I had herniated l4 l5 disc resulting to moderate to severe stenosis and my doctor advise me for surgery. The pain is unbearable i cant even stand, i had been dealing with the pain for 4 months already. Even moving a little was very hard.But by Gods grace, im recovering now. I can walk now and pain is slowly getting better. I had my chiropractic adjustment after 3.5 months of rest. I also tried deep tissue massage just to ease the pain. To all who had been suffering this pain just have faith in the Lord and he will heal you. Thank you to all of those who continue to pray for my fast recovery.
Im 90% getting better now! No surgery, im having my chiropractic session. We just need to deepen our faith in Him. Praise God for his mercy and goodness!
I have c5c6 extrusion and severe cord compression and bruishing .doctor told me if I didn't operate I can be quadruple. But i didnot operate..I am much better now..I was healed in the name of jesus❤❤❤❤
Yikes! 3 months is too long to deal with a herniated disc, let alone 3 years. It's unusual---unless the disc was huge--- for the pain to hang on this long. Sometimes I see the pain go from the leg to be focused on the low back. Usually in this case the source of pain has shifted from the herniated disc to the facet joint. It matters because the treatment is different. The treatment for a sore facet joint is RFA (radiofrequency ablation). Does this sound familiar or not? One thing to check is if the facet joints at the level of the herniated disc look different on MRI today than they did at the beginning. For more on facet pain and RFA check this playlist out: ruclips.net/p/PLsYo8ENYsvpxyo-QrlRIROPJ3TNWP882b
Bro u go to ur nearest ceragem center ur herniated disc will heal in few days bcoz the disc which herniated is gel liquid which body will heal in 10 years but ceragem will in 10 days it will make herniated disc into dry leave n it will not bother u any more hope u understand👍👍👍
Very informative. After all these years of back pain and one major surgery, no one ever explained the nucleus pulposas not having its own blood supply an getting reabsorbed by the body. Thank you.
@@omarsamy122 No, not after laminectomy/discectomy surgery on L5. I am doing extremely well. I have some slight paralysis in my toes. The damage was done before surgery. I have adapted well. I hope you are also well.
@Omär Sämÿ mine was ruptured. I had protrusion (bulging) for years. Sometimes the protrusion went away with time and physical therapy. In the end, my disk just wore out. There was no way the debris was going to be reabsorbed. It was pushing against the nerve causing damage. We are all quite different. The treatment is the same. Step 1, physical therapy. Step 2, cortisone shots, Step 3, surgery. Always do your best to stay in shape, strong and not too heavy. God bless you.
Love how caring and informative you are.I suffer from knee and back pain would love to one day enjoy life without pain. Thank you for making these videos ❤
Maintain or get to ideal weight, eat healthy balanced diet, do whatever sport you can that doesn't make the sciatica pain worse, walking 3/4 hours per week can be very good, isometric exercizes too, etc.
@@BestPracticeHealth doc mine got better after 6 weeks but the back pains returns!!! some days its severe and it goes away with 975 tylenol, somedays its mild and nagging and somedays its like 1/10 pain. i had disc herniation in the L5S1 area.....does this mean i fit into that 6% that did not recover?
Hi Doctor! Back in 2010 I had a herniated disk, L5/S1, got an epidural that worked well, but several months later relapsed with terrible sciatica on the right side. It was horrendous. I was pregnant at the time and therefore had to wait it out. I got better in about 4 months and believe the pregnancy helped my condition, ironically. No issues since except every few years my back "goes out" and I rely on super hot heating pads 24/7 for a week until my back unlocks. Then I am fine. Fast forward to late Nov 2023, I had two instances of terrible back spasms a week apart. Heat worked. By mid-December 2023 I had continued pain, stiffness, muscle tightness and limited range of motion. Heat works best, better than advil. No radiating pain this time! Just lower back pain, slightly off to the right side, with tightness in the mid buttock, but pain is centralized in the mid back. I can sit in a decent chair, no problem, but cannot stand for a long time, but the biggest issue is sudden movements or any twisting or bending. Based on your videos, I thought I could have annular tear, but my pain isn't worse sitting down. I didn't think the disc was herniated, because I don't have radiating pain. But my MRI showed this below. I have no weakness/numbness. Pain is bearable but it's been a month+ and I am not much better. Would an epidural work if I don't have leg pain, just back pain? I am 47 years old. Bone marrow: Degenerative endplate marrow edema at L5-S1. No suspicious osseous lesions. L4-L5: Central zone annular fissure and disc protrusion measuring 2 x 17 x 8 mm. Mild effacement of the bilateral lateral recesses. Mild bilateral facet arthropathy. L5-S1: Broad-based disc bulge. Effacement of bilateral lateral recesses. Mild bilateral facet arthropathy. Moderate bilateral neural foraminal narrowing. Visualized sacrum and bony pelvis: Minimal degenerative spurring along superior aspects of the bilateral sacroiliac joints.
Oh, goodness. You’ve been healing with this for so long. I admire your patience. And your persistence! The painter describing is very typical of a facet joint. The introvert discs are the shock absorbers of the facet joint. What happens often is you have a disc injury, like you experienced, when you were pregnant, which heals up. Unfortunately, without it, shock, absorber, that facet joints go onto become arthritic. The MRI report you shared doesn’t comment on the shape or swelling of your facet joints. Given your symptoms, the most likely cause is facet arthropathy. The Doctor Who usually treat this upfront or Pain Management physicians. Make sure you find a Pain Management physician who meets best practice criteria. That means they are double board-certified, specialize in pain, and don’t use narcotics for chronic pain management. Let me know how it goes! Hang in there. Please realize there’s nothing wrong with you that can’t be effectively treated based on what we now know.
Hi Madeleine I’m suffering from this now and I’m about 3 months in. My neurosurgeon said mine isn’t laying on the nerve and there’s nothing to operate on but I’m still having symptoms. Did you have a “mild” herniation by chance?
So lets say you are part of the 94% where the nucleus is re-absorbed in the body. Does the annulus repair so the nucleus doesn't keep leaking out? What would be the range of time for the annulus to repair? And If so, I would assume the annulus would be weaker (much like when you badly sprain an ankle - it is truly never back to 100 percent and is slightly more likely to be re-sprained, but can get close to 100 percent).
Yes. The outer part of the annulus does have a blood supply and is capable of limited healing. While there is no strong data, many neurosurgeons believe the annulus heals for around six weeks after it is torn whether that is by injury or surgery. It's likely that you are correct the healed annulus will never be 100%, but hopefully it will be enough to protect the nucleus from your body's immune system, and prevent further nuclear disc herniation and more inflammation around the adjacent nerve root causing sciatica.
Also, what about the resultant disc size? Since some portion of the nucleus has leaked out, the disc size reduces. Is the disc able to get back to its normal size later?
I took a bad fall and herniated C6/C7 just prior to the pandemic. It took well over a year for the pain to finally go away. Extremely painful and caused muscle spasms in my arm, shoulder and back for months. It does heal without any surgery. There's a number of things that help. Try using traction to stretch and open the area. Don't smoke. Nicotine causes spinal injuries to take longer time to heal. Continue to move the spine as movement is how the fluids in the spine circulate and heal. This video is spot on. However, some herniations will take longer. As much as 24 months. If you have a herniated disk it is far better than if the disk is bulging. Only 50% of bulging disks improve compared to well over 90% of disks that herniate.
Awesome explanation of a herniated disc. I herniated my L4/L5 and L5/S1. I have been doing decompression at a chiropractor and pool exercises 5 days a week. Seen a lot of improvement in 4 weeks. What are your thought on PRP(platelet rich plasma ) injections? Do you think that can be beneficial into the back?
Sorry to hear about your discs! PRP and other stem cell-derived growth factors (SCDGF) are increasingly being used for the treatment of back pain due to facet joints. In those patients, the injection is done into the joint, as the problem is not the herniated disc. Very few pain management doctors are doing PRP or SCDGF injections in the epidural space. Back when I was in practice I tried several SCDGF injections into painful discs for chronic discogenic pain with surprisingly great results; however, those people had pain for years and MRI showed inflammation around the disc space (modic changes). Overall, given the lack of solid data and a great prognosis (94% of people with non-specific back pain resolve in 12 weeks), I'd hold off any alternative injections for now.
Just a correction from my POV: chiropractic heps contracted parts to return be movable....tigether with anti-inflammatory are the key to exercise.... without exercise no solution. Keep brave and constant ❤
Yeah, pushing it back in through physical therapy exercises never made sense to me. When a physical therapist said that to me, my brain could not fathom how, even if you could push it back in, it would stay in if there was a tear in the wall? Wouldn't it just move back out? lol! After watching this video, I'm glad I didn't go back there.
I had mild sciatica beginning around the start of June, with it getting really bad one night 2 weeks ago (now is beginning of july) and ive been treating it with proper sitting posture (lumbar support pillow) when I drive, walking and cobras throughout the day, copper suppliments (i dont eat enough leafy greens), and CBD. Im at the point now that I dont have any pain unless i sit for too long.
@@tapas1505 cannabis has lots of different molecules in it, CBD is one of them that's not psychoactive but it greatly reduces the body's inflammation response
So, I've been dealing with this for almost 3 years after 2 very close together MVAs. I keep getting turned down by neurosurgeons due to "long COVID waitlists". The pain keeps progressing down my legs. It started in my hips, then would go down to my knees, and now is persistently in my feet. I am regularly seeing a kinesio and doing active rehab. But, like, where do I go from here? Are you taking on new patients 😂😂😂
HI! Sorry to hear you've been in pain so long! I"m not in practice due to essential tremor. But there are many great spine surgeon and pain management out there.
You are welcome! Thanks very much for the comment. This video is an FAQ for our RUclips series The Clinic. Have you seen any of the episodes? It's kind of cool... like sitting in on someone else doctor visit. The Clinic episode this video references is here: ruclips.net/video/gbGSWGOL1_8/видео.html. There are 2 other FAQ videos from that episode, here ruclips.net/video/2iXy6KWpP50/видео.html and here ruclips.net/video/X6qCrROoKYo/видео.html. I hope these videos help!
Being at a healthy weight helps. Ya see, I was about 175 pounds in may of 2021. A physiatrist suggested I be out on a mood stabilizer, called abilify. I didn’t think anything of it, but before about 2 years before this I was on Paxil, and much like abilify I gained a significant amount of weight. The first time 50 pounds, and this most recent time 75+ pounds putting me well into the 240s. I may have had this herniated disc for a couple years but starting in early 2021 I had a lot of back pain. And for the last 8 months we’ve done scans and therapy and I’ve gotten myself down to 233 as of today. 2 weeks ago I got a steroid injection and within a couple days up to the present I’ve had extreme loss of mobility and function of my lower spine and left hip. The same day I got the injection I was moving a lot of heavy items at work, after I did this I went and got the shot and they numbed me up. I’m wonder if the numbing medication blanketed the aggravation of my already injured back more from moving the heavy items. Not sure what to do now. Might lose job. Moral of the story is so not ever let someone put you on a controlled substance without knowing all the side effects because they have a high probability of affecting your weight. Which can lead to more health problems such as liver, pancreas, cholesterol and LFTs along with type 2 diabetes. Please please please don’t let anyone out you on medication just because “somebody feels safer with you on it” your overall health is more important than appeasing people.
Worker's comp doctor cleared me back to work with restrictions so i got worse. Then they put me on pt and aquatherapy. Worse months of my life. Aquatherapy was so painful.They should have let me heal first. Now i have ddd, annular tear, protrusions, nerve pain, and stenosis. 7 months since work injury.
I’m really sorry to hear that. It can be so challenging to get better in the context of a work related injury. The doctors are usually not the best, and you have everything going through Workmen’s Comp. which limits the timeliness and effectiveness of treatment. Hang in there. I hope you get relief.
I had a inflammation back in 2021 and couldn’t bare to get up for the first 4-5 days and close to a month I got better. I stopped going 6 to 5 days to the gym now. Now In 2022. I decided to go onto 4 days a week but heavy setting on a Dailey. I was deadlifting and next thing I knew I felt like I got struck by thunder dropped the weight mid-set. I fell but got back up right away and confused in what just occurred (in shock) I tried to get on my feet but couldn’t! I sat on knees it’s like I couldn’t feel my legs for the first few 3 minutes. I drove back home got tingles and numbness on my lower body (nerves). 2 weeks in now my lower back feel better and the inflammation on my lower body hasn’t occurred today! Thank goodness it was a hell week! I just have trouble sleeping. I tend to wake 3 to 4 times a night. I’m having more left leg pain but some of the pain went away and feeling better but still in pain if you get the memo😅 I’ve been icing and taking meds as well to help with my pain. I did sleep well for 4 days this week which felt great but now waking up 3x a night which is odd cause I had 4 good days .. Right now it’s my lower body just hurts to walk and sometimes I tend to crash down if I’m in a odd position like squatting really low and I can’t do nothing about but fall the pain is unbearable and can’t really do nothing about it. It happens not just squatting but like just walking the pain will hit me but today I feel like the pain slightly reduced but not really much it kinda feels the same. My worst pain I’ve yet had was last Saturday night that it occurred for like 45 min and I even cried when it finally went away and it was behind my thigh on my left. The worst pain I ever felt! I made the mistake of taking hot showers as well so now I will reduce my hot water to more of a cool water temp. I’m 25 right now and fit and active and hope for this pain to go away soon. I pray week 3 I get some good reduction of pain and walk slight better. I appreciate the info thank you! 🫱🏼🫲🏽
Yikes! I'm so sorry this is happening to you. Sadly, you give a perfect description of what it feels like to have a herniated disc. I'd be happy to answer your questions on youtube, like we do. Your experience is so important to share with others... are you willing to do an interview?
This is exactly what happened to me, I’m in my 5 weeks now my lower back left side is still swollen but i don’t have any much pain anymore more like a discomfort. Hope you’re doing well at this time and able to get back to doing things you have been doing
@@dingdong6005 I'm doing so much better at 6 months. there's still tightness on my lower back and some impaired sensation on my lower left leg (feels inflamed to be exact). I'm not sure if my lower left extremity is inflamed to some extent because that's how exactly I feel about it due to the nerves irritated. but strengthening hips and back and more hip mobility is the key factors to getting back to normal again
Hi Dr, I’m 28 and been dealing with back pain for three years now. I go to the gym and Im in very good shape, the pain was minimum until two months ago i was in so much pain and had to do the mri and report was L4-5: There is asymmetric loss of disc height and circumferential bulging with endplate spurs, with more prominent protrusion on the left side. This results in moderate left foraminal and left lateral recess stenosis, but only mild right foraminal and lateral recess stenosis. There is minimal endplate edema at this level. Facets normal. L5-S1: There is slight disc desiccation and loss of height with mild bulging on the right side causing minimal right foraminal narrowing. Canal and left foramen patent. Facets normal I refuse to take the steroids injection because I was worried to make me gain weight. I start doing decompression treatment and it’s not bad the pain comes and goes, knowing I stopped going to the gym for now. My question is will I deal with this for the rest of my life?? Will the pain go away???
