943 9 месяцев назад

      Thank you so much doctor. I'll take your advice into consideration

    • @Preeti-lw9jc
      @Preeti-lw9jc 7 месяцев назад

      ​@@shrutilahoti7943Hey Shruti, how are you now?? Hope you're doing well ❤️‍🩹. Did you had any improvement in your pain

  • @es-engineer4295
    @es-engineer4295 6 месяцев назад

    Hello i had a L4 L5 and L5S1 disc protrusion is it is recover naturally or not

    • @BestPracticeHealth
      @BestPracticeHealth  6 месяцев назад

      No one can predict for sure. The best thing is to do your homework and act when you need to. Check out the videos on this playlist to get informed. ruclips.net/p/PLsYo8ENYsvpz8bmjf5QkF5IdaX6UPZrPk

  • @julietvlalbiaktluangi1010
    @julietvlalbiaktluangi1010 Год назад

    Hello Doctor I have herniated disc in L4,L5 am having pain in my hip and calf muscle .am taking medicine and injection but the pain don't go away. I can't stand and walk for long. It has been ten months now .my Doc said surgery is not required .but pain dont go away with the treatment an doing .what do I have to do now. Please help

    • @BestPracticeHealth
      @BestPracticeHealth  Год назад

      Juliet, I'm sorry this is happening to you. I'm having a hard time processing your comment. L4/5 disc herniation should cause L4 or L5 radiculopathy, which is not typically in the calf (that's S1 from the disc below). Microdiscectomy surgery is also typically an option for treatment of a herniated disc with sciatica after 12 we3eks of failed conservative care... so why is your doctor not offering that to you? Maybe you should come on the show so we can straighten this out.

  • @dsa4931
    @dsa4931 11 месяцев назад +1

    Hello doc. Nowadays i am seeing many disc patients who undergo fusion as well at the time of discectomy . What are your indications if any for fusion during discectomy ?

    • @BestPracticeHealth
      @BestPracticeHealth  11 месяцев назад

      It's a terrible idea! The indications for fusion surgery and the indications for discectomy are not the same and do not overlap. One of the greatest examples of over utilization in medical history was the use of fusion for degenerative disc disease. I hope none of that is still going on! There are rare cases, but for the vast majority of people with disc issues fusion is not the answer.

  • @anamaldonado8566
    @anamaldonado8566 Год назад

    This is exactly my case. I have no insurance and planning to head over the ER. Should I take the risk and get surgery thru a random doctor? I really need the surgery and I don't have an option to use a different surgeon because of the emergency.

    • @BestPracticeHealth
      @BestPracticeHealth  Год назад

      Yes. The emergency room is usually your best option in this case.

    • @BestPracticeHealth
      @BestPracticeHealth  Год назад

      Dr Lieberman responded to you question in more depth on the live show. Here is a timecoded link: ruclips.net/video/R4VqsA0RmNM/видео.html

    • @Islam-for-all-2023
      @Islam-for-all-2023 Год назад

      Sergey is thé Last solution: first try exercices and see a lot of doctor on youtube and surgey can causes a lots of problem

  • @TheJessica44023
    @TheJessica44023 9 месяцев назад +3

    Thanks for this video. I have questions: When you mention 'after 2 years the outcome is the same,' do you mean both patients were completely healed? I am suffering from L4 L5 S1, with bulged discs but not herniated, as well as one level in my cervical. The pain is constant, preventing me from living my life. I am a wife and a mother of 3 teenagers, with three furry babies that I am constantly picking up from the floor. I used to have a studio where I made art every day, but for a year, I haven't been able to do anything because whether sitting or standing, I am in pain.
    I had a very active life, always at the gym lifting weights. Before this happened, I was fit, but now I have lost all my muscles and feel miserable. I am trying my best to walk daily now, so I won't be sedentary, but everything I do causes constant pain. The bulging discs cause pain all over my body. It starts from my lower back and goes to my hips, buttocks, legs, knees, and even causes a lot of cramps in my legs and feet, on both sides of my body. The bulged disc in my cervical area causes pain in my upper back, neck, shoulders blades and sometimes even my skull hurts.
    I was about to undergo surgery, but I came across this clinic here in Florida that has a table for decompressing the spine. The doctor guarantees that I can recover completely from the pain if I undergo this decompression 30 times. He says that many of his patients become pain-free after the treatment. Now, I am torn about what I should do. This table decompress treatment will cost me $8.000,00. Also, the surgeon I was about to schedule surgery with says that I should get disc replacement in my neck. That is his recommendation. He said I need to do the neck first because is compressing my spinal cord, and then discuss the procedure for my lower back after my neck is fixed. You mentioned microdiscectomy, not disc replacement. Why? And why is my doctor recommending disc replacement? What are the advantages of disc replacement over microdiscectomy? I heard that once you remove through microdiscectomy the piece of the disc that is compressing the spine cord or the nerve, you will have a weaker vertebra that can easily herniate again or even cause your spine to develop other problems, because now you have less disc holding the vertebra space. I would love to hear your opinion and explanation on this.
    I can tiptoe walk, and I can also walk on my heels. However, I have a strong burning, shooting, tingling pain all over my upper back, shoulder blades, lower back, buttocks, hips, legs, knees, and cramps in my feet, on both sides. I am no longer in photos because I don’t go anywhere. I am only 47 years old and was always full of life and very healthy. I am not overweight, I eat healthily, and I always exercised. Now, I can't drive for more than 10/15 minutes, I can't travel, something I love, I can't hike and play sports with my kids, something I always did. I've stopped exercising and socializing with people. To go to church, I have to lie down on my stomach in the back seat all the way there, and I can't participate in the whole service because sitting for an hour is excruciating. I feel miserable, and now I don't know if I should go through surgery and get the disc replacement, do another type of surgery, or give the table decompression treatment a try. I worry that if it doesn't work, I'll just prolong this miserable pain and spend this much money for nothing. I need help! I'm sorry for the long text. I just wanted you to have the full picture of what I am going through. Thank you! I can’t wait to hear from you. 😊🙏🏼

