L4 L5 disc herniation treatment

[Flowers8989]

Posred here for traffic.

I have around £800 to spend on some treatments that might help.

Osteopathy did nothing for me but at the time I hadn't had an MRU so we weren't specifically sure on the issues.

I have left leg sciatica when standing and awful back pain.

Has anyone been to a chiropractor or could recommened a good physio who could deal with the issues in Mancheater area.

Thanks

Hi, I lived on Merseyside and had exactly your issue, hospitalised due to it. I still have numb leg issues but, I used Mr Fulwood Southport if you're are up to travel. It's called Birkdale Chiropractor he has Facebook now as semiretired from his own big clinic. I have used him since 1996.

I’m really sorry you are in this position. A very long time ago I started a thread called The Back Story. If you can find it it might be helpful.

you don’t say how long you have had the symptoms but the bad news is that it can take quite a long time to resolve even with excellent physio. Discs do mostly resolve in time. Resting and pottering is my mantra. Plus good medication support from your GP.

im really sorry, its awful but letting it heal and strengthen in time is likely to be your friend.

Since March its literally ruining my life 😪😪😪 I can't stnd for more than 5 minutes. Its taken me minths to even get an MRI. I'm so wary of medication as my Mum takes a lot and is like a zombie.

It's shit, OP, I get it. I have a lengthy and sorry tale of my terrible back, which ended up in 4 surgeries over a 12 year period (x2 microdiscectomies at L4/L5 & L5/S1; a spinal fusion at both levels; and then a revision because of a very quick re-herniation.) The surgeries were because I had foot drop, and then cauda equina - both of these should have been advised to you as red flag alert symptoms.

I would say that, from my experience, don't let a chiro touch your back. They are largely ungoverned, and you can get terrible, as well as great, ones. My advice would be to find a really good physio, with specialist experience in back injuries. Things which have helped my maintenance have been getting, and keeping, a really strong core - so Pilates, regular physio, and things like swimming. I've also had a series of nerve root injections - privately, and on the NHS. Privately, they were about £1900 each (I know!!) because they're guided under a contrast nerve scanner. However, I went on to have almost the same on the NHS, in slightly less luxurious surroundings, and with dodgier coloured gowns. 😂

As others have said, it's worth waiting to see if it does resolve, with really conservative treatment, like the above, before looking to injections and surgeries. If you do end up having to go that way, see a neurosurgeon. One of the best pieces of advice I got from a surgeon friend was not to let an orthopedic surgeon do this stuff. They can be great - but more often than not, they're not doing enough of them.

Anyway. If I had £800, I'd be finding a really good physio, and getting 1/2 a dozen sessions with them - and then some 1:1 Pilates to get that moving. In the meantime, be really aware of the red flag symptoms (numbness in your saddle, inability to control bladder/bowels, and loss of power in the leg/foot.) Also, get your GP to get you on some good nerve painkillers. Here, in Scotland, where I am, the protocol is Amitriptyline first (no effect for me), then Gabapentin (I was loopy for weeks on it), then Pregabalin (takes the edge off, and no horrific side effects for me.) I'm still on Pregabalin, as I ended up with permanent nerve damage, and chronic pain. My biggest regret was leaving it too long before getting real help - and not paying for a private MRI, instead of waiting 9 months for an NHS one (I was too functional, apparently....)
Take care, rubbish backs are shit.

Ps..i just found your thread from 2013 you sound like me! How are you these days? I hope I can recover. I'm only 36 😪

Sorry - cross post, as it took me 10 mins to post.... If it's been since March, it's probably time to go at it more aggressively now.

Agreed...any tips re treatment?

Hopefully you can see my longer message from 23:20. That would be my advice.... and keep pushing your GP/Neuro rehab services.
(If you were in Central Scotland, I'd recommend 3 or 4 people, but it really takes a village.)

I used to say that I'd never had bother with my back until I was 37/38. Then I started to think back, and had 'oh, do you remember that holiday where my back was so sore', and 'yeah, that was the day someone else had to drive your car home because your back went into spasm'. So, really, I've had a sporadically shitty back for most of my adult life. First surgery at 39, and my entire 40s were bookmarked with painful spinal episodes. It was a horrible decade. I'm now just turned 50, and hopefully my regime has made me stronger and more durable. I do notice when I let my routine slip, though, so consistency is key.