There is only one treatment for discs if damaged that mentioned by the last messenger of god Mohammed peace upon of him beyond that no treatment and will be healing 100 percent you can return to gym or hard work
Do sciatica and herniation always go together? Can you have herniated disc without also having sciatica? I woke up yesterday with my back in a lot of pain. It’s a spot that’s been bothering me for 25+ years but it was never what I would call painful. But yesterday tiny movements sent me into all the symptoms of serious pain: shaking, nausea, fast breathing, etc. It’s not as bad today but that was not something I would want to handle over a long period of time!
Sciatic is low back pain that radiates down the leg in the distribution of the sciatic nerve. Sciatica is commonly caused by a herniated disc causing inflammation of a nerve root. If you have no red flags, then the initial treatment is light activity and safe anti-inflammatories. If that fails, you get an MRI and often consultation with a pain management doctor. That's effective for the vast majority of people; however a small subset end up needing microdiscectomy surgery.
Thank you for the clarity. I have been suffering with back pain for more than 2 years now. It's at it's worse now, but I grit my teeth and carry on with my chores. In this 2 years I have had injections and some relief . I am getting ready to have the epidural injection and looking forward to some relief . I have a couple questions that I should have asked my pain management doctor. How painful is this epidural injection without having the pain med? Should I be taking it easy at this time? I live on a farm and do some chores that are quite painful to do, but I carry on. Housework, vacuuming the worse. never realized how many times you bend over in a day, I have this painful catch when I try to straighten up. Should I be do this work at this time or carry on? Now the last injections I had I gained 25 lbs. I've managed to lose 15 lbs since the injections worn off. Now the nurse told me I didn't gain the weight from the steroids. Is this true? I'm a 69 year old active female, that still thinks she 25 years old. Any answers you can give me will be quite appreciative .
Epidural injection is not super painful without pain meds; I have done a thousand of them without any pain meds myself in the past. Rest is important but not too much; think water aerobics instead of running on cement. Work or activity, farm or otherwise, that causes paint that continues after you stop should be avoided. Steroids can cause weight gain, but you have to eat the extra calories; watch the diet carefully after steroid injection. Hang in there. Watch facebook for our new show where we go over your MRI with you. Sounds like that may be helpful for you.
So sorry to hear about your pain and suffering. Everyone deserves someone to help them when they are sick; I hope you have a good doctor. People with back pain are generally treated by pain management or physical medicine and rehab PM&R doctor initially, and then a specialist as needed. Are you getting the help you need?
@@nirmalibhuyan216 Finding the right doctor is often the key to getting better. We listen to your story and help get you into the right doctor. If you need help call us at 602 256 2525.
reduced physiological lumbar lordosis almost eliminated.. absence of focal bone lesions. height of vertebral bodies preserved: absence of intra-cancellous edema. signs of l4, l5 and l5 -s1 disc disease. annulus fibrosus in the posterior median area with hint of minimal subligament herniation. At the l5-s1 level, median-paramedian and right posterolateral disc herniation is present with foraminal involvement. The other disc spaces were normal. Vertebral canal and conus medullaris normal.
I have been in pain for 4.5 months so I’d be happy with 12 weeks. So being that it’s been this long does that mean it won’t be healing on its own. I’m waiting 3 years to even see a surgeon. I’ve been told. I was in even worse pain over a decade ago for 3 years, so I’ve been through extreme hell. Had microdiscectomy the first time and it fixed me up. Really sad this has come back I’m still fairly young at 43 YO.
Ive had a bugle disk accompanied with left leg sciatica for 4 years now. I am only 28 yo. During this period of time ive had 4 epidural back shots. Got my first one back in 2021 and had relief for 7 months. Then it came back again and got another shot and got relief again for 8 months and then go another shot which was my 3rd one and felt relief for 9 months and now I am here typing this comment not being able to walk again. I got a shot on Monday and I am getting worse. Ive done PT and done more than 12 weeks of myself doing exercises to “fix” this but i see now progress. I dont know what to do anymore. 😢
unfortunately, epidural injection helps relieve inflammation, but it doesn’t change the underlying condition. It sounds like you have multiple recurrent episodes of radiculopathy, that’s inflammation, or compression of a nerve root, usually caused by herniated disc. This is especially likely given your relatively young age. You must’ve had an MRI by now. Look at the report and see if it mentions a herniated disc, and whether it is large, medium, or small. That may help decide whether a visit to a surgeon is the next best step.
Week 1 down...on crutches..can't put weight on right leg ibuprofen 1000 mg a day ( 200 x5 ) take 1 pill 💊 every 5 hrs as needed..warm bath ..I had massive sciatic pain ..had to get .5 mg corticosteroids in glute..some relief .. will update week 2 .
Oh, goodness! So sorry you are going through this. Keep you chin up if you can... most pain of this type resolves by itself. See a doctor right away if you have intractable pain, functional weakness or numbness, or any bowel or bladder dysfunction. Hang in there and let us know how you are doing.
I've heard of this theory before that your body e eats up the herniated part, but its been 8 years since i herniated my disc and I'm still in the same pain that i was and the scan shows exactly the same 3mm. I consider myself a disabled person because of this.
Did you rest it? If yes, for how long? And have you done proper body mechanics and good posture while sitting? And how’s your weight relatively to your height?
Thank you, doctor, for sharing this information. I recently had an MRI, and the findings showed degenerative disc disease at L4-5 and L5-S1. At L4-5, there’s a diffuse disc bulge with a central protrusion causing mild spinal canal stenosis and slight narrowing of the bilateral subarticular zones. The main concern, though, is at L5-S1, where a large posterior disc extrusion is causing severe spinal canal stenosis and compressing the cauda equina. My orthopedic specialist initially recommended a conservative approach, but after seeing me today and noting weakness in my left leg, I’m wondering if I should be considering surgery more seriously or if waiting it out is still advisable. Any insight on how to weigh these options would be greatly appreciated.
I have been dealing with a herniated disc and nerve pain since early 2019 it is now almost 2024. I have tried many things. So far the home traction unit helps the most. Hasn't fixed it and I doubt that it will. Surgery sure isn't an option due to no insurance during the recovery time. I sadly believe I am gonna have to deal with it for life. Mine was a small herniation at L4/L5
It's only one treatment for all discs damage that mentioned by the last messenger of god Mohammed peace upon of him will be healing 100 percent and u can return to your work or gym
Thanks for the video! According to my mri i have bone spurs and a bulging disc on c6-c7. It’s been 14 weeks now and the pain has slightly reduced and moved multiple times to different places. The doctor prescribed an oral steroids course. Do you think the risk/reward is worth it? Will it fix the problem? Or just hide it for some time. I have also refused steroid injection in the neck for now I have no weakness but quite some pain(tingling went away). Is steroid injection also worth? Sorry for all the questions
Yikes! 14 weeks of cervical radiculopathy is a long time to be in that much pain. Cervical epidural injection is higher risk and lower reward than the low back. If you are concerned about it I'd skip. I guess it comes down to severity in your case... if your nerve root is pinched and 14 weeks of SEVERE pain, then it's time to see a surgeon. Make sure you follow best practice guidelines for selecting one.
I have a moderate disc bulge in my c6 c7.I felt much better going into fourth week in terms of pain. It's my six week now but the tingling and numbness in my first two fingers haven't completely gone yet. Also, my triceps on my right arm have gotten really weak. I used to press 110lb dumbbells and now I can barely press 15lb. It's really overwhelming and can make you really upset and emotional.
It appears you're experiencing a four-week history of right C7 radiculopathy due to a herniated C6/7 disc. While you mentioned a disc bulge, it typically requires a true herniation to cause this much trouble. This condition is causing significant motor and sensory issues, including weakness in your tricep and numbness in the right middle finger. Thus, you have motor and sensory weakness in the distribution of the C7 nerve root, which is the one that is pinched and/or inflamed by a C6/7 disc herniation. Given the severity of your triceps weakness, surgical decompression should be seriously considered. I highly recommend consulting a qualified spine surgeon promptly. An evaluation for procedures like anterior cervical discectomy and fusion or anterior cervical disk replacement (C6-7) might be necessary to alleviate your symptoms effectively. Early intervention is key to ensuring a successful recovery. Reach out to a specialist soon to discuss your treatment options and regain your quality of life."
@@BestPracticeHealth Thanks for responding, Doc. According to my MRI and my doctor there's a moderate protrusion of disc. He told me if it was literally choking my nerve then they would have to refer me to a surgeon. I'll have a second opinion on my MRI results. So can my strength not come back without surgery? I had the same issue about four years ago with my c5c6 disc which really weakened my right biceps it took quite some time to almost come back to normal from that but it came back.
@@Preeti-lw9jc well, i have been waiting for my appointment with a specialist. Might take a little while. Weakness hasn’t improved at all and tingling comes back strong and goes away after a while. I guess surgery is the way to go. Hopefully get it done in the next two months. Fingers crossd
Hello mate, I’ve got exactly the same symptoms as you! Horrendous pain down arm, mri showed my nerve being choked like you say! Loss of strength in the my can normally do 100 press ups straight off and at the moment can’t even do one! I’m waiting to see a consultant now, how are you? Are you any better
I’ve had bad sciatica for 11 months; meaning I can only walk for 30-45 min until I have pain in my leg, buttocks and lower back to the point my hips become shifted, I’m walking crooked and in pain and have to lay down. Just recently (few days ago) I went for a walk in a park that was vey hilly, after that my pain became substantially worse and I can’t walk not even for a min or sit on the toilet without being in extreme pain like someone is stabbing me in the lower back. I cannot sit much if at all. I don’t know what’s happening. When this all started Initially a year ago, my MRI showed ruptured disc at l4-l5. That’s what was Initially seen at least. I’m loss for words…
It sounds like you had a progression (recurrent) disc herniation. If you have any red flags then you need medical attention now. Otherwise, consult the matrix and decide what to do. It's been 11 months...sounds like you need help. Feel free to submit a video question and a pic of your mri here: bestpracticehealth.tv/
@@BestPracticeHealth Thank you for your response. I will go ahead and do that. I just came out of hospital today for this issue. Doctor wants to do surgery. I have improved a little and pain calmed down a bit but still worse over all than before. I am seriously considering my current options.
Hey Joey, Dr Lieberman answered your question today on our live show. Here is a timestamped link: ruclips.net/user/liveLryTnQ3aC6I?feature=share&t=3001
@@BestPracticeHealth Yes, I just saw the video. Very insightful. Thank you for passing my situation on to the Doc. I think surgery is good option for anyone under the circumstances,I’ve just read some info that surgery could be not so good of an option. Everyone is different I guess. I’ve got some thinking to do!
Great video!! But I have a question to the following steps the body take: after absorbing the substance how does the outer layer of the disc prevent more run out? can it close up again? or does the nucleus keep running out? By "healing itself" I consider some kind of "closing the wound" like a cut
Thanks! The white cells of the body eat up the herniated nucleus, allowing the edges of the annulus to be approximate to one another. Once two like layers are touching they can heal. Think of your skin. If the edges of a cut are clean and touching they can scar back together. If they are far apart then healing take a different form. Same with the annulus.
@@BestPracticeHealth Thank you so mich for your helpful answer! I couldn‘t imagine how it works because I read that the disc has no own blood flow. But I‘m glad I learned something new ❤️
Recently i diagnosed with Disc Herniation on L5 🙁 The doctor said i need surgery, but i don't want to pass by this procedure. I feel my left leg and foot more weak, and i cannot do my sport activities like skateboarding or gym workout, i'm very sad with that, i'm taking the medicaments, and what's the most wrong thing i have do in my case is stop workout 100% and rest, my pain is get even worse. When i started to do some exercises to my lowerback without weight it get better again, the pain not good now, but a little bit better that i can hold on.
It sounds like you're facing a tough decision regarding your herniated disc at L4/5. Opting for a conservative approach initially is a reasonable choice, especially if your symptoms are manageable. The SPORT trial provides valuable insights into the management of spinal conditions like yours. The findings suggest that for many patients, the long-term outcomes (around 2 years) of conservative management versus surgery like microdiscectomy are similar. This supports the idea that waiting it out could be a viable option, provided your symptoms do not worsen significantly. If you haven't already, discussing the option of an epidural steroid injection with your doctor could be beneficial. These injections can help reduce inflammation and pain, potentially giving you relief for several months. This could make it easier to cope while you see if your condition improves without surgery. And keep a close watch on your symptoms. If you experience an increase in pain, or if neurological symptoms like weakness or numbness worsen, it's important to reassess your options. Progressive neurological deficits can be a sign that surgery might be needed sooner rather than later. Consider how the pain and weakness are affecting your daily life. If these symptoms start to interfere significantly with your ability to function (e.g., walking, standing, or performing daily tasks), discussing surgery more promptly with your surgeon could be crucial. Be mindful of your activities to avoid aggravating your condition. Avoid heavy lifting, twisting motions, or any activity that puts excessive strain on your back. Gentle exercises, as recommended by a physical therapist, can help maintain back health without exacerbating your condition. It sounds like you are not out of the woods yet. Stay in regular contact with your doctor. They can help monitor your condition, adjust your treatment plan as needed, and provide guidance on when or if surgery should be reconsidered based on your symptoms and quality of life.
Thank you again for your insight. I had surgery one year ago, discectomy/laminectomy on my l5 s1. Never gave relief. I have a disc extrusion, so a tear in the outer disc. I get flare ups that swell my lower back( mostly left side). Is there any way to differentiate between scar tissue and the actual herniation that is causing the sharp pain? Is scar tissue inflammatory? Can’t bend or something catches. I took prednisone and that helped my ability to bend. Any insight on how to differentiate between scarring from surgery, or the herniation? I understand every case is different. Any input from your expertise would help. Thank you again for your work.
Unfortunately, pain after spine surgery is common. The question is whether that pain is coming from the torn annulus, inflammation of a nerve root, or the adjacent facet joints. The only way to know for sure is to have diagnostic injections of those structures. A medial branch block is an injection that temporarily numbers the pain fibers to the facet joint. If you were pain-free for a few hours after a medial branch block then the problem is the facet joint and not the annular tear or nerve root. Similarly, a transforaminal epidural steroid injection numbness the nerve root and not the facet joint. These blocks are done by pain management physicians. The trick is to find one who will help you work out exactly what hurts. Until you know the problem, the solution is impossible to figure out precisely.
@@BestPracticeHealth thank you for the response. I got a caudal injection 2 weeks ago. Didn’t do anything. Like you said, difficult to decipher what exactly is the cause.