    • @BestPracticeHealth
      @BestPracticeHealth  9 месяцев назад +2

      You're welcome, Jessica. It sounds like you've been grappling with severe neck and low back pain for over a year, significantly disrupting your previously active life. You've explored medical options, including consulting a surgeon who suggested artificial disc replacement in the neck and spinal table decompression. You're contemplating 30 sessions of spinal decompression for $8000 before considering surgery.
      While I don't have access to your films or complete medical history, I'm concerned about the approach you're considering. Bulging discs typically don't cause the level of severe pain you're experiencing. It's more likely that your pain stems from internal disk disruption, commonly known as an annular tear. This condition might be present in both your neck and low back.
      Spinal decompression, especially table-based treatments, do not effectively address the type of pain caused by an annular tear. Moreover, it's not a permanent solution but rather a temporary relief akin to dental hygiene. Spinal traction, while beneficial for low back and neck pain due to facet arthropathy, requires ongoing consistency, much like maintaining good oral hygiene. IF you stop brushing your teeth today, the fact that you did so for decades will not make a difference for long.
      Computer-based table programs, considering their cost, might not be a practical long-term solution. The expense for prolonged use, potentially for life, might not be sustainable.
      Remember, the key to improvement lies in consistent effort and diligence. Hang in there, Jessica. I hope this information helps guide your decisions effectively. Wishing you strength and resilience on your journey toward recovery.

    • @patriciaortiz1683
      @patriciaortiz1683 8 месяцев назад +1

      Hi I also don’t know what to do!! This is so depressing I’m depressed! I have a three month old and this sucks it’s like a living nightmare!!

  • @lekesiaknight7495
    @lekesiaknight7495 Год назад

    I am currently suffering from two herniated disc in my thoracic spine . I am constantly experiencing excruciating pain mostly on the left side of my body . I do have weakness in my feet , fingers , swelling of my back and sharp , shooting pain from the left side of my neck throughout my arm. I am a housekeeper as well. Will physical therapy help me or surgery ? I’ve been having pain for years . Only recently got diagnosed. Please help . Thank you .

    • @BestPracticeHealth
      @BestPracticeHealth  Год назад

      Wow. It must be very hard to work as a housekeeper with all of this nerve pain. A thoracic disc cannot cause arm pain... so you have have another problem in your neck. Have you had a neck MRI?

    • @lekesiaknight7495
      @lekesiaknight7495 Год назад

      @@BestPracticeHealth yes please. I did have an mri done and it only showed that I have two herniated discs … T7-8 and T8-9.

    • @lekesiaknight7495
      @lekesiaknight7495 Год назад

      @@BestPracticeHealth they did do the mri on my cervical and thoracic spine . My cervical spine was normal .

  • @jessikagonzalez3544
    @jessikagonzalez3544 Год назад +2

    I’m suffering so much since August hernia L5 s1. 😢

    • @BestPracticeHealth
      @BestPracticeHealth  Год назад +2

      So sorry, Jessika. Herniated discs can be hell! Have you seen the rest of our content? Check out this playlist for more information. ruclips.net/p/PLsYo8ENYsvpz8bmjf5QkF5IdaX6UPZrPk
      I hope you feel better soon! Remember, it always goes away. We know that. Just not when. Hang in there. You've got this!

