Recovering from slipped disc - microdisctectomy recommended but not sure whether to proceed

[Neenaw20]

Hi

Apologies for another slipped disc post.

I have a large slipped disc in S5 L1. I believe it happened back in august.

I suffered from a fair level of pain from august through to Nov but had treatments from an osteo which provided limited help. I thought I’d pulled a muscle.

Then in late Nov the pain escalated. I couldn’t sit, stand and walk without extreme pain. I found the pain would build until I would experience a horrific snapping in my back which would floor me. I live by myself and couldn’t operate, my 80 year old parents had to provide support.

Thankfully I had private healthcare and was diagnosed quickly and had a steroid injection before Xmas. This addressed 50% of the pain and I have been having tension treatments at my physio since. I have slowly seen my pain reduce but am finding my leg weakness isn’t improving which means I am limping quite badly and this causes my pain to increase throughout the day.

I saw the consultant today and he has recommended a microdisctectomy. He is concerned about my leg weakness and that I am still experiencing pain.

I don’t know what to do. Do I continue as I am and hope things continue to improve?

Or do I just bite the bullet and have the surgery and hopefully it will address the remaining weaknesses and pain? I still can’t walk the dog alone, food shop and struggle with anything that requires me to bend.

I am concerned that my health insurance will not cover treatment at a later day if I delay the decision. And I want to get back to work and to continue being able to work as I pay all the bills myself.

Has anyone been in the same position? What did you do? Any thoughts as to what I should do?

I had exactly the same thing in 2018 with it culminating in my right leg being completely numb. I went ahead with the surgery and it’s changed my life, no pain and all symptoms had disappeared when I woke up and I am still the same 5 years later. For the last 2 years I have been strength training 4 times a week. Before my surgery I couldn’t even Hoover the house.

I would have the surgery. (I did, for another disc, and it made a massive difference.) If you wait (or even if you don't) you might still have some weakness or pain after the surgery. But in my case, the pain was completely cured.

Thanks both for your feedback. Much appreciated.

I am now at a point where my pain is much reduced (by approx 60%), the tension treatment has really helped. I can finally put my knickers, socks and shoes on without too much difficulty 🥳 (it’s amazing how the small things matter the most).

I still have some sciatica and moments where my back pain kicks in, my leg weakness remains. It’s a week to the surgery which makes the decision harder. Has my improvement peaked or will it continue to get better? Is it worth having the op for the residual pain and weakness? Arghhh

I think I’ll email the consultant to see if it’s worth doing an MRI to check progress and to determine the worthwhileness of the procedure at this point. I wish I’d just opted for it at the start 🙄

I had this operation 18 months ago, would thoroughly recommend it. I don't think a surgeon would suggest it if they thought it wasn't really necessary. It took a good few weeks to recover but compared to the pain and limited lifestyle before hand it was so worth it. I wouldn't hesitate to have it done again if it ever becomes necessary.

@Neenaw20

I work for a spinal injuries unit. Please feel free to message me if you have any queries. Whilst we deal with an inpatient bed base of severe spinal cord injury, we also see 100s of outpatients each year with very similar circumstances to your own. We do not operate but we provide post surgical care and follow up from a rehab perspective.

DH had one two years ago. Utterly life changing for him. Went from not being able to walk for ten minutes to weight training a year later. Good luck whatever you decide.

Glad you're feeling better, OP. I think you have to bear in mind whether you want to be able to manage some of the time, or if you actually want rid of the problem entirely.

In my case, I would recover a bit (or even a lot) and then the disc got a lot worse again. This happened several times. I tried to avoid an operation, but, in the end, getting rid of the source of the problem was the best move I could have made. Apparently, most people do not relapse like this though and other discs in my back have not done that when they prolapsed.

NHS advanced practice spinal physio here. Without knowing the exact details of your MRI and degree of nerve compression it's hard to judge. However the surgery is to reduce nerve compression so will address the weakness and leg pain. It isn't for the back pain. That being said if the compression on the nerve is such that it is causing the nerve to not function (ie messages not reaching the muscles in the leg causing weakness) then this is a good reason to have the surgery. Long term outcomes (after a year or so) can be similar to waiting but if you can't be active then surgery could be helpful for you to get back to walking , work etc. There is evidence that it can speed up recovery to have the surgery. As it's not been there for a long time, as in years of compression, the sooner you have the surgery the better the outcome. It's a tough choice to have spinal surgery but in your case I would definitely consider it for the weakness. Although understand your hesitation as the idea of spinal surgery is scary. Good luck

I had the surgery in 2010 and have no regrets.

Thanks for all the feedback. It’s been reassuring re the outcome of the op.

I have spoken to the surgeon and he has been unable to secure theatre time for at least another week which gives me time to think on it.

@Poachedleggs and @deflatedbirthday i appreciate the surgery won’t treat the back pain but should help the leg weakness. Do you know if it will help with the following:

1. Nerve that is triggered from my bum to the outside of my left hip and down my leg. This is painful all the time (low level pain) but triggers sharp stinging pain down my leg when I cough, sneeze or clear my throat.
2. When I turn my head or reach my arms up I experience sharp pain in my back and legs. It’s a nightmare when walking the dog in the wind or if I need to get something from a shelf.
3. Pain in my back and leg when I lift and bend my knee outward (as you would for a smear test or for waxing)

Also would you know if the tension treatment provided by the physio is just a short term fix? I am finding the day after the treatment I feel fab but the following day my leg and back pain is back? The improvements all feel a bit temporary.

It’s been approx 5 months since the original injury and 2 months since the severe pain