@@jasonshamoon7427 You're welcome. Thank you for the comment! A caudal injection is when a doctor places a needle under the sacrum and injects something, typically steroid. The rationale is that the epidural space connects with the space under the sacrum. The advantage of a caudal injection is that it’s easy to do and does not require x-ray guidance. In my opinion, caudal injections really have no role in modern pain management. What you want is a doctor who can look at the MRI, identify a potential problem related to a compressed or inflamed nerve root, confirm with a physical examination targeted to the nerve root involved, then if appropriate do a transforaminal injection of steroid to reduce inflammation on the affected nerve root. A transforaminal block requires fluoroscopy and training, but it’s better because it focuses the treatment on the problem. The second advantage of a transforaminal block is that it confirms your doctor’s theory about what’s wrong. A doctor may have their own reason for doing a caudal, but the reason I see most is that the doctor is not qualified to figure out what’s wrong and offer specific treatment. We are putting out a new video on how to pick a pain management doctor next week. Please subscribe and look out for that when it's released.
What exercises should I be doing. Dx with L4, L4, S1 Disc herniation ,, Sciatica left leg .. Tried RF Ablation (RFA) That did not help at all. Tried PT with pool therepy when finished I was in much more pain than before PT sessions.. Had to stop.. Problems sleeping as Pain management says not to sleep on left side as the discs shift and pain wakes me. Sleep approx 3-4 hrs nighly , toss and turn to find a spot that I can deal with. Right side have Rotator cuff tear.. What excercises will give me relief? also I have lost 30lbs over the past yr due to not being able to regain muscle.. Thx so much..I was allso looking at stem cell therapy/& peptides for shoulder Rotator.. What direction w/ excercise...
I'm 21 F and I'm 7 weeks in now into this. I have a left paracentral disc bulge which is causing mild narrowing of left lateral recess at l5s1 disc and type 2 modic change in s1 vertebrae. now can you explain it to me please. I have few questions to ask you. 1. Why do i have sciatica symptoms in both legs 2. Will i ever get better or it will get worse and never heal 3. I went to two doctor one said it will stay same and I need to work on my posture and if the pain is more than i should get an epidural injection. But my pain is not that severe and the second doctor a ortho spine surgeon said it will get better and it may necessary not be the cause of my pain he told me do spinal extension excercise And engage in any sport activities and do drill exercise. Now if i do such things won't it cause my disc to herniate and rupture. 4. I asked for medical leave from my doctor which he denied by saying that we don't recommend rest in back pain As i mentioned I'm a nursing student i have my clinical duties From 8 am to 1pm and then classes from 2 to 5 pm. At such hectic schedule will my fisc ever heal, infact due today sitting and standing for such time will only make my disc worse. Can i get mu mri reviewed by doctor. Please help I'm very stressed and i don't see any hope. I can walk upto 4 miles per day. My MRI also shows type 2 modic change in s1 vertebrae.what should I do should I get And epidural or should I wait or do surgery One last question do disc bulge ever heal??? Is annular fibrosis layer broken in disc bulge or not?? If Yes will it ever heal
First thing don't worry about discs , second thing there is only one treatment that healing 100 percent all damage happened to discs bulging or even herniated that treatment mentioned by the last messenger of god Mohammed peace upon of him
Hi, I am 25 yr old female , and have a L5-s1 disc protusion and diffuse disc bulge, as per report by radiologist. Some doc say its extrusion and some protusion. Having sciatica pain while walking more than 20-30min. Doc has advised bed rest for 2 weeks with limited exercise.On medications also. In my case is resorption possible?
Because disc material has no blood supply and is "foreign" even to your own body, all disc protrusions are reabsorbed into the body by inflammation over time. If either the compression by the fragment or the inflammation is causing damage to the neighboring nerve root, then microdiscectomy surgery should be considered. The way to know there is damage to the nerve root is from the presence of 1) functional weakness, 2) numbness, or 3) unbearable pain. If 1,2,3 are absent, then the traditional advice is to wait it out. During the waiting period, you can get temporary relief with a transforaminal injection.
with that many herniated discs, over such a long period of time, the problem is not really the herniated disc. There’s an underlying issue that needs to be dealt with. The best doctor to handle this kind of problem is a physiatrist. That’s technically a real rehabilitation doctor, but these days they usually specialize in spinal intervention, and can really help you manage the problem. You need a quarterback, as this is likely to require a team effort. Hang in there. you can get better. But you definitely need the right team around you.
I put half of my body weight on the bed and used my upper body strength to "pull" my spine muscles (to identify damage) but it suddly felt like when you're trying to put the same faces of a magnet together and i stopped. I couldn't move for about 15min because it was sore. It definitely felt like something was being pinched.
It sounds like you put your low back in traction. That’s not a test! Watch my video on “when back pain is serious” to be sure you have no red flags that require immediate attention.
I got herniated disc L4-5 and just got epidural steroids injection and I'm more pain than b4. I got injured in June 2023 and as of now November still hurts
I'm so sorry to hear about your pain. It's often difficult for others to fully grasp the intensity of severe pain unless they've experienced it themselves. Hang in there. I sincerely hope you find some relief soon and start feeling better. You're not alone in this!
@@BestPracticeHealth thank you so much for your kind words. The Dr wants to do surgery on me 😮💨 i don’t want to, it scares me. All the risk and everything. I’m going to wait and see if the thing gets better.
2 years ago i had it for nearly 4 months. Severed 3 month plus no surgery. Bed rest, painkillers, and some mellow strech. Now its came back. Had it for almost 2 months now still no improvement. This injury is really traumatic i cried when it came back
I'm so sorry you are in pain. It really is terrible. Population data suggests at 94% resolve in 12 weeks. Eight weeks (where you are now) is typically 84%. So, there is a real chance it gets better over the next 4 weeks; however, only 10%. Have you seen a doctor?
@@BestPracticeHealth yes i seen a doctor today. did an xray image shown L5 S1 compressed. same as 2 years ago. he arranged a PT session next week. hope will do my best to heal it. thanks
I have slight neck disc bulge which I got from exercise, after that I had lot of rest for 1 month, then I walked a lot, I don't know, nowadays, I don't have to medicines for pain and that, sometime the pain comes back with headaches and slight dizziness but a lot less, it's 3 months from the point I got the injury, is it healing? And by what time I can get back to my normal routine, like I'm athletic , can I able to do the exercises again?
My injury is 9 months old. Now I have a mild pain around calf and at the lower back portion. But whenever I consume alcohol, my pain goes as away and I feel normal for that very moment. I dunno what's happening
What does it mean if I've definitely aggravated a disc in my lower back (Incredible pain, reduced range of motion, cant bend down well, etc) but I never had the shooting pain down the leg?
Hi this is my MRI results I just saw my doctor he said to get the The Surgical Procedure is : THORACO-LUMBAR laminectomy discectomy for L5-S1. Question is if I have two herniated disks why he only doing one? He said my herniated got bigger compared to my first mri from Last year. L4-5. there is a small left foraminal disc protrusion superimposed upon a diffuse disc annular bulge with mild facet arthropathy and endplate spurring. Mild left foraminal narrowing results. The central canal nda right neural foramen appear patent. AtL5-SI, hetr isa small left paracentral/left foraminal disc protrusion and annular tear superimposed upon adiffuse disc annular bulge with mild facet arthropathy and endplate spurring. dMli inferior left foraminal narrowing results. The central canal and right neural foramen appear wdieyl patent. Thank you.
How bout 12 months? Lol. Couldn't take it anymore... now I'm still hoping residual numbess will go away oneday. Smh. I'll be 5 most post-op on the 20th of May. L5-S1 MD.
Doctor. I did my MRI and it looks like I have herniated disc at L4-L5 and L5-S1. I dont have any numbness but the pain radiates through my right leg all the way down. This pain is only felt if I sit down for long. When I stand up and do some walking, it slowly reduces. Do you think it will heal by itself? I’m willing to wait.
Hi, SadiQium. Nice to meet you. If I have this right your pain is more in the back, worse when sitting. That kind of pain is more typical of an annular tear or a facet. The first step is to figure out what's causing your pain because the treatment---if any is needed at all---depends entirely on the cause and severity. Check out this blog to help understand what is causing your pain. Pick A,B,C, or D based on how it feels. phoenixspineandjoint.com/the-3-things-neurosurgeons-recommend-for-new-low-back-pain-spoiler-alert-panic-isnt-one-of-them/
@@BestPracticeHealth thank you for your quick reply. Actually my pain is more towards right leg (from hips to calf) with very minimal pain at the back. If I sit for long, the pain will start to come. Once I stand up and start walking, the pain reduces significantly so I wonder, it is this a good sign.
Hi there! We were able to answer your question on last week's Q&A episode of Best Practice LIVE. You can view it HERE: ruclips.net/video/7WHPRbIoVCM/видео.html
I'm definitely in the 4%. I've had lower back pain for maybe 15 years (I'm 41 now) and last year only had an MRI and got told I had degenerative disc and also lack curvature in the spine (lumbar). I also have another condition which I've had most of my adult life - overactive bladder - hospital have told me years ago they can't find anything wrong with me (all tests clear). When I had some physio for my back initially I had a week free of back pain (maybe 6 days or so) and I couldn't believe it but my overactive bladder also cleared up during this period. I never even noticed they were linked but I replicated the relief around 4-5 times, each time the same result. I'm a year down the line however and have been doing regular exercises and decompression stuff (at home) but it's still very bad. My osteopath told me it was coincidence and that the only bladder issue is Cauda Equina - I know it's not though and wonder how many others' have had this experience and not linked the two?
Hmm. The test that determines if an "overactive bladder" is due to a nerve root problem is called a "cystometrogram." They put a catheter in your bladder and record the pressure as it fills. Not fun, but it is a definitive test done by a urologist. If you go that route, you want one who specializes in neurological urology. Or, come on my show, and let's look at your images together. It takes really severe stenosis to cause a neurogenic bladder. phoenixspineandjoint.com/best-practice-medical-questions-and-answers/?fbclid=IwAR1-EAG1KG0ltuYtM3pKQuLW3Q6pzf9DHfDfsoJJzo-YmWAS7GFnWF9c6DE
@@BestPracticeHealth Thanks for the reply. Yes I spent a lot of time at the urology department at Kings College London and all my tests were clear. No infections, prostate and the cystometrogram all were fine. That was before I linked with my back condition but no one ever asked if I had back pain. I have my MRI scan I'd be happy to share if it helps others'.
@@BestPracticeHealth I was looking into this a bit more - as to why others' don't have this over active bladder - I was wondering if it was due to me having an L6 extra vertebrae? Would it cause the nerves to take a different route?
@@silkee Did you check whether the anxiety that causes the OAB? I experience frequent urination and did all the tests, everything was fine. Later I found it's my anxiety/stress that causes it. Also confirmed with my psychiatrist
I have disc bulge in C5-6 in MRI. I dont know if disc bulge or herniation is same but I have extreme pain in neck, head and occassional numbness in whole right arm or both legs sometimes. I have wekaness in both arms. Doctors i have visited dont take it seriously. I have been on NSAIDs and pain medicines but they are not working
I'm so glad to hear that you're finding relief with cupping and dry needling. Back pain can be incredibly frustrating, so it's great to know these treatments are helping. While dry needling and acupuncture are often thought of as similar, they do differ. In areas where there are restrictions on who can perform acupuncture, it's often referred to as dry needling. The best treatment is the one that works, and since dry needling is helping you, that's what matters. Not everyone experiences relief from it, so you might also consider trying acupuncture in the future. As for cupping, I must admit I'm a bit skeptical, as I can’t quite explain how it works from a mechanism perspective. That said, if it’s working for you, that’s fantastic. However, if I had to choose just one treatment, I'd lean towards dry needling. Other options to consider for non-specific low back pain include moist heat and safe anti-inflammatory medications like Aleve, ibuprofen, or Tylenol.
Thank you so much for the info. I was wondering i herniated a disk in my lower back when i was 26 years old i am 47 now. It hurts if i sit too long latley i have to sleep on the floor might get a new matress. i was wondering what might be my chances of needing surgery done the road? Thank you so kindly.
I have spondolysthesis. My l5 has moved a bit. My pain in my leg and hip area has increased and my feet at night feel like they are hot. I am 26. What do you suggest I do? I was trying acupuncture. Do you think it can help? I have been having loxoprofen 60mg and mecobalamin 500 for the past 6 days and my pain has reduced. Please suggest what can be done!
Burning or strange sensations in your feet at night are often due to neuropathy, and not related to your back. Some neuropathy runs in families, so as your parents if anyone else has it. Leg and hip pain is usually facet mediated pain. Watch this video to figure this out: ruclips.net/video/rBmHQ7VCDIk/видео.html. If your pain is more than 12 weeks old and due to a facet injury then medial branch block done by a pain management doctor is the key to finding out what is wrong. If the medial branch block is positive then radiofrequency ablation is the next step. Learn more about spine problems here: ruclips.net/p/PLsYo8ENYsvpxyo-QrlRIROPJ3TNWP882b
I have been suffering from a sore back for five months and got a MRI scan two months ago. I am suffering from a sore back painful calf and occasional numbness in the foot. Sometimes it’s better and sometimes the pain gets worse. It’s very up-and-down. My desk bulge is 8 mm which is pressing on the nerve causing all the pain. I have read about it and it says the bigger the bulge sometimes the better it can heal. Is this true? Interesting video and learnt a lot thank you
It's hard for a bulging disc to heal because healing requires inflammation and the annulus shields the disc from your the rest of your body. But bulging discs usually do not cause sciatica. Are you sure that is the issue?
Hi doc, My question for you is, will the lost pulp due to the hernia refill itself? If not will this have impact on the disc and quality of life? I would assume with the loss of the pulp the 2 vertebrae between the discs will grind because the volume has decreased. I my self hear grinding noises coming from my back after the herniation. Also will the tear that happend re-close and be strong again like before? Thank you.
Hello. Thanks so much for your question. No is the short answer. Once a disc has torn and the soft inner part herniated, the pulp cannot replenish itself or replace itself. That does lead to grinding, particularly more of the facet joints than the bones of the intervertebral disc space itself. I hope this helps.
Dr can you please reply my question Is bulging disc heal or not? I have bug disc but not compression to nerve as ct scan showed I really scare and cry a lot I have sciatica pain within 4 weeks, so l cried a lot because really l scare about the permanent problems. I did CT scan and the Dr diagnose l have budging disc on S1 and L5 but the disc does not pressure on the nerve. So l have pain in my calf and ankle I don't have any idea because my both legs have problem, one of them too much and next is sometimes As l am young and student, l am very worried and cry alot I do pray for all people to recover from sciatica 🙏
I'm so sorry you are suffering. Sciatica pain is really severe and naturally frightening. The first step is to figure out what is wrong. Then you will know how to fix it. A bulging disc typically does not heal on it's own. A herniated disc heals because of an immune reaction between the soft "nuclear" contents of the disc being exposed to the rest of the body. In a bulging disc the nucleus of the disc is still behind the annulus and doesn't heal in this way. In any event, a bulging disc shown on CT without nerve root compression is unlikely to cause sciatica. However, most of the things that do cause sciatica should have "shown up" on a CT. Absent a really large problem or narrowing (stenosis), sciatica is rarely present in both legs. Not all nerve problems are sciatica in the first place. A neurologist would consider nerve problems like neuropathy in evaluating a nerve problem in the leg. The test to separate nerve problems from nerve root problems is the electromyogram (EMG). The EMG test is typically done by a specially trained physiatrist, or historically by a neurologist. I can't give you medial advice over internet. But the key to figuring out what is wrong is the right doctor. A spine surgeon is typically a good choice if you need surgery; if you want to find out what is wrong a pain management doctor, or physiatrist are typically the doctor with whom people start. *** Pain management doctors are *board certified in anesthesia or physiatry; ** subspecialty certified in pain management; and *** don't abuse narcotics except for cancer or surgical pain treatment. I hope this helps. Please let me know how you do.