    • @chuyinram2223
      @chuyinram2223 10 месяцев назад

      How are doing now??
      Have your pain improved??
      What have you been doing to get better??
      I have been with herniared disc since 4 months ago. Been doing physical therapy and ibuprofen and the pain is been improving but very little

  • @Tazz45
    @Tazz45 11 месяцев назад

    Hi I already had 3 epidural injection one on S1 the second was for l4-l5 and last was l5 s1. For all three same just took some inflammation but then pain comes back . I have l4 l5 s1 herniated disks. My job is physical long hours of work. I feel pain in my leg, back spasms, buttocks, ankle, heel, calf, knee, toes except the small toe. It starts to bother me when I sit down, lay flat in bed, and walk that’s when it starts to bother more. My options now is surgery? Since I already had 3 injections? Thanks. Good informative videos.

    • @BestPracticeHealth
      @BestPracticeHealth  11 месяцев назад +2

      IF it's been more than 12 weeks and you have severe pain then you should consider microdiscectomy. The results after 2 years are the same whether you have surgery or not, but surgery helps get things over with faster.

    • @Tazz45
      @Tazz45 11 месяцев назад

      @@BestPracticeHealth thank you for you time and help. One more question please. if my left side is the problem can that pain also reflect on my ride side in anyway or it would affect only my left side since thats the problem? I ask because sometimes I feel the pain in left side and sometimes when I sit or lay down I feel it on the ride side but the main side left is more frequent stationary. Thanks 🙏

    • @ilhommuminov708
      @ilhommuminov708 10 месяцев назад

      @@Tazz45don’t do surgery your be patient you be alright be patient

  • @summerforever6736
    @summerforever6736 Год назад

    It is a terrible feeling im telling you!!

    • @BestPracticeHealth
      @BestPracticeHealth  Год назад +2

      I'm so sorry you are having this pain. I know. Hang in there. You've got this. It never ever never last forever.

  • @johnmitchell2741
    @johnmitchell2741 12 дней назад

    Lady you havent seen nothing yet😭

  • @Dashone93
    @Dashone93 9 месяцев назад

    8mm 12mm how big is too big

    • @BestPracticeHealth
      @BestPracticeHealth  9 месяцев назад

      The decision to treat a herniated disc is primarily based on the symptoms it causes rather than its size. If the pain is unbearable or if there's a neurological deficit like weakness or numbness, intervention becomes necessary. Surgeons typically assess the severity of symptoms and the impact on a person's quality of life before recommending treatment. If you have any more questions or if there's anything specific you'd like to know, feel free to ask!

  • @jenellecotto8456
    @jenellecotto8456 Год назад

    I have a herniated disc and have been doing PT and was going to go for an injection and just found out I’m 4 weeks pregnant. I’m looking for advice on what I should do? I cannot stand or walk for more than 5 minutes before my whole leg is in horrible pain. I see my neurosurgeon in a week. He doesn’t know yet I’m pregnant. Just looking for a second opinion

    • @BestPracticeHealth
      @BestPracticeHealth  Год назад

      Oh, you poor lady! So sorry. Disc herniation are not uncommon in pregnancy. Injection requires x-ray so that is out. You are probably looking at rest as the mainstay of treatment. Sorry.

    • @mrmrsdhillon8780
      @mrmrsdhillon8780 6 месяцев назад

      Hello, I just want to know how was your pregnancy with herniated disc. I also want to plan pregnancy just want to know.
      Please reply

    • @jenellecotto8456
      @jenellecotto8456 6 месяцев назад

      @@mrmrsdhillon8780 Believe it or not, I was completely healed by my 3rd month of pregnancy. I don’t know how it happened because I didn’t do anything. I even stopped going to physical therapy. The pain just slowly started to go away. I had this pain for 6 months, long before I got pregnant. It was the worst pain in my life! I was homebound because of it. I couldn’t even stand to wash dishes or cook, I had to pull up a chair and sit while doing it. I was at the point that I was looking on Amazon for scooters. The only thing I can think of is that God healed me because I prayed and prayed for healing.

  • @johnmitchell2741
    @johnmitchell2741 12 дней назад

    if you didnt have back pain what would you be doing 🤣😂

  • @C01N
    @C01N 2 месяца назад

    discseel

  • @rosekelly9759
    @rosekelly9759 8 месяцев назад +1

    😂

  • @GAINZonWHEELS
    @GAINZonWHEELS 8 месяцев назад

    I have 7 big bulging hernia, one makes me paralysed..

  • @solidfuel0
    @solidfuel0 5 дней назад

    Looks sooo bad how come she can even walk! Crazy