Degenerative Discs in Lumbar Spine

[Discoteka]

Hail COTH!

I have been riddled with back issues for as long as I can remember. I ended up having surgery a little over a year ago to clean up a herniated disc. The doctor didn’t find what he was expecting during the surgery…and alas my symptoms continued. I recently had a checkup round of x-rays and was told all of my discs in my lumbar spine are degenerating. I’m only in my mid 30s. I haven’t ridden since prior to my back surgery because of the pain, but plan on saddling up here shortly.

Anyone with experience have any tips for riding? I already do a ton of stretching and exercises. My doctor advised against back braces due to them weakening the muscles in the back (by becoming dependent on the brace).

[MsM]

I have a more minor problem, but my doctor did prescribe a back brace for occasional use. I use it when I am doing something that might aggravate my back. Vacuuming was a big one for me - nothing more aggravating than hurting yourself doing a disliked chore! I have used it for other chores that are on the edge of my tolerance to help prevent a flare up. I too was warned about dependence if used too often. It has really worked well for me in its limited use.

[Where_sMyWhite]

OP

What type of doctor are you seeing?

Have you had a second opinion?

What diagnostic studies have you had other than x-rays?

[Discoteka]

I have had an MRI and Xrays. This doctor is a family doctor, but I have seen a neurologist and rheumatologist. The neurologist gave me the same story on the back brace after he had given me the clear after my last surgery.

[Where_sMyWhite]

MRI - check

Second opinions - check

What type of doctor did your first surgery? What did they find the first time that they didn’t expect?

Herniated disks can sometimes heal themselves. Degenerating disks usually don’t.

Only reason I’m asking is that I have had back surgery to address multiple issues including no disks (bone on bone). A bit of a BTDT.

[Discoteka]

I was in physical therapy prior to surgery. A neurologist surgeon did the surgery. When they went in for the surgery, the herniation was much improved and he was surprised I was still as symptomatic as I was with little to no herniation. It was only one disc at the time, but it is now seen that the disc degeneration has progressed along all discs - the worst being the one that was previously herniated.

I did ride for the first time today since my surgery! It was a bareback walk around the neighborhood, but still looking between the ears! Very little pain afterwards also. They have me on meloxicam (which helps a ton) as well as lidocaine patches as needed.

[Where_sMyWhite]

FWIW, and this is a very personal decision… both neurosurgeons and orthopedic surgeons can do surgery on the spine (neurologist don’t do surgery usually, neurosurgeons do).

If you troll the internet, each believe they are most well qualified to do spine surgery.

I had my spinal surgery done by an orthopedic surgeon who did only spinal surgery. Maybe ask for a second opinion from an orthopedic surgeon as well as the plan from the neurosurgeon.

Thanks for answering my questions (not trying to be nosy, seeing what I can say that would make sense remembering that I am not a doctor but a patient who’s had spine surgery).

It seems that often herniated discs do, over time, “fix” themselves. The continued degeneration has got to be concerning for all parties involved.

Glad you enjoyed your ride!

What are your plans going forward? Disc replacement? Leave things as they are?

A friend of mine told me once that in her opinion all back surgery was elective (with the exception of traumatic injury). At some point, you may elect to have that surgery over the quality of life that you are experiencing at the time. I get that completely as I postponed surgery for close to 10 years until quality of life was just not what I wanted and I was willing to take the leap into the unknown. Took over a year from that point to find my surgeon and do all the steps needed to do the surgery. I am intentionally not telling you my outcome as I don’t want it to influence your choices

[vineyridge]

take a look at the McKenzie Method for handling back problems. It’s a series of special exercises and gadgets that treat back issue mechanically, not surgically. It’s helped me tolerate back pain for decades. IMO, back surgery is a risk benefit question, and is indicated only when the benefits outweigh the risks by a considerable amount.

Robin McKenzie was a New Zealand physiotherapist whose method has been spread worldwide and, IMO, is very effective and the first place to start when back problems crop up.

Also, I believe firmly that all riders will develop back problems over time, thanks to falls.