Very informative video. I had an injury 14 months ago, had a nerve root block at l5 s1 level 3 months ago got some pain relief but eventually around 30-40% pain came back. I am not taking any painkillers because pain is nothing like it was before nerve root block but my SLR is still positive at around 30-35° and I can not touch my toes, my back feels really stiff. I wanted to know if I'm a candidate for surgery or not. My Dr is suggesting me to get an endoscopic microdiscectomy. Would love to hear your advice as I'm just 23 and want to go back to my normal life again as soon as possible.
Your priority now is stopping the sciatica. The longer it goes on the more permanent nerve damage you can expect. If a good surgeon recommended microdiscectomy then I would definitely consider it.
Could it take longer to heal if you are taking and immune suppressant called methotrexate? Since the body can’t chew it up as fast, I’ve been having pain for 2 months now
@@BestPracticeHealth thank you for replying, I stopped MTX 2 weeks ago and started a biological called dupixent, I don’t have arthritis but I have atopic dermatitis (eczema) so my doctor said it’s less of an immune suppressant, targeting the eczema and not much more so does that mean I would heal or do you have any pointers for me?
Great video! Im 24 and got a herniated disc i had back spasm or back problems since i was younger doctor says it does not look very good ive lifted heavy stuff in a bad form not so much this past year but i started playing soccer and looks like i have back pain every time i play so i decided to get an mri to see what was going on hope its not to late . And hopefully it can heal on its own with physical therapy after this last injury almost a week ago the painful part was the first two days o could hardly walk and stand up but only pain was on my back But very sharp now im doing much better still feel little pain not much just feels sensitive 6 days after i can walk great but i would some advice or opinions i love soccer sports running and training with my daughter and i wonder if im ever going to be able to do it again . Im in texas but i would love to go to Phoenix for a consultation i would like to know the cost for an opinion I can make it to phoenix in next week or so hope to hear a response soon. Im a bit worried i just want to go in the right path.:(
Hi Bryan! We were able to answer your question on last week's Q&A episode of Best Practice LIVE. You can view it HERE: ruclips.net/video/7WHPRbIoVCM/видео.html
I have herniated disc L4 L5 L5 S1 Stage 2, and L3 L4 stage 1 for 2 months pain is there. But afterwards pain subsides up to the writing of this comment. But my right foot sole is having numbness up to now. What do say? I my hernitated disc has healed?
Doctor, I have a herniating at C6-7 with numbness/tingling in my right index and middle fingers. Happened back in April. Confirmed via MRI in May. I’ve held off on surgery while trying several conservative methods, but no luck yet. I decided to lose 25lbs because, well, that’s never unhealthy and figured might help my mobility and pain level. And it has. My question: when is it time to throw in the towel and go get the scalpel? I have been researching photobiomodulation therapy and wondered if a Diowave 60w high power therapeutic laser would be worth it. Your time and response is appreciated in advance. 🙏🏻
Hi, Brent. Sorry for the slow response. I'm sorry to learn of your neck troubles. I'm going to answer your question on my live show tomorrow at 10 AM (12 PM Central). If you would like a review of your MRI included call my staff at (602) 256 - 2525 to upload the images to our confidential online drive. I will send you a link to the discussion afterward.
Hey, Brent. Here's a link to BP Live. I answered your question today. The discussion of your case begins around 40 min in. ruclips.net/video/zb9UGqWtjf4/видео.html. If you have not already please subscribe! Thanks for the great question. I think many of our viewers have the same issue.
I have a moderate herniation at my L5-S1 with a measurement. It's been a long 4 months but I am slowly getting better. Is this herniation too large to heal on its own? (See MRI details below) Thanks! (Been doing PT weekly & 2 epidural shots so far that were not very effective unfortunately) At the level of L5-S1, there is a moderate size left posterior paracentral disc protrusion that measures approximately 7 x 5 x 13 mm. This causes mild ventral effacement of thecal sac and moderate left lateral recess effacement. There is displacement of the transiting left S1 nerve root. Minimal hypertrophic facet arthrosis at this level.
The key to taking the right step in the treatment of a disc protrusion is not usually the size of the disc; it's whether or not the patient has a functional weakness, numbness, or uncontrollable pain. The s1 nerve root provides sensation on the outside of the foot and works the calf muscles. A good way to test for functional weakness caused by damage to the S1 nerve root is to walk on your tip toes. One can test for S1 numbness by gently touching the outside of the foot, by the pinky toe, and comparing it to the other side. Disc protrusions do heal, as they are exposed to the epidural space, as opposed to bulges. I'm sorry you're in pain. I hope you feel better soon.
Informative video. I have been dealing with chronic pain caused from multiple disks in my lower back. I have had 2 MRIs. I had a lot of nerve pain down my leg, numbness in my foot, i walked with an obvious limp. I was a candidate for surgery, but opted to try other options first. I took gabapentin for the nerve pain and pain meds for the pain in my back. Today, years later my back feels pretty good. Nerve pain is gone, I am not in as much pain as i was. I have a different problem, my body is addicted/dependant to the pain meds. I am weening myself off the pain meds (which is no easy thing) and my back to my amazement doesn't cause the extreme pain it once did. I find it exasperating how Drs treat pain patients. Drs wanted me to take long acting time release pills (oxycontin or morphine extended release) or have a pain pump installed. I knew when i started taking the long acting pain meds that my body would become dependant on them and that i would have withdraw when i decided to stop taking them. Last month i cut out 80 mil of pain meds. (i now take half the meds i was taking) It wasn't fun, withdraw is horrible. My eye twitched for a month. Now Drs don't want to give anything for pain. I don't understand letting people suffer. I am greatful for the Drs i saw, they didn't leave me to suffer and i didn't have to have surgery to get pain relief.
I agree with weaning off the pain meds. I'm glad you are doing that. Once you are off I think you will find you feel better, your relationships are easier and more productive, and you can live a much better life.
Hi sir, I had a microdisactomy surgery L3-L4 And L4-L5 2disc. Now it's 1month completed, doctor suggested me to resume my activities after 1week since my surgery. I having some weakness in my left leg, I can apply force on it but can't lift my ankle up. right after the surgery I was not able to move my left leg fingers,not to walk on left toe. But now I can manageable to walk on toe and move my fingers, still difficult to walk on heel. The question is : 1) do I resume my activity now driving car or raiding bike? 2)How frequently I can sit or walk? 3) what are the major activity which I need to avoid like (twisting, forward bending) ? 4)What action need to take avoiding disc degenerative disease in feature? 5)How I can repair dissolved amount of nucleus purpose ? 6)If not what precaution need to follow not to persist again? 7)How do I strengthen and stability of my back? I would really great full to youif I get all the answers. Thank you in advance.
The big concern for you is recurrent disc herniation. The risk of recurrent disc herniation after microdiscectomy surgery is relatively low, estimated to be around 5-15%. This means that most patients who undergo this surgery experience significant improvement in their symptoms and do not have a recurrence of their herniated disc. However, you certainly can cause a recurrent disc hernaiton with excessive strain or trauma to the spine during the postoperative period, which can cause a new herniation To minimize the risk of recurrent disc herniation after microdiscectomy surgery, it is important for patients to follow their surgeon's instructions carefully during the postoperative period. This may include avoiding heavy lifting or strenuous activities, participating in a structured physical therapy program, and maintaining a healthy lifestyle. Your surgeon said no restrictions 1 week after surgery. That is not typical. I am not a surgeon anymore. However, for what it's worth, here are my recommendations: No bending, lifting more than 5 lbs. or twisting for 3 weeks during which time you can walk more every day. Once you can walk a mile, you can walk all you want. You can drive a car or ride a bike now, but don't crash or fall. You don't need to dissolve the herniated disc as your surgeon should have removed it. In the long term you can reduce your chances of recurrent herniation by building core strength. Yoga or tai chi are good avenues to get stronger.
I had this issue started almost a year ago and in the beginning the spinal canal diameter between my L4/5 was 6mm and now it’s 9.5mm also the pain i feel is lesser these days as compared to months ago. Doctors are recommending me surgery but i want to recover it without any surgery, could it be healed in some more time as one year had already passed or surgery is the last option I have?
Oh, no! Sorry to hear you are suffering. Unfortunately, spinal stenosis only gets worse, and the only treatment that actually restores the spine and protects the nerves is laminectomy surgery. What you have to consider is the timing. I've seen so many patients wait too long, until they were not healthy enough to have it, and then suffer for the remainder of their life with something that could have been addressed.
Hi, the depictions of herniations in this video explicitly show the nucleus bursting through the annulus of the disc. I have seen other depictions that show the annulus being deformed outward but still containing the portion of the nucleus that is protruding. If I have a Protrusion but not a Sequestration, is my nucleus hanging out totally exposed or is there a layer of stretched out annulus still surrounding it?
Yes, you are exactly right. The annulus can tear, but the nuclear stays confined. The good news is that the nucleus is not compressing and irritating the nerve root. The bad news is that pain fibers grow into the disc and can cause a painful annular tear.
@@BestPracticeHealth if the nucleus is still confined for a given herniation, is that herniated nucleus material still eaten away by the body or can it migrate back to where it should be? Thanks for the info!
@@GeneralJoey747 The annulus is an outer layer or wrapper of the nucleus pulposis. If a tear in the annulus heals over then the nucleus pulposis is again shielded from the body's immune system and the cycle is over. Since the nucleus has no blood supply there is no route for the body's immune system to attack it. Doctors see this battle play out on MRI all the time. Inflammation at the junction of a torn annulus and the vertebral body bone is called "Modic changes" on MRI reads. If you have an MRI of your back check the report for that language. "Modic change" is the evidence of a long-term tear in a disc causing inflammation in the adjacent vertebral body.
@@BestPracticeHealth my MRI report did not mention any modic changes, just a foraminal hernation pressing on the nerve. At first I was worried I would always have this herniation unless i get surgery but after reading more and watching videos like these I'm more optimistic about this resolving without surgical intervention. With that being said it is confusing for a layman like me to understand what's happening with my body and what the possible outcomes could be. It also seems like there is still a lot left for scientists and medical professionals to learn in this space.
im curious about the pulp. You said that the body digests the part that has "escaped" the annulus. Does the body make more pulp to replace the dissolved amount? If not, how does that affect the stability, strength, or cushion of the discs?
Oh, man...that would be great. Sadly, no. Our bodies do not replace the nucleus pulposis after it herniates and is digested by our immune systems. That's why we get "degenerative disc disease."
Hi doctor , I am waiting for results of MRI, I believe I injure my back while doing very heavy hip thrusts . I have been taking it easy at the gym however I have been doing machine leg extensions but my pain comes back . Is this exercise not recommended ? What type of exercises should I do? Thank you
Exercise and therapy have been studied a lot and have not been shown to be effective in the treatment of herniated discs. What works are natural healing over time, epidural steroid injection for temporary nerve root pain relief, and microdiscectomy surgery when all else fails. The gym is awesome and critically important for your long term health; but it won't help with your herniated disc. Let me know when your MRI is back and we can review it together if you like!
I had herniated l4 l5 disc resulting to moderate to severe stenosis and my doctor advise me for surgery. The pain is unbearable i cant even stand, i had been dealing with the pain for 4 months already. Even moving a little was very hard.But by Gods grace, im recovering now. I can walk now and pain is slowly getting better. I had my chiropractic adjustment after 3.5 months of rest. I also tried deep tissue massage just to ease the pain. To all who had been suffering this pain just have faith in the Lord and he will heal you. Thank you to all of those who continue to pray for my fast recovery.
Thank you. I really appreciate your kindness! Especially after all you have been through.
Hi there, happy you’re getting better! 🙌✊Did you had the surgery or not? Did you had sciatic pain?
Im 90% getting better now! No surgery, im having my chiropractic session. We just need to deepen our faith in Him. Praise God for his mercy and goodness!
I have c5c6 extrusion and severe cord compression and bruishing .doctor told me if I didn't operate I can be quadruple. But i didnot operate..I am much better now..I was healed in the name of jesus❤❤❤❤
Thank you for reminding me that there is a God in heaven who answers prayers ❤in Jesus name 🙏
Me at 3 years of dealing with pain from a herniation thinking 12 weeks doesn’t sound bad at all💀💀
Yikes! 3 months is too long to deal with a herniated disc, let alone 3 years. It's unusual---unless the disc was huge--- for the pain to hang on this long. Sometimes I see the pain go from the leg to be focused on the low back. Usually in this case the source of pain has shifted from the herniated disc to the facet joint. It matters because the treatment is different. The treatment for a sore facet joint is RFA (radiofrequency ablation). Does this sound familiar or not? One thing to check is if the facet joints at the level of the herniated disc look different on MRI today than they did at the beginning.
For more on facet pain and RFA check this playlist out: ruclips.net/p/PLsYo8ENYsvpxyo-QrlRIROPJ3TNWP882b
@@BestPracticeHealth i have it for 5 years
Bro u go to ur nearest ceragem center ur herniated disc will heal in few days bcoz the disc which herniated is gel liquid which body will heal in 10 years but ceragem will in 10 days it will make herniated disc into dry leave n it will not bother u any more hope u understand👍👍👍
@@akshaysuprohit7588 brother is this true????
Same here. 3 damaged Discs with stenosis . No healing for the Rest of my Life i think.
Very informative. After all these years of back pain and one major surgery, no one ever explained the nucleus pulposas not having its own blood supply an getting reabsorbed by the body. Thank you.
Did u do mri again
@@omarsamy122 No, not after laminectomy/discectomy surgery on L5. I am doing extremely well. I have some slight paralysis in my toes. The damage was done before surgery. I have adapted well. I hope you are also well.
@@stevepd1 thx
But i have protrusion can the bodt reabsorb the nucleus
@Omär Sämÿ mine was ruptured. I had protrusion (bulging) for years. Sometimes the protrusion went away with time and physical therapy. In the end, my disk just wore out. There was no way the debris was going to be reabsorbed. It was pushing against the nerve causing damage. We are all quite different. The treatment is the same. Step 1, physical therapy. Step 2, cortisone shots, Step 3, surgery. Always do your best to stay in shape, strong and not too heavy. God bless you.
Best explanation I came across on the internet so far. Thank you!!!
I appreciate the empathy, and the hope.
Love how caring and informative you are.I suffer from knee and back pain would love to one day enjoy life without pain. Thank you for making these videos ❤
I am hoping for that day as well. Hang in there. You've got this.
