Herniated Disc, Now what?

A week ago I was diagnosed with an L-5/S-1 hernia, which I gather is fairly common. In fact, I suspect I have had it for at least 4 years. However, I recently managed to make it very, very angry and ended up in the ER in serious pain. They did a great job, patched me up and sent me on my way and I have been pain free for about a week. I do have residual numbness in my left calf and foot, which I read can take up to 6 months to fully resolve.

My question is, how quickly is it reasonable to get back in the saddle?

Do you have an idea of a cause? I would be mainly worried about reaggravating it, even though you are pain free at the moment. Are you in PT to rehab/strengthen around it?

While I don’t know the cause of the original injury 4 or more years ago, most recently I do know that I (re-aggravated? re-injured?) it by picking up my 55 lb. dog. He was having trouble getting up the stairs and I bent over to pick him up. I felt the strain in my back.

I usually can just alternate tylenol and advil and get by. I continued to ride, move around poles and cavalettis at the barn, etc. I had a lesson and I couldn’t sit the canter. I drove home and after sitting for 20 minutes in the car, my back went into spasm. That’s when I ended up in the ER, about a week or more after the picking-up-the-dog injury.

I would see if you can get a referral to PT and/or a specialist to look closely and help you avoid future issues. I assume what I did some years ago was herniate a disk, and wish I had gotten to PT sooner. The numbness in my leg took about 4 months to fully dissipate. But I would never want that pain again.

Most of the time disk issues are indirectly caused by a lack of strength or balance; usually core strength. The few times I’ve tweaked mine is always related to reaching forward and picking something up that is too heavy - just as you describe. So, usually bulky and heavy.

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I herniated that disc on the right side years and years ago. It took me 4 months before I felt good enough to get back in the saddle. After a round of physical therapy I found what worked the best was 2x/week deep muscle massage to resolve the spasms and sciatica. I found a therapist that would do concentrated work on that area for 30 minutes/session 2x/week. Same cost as a longer 1hr massage. It probably took nearly a year for the right foot weakness and numbness to resolve.

Susan

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I’ve had herniated disks in my back since I was in my late twenties. It’s been the last twenty years they really become problematic as they have degenerated. It’s good the ER helped you out but you should really get with a specialist and get a good diagnosis with imagery. The imagery is good to have as you can see how things are progressing over time. Also a pain management specialist who does injections. One thing a back specialist told me is that the further away from the spine you can feel the pain, the worse you have herniated the disk.

As someone noted above, strength and flexibility are key but nothing will totally prevent re-injury or further degradation. I work out 5-6 days a week on strength and flexibility and yet the disk will cause problems over seemingly non-events. Like just the other day. I had foxhunted the day before with no problems. I worked out in the morning including all of my stretching and PT. I was cleaning tack and bent over to pick up one of my boots when I felt it go. I no longer have minor outages so my first call was to the pain management doc. Hopefully they can get me in on Tuesday. In the mean time, it is several rounds per day of loosening up on the treadmill/elliptical followed by stretching, followed by ice and TENS. I find the key when you have an incident is to attack it right away.

Tomorrow’s weather is supposed to be warm so I am hoping to get back on the horses just to walk around. Walking on the horse seems to be helpful.

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Thank you @FitToBeTied. That is super helpful info to have. That does help shape my path forward. I do have a lot of numbness in my left foot and the bottom front of my left calf.

I contacted my primary care doctor after my ER visit and she said that if the numbness did not go away in a week, that she would order a consultation with orthopedics and an MRI.

Now that I’m out of pain, I had been planning to ignore the numbness and hope it resolved with time, but your thoughtful post makes me think that I should pursue further diagnostics and treatment instead. I hadn’t considered further degeneration and what my back might be like in another 20 years. I should probably do all I can now to make sure that I preserve function for the future.

I’m fortunate that I’m in one of the areas in the country with the top medical communities in the world and I have access to the best of the best. Perhaps it would be foolish to ignore that.

I agree that nothing can totally prevent another injury, but PT is really critical to strengthen your core to protect your back. But also - a good PT should go through safe lifting techniques for your injury and especially the type of movement that is likely to cause the injury – usually, as described - bending over to pick something up. We all do it, but I try to remember safe lifting for things that might be risky - using legs, engaging core, not leaning forward past a certain angle. I also think that PT for my back was pretty minimal as far as core strength goes; I definitely do way more than that now and use a personal trainer to keep me accountable.

I had a disc herniation which caused quite a few issues. I ignored it longer than I should have, hoping it would just go away and ended up with foot drop (was unable to lift my foot) and unbearable pain. Next step was a cortisone injection which was of no help. Eventually I had to have surgery on the disc which was effective in resolving the foot drop and most of the sciatic pain, but comes with a long recovery period. Nerve damage takes a long, long time to resolve. Agree with the comments about physical fitness and lifting awareness. Hope yours does not continue to trouble you.

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