[Calvincrowe]

I had a lamectomy/discotomy (spelling??) more than 10 years ago. I did every kind of PT known to help me before deciding on surgery. I use a fabulous Orthopedic group for all my injuries (and they are numerous!) but my surgery was performed by a neurologist. I was also seen by a back ortho surgeon in the same practice during and after this episode.

Have you had any injections done? I did and they helped immensely, though not permanently. I’d definitely ask about them, as well as more PT and a consult with a second ortho or neurologist.

Since my surgery I’ve worked very hard on developing a strong core and keeping it. If I don’t my back hurts. My PT refers to this as “PODS” or pissed off disc syndrome (yeah, it’s made up…but quite descriptive) when my back flares up after doing something stupid like lifting wrong or bending over too much gardening.

[Discoteka]

I am planning on putting any further surgeries off indefinitely until it becomes a quality of life issue. Recovering from the surgery I had was awful, and I do not want to go through it any time soon, especially if at this point in time, it won’t do anything to actually help. For now, I am moderately comfortable with the regimen I am on. I have ridden over the past couple of days (nothing more than a walk) and have had no pain that could be directly related to riding…so that is a bonus for sure.

Doctor did say the next step may be to try injections, but I don’t think the pain is enough at this point to warrant taking that leap.

Thank you everyone for your input, and I will check out the aforementioned McKenzie method.

[Where_sMyWhite]

Discoteka, I think a very decent strategy.

What kept me off the table was Feldenkrais Functional Integration. I would explore “alternative” therapies if you can… Feldenkrais, Alexander Technique (both body work modalities).

Research and really talk to your Dr about injections. In my personal journey, they were not recommended and it was felt they may make things worse than they already were.

As I said, it is elective surgery and only you know if and when you will choose to elect surgery over your current quality of life.

[vineyridge]

Here’s a link to the US McKenzie Institute: https://www.mckenzieinstituteusa.org/method-patients.cfm

[TWH_Girl]

I’m sorry to hear about your back especially being so young. It sucks!

I’m ready to try injections! Until then, I also use the lidocaine patches, gabapentin, and Tylenol prn as I can’t use NSAIDs due to my stomach. I have meloxicam and it does work well though I try to avoid it. Heating pads help as do the occasional chiro and massage…Also muscle relaxers! It’s tiresome to be stiff and sore and some relief with injections would be nice!

[Write_amp_Ride]

I was diagnosed with a ruptured disc at age 12 after getting thrown from my horse. I didn’t ride again till I was an adult. I would periodically have severe episodes of pain, once landing in the hospital; I did physical therapy and injections. When I was in my 30s I happened upon the book Healing Back Pain- The Mind Body Connection by Dr. John Sarno. I am extremely skeptical of gimmicky sounding stuff and yet… just reading the book made my severe pain episode subside. I never had an episode that bad again. I no longer have sciatica, which I had constantly. I have run 8 marathons and ridden for many years now. Occasionally I will feel my back start to “tweak” a bit and I use a Back on Track brace to relax the muscles. That’s it. It doesn’t hurt to try the book… And oddly, I read another book of his and found it unhelpful. But the first one changed my life.

[Rackonteur]

@Where'sMyWhite

OP

What type of doctor are you seeing?

Have you had a second opinion?

What diagnostic studies have you had other than x-rays?

Good questions, OP.

20-odd years ago I ruptured the 3rd lumbar disk in my back. In the city where I lived at the time the doctors were still talking surgery for this sort of injury. STILL – and that was 20 years ago! Meanwhile – and this was the early days of the Internet – I researched and learned that a surgeon in Miami had stopped doing surgery in many cases because he had learned that the therapy he did with patients before planned back surgery helped them so much that they didn’t have to have the surgery.

So now it’s 20-something years later, and you are 30-some years younger than I am! See a different doctor and get a second opinion (I didn’t have the surgery, BTW).

[2horseowner]

Totally agree w/ Vineyridge. The McKenzie Method has saved me. I got the recommedation from another COTHer. What a lifesaver. I too have a herniated disc that happened a while back, and am prone to SI pain and spasms. The surgeon told me to pick something else I liked to do. No way in H3** was I giving up riding or running. The McKenzie Method was a huge game changer. Good Luck. I am no spring chicken either-55!

[Magicboy]

I also credit the MacKenzie method with helping manage back pain.