Maintain or get to ideal weight, eat healthy balanced diet, do whatever sport you can that doesn't make the sciatica pain worse, walking 3/4 hours per week can be very good, isometric exercizes too, etc.
Can a tear be repaired by the body or will it remain a tear?
@@BestPracticeHealth doc mine got better after 6 weeks but the back pains returns!!! some days its severe and it goes away with 975 tylenol, somedays its mild and nagging and somedays its like 1/10 pain. i had disc herniation in the L5S1 area.....does this mean i fit into that 6% that did not recover?
Gently answered. Understood everything you said. You spoke clearly just an overall excellent explanation. So far the best I've seen.
Hi Doctor! Back in 2010 I had a herniated disk, L5/S1, got an epidural that worked well, but several months later relapsed with terrible sciatica on the right side. It was horrendous. I was pregnant at the time and therefore had to wait it out. I got better in about 4 months and believe the pregnancy helped my condition, ironically. No issues since except every few years my back "goes out" and I rely on super hot heating pads 24/7 for a week until my back unlocks. Then I am fine. Fast forward to late Nov 2023, I had two instances of terrible back spasms a week apart. Heat worked. By mid-December 2023 I had continued pain, stiffness, muscle tightness and limited range of motion. Heat works best, better than advil. No radiating pain this time! Just lower back pain, slightly off to the right side, with tightness in the mid buttock, but pain is centralized in the mid back. I can sit in a decent chair, no problem, but cannot stand for a long time, but the biggest issue is sudden movements or any twisting or bending. Based on your videos, I thought I could have annular tear, but my pain isn't worse sitting down. I didn't think the disc was herniated, because I don't have radiating pain. But my MRI showed this below. I have no weakness/numbness. Pain is bearable but it's been a month+ and I am not much better. Would an epidural work if I don't have leg pain, just back pain? I am 47 years old.
Bone marrow: Degenerative endplate marrow edema at L5-S1. No suspicious osseous lesions.
L4-L5: Central zone annular fissure and disc protrusion measuring 2 x 17 x 8 mm. Mild effacement of the bilateral lateral recesses. Mild bilateral facet arthropathy.
L5-S1: Broad-based disc bulge. Effacement of bilateral lateral recesses. Mild bilateral facet arthropathy. Moderate bilateral neural foraminal narrowing.
Visualized sacrum and bony pelvis: Minimal degenerative spurring along superior aspects of the bilateral sacroiliac joints.
Oh, goodness. You’ve been healing with this for so long. I admire your patience. And your persistence! The painter describing is very typical of a facet joint. The introvert discs are the shock absorbers of the facet joint. What happens often is you have a disc injury, like you experienced, when you were pregnant, which heals up. Unfortunately, without it, shock, absorber, that facet joints go onto become arthritic. The MRI report you shared doesn’t comment on the shape or swelling of your facet joints. Given your symptoms, the most likely cause is facet arthropathy. The Doctor Who usually treat this upfront or Pain Management physicians. Make sure you find a Pain Management physician who meets best practice criteria. That means they are double board-certified, specialize in pain, and don’t use narcotics for chronic pain management. Let me know how it goes! Hang in there. Please realize there’s nothing wrong with you that can’t be effectively treated based on what we now know.
Thank you all for giving a comprehensive answer ♥ ️ ♥ ️ ♥ ️ ♥ ♥
You are right. Mine went away after 5 months. Thanks for the video.
Hi Madeleine I’m suffering from this now and I’m about 3 months in. My neurosurgeon said mine isn’t laying on the nerve and there’s nothing to operate on but I’m still having symptoms. Did you have a “mild” herniation by chance?
So lets say you are part of the 94% where the nucleus is re-absorbed in the body. Does the annulus repair so the nucleus doesn't keep leaking out? What would be the range of time for the annulus to repair? And If so, I would assume the annulus would be weaker (much like when you badly sprain an ankle - it is truly never back to 100 percent and is slightly more likely to be re-sprained, but can get close to 100 percent).
Yes. The outer part of the annulus does have a blood supply and is capable of limited healing. While there is no strong data, many neurosurgeons believe the annulus heals for around six weeks after it is torn whether that is by injury or surgery. It's likely that you are correct the healed annulus will never be 100%, but hopefully it will be enough to protect the nucleus from your body's immune system, and prevent further nuclear disc herniation and more inflammation around the adjacent nerve root causing sciatica.
Also, what about the resultant disc size? Since some portion of the nucleus has leaked out, the disc size reduces. Is the disc able to get back to its normal size later?
I took a bad fall and herniated C6/C7 just prior to the pandemic. It took well over a year for the pain to finally go away. Extremely painful and caused muscle spasms in my arm, shoulder and back for months. It does heal without any surgery. There's a number of things that help. Try using traction to stretch and open the area. Don't smoke. Nicotine causes spinal injuries to take longer time to heal. Continue to move the spine as movement is how the fluids in the spine circulate and heal. This video is spot on. However, some herniations will take longer. As much as 24 months. If you have a herniated disk it is far better than if the disk is bulging. Only 50% of bulging disks improve compared to well over 90% of disks that herniate.
What measures helped you heal
This was so well put and reassuring to hear and informative to the very end. You need offices on the east doctor. Thank You!
Mine took 6 months .. most pain I’ve ever been in lol thank god that was 2 years ago
Great point. The numbers are averages. They don't mean much when you are outside the average. I'm glad you are feeling better!
Awesome explanation of a herniated disc. I herniated my L4/L5 and L5/S1. I have been doing decompression at a chiropractor and pool exercises 5 days a week. Seen a lot of improvement in 4 weeks. What are your thought on PRP(platelet rich plasma ) injections? Do you think that can be beneficial into the back?
Sorry to hear about your discs! PRP and other stem cell-derived growth factors (SCDGF) are increasingly being used for the treatment of back pain due to facet joints. In those patients, the injection is done into the joint, as the problem is not the herniated disc. Very few pain management doctors are doing PRP or SCDGF injections in the epidural space. Back when I was in practice I tried several SCDGF injections into painful discs for chronic discogenic pain with surprisingly great results; however, those people had pain for years and MRI showed inflammation around the disc space (modic changes). Overall, given the lack of solid data and a great prognosis (94% of people with non-specific back pain resolve in 12 weeks), I'd hold off any alternative injections for now.
@@BestPracticeHealth to
How are you going now?
How are you now?? I hope you are doing well now 😊
Stop eating animals
Dairy
Eggs
Oils
3-6 months at 100%
Will be healing 100 percent and all damage discs will rebuild as before or stronger even you can return to hard work or gym
Just a correction from my POV: chiropractic heps contracted parts to return be movable....tigether with anti-inflammatory are the key to exercise.... without exercise no solution. Keep brave and constant ❤
Yeah, pushing it back in through physical therapy exercises never made sense to me. When a physical therapist said that to me, my brain could not fathom how, even if you could push it back in, it would stay in if there was a tear in the wall? Wouldn't it just move back out? lol! After watching this video, I'm glad I didn't go back there.
Me too.
Very informative and well explained
My teacher
You scared me a little
you just cheered up
thank you for everything
❤❤💚💚💙💙
Yes it can. I've been there.
Brady explanation I've come across on the Internet. Thanks Doc Great Channel.
Thanks for watching!
I had mild sciatica beginning around the start of June, with it getting really bad one night 2 weeks ago (now is beginning of july) and ive been treating it with proper sitting posture (lumbar support pillow) when I drive, walking and cobras throughout the day, copper suppliments (i dont eat enough leafy greens), and CBD.
Im at the point now that I dont have any pain unless i sit for too long.
what is CBD? Cannabis?
@@tapas1505 cannabis has lots of different molecules in it, CBD is one of them that's not psychoactive but it greatly reduces the body's inflammation response
@@LazySillyDog True. I also take cannabis orally. And no doubt its elixir and have no side effects unlike alopathic pills.
How much does anxieties and stress play a part in back pain ? Can a lot of this be mental?
Yes to both. Stress is a common cause of low back pain. Maybe the most common cause. It's important to deal with stress and all it's forms.
So, I've been dealing with this for almost 3 years after 2 very close together MVAs. I keep getting turned down by neurosurgeons due to "long COVID waitlists".
The pain keeps progressing down my legs. It started in my hips, then would go down to my knees, and now is persistently in my feet. I am regularly seeing a kinesio and doing active rehab.
But, like, where do I go from here? Are you taking on new patients 😂😂😂
HI! Sorry to hear you've been in pain so long! I"m not in practice due to essential tremor. But there are many great spine surgeon and pain management out there.
How are you now?
94%? I like those odds.
Thank you for this video. Wheres the second part?
You are welcome! Thanks very much for the comment. This video is an FAQ for our RUclips series The Clinic. Have you seen any of the episodes? It's kind of cool... like sitting in on someone else doctor visit. The Clinic episode this video references is here: ruclips.net/video/gbGSWGOL1_8/видео.html. There are 2 other FAQ videos from that episode, here ruclips.net/video/2iXy6KWpP50/видео.html and here ruclips.net/video/X6qCrROoKYo/видео.html. I hope these videos help!
Being at a healthy weight helps. Ya see, I was about 175 pounds in may of 2021. A physiatrist suggested I be out on a mood stabilizer, called abilify. I didn’t think anything of it, but before about 2 years before this I was on Paxil, and much like abilify I gained a significant amount of weight. The first time 50 pounds, and this most recent time 75+ pounds putting me well into the 240s. I may have had this herniated disc for a couple years but starting in early 2021 I had a lot of back pain. And for the last 8 months we’ve done scans and therapy and I’ve gotten myself down to 233 as of today. 2 weeks ago I got a steroid injection and within a couple days up to the present I’ve had extreme loss of mobility and function of my lower spine and left hip. The same day I got the injection I was moving a lot of heavy items at work, after I did this I went and got the shot and they numbed me up. I’m wonder if the numbing medication blanketed the aggravation of my already injured back more from moving the heavy items. Not sure what to do now. Might lose job.
Moral of the story is so not ever let someone put you on a controlled substance without knowing all the side effects because they have a high probability of affecting your weight. Which can lead to more health problems such as liver, pancreas, cholesterol and LFTs along with type 2 diabetes.
Please please please don’t let anyone out you on medication just because “somebody feels safer with you on it” your overall health is more important than appeasing people.
What an important story. Thank you for sharing it.
Why are you moving heavy things at work if you know you're injured?
@@johnborris3222 because if i dont ill get fired?
You make total sense. Thank you!!
You are so welcome
Worker's comp doctor cleared me back to work with restrictions so i got worse. Then they put me on pt and aquatherapy. Worse months of my life. Aquatherapy was so painful.They should have let me heal first. Now i have ddd, annular tear, protrusions, nerve pain, and stenosis. 7 months since work injury.
I’m really sorry to hear that. It can be so challenging to get better in the context of a work related injury. The doctors are usually not the best, and you have everything going through Workmen’s Comp. which limits the timeliness and effectiveness of treatment. Hang in there. I hope you get relief.
Been dealing with it for years. Now the pain has started shooting down my right leg. It's hard to walk for even 10 minutes. Life's become tough.
Are you trying consistent physical therapy?
I had a inflammation back in 2021 and couldn’t bare to get up for the first 4-5 days and close to a month I got better. I stopped going 6 to 5 days to the gym now.
Now In 2022. I decided to go onto 4 days a week but heavy setting on a Dailey. I was deadlifting and next thing I knew I felt like I got struck by thunder dropped the weight mid-set. I fell but got back up right away and confused in what just occurred (in shock) I tried to get on my feet but couldn’t! I sat on knees it’s like I couldn’t feel my legs for the first few 3 minutes. I drove back home got tingles and numbness on my lower body (nerves).
2 weeks in now my lower back feel better and the inflammation on my lower body hasn’t occurred today! Thank goodness it was a hell week! I just have trouble sleeping. I tend to wake 3 to 4 times a night. I’m having more left leg pain but some of the pain went away and feeling better but still in pain if you get the memo😅
I’ve been icing and taking meds as well to help with my pain.
I did sleep well for 4 days this week which felt great but now waking up 3x a night which is odd cause I had 4 good days ..
Right now it’s my lower body just hurts to walk and sometimes I tend to crash down if I’m in a odd position like squatting really low and I can’t do nothing about but fall the pain is unbearable and can’t really do nothing about it. It happens not just squatting but like just walking the pain will hit me but today I feel like the pain slightly reduced but not really much it kinda feels the same.
My worst pain I’ve yet had was last Saturday night that it occurred for like 45 min and I even cried when it finally went away and it was behind my thigh on my left. The worst pain I ever felt! I made the mistake of taking hot showers as well so now I will reduce my hot water to more of a cool water temp. I’m 25 right now and fit and active and hope for this pain to go away soon. I pray week 3 I get some good reduction of pain and walk slight better.
I appreciate the info thank you! 🫱🏼🫲🏽
Yikes! I'm so sorry this is happening to you. Sadly, you give a perfect description of what it feels like to have a herniated disc. I'd be happy to answer your questions on youtube, like we do. Your experience is so important to share with others... are you willing to do an interview?
This is exactly what happened to me, I’m in my 5 weeks now my lower back left side is still swollen but i don’t have any much pain anymore more like a discomfort.
Hope you’re doing well at this time and able to get back to doing things you have been doing
How are you doing now?
@@dingdong6005 I'm doing so much better at 6 months. there's still tightness on my lower back and some impaired sensation on my lower left leg (feels inflamed to be exact). I'm not sure if my lower left extremity is inflamed to some extent because that's how exactly I feel about it due to the nerves irritated. but strengthening hips and back and more hip mobility is the key factors to getting back to normal again
Hi Dr, I’m 28 and been dealing with back pain for three years now. I go to the gym and Im in very good shape, the pain was minimum until two months ago i was in so much pain and had to do the mri and report was
L4-5: There is asymmetric loss of disc height and circumferential bulging with endplate spurs, with more prominent protrusion on the left side. This results in moderate left foraminal and left lateral recess stenosis, but only mild right foraminal and lateral recess stenosis. There is minimal endplate edema at this level. Facets normal.
L5-S1: There is slight disc desiccation and loss of height with mild bulging on the right side causing minimal right foraminal narrowing. Canal and left foramen patent. Facets normal
I refuse to take the steroids injection because I was worried to make me gain weight.
I start doing decompression treatment and it’s not bad the pain comes and goes, knowing I stopped going to the gym for now.
My question is will I deal with this for the rest of my life?? Will the pain go away???
There is only one treatment for discs if damaged that mentioned by the last messenger of god Mohammed peace upon of him beyond that no treatment and will be healing 100 percent you can return to gym or hard work
Do sciatica and herniation always go together? Can you have herniated disc without also having sciatica?
I woke up yesterday with my back in a lot of pain. It’s a spot that’s been bothering me for 25+ years but it was never what I would call painful. But yesterday tiny movements sent me into all the symptoms of serious pain: shaking, nausea, fast breathing, etc. It’s not as bad today but that was not something I would want to handle over a long period of time!