Hi, sorry just seen this...that message is helpful thank you...so my timeline is I went to my GP in March with calf pain. I was then transderred to MSK. A long wait later I recently had an MRI which revealed the L4 L5 herniation. MSK referred ne to the paun clinic for I think its caled a radio frequency injection...I had a telephone assessment with rhe pain clinic last week who said the radio frequency jab wasn't suitable and partially suggested an epidural but in the same breath said it might make my pain worse or not last long. I've got to wait for a face to face assessment. Pain management has veen suggested but I feel like thats kind of putting up with the issue but not finding a resolution. I asked the pain clinic about seeing a surgeon snd tgey said I would have to go back to the GP for a referral....can you see why I'm going in circles 🤣.

I will admit I am a bugger for sitting at my desk...I could be better with trying to walk and general exercise.

Pain killers scare me. The ones you mentioned my mum takes them all and getd withdrawal symptoms if she doesn't get them on time!

My thoughts were, that, at this point, about 12 years ago, I would try anything to avoid the surgery. The first 3 or 4 injections (sound almost identical) did work; but after the first 3, the effects got less - and I wasn't willing to pay another almost £2k to not have a great therapeutic effect.

I know it's easy to get stuck sitting at your desk every day, but seriously, you need to move more. I have one of those pretend cheapy Fitbit things. It buzzes every 45-60 mins: so, if I don't move at 45 mins, it reminds me at 60 mins. I did a 28 hour journey to Australia, with it going every 45/60 mins. Other than when I was asleep for a couple hours here and there, I walked around that plane, like a convict in a prison yard. But, I arrived in Sydney, still able to move. I also have a sit/stand desk at work, and a variodesk thing at home. They're about £200 on Amazon now - not the £450 I paid in the early days of the pandemic! I find it good to be able to regularly change my position. Have a good chair, with excellent lumber spinal support. Use a knee pillow in bed to keep your pelvis from dropping and rolling. But, it's a smorgasbord of techniques, tricks and equipment - very trial and error.

Other things I find mildly therapeutic are heat and ice. Try a Tens machine. But, yeah, you might just have to take the drugs. At least on a temporary basis. I take a bit of a cocktail, but manage them well. I work full-time, live alone, drive, travel, etc. I've constant chronic pain, and still have some weakness and numbness, but what else do you do? Can't lie on the floor and cry all the time. (Which was how pain clinic left me feeling.... so I would say that it's an approach for some folks, but not for others... but that's a whole other post.)

Getting the MRI is the most important step.

Once you have that the doctor should be able to see the problem and advise on the most appropriate treatment- physio or surgery

L4/5 and s1 here.
I'm on Gabapentin and it's a life saver for me (yes it made me loopy at first but now I'm used to it) as it keeps the worst pain down.
But avoiding surgery is a priority for me. My DD is a doctor and says absolute last result only and seeing friends who have had surgery , they don't seem to be pain free, so I'd really rather not.
I'm not a fan of chiropracters or osteopaths either. I have found physios more helpful, and actually a sports physio has been the best.
However the single most useful thing has been exercise. Sounds impossible but it's true. Moving...not just a gentle potter, but core strengthening has made a BIG difference. I don't enjoy it, but it really really makes a differerence.
I need the meds to be able to DO exercise but the exercise reduces the need for so many tablets...don't dismiss medication!

I'm off to Australia in feb (my DS1 married an Aussie so we go every other year) and like the PP said...I shall be setting an alarm to get up and move every other hour otherwise I will be totally incapacitated by pain by the time we arrive. You have to move, and move lots.

A friend of mine is having ozone therapy and it’s been life changing for him. I’m now considering it for my own sciatica. I presume there would be some where private near you that does it.

Have you tried acupuncture? It took over two years from slipping my disc to having a microdiscectomy and I would never have got through that without acupuncture. I saw a chiropractor for the first three months once I was able to sit up long enough to get to him but it didn’t help very much. I also paid for a private mri scan early on. Once I started acupuncture I was able to walk again and life became a bit more bearable.. I found a combination of codeine and naproxen worked best for my pain. I wasn’t prepared to try gabapentin or pregabalin because I had seen how they affected my mum when she had back problems and the vast majority of doctors seem to have no idea how slowly the dose has to be increased and decreased. I was also very concerned by the supposed link between gabapentin and dementia.

Not local to you, but chiropractors aren’t evidence based and the research says physio is the gold standard as first step. A good physio is gold.

Coming back to this, as I just remembered I also had some acupuncture - for the nerve pain in my leg; but didn't do anything for my back, or the actual injury. However, if you're trying to get through the 6 months or so, to see if the herniation/bulge (not sure what stage your disc is at....) will resolve, it's maybe worth a try.
I would be cautious with trying lots of different things all at once though, OP, as you're going to burn through that £800 pretty quickly, and not necessarily know what is helping, and therefore, worth continuing. Just a thought....