Sciatic is low back pain that radiates down the leg in the distribution of the sciatic nerve. Sciatica is commonly caused by a herniated disc causing inflammation of a nerve root. If you have no red flags, then the initial treatment is light activity and safe anti-inflammatories. If that fails, you get an MRI and often consultation with a pain management doctor. That's effective for the vast majority of people; however a small subset end up needing microdiscectomy surgery.
@@BestPracticeHealth Thanks! So do herniation and sciatica always go together? That’s what I’m curious about. I think the answer is no.
Thank you for the clarity. I have been suffering with back pain for more than 2 years now. It's at it's worse now, but I grit my teeth and carry on with my chores. In this 2 years I have had injections and some relief . I am getting ready to have the epidural injection and looking forward to some relief . I have a couple questions that I should have asked my pain management doctor. How painful is this epidural injection without having the pain med? Should I be taking it easy at this time? I live on a farm and do some chores that are quite painful to do, but I carry on. Housework, vacuuming the worse. never realized how many times you bend over in a day, I have this painful catch when I try to straighten up. Should I be do this work at this time or carry on? Now the last injections I had I gained 25 lbs. I've managed to lose 15 lbs since the injections worn off. Now the nurse told me I didn't gain the weight from the steroids. Is this true? I'm a 69 year old active female, that still thinks she 25 years old. Any answers you can give me will be quite appreciative .
Epidural injection is not super painful without pain meds; I have done a thousand of them without any pain meds myself in the past. Rest is important but not too much; think water aerobics instead of running on cement. Work or activity, farm or otherwise, that causes paint that continues after you stop should be avoided. Steroids can cause weight gain, but you have to eat the extra calories; watch the diet carefully after steroid injection.
Hang in there. Watch facebook for our new show where we go over your MRI with you. Sounds like that may be helpful for you.
Great explanation 👍🏻👍🏻👍🏻
Amazing information, and nice personality. Thanks
Glad you liked it!
I m suffering from back pain and sometimes leg pain since 2017. And I'm 29 years old now.. really I m suffering a lot
So sorry to hear about your pain and suffering. Everyone deserves someone to help them when they are sick; I hope you have a good doctor. People with back pain are generally treated by pain management or physical medicine and rehab PM&R doctor initially, and then a specialist as needed. Are you getting the help you need?
@@BestPracticeHealth i went to orthopedic, neurosurgeon and pT also.. but my pain is not healing..
@@nirmalibhuyan216 Finding the right doctor is often the key to getting better. We listen to your story and help get you into the right doctor. If you need help call us at 602 256 2525.
Thanks doc for giving us hope!
reduced physiological lumbar lordosis almost eliminated.. absence of focal bone lesions. height of vertebral bodies preserved: absence of intra-cancellous edema. signs of l4, l5 and l5 -s1 disc disease. annulus fibrosus in the posterior median area with hint of minimal subligament herniation. At the l5-s1 level, median-paramedian and right posterolateral disc herniation is present with foraminal involvement. The other disc spaces were normal. Vertebral canal and conus medullaris normal.
Hmm. No sign of what is causing the pain. Is it back pain? In my experience radiologists often don't comment on swollen facet joints.
I have been in pain for 4.5 months so I’d be happy with 12 weeks. So being that it’s been this long does that mean it won’t be healing on its own. I’m waiting 3 years to even see a surgeon. I’ve been told.
I was in even worse pain over a decade ago for 3 years, so I’ve been through extreme hell. Had microdiscectomy the first time and it fixed me up.
Really sad this has come back I’m still fairly young at 43 YO.
Ive had a bugle disk accompanied with left leg sciatica for 4 years now. I am only 28 yo.
During this period of time ive had 4 epidural back shots.
Got my first one back in 2021 and had relief for 7 months. Then it came back again and got another shot and got relief again for 8 months and then go another shot which was my 3rd one and felt relief for 9 months and now I am here typing this comment not being able to walk again. I got a shot on Monday and I am getting worse. Ive done PT and done more than 12 weeks of myself doing exercises to “fix” this but i see now progress. I dont know what to do anymore. 😢
unfortunately, epidural injection helps relieve inflammation, but it doesn’t change the underlying condition. It sounds like you have multiple recurrent episodes of radiculopathy, that’s inflammation, or compression of a nerve root, usually caused by herniated disc. This is especially likely given your relatively young age. You must’ve had an MRI by now. Look at the report and see if it mentions a herniated disc, and whether it is large, medium, or small. That may help decide whether a visit to a surgeon is the next best step.
Yesterday i was praying to have a baby in my belly than experiencing this pain
I told you there is treatment 100 percent
Week 1 down...on crutches..can't put weight on right leg ibuprofen 1000 mg a day ( 200 x5 ) take 1 pill 💊 every 5 hrs as needed..warm bath ..I had massive sciatic pain ..had to get .5 mg corticosteroids in glute..some relief .. will update week 2 .
Oh, goodness! So sorry you are going through this. Keep you chin up if you can... most pain of this type resolves by itself. See a doctor right away if you have intractable pain, functional weakness or numbness, or any bowel or bladder dysfunction. Hang in there and let us know how you are doing.
I've heard of this theory before that your body e eats up the herniated part, but its been 8 years since i herniated my disc and I'm still in the same pain that i was and the scan shows exactly the same 3mm. I consider myself a disabled person because of this.
I"m so sorry. I'm disabled, too. I have essential tremor. I hope you feel better soon.
Did you rest it? If yes, for how long? And have you done proper body mechanics and good posture while sitting? And how’s your weight relatively to your height?
@@andreparagas5443 why is it important? if the body is so clever to eat up the unnecessary part, then it should have done it regardless
@@BestPracticeHealthi also hope you get better doctor. I really like you personally
Thank you, doctor, for sharing this information. I recently had an MRI, and the findings showed degenerative disc disease at L4-5 and L5-S1. At L4-5, there’s a diffuse disc bulge with a central protrusion causing mild spinal canal stenosis and slight narrowing of the bilateral subarticular zones. The main concern, though, is at L5-S1, where a large posterior disc extrusion is causing severe spinal canal stenosis and compressing the cauda equina. My orthopedic specialist initially recommended a conservative approach, but after seeing me today and noting weakness in my left leg, I’m wondering if I should be considering surgery more seriously or if waiting it out is still advisable. Any insight on how to weigh these options would be greatly appreciated.
I have been dealing with a herniated disc and nerve pain since early 2019 it is now almost 2024. I have tried many things. So far the home traction unit helps the most. Hasn't fixed it and I doubt that it will. Surgery sure isn't an option due to no insurance during the recovery time. I sadly believe I am gonna have to deal with it for life. Mine was a small herniation at L4/L5
Don't be sad there is treatment for herniated disc or bulging or any damage that happened to u or anyone
It's only one treatment for all discs damage that mentioned by the last messenger of god Mohammed peace upon of him will be healing 100 percent and u can return to your work or gym
Thanks for the video!
According to my mri i have bone spurs and a bulging disc on c6-c7.
It’s been 14 weeks now and the pain has slightly reduced and moved multiple times to different places.
The doctor prescribed an oral steroids course.
Do you think the risk/reward is worth it? Will it fix the problem? Or just hide it for some time.
I have also refused steroid injection in the neck for now
I have no weakness but quite some pain(tingling went away).
Is steroid injection also worth?
Sorry for all the questions
Yikes! 14 weeks of cervical radiculopathy is a long time to be in that much pain. Cervical epidural injection is higher risk and lower reward than the low back. If you are concerned about it I'd skip. I guess it comes down to severity in your case... if your nerve root is pinched and 14 weeks of SEVERE pain, then it's time to see a surgeon. Make sure you follow best practice guidelines for selecting one.
I have a moderate disc bulge in my c6 c7.I felt much better going into fourth week in terms of pain. It's my six week now but the tingling and numbness in my first two fingers haven't completely gone yet. Also, my triceps on my right arm have gotten really weak. I used to press 110lb dumbbells and now I can barely press 15lb. It's really overwhelming and can make you really upset and emotional.
It appears you're experiencing a four-week history of right C7 radiculopathy due to a herniated C6/7 disc. While you mentioned a disc bulge, it typically requires a true herniation to cause this much trouble. This condition is causing significant motor and sensory issues, including weakness in your tricep and numbness in the right middle finger. Thus, you have motor and sensory weakness in the distribution of the C7 nerve root, which is the one that is pinched and/or inflamed by a C6/7 disc herniation. Given the severity of your triceps weakness, surgical decompression should be seriously considered.
I highly recommend consulting a qualified spine surgeon promptly. An evaluation for procedures like anterior cervical discectomy and fusion or anterior cervical disk replacement (C6-7) might be necessary to alleviate your symptoms effectively. Early intervention is key to ensuring a successful recovery. Reach out to a specialist soon to discuss your treatment options and regain your quality of life."
@@BestPracticeHealth Thanks for responding, Doc. According to my MRI and my doctor there's a moderate protrusion of disc. He told me if it was literally choking my nerve then they would have to refer me to a surgeon. I'll have a second opinion on my MRI results. So can my strength not come back without surgery? I had the same issue about four years ago with my c5c6 disc which really weakened my right biceps it took quite some time to almost come back to normal from that but it came back.
@@FullChamber How are you??? Did you had second opinion??
@@Preeti-lw9jc well, i have been waiting for my appointment with a specialist. Might take a little while. Weakness hasn’t improved at all and tingling comes back strong and goes away after a while. I guess surgery is the way to go. Hopefully get it done in the next two months. Fingers crossd
Hello mate, I’ve got exactly the same symptoms as you! Horrendous pain down arm, mri showed my nerve being choked like you say! Loss of strength in the my can normally do 100 press ups straight off and at the moment can’t even do one! I’m waiting to see a consultant now, how are you? Are you any better
I’ve had bad sciatica for 11 months; meaning I can only walk for 30-45 min until I have pain in my leg, buttocks and lower back to the point my hips become shifted, I’m walking crooked and in pain and have to lay down. Just recently (few days ago) I went for a walk in a park that was vey hilly, after that my pain became substantially worse and I can’t walk not even for a min or sit on the toilet without being in extreme pain like someone is stabbing me in the lower back. I cannot sit much if at all. I don’t know what’s happening. When this all started Initially a year ago, my MRI showed ruptured disc at l4-l5. That’s what was Initially seen at least. I’m loss for words…
It sounds like you had a progression (recurrent) disc herniation. If you have any red flags then you need medical attention now. Otherwise, consult the matrix and decide what to do. It's been 11 months...sounds like you need help. Feel free to submit a video question and a pic of your mri here: bestpracticehealth.tv/
@@BestPracticeHealth Thank you for your response. I will go ahead and do that. I just came out of hospital today for this issue. Doctor wants to do surgery. I have improved a little and pain calmed down a bit but still worse over all than before. I am seriously considering my current options.
Hey Joey, Dr Lieberman answered your question today on our live show. Here is a timestamped link: ruclips.net/user/liveLryTnQ3aC6I?feature=share&t=3001
@@BestPracticeHealth Yes, I just saw the video. Very insightful. Thank you for passing my situation on to the Doc. I think surgery is good option for anyone under the circumstances,I’ve just read some info that surgery could be not so good of an option. Everyone is different I guess. I’ve got some thinking to do!
Great video!! But I have a question to the following steps the body take: after absorbing the substance how does the outer layer of the disc prevent more run out? can it close up again? or does the nucleus keep running out? By "healing itself" I consider some kind of "closing the wound" like a cut
Thanks! The white cells of the body eat up the herniated nucleus, allowing the edges of the annulus to be approximate to one another. Once two like layers are touching they can heal. Think of your skin. If the edges of a cut are clean and touching they can scar back together. If they are far apart then healing take a different form. Same with the annulus.
@@BestPracticeHealth Thank you so mich for your helpful answer! I couldn‘t imagine how it works because I read that the disc has no own blood flow. But I‘m glad I learned something new ❤️
Recently i diagnosed with Disc Herniation on L5 🙁 The doctor said i need surgery, but i don't want to pass by this procedure. I feel my left leg and foot more weak, and i cannot do my sport activities like skateboarding or gym workout, i'm very sad with that, i'm taking the medicaments, and what's the most wrong thing i have do in my case is stop workout 100% and rest, my pain is get even worse. When i started to do some exercises to my lowerback without weight it get better again, the pain not good now, but a little bit better that i can hold on.
It sounds like you're facing a tough decision regarding your herniated disc at L4/5. Opting for a conservative approach initially is a reasonable choice, especially if your symptoms are manageable. The SPORT trial provides valuable insights into the management of spinal conditions like yours. The findings suggest that for many patients, the long-term outcomes (around 2 years) of conservative management versus surgery like microdiscectomy are similar. This supports the idea that waiting it out could be a viable option, provided your symptoms do not worsen significantly.
If you haven't already, discussing the option of an epidural steroid injection with your doctor could be beneficial. These injections can help reduce inflammation and pain, potentially giving you relief for several months. This could make it easier to cope while you see if your condition improves without surgery.
And keep a close watch on your symptoms. If you experience an increase in pain, or if neurological symptoms like weakness or numbness worsen, it's important to reassess your options. Progressive neurological deficits can be a sign that surgery might be needed sooner rather than later. Consider how the pain and weakness are affecting your daily life. If these symptoms start to interfere significantly with your ability to function (e.g., walking, standing, or performing daily tasks), discussing surgery more promptly with your surgeon could be crucial.
Be mindful of your activities to avoid aggravating your condition. Avoid heavy lifting, twisting motions, or any activity that puts excessive strain on your back. Gentle exercises, as recommended by a physical therapist, can help maintain back health without exacerbating your condition.
It sounds like you are not out of the woods yet. Stay in regular contact with your doctor. They can help monitor your condition, adjust your treatment plan as needed, and provide guidance on when or if surgery should be reconsidered based on your symptoms and quality of life.
Thank you so much
You're most welcome
Thank you again for your insight. I had surgery one year ago, discectomy/laminectomy on my l5 s1. Never gave relief. I have a disc extrusion, so a tear in the outer disc. I get flare ups that swell my lower back( mostly left side). Is there any way to differentiate between scar tissue and the actual herniation that is causing the sharp pain? Is scar tissue inflammatory? Can’t bend or something catches. I took prednisone and that helped my ability to bend. Any insight on how to differentiate between scarring from surgery, or the herniation? I understand every case is different. Any input from your expertise would help. Thank you again for your work.
@Jason Shamoon I have the same surgery and the same issue. I suspect it's a scar tissue issue. I'll try to share my prognosis with you.
Unfortunately, pain after spine surgery is common. The question is whether that pain is coming from the torn annulus, inflammation of a nerve root, or the adjacent facet joints. The only way to know for sure is to have diagnostic injections of those structures. A medial branch block is an injection that temporarily numbers the pain fibers to the facet joint. If you were pain-free for a few hours after a medial branch block then the problem is the facet joint and not the annular tear or nerve root. Similarly, a transforaminal epidural steroid injection numbness the nerve root and not the facet joint. These blocks are done by pain management physicians. The trick is to find one who will help you work out exactly what hurts. Until you know the problem, the solution is impossible to figure out precisely.
@@BestPracticeHealth thank you for the response. I got a caudal injection 2 weeks ago. Didn’t do anything. Like you said, difficult to decipher what exactly is the cause.
@@jasonshamoon7427 You're welcome. Thank you for the comment!
A caudal injection is when a doctor places a needle under the sacrum and injects something, typically steroid. The rationale is that the epidural space connects with the space under the sacrum. The advantage of a caudal injection is that it’s easy to do and does not require x-ray guidance.
In my opinion, caudal injections really have no role in modern pain management. What you want is a doctor who can look at the MRI, identify a potential problem related to a compressed or inflamed nerve root, confirm with a physical examination targeted to the nerve root involved, then if appropriate do a transforaminal injection of steroid to reduce inflammation on the affected nerve root. A transforaminal block requires fluoroscopy and training, but it’s better because it focuses the treatment on the problem.
The second advantage of a transforaminal block is that it confirms your doctor’s theory about what’s wrong.
A doctor may have their own reason for doing a caudal, but the reason I see most is that the doctor is not qualified to figure out what’s wrong and offer specific treatment.
We are putting out a new video on how to pick a pain management doctor next week. Please subscribe and look out for that when it's released.
@@BestPracticeHealth will do. Thank you for your time
Very informative video Doc, can I ask you doctor, does large extrusion herniated disc can it heal it self.....
What exercises should I be doing. Dx with L4, L4, S1 Disc herniation ,, Sciatica left leg .. Tried RF Ablation (RFA) That did not help at all. Tried PT with pool therepy when finished I was in much more pain than before PT sessions.. Had to stop.. Problems sleeping as Pain management says not to sleep on left side as the discs shift and pain wakes me. Sleep approx 3-4 hrs nighly , toss and turn to find a spot that I can deal with. Right side have Rotator cuff tear.. What excercises will give me relief? also I have lost 30lbs over the past yr due to not being able to regain muscle.. Thx so much..I was allso looking at stem cell therapy/& peptides for shoulder Rotator.. What direction w/ excercise...
Wait, what? RFA is not a treated for herniated disc with sciatica. If that's the problem, then no wonder you are still in pain.
I'm 21 F and I'm 7 weeks in now into this. I have a left paracentral disc bulge which is causing mild narrowing of left lateral recess at l5s1 disc and type 2 modic change in s1 vertebrae. now can you explain it to me please. I have few questions to ask you.
1. Why do i have sciatica symptoms in both legs
2. Will i ever get better or it will get worse and never heal
3. I went to two doctor one said it will stay same and I need to work on my posture and if the pain is more than i should get an epidural injection. But my pain is not that severe and the second doctor a ortho spine surgeon said it will get better and it may necessary not be the cause of my pain he told me do spinal extension excercise And engage in any sport activities and do drill exercise. Now if i do such things won't it cause my disc to herniate and rupture.
4. I asked for medical leave from my doctor which he denied by saying that we don't recommend rest in back pain
As i mentioned I'm a nursing student i have my clinical duties From 8 am to 1pm and then classes from 2 to 5 pm. At such hectic schedule will my fisc ever heal, infact due today sitting and standing for such time will only make my disc worse.
Can i get mu mri reviewed by doctor. Please help I'm very stressed and i don't see any hope. I can walk upto 4 miles per day. My MRI also shows type 2 modic change in s1 vertebrae.what should I do should I get And epidural or should I wait or do surgery
One last question do disc bulge ever heal??? Is annular fibrosis layer broken in disc bulge or not?? If Yes will it ever heal
First thing don't worry about discs , second thing there is only one treatment that healing 100 percent all damage happened to discs bulging or even herniated that treatment mentioned by the last messenger of god Mohammed peace upon of him
Also you can return to your work or gym or anything that u want to do will be healing 100 percent
Hi, I am 25 yr old female , and have a L5-s1 disc protusion and diffuse disc bulge, as per report by radiologist. Some doc say its extrusion and some protusion. Having sciatica pain while walking more than 20-30min. Doc has advised bed rest for 2 weeks with limited exercise.On medications also. In my case is resorption possible?
Because disc material has no blood supply and is "foreign" even to your own body, all disc protrusions are reabsorbed into the body by inflammation over time. If either the compression by the fragment or the inflammation is causing damage to the neighboring nerve root, then microdiscectomy surgery should be considered. The way to know there is damage to the nerve root is from the presence of 1) functional weakness, 2) numbness, or 3) unbearable pain. If 1,2,3 are absent, then the traditional advice is to wait it out. During the waiting period, you can get temporary relief with a transforaminal injection.
ruclips.net/video/2iXy6KWpP50/видео.html
Iska koi treatment nehi hey niece jokes its own heal
Idk what else to do !😢 I have 16 herniated discs some in my neck are ruptured and 4 are impinged and I’ve been dealing w this pain since 1999!😳😏
with that many herniated discs, over such a long period of time, the problem is not really the herniated disc. There’s an underlying issue that needs to be dealt with. The best doctor to handle this kind of problem is a physiatrist. That’s technically a real rehabilitation doctor, but these days they usually specialize in spinal intervention, and can really help you manage the problem. You need a quarterback, as this is likely to require a team effort. Hang in there. you can get better. But you definitely need the right team around you.
I put half of my body weight on the bed and used my upper body strength to "pull" my spine muscles (to identify damage) but it suddly felt like when you're trying to put the same faces of a magnet together and i stopped. I couldn't move for about 15min because it was sore. It definitely felt like something was being pinched.
It sounds like you put your low back in traction. That’s not a test! Watch my video on “when back pain is serious” to be sure you have no red flags that require immediate attention.
I got herniated disc L4-5 and just got epidural steroids injection and I'm more pain than b4.
I got injured in June 2023 and as of now November still hurts
It’s the most horrible pain I’ve ever experienced 😢
I'm so sorry to hear about your pain. It's often difficult for others to fully grasp the intensity of severe pain unless they've experienced it themselves. Hang in there. I sincerely hope you find some relief soon and start feeling better. You're not alone in this!
@@BestPracticeHealth thank you so much for your kind words. The Dr wants to do surgery on me 😮💨 i don’t want to, it scares me. All the risk and everything. I’m going to wait and see if the thing gets better.
Great words
Thanks!
2 years ago i had it for nearly 4 months. Severed 3 month plus no surgery. Bed rest, painkillers, and some mellow strech. Now its came back. Had it for almost 2 months now still no improvement. This injury is really traumatic i cried when it came back
I'm so sorry you are in pain. It really is terrible. Population data suggests at 94% resolve in 12 weeks. Eight weeks (where you are now) is typically 84%. So, there is a real chance it gets better over the next 4 weeks; however, only 10%. Have you seen a doctor?
@@BestPracticeHealth yes i seen a doctor today. did an xray image shown L5 S1 compressed. same as 2 years ago. he arranged a PT session next week. hope will do my best to heal it. thanks
How are you now?
@@seeratahmad775 my pain got worse since a month ago. i will have a laser spine surgery on this sunday
I have slight neck disc bulge which I got from exercise, after that I had lot of rest for 1 month, then I walked a lot, I don't know, nowadays, I don't have to medicines for pain and that, sometime the pain comes back with headaches and slight dizziness but a lot less, it's 3 months from the point I got the injury, is it healing? And by what time I can get back to my normal routine, like I'm athletic , can I able to do the exercises again?
My injury is 9 months old. Now I have a mild pain around calf and at the lower back portion. But whenever I consume alcohol, my pain goes as away and I feel normal for that very moment. I dunno what's happening
What does it mean if I've definitely aggravated a disc in my lower back (Incredible pain, reduced range of motion, cant bend down well, etc) but I never had the shooting pain down the leg?
Hi this is my MRI results I just saw my doctor he said to get the The Surgical Procedure is : THORACO-LUMBAR
laminectomy discectomy for L5-S1.
Question is if I have two herniated disks why he only doing one? He said my herniated got bigger compared to my first mri from
Last year.
L4-5. there is a small left foraminal disc protrusion superimposed upon a diffuse disc annular bulge with mild facet arthropathy and endplate spurring. Mild left foraminal narrowing results. The central canal nda right neural foramen appear patent.
AtL5-SI, hetr isa small left paracentral/left foraminal disc protrusion and annular tear superimposed upon adiffuse disc annular bulge with mild facet arthropathy and endplate spurring. dMli inferior left foraminal narrowing results. The central canal and right neural foramen appear
wdieyl patent.
Thank you.
Thank you for your sharing. Can I send you the MRI link and can you talk about my condition?
I'd love to have you on the show so we can go over the MRI together. Submit a question to bestpracticeheatlh.tv and we can connect!
How bout 12 months? Lol. Couldn't take it anymore... now I'm still hoping residual numbess will go away oneday. Smh. I'll be 5 most post-op on the 20th of May. L5-S1 MD.
Doctor. I did my MRI and it looks like I have herniated disc at L4-L5 and L5-S1. I dont have any numbness but the pain radiates through my right leg all the way down. This pain is only felt if I sit down for long. When I stand up and do some walking, it slowly reduces. Do you think it will heal by itself? I’m willing to wait.
Hi, SadiQium. Nice to meet you. If I have this right your pain is more in the back, worse when sitting. That kind of pain is more typical of an annular tear or a facet. The first step is to figure out what's causing your pain because the treatment---if any is needed at all---depends entirely on the cause and severity. Check out this blog to help understand what is causing your pain. Pick A,B,C, or D based on how it feels.
phoenixspineandjoint.com/the-3-things-neurosurgeons-recommend-for-new-low-back-pain-spoiler-alert-panic-isnt-one-of-them/
@@BestPracticeHealth thank you for your quick reply. Actually my pain is more towards right leg (from hips to calf) with very minimal pain at the back. If I sit for long, the pain will start to come. Once I stand up and start walking, the pain reduces significantly so I wonder, it is this a good sign.
Hi there! We were able to answer your question on last week's Q&A episode of Best Practice LIVE. You can view it HERE: ruclips.net/video/7WHPRbIoVCM/видео.html
Nice joke's its heal
I'm definitely in the 4%. I've had lower back pain for maybe 15 years (I'm 41 now) and last year only had an MRI and got told I had degenerative disc and also lack curvature in the spine (lumbar). I also have another condition which I've had most of my adult life - overactive bladder - hospital have told me years ago they can't find anything wrong with me (all tests clear). When I had some physio for my back initially I had a week free of back pain (maybe 6 days or so) and I couldn't believe it but my overactive bladder also cleared up during this period. I never even noticed they were linked but I replicated the relief around 4-5 times, each time the same result. I'm a year down the line however and have been doing regular exercises and decompression stuff (at home) but it's still very bad. My osteopath told me it was coincidence and that the only bladder issue is Cauda Equina - I know it's not though and wonder how many others' have had this experience and not linked the two?
Hmm. The test that determines if an "overactive bladder" is due to a nerve root problem is called a "cystometrogram." They put a catheter in your bladder and record the pressure as it fills. Not fun, but it is a definitive test done by a urologist. If you go that route, you want one who specializes in neurological urology. Or, come on my show, and let's look at your images together. It takes really severe stenosis to cause a neurogenic bladder. phoenixspineandjoint.com/best-practice-medical-questions-and-answers/?fbclid=IwAR1-EAG1KG0ltuYtM3pKQuLW3Q6pzf9DHfDfsoJJzo-YmWAS7GFnWF9c6DE
@@BestPracticeHealth Thanks for the reply. Yes I spent a lot of time at the urology department at Kings College London and all my tests were clear. No infections, prostate and the cystometrogram all were fine. That was before I linked with my back condition but no one ever asked if I had back pain. I have my MRI scan I'd be happy to share if it helps others'.
@@BestPracticeHealth I was looking into this a bit more - as to why others' don't have this over active bladder - I was wondering if it was due to me having an L6 extra vertebrae? Would it cause the nerves to take a different route?
@@silkee Did you check whether the anxiety that causes the OAB? I experience frequent urination and did all the tests, everything was fine. Later I found it's my anxiety/stress that causes it. Also confirmed with my psychiatrist
I am very sure about that dont do any surgery if the problem discs
What about red light therapy? Does it repair the tissue?
I have disc bulge in C5-6 in MRI. I dont know if disc bulge or herniation is same but I have extreme pain in neck, head and occassional numbness in whole right arm or both legs sometimes. I have wekaness in both arms. Doctors i have visited dont take it seriously. I have been on NSAIDs and pain medicines but they are not working
Use serrapeptase and neck traction excercise
Cupping and dry needling helped !
I'm so glad to hear that you're finding relief with cupping and dry needling. Back pain can be incredibly frustrating, so it's great to know these treatments are helping.
While dry needling and acupuncture are often thought of as similar, they do differ. In areas where there are restrictions on who can perform acupuncture, it's often referred to as dry needling. The best treatment is the one that works, and since dry needling is helping you, that's what matters. Not everyone experiences relief from it, so you might also consider trying acupuncture in the future.
As for cupping, I must admit I'm a bit skeptical, as I can’t quite explain how it works from a mechanism perspective. That said, if it’s working for you, that’s fantastic. However, if I had to choose just one treatment, I'd lean towards dry needling.
Other options to consider for non-specific low back pain include moist heat and safe anti-inflammatory medications like Aleve, ibuprofen, or Tylenol.
Thank you so much for the info. I was wondering i herniated a disk in my lower back when i was 26 years old i am 47 now. It hurts if i sit too long latley i have to sleep on the floor might get a new matress. i was wondering what might be my chances of needing surgery done the road? Thank you so kindly.
I have spondolysthesis. My l5 has moved a bit. My pain in my leg and hip area has increased and my feet at night feel like they are hot. I am 26. What do you suggest I do? I was trying acupuncture. Do you think it can help? I have been having loxoprofen 60mg and mecobalamin 500 for the past 6 days and my pain has reduced. Please suggest what can be done!
Burning or strange sensations in your feet at night are often due to neuropathy, and not related to your back. Some neuropathy runs in families, so as your parents if anyone else has it. Leg and hip pain is usually facet mediated pain. Watch this video to figure this out: ruclips.net/video/rBmHQ7VCDIk/видео.html.
If your pain is more than 12 weeks old and due to a facet injury then medial branch block done by a pain management doctor is the key to finding out what is wrong. If the medial branch block is positive then radiofrequency ablation is the next step.
Learn more about spine problems here: ruclips.net/p/PLsYo8ENYsvpxyo-QrlRIROPJ3TNWP882b
I have been suffering from a sore back for five months and got a MRI scan two months ago. I am suffering from a sore back painful calf and occasional numbness in the foot. Sometimes it’s better and sometimes the pain gets worse. It’s very up-and-down. My desk bulge is 8 mm which is pressing on the nerve causing all the pain. I have read about it and it says the bigger the bulge sometimes the better it can heal. Is this true? Interesting video and learnt a lot thank you
It's hard for a bulging disc to heal because healing requires inflammation and the annulus shields the disc from your the rest of your body. But bulging discs usually do not cause sciatica. Are you sure that is the issue?
Thank you Doctor!
I just want to ask if it is a bad thing that the muscle on my back of the affected side was tighten?
Hi doc,
My question for you is, will the lost pulp due to the hernia refill itself? If not will this have impact on the disc and quality of life? I would assume with the loss of the pulp the 2 vertebrae between the discs will grind because the volume has decreased. I my self hear grinding noises coming from my back after the herniation. Also will the tear that happend re-close and be strong again like before?
Thank you.
Hello. Thanks so much for your question. No is the short answer. Once a disc has torn and the soft inner part herniated, the pulp cannot replenish itself or replace itself. That does lead to grinding, particularly more of the facet joints than the bones of the intervertebral disc space itself. I hope this helps.
Dr can you please reply my question
Is bulging disc heal or not?
I have bug disc but not compression to nerve as ct scan showed
I really scare and cry a lot
I have sciatica pain within 4 weeks, so l cried a lot because really l scare about the permanent problems.
I did CT scan and the Dr diagnose l have budging disc on S1 and L5 but the disc does not pressure on the nerve.
So l have pain in my calf and ankle
I don't have any idea because my both legs have problem, one of them too much and next is sometimes
As l am young and student, l am very worried and cry alot
I do pray for all people to recover from sciatica 🙏
I'm so sorry you are suffering. Sciatica pain is really severe and naturally frightening. The first step is to figure out what is wrong. Then you will know how to fix it.
A bulging disc typically does not heal on it's own. A herniated disc heals because of an immune reaction between the soft "nuclear" contents of the disc being exposed to the rest of the body. In a bulging disc the nucleus of the disc is still behind the annulus and doesn't heal in this way.
In any event, a bulging disc shown on CT without nerve root compression is unlikely to cause sciatica. However, most of the things that do cause sciatica should have "shown up" on a CT. Absent a really large problem or narrowing (stenosis), sciatica is rarely present in both legs. Not all nerve problems are sciatica in the first place. A neurologist would consider nerve problems like neuropathy in evaluating a nerve problem in the leg. The test to separate nerve problems from nerve root problems is the electromyogram (EMG). The EMG test is typically done by a specially trained physiatrist, or historically by a neurologist.
I can't give you medial advice over internet. But the key to figuring out what is wrong is the right doctor. A spine surgeon is typically a good choice if you need surgery; if you want to find out what is wrong a pain management doctor, or physiatrist are typically the doctor with whom people start. *** Pain management doctors are *board certified in anesthesia or physiatry; ** subspecialty certified in pain management; and *** don't abuse narcotics except for cancer or surgical pain treatment.
I hope this helps. Please let me know how you do.
Pp@@BestPracticeHealth
Very informative video.
I had an injury 14 months ago, had a nerve root block at l5 s1 level 3 months ago got some pain relief but eventually around 30-40% pain came back. I am not taking any painkillers because pain is nothing like it was before nerve root block but my SLR is still positive at around 30-35° and I can not touch my toes, my back feels really stiff.
I wanted to know if I'm a candidate for surgery or not.
My Dr is suggesting me to get an endoscopic microdiscectomy.
Would love to hear your advice as I'm just 23 and want to go back to my normal life again as soon as possible.
Your priority now is stopping the sciatica. The longer it goes on the more permanent nerve damage you can expect. If a good surgeon recommended microdiscectomy then I would definitely consider it.
Could it take longer to heal if you are taking and immune suppressant called methotrexate? Since the body can’t chew it up as fast, I’ve been having pain for 2 months now
Yes. MTX will dramatically slow or potentially stop the healing.
@@BestPracticeHealth thank you for replying, I stopped MTX 2 weeks ago and started a biological called dupixent, I don’t have arthritis but I have atopic dermatitis (eczema) so my doctor said it’s less of an immune suppressant, targeting the eczema and not much more so does that mean I would heal or do you have any pointers for me?
Great video! Im 24 and got a herniated disc i had back spasm or back problems since i was younger doctor says it does not look very good ive lifted heavy stuff in a bad form not so much this past year but i started playing soccer and looks like i have back pain every time i play so i decided to get an mri to see what was going on hope its not to late . And hopefully it can heal on its own with physical therapy after this last injury almost a week ago the painful part was the first two days o could hardly walk and stand up but only pain was on my back
But very sharp now im doing much better still feel little pain not much just feels sensitive 6 days after i can walk great but i would some advice or opinions i love soccer sports running and training with my daughter and i wonder if im ever going to be able to do it again . Im in texas but i would love to go to Phoenix for a consultation i would like to know the cost for an opinion
I can make it to phoenix in next week or so hope to hear a response soon. Im a bit worried i just want to go in the right path.:(
Call us at +1(608) 602-4022 asap!
Hi Bryan! We were able to answer your question on last week's Q&A episode of Best Practice LIVE. You can view it HERE: ruclips.net/video/7WHPRbIoVCM/видео.html
How are you doing now?
I would likw to ask, can the nucleus polposis refill naturally?
I have herniated disc L4 L5 L5 S1 Stage 2, and L3 L4 stage 1 for 2 months pain is there. But afterwards pain subsides up to the writing of this comment. But my right foot sole is having numbness up to now.
What do say? I my hernitated disc has healed?
Doctor, I have a herniating at C6-7 with numbness/tingling in my right index and middle fingers. Happened back in April. Confirmed via MRI in May. I’ve held off on surgery while trying several conservative methods, but no luck yet. I decided to lose 25lbs because, well, that’s never unhealthy and figured might help my mobility and pain level. And it has.
My question: when is it time to throw in the towel and go get the scalpel? I have been researching photobiomodulation therapy and wondered if a Diowave 60w high power therapeutic laser would be worth it.
Your time and response is appreciated in advance. 🙏🏻
Hi, Brent. Sorry for the slow response. I'm sorry to learn of your neck troubles. I'm going to answer your question on my live show tomorrow at 10 AM (12 PM Central). If you would like a review of your MRI included call my staff at (602) 256 - 2525 to upload the images to our confidential online drive. I will send you a link to the discussion afterward.
Hey, Brent. Here's a link to BP Live. I answered your question today. The discussion of your case begins around 40 min in.
ruclips.net/video/zb9UGqWtjf4/видео.html.
If you have not already please subscribe! Thanks for the great question. I think many of our viewers have the same issue.
I have a moderate herniation at my L5-S1 with a measurement. It's been a long 4 months but I am slowly getting better. Is this herniation too large to heal on its own? (See MRI details below) Thanks! (Been doing PT weekly & 2 epidural shots so far that were not very effective unfortunately)
At the level of L5-S1, there is a moderate size left posterior
paracentral disc protrusion that measures approximately 7 x 5 x 13 mm.
This causes mild ventral effacement of thecal sac and moderate left
lateral recess effacement. There is displacement of the transiting left
S1 nerve root. Minimal hypertrophic facet arthrosis at this level.
The key to taking the right step in the treatment of a disc protrusion is not usually the size of the disc; it's whether or not the patient has a functional weakness, numbness, or uncontrollable pain. The s1 nerve root provides sensation on the outside of the foot and works the calf muscles. A good way to test for functional weakness caused by damage to the S1 nerve root is to walk on your tip toes. One can test for S1 numbness by gently touching the outside of the foot, by the pinky toe, and comparing it to the other side.
Disc protrusions do heal, as they are exposed to the epidural space, as opposed to bulges.
I'm sorry you're in pain. I hope you feel better soon.
Informative video. I have been dealing with chronic pain caused from multiple disks in my lower back. I have had 2 MRIs. I had a lot of nerve pain down my leg, numbness in my foot, i walked with an obvious limp.
I was a candidate for surgery, but opted to try other options first. I took gabapentin for the nerve pain and pain meds for the pain in my back.
Today, years later my back feels pretty good. Nerve pain is gone, I am not in as much pain as i was. I have a different problem, my body is addicted/dependant to the pain meds.
I am weening myself off the pain meds (which is no easy thing) and my back to my amazement doesn't cause the extreme pain it once did.
I find it exasperating how Drs treat pain patients.
Drs wanted me to take long acting time release pills (oxycontin or morphine extended release) or have a pain pump installed. I knew when i started taking the long acting pain meds that my body would become dependant on them and that i would have withdraw when i decided to stop taking them.
Last month i cut out 80 mil of pain meds. (i now take half the meds i was taking) It wasn't fun, withdraw is horrible. My eye twitched for a month.
Now Drs don't want to give anything for pain. I don't understand letting people suffer. I am greatful for the Drs i saw, they didn't leave me to suffer and i didn't have to have surgery to get pain relief.
I agree with weaning off the pain meds. I'm glad you are doing that. Once you are off I think you will find you feel better, your relationships are easier and more productive, and you can live a much better life.
Hi Doc, question. If inflammation process is helping to eat away the disc. Would not anti inflammatories delay healing or eating up process
Great question! In theory anti-inflammatories would slow down the healing process. In practice I have never seen that.
Hi sir, I had a microdisactomy surgery L3-L4 And L4-L5 2disc. Now it's 1month completed, doctor suggested me to resume my activities after 1week since my surgery.
I having some weakness in my left leg, I can apply force on it but can't lift my ankle up. right after the surgery I was not able to move my left leg fingers,not to walk on left toe. But now I can manageable to walk on toe and move my fingers, still difficult to walk on heel.
The question is :
1) do I resume my activity now driving car or raiding bike?
2)How frequently I can sit or walk?
3) what are the major activity which I need to avoid like (twisting, forward bending) ?
4)What action need to take avoiding disc degenerative disease in feature?
5)How I can repair dissolved amount of nucleus purpose ?
6)If not what precaution need to follow not to persist again?
7)How do I strengthen and stability of my back?
I would really great full to youif I get all the answers. Thank you in advance.
The big concern for you is recurrent disc herniation.
The risk of recurrent disc herniation after microdiscectomy surgery is relatively low, estimated to be around 5-15%. This means that most patients who undergo this surgery experience significant improvement in their symptoms and do not have a recurrence of their herniated disc. However, you certainly can cause a recurrent disc hernaiton with excessive strain or trauma to the spine during the postoperative period, which can cause a new herniation
To minimize the risk of recurrent disc herniation after microdiscectomy surgery, it is important for patients to follow their surgeon's instructions carefully during the postoperative period. This may include avoiding heavy lifting or strenuous activities, participating in a structured physical therapy program, and maintaining a healthy lifestyle. Your surgeon said no restrictions 1 week after surgery. That is not typical.
I am not a surgeon anymore. However, for what it's worth, here are my recommendations:
No bending, lifting more than 5 lbs. or twisting for 3 weeks during which time you can walk more every day. Once you can walk a mile, you can walk all you want.
You can drive a car or ride a bike now, but don't crash or fall.
You don't need to dissolve the herniated disc as your surgeon should have removed it.
In the long term you can reduce your chances of recurrent herniation by building core strength. Yoga or tai chi are good avenues to get stronger.
@@BestPracticeHealth thank you
My Dr told me with in a year 75% heal, 2 yrs. 85% and 3 yrs. 95%.
those numbers are definitely in the ballpark of the ones I’ve read. What’s going on with you? Are you getting better?
I had this issue started almost a year ago and in the beginning the spinal canal diameter between my L4/5 was 6mm and now it’s 9.5mm also the pain i feel is lesser these days as compared to months ago. Doctors are recommending me surgery but i want to recover it without any surgery, could it be healed in some more time as one year had already passed or surgery is the last option I have?
Oh, no! Sorry to hear you are suffering. Unfortunately, spinal stenosis only gets worse, and the only treatment that actually restores the spine and protects the nerves is laminectomy surgery. What you have to consider is the timing. I've seen so many patients wait too long, until they were not healthy enough to have it, and then suffer for the remainder of their life with something that could have been addressed.
Hello! Your questions is being answered on Best Practice LIVE! Check it out HERE: ruclips.net/video/9Yi6NIJ86zo/видео.html
You can see Dr. Lieberman's full explanation HERE: ruclips.net/video/9Yi6NIJ86zo/видео.html
Iska koi treatment nehi hey nice joke's heal own
Can a tear be repaired by the body or will it remain a tear?
Hi, the depictions of herniations in this video explicitly show the nucleus bursting through the annulus of the disc. I have seen other depictions that show the annulus being deformed outward but still containing the portion of the nucleus that is protruding. If I have a Protrusion but not a Sequestration, is my nucleus hanging out totally exposed or is there a layer of stretched out annulus still surrounding it?
Yes, you are exactly right. The annulus can tear, but the nuclear stays confined. The good news is that the nucleus is not compressing and irritating the nerve root. The bad news is that pain fibers grow into the disc and can cause a painful annular tear.
@@BestPracticeHealth if the nucleus is still confined for a given herniation, is that herniated nucleus material still eaten away by the body or can it migrate back to where it should be? Thanks for the info!
@@GeneralJoey747 The annulus is an outer layer or wrapper of the nucleus pulposis. If a tear in the annulus heals over then the nucleus pulposis is again shielded from the body's immune system and the cycle is over. Since the nucleus has no blood supply there is no route for the body's immune system to attack it. Doctors see this battle play out on MRI all the time. Inflammation at the junction of a torn annulus and the vertebral body bone is called "Modic changes" on MRI reads. If you have an MRI of your back check the report for that language. "Modic change" is the evidence of a long-term tear in a disc causing inflammation in the adjacent vertebral body.
@@BestPracticeHealth my MRI report did not mention any modic changes, just a foraminal hernation pressing on the nerve. At first I was worried I would always have this herniation unless i get surgery but after reading more and watching videos like these I'm more optimistic about this resolving without surgical intervention. With that being said it is confusing for a layman like me to understand what's happening with my body and what the possible outcomes could be. It also seems like there is still a lot left for scientists and medical professionals to learn in this space.
@@GeneralJoey747 how ur protrusion now ???
im curious about the pulp. You said that the body digests the part that has "escaped" the annulus. Does the body make more pulp to replace the dissolved amount? If not, how does that affect the stability, strength, or cushion of the discs?
Oh, man...that would be great. Sadly, no. Our bodies do not replace the nucleus pulposis after it herniates and is digested by our immune systems. That's why we get "degenerative disc disease."
@@BestPracticeHealth ok what about protrusion ?? So the body gonna reabsorb the nucleus and there is not any part dissolved ?? Right
So the disc is keeping all contents right ??
Hi doctor , I am waiting for results of MRI, I believe I injure my back while doing very heavy hip thrusts . I have been taking it easy at the gym however I have been doing machine leg extensions but my pain comes back . Is this exercise not recommended ? What type of exercises should I do? Thank you
Exercise and therapy have been studied a lot and have not been shown to be effective in the treatment of herniated discs. What works are natural healing over time, epidural steroid injection for temporary nerve root pain relief, and microdiscectomy surgery when all else fails. The gym is awesome and critically important for your long term health; but it won't help with your herniated disc.
Let me know when your MRI is back and we can review it together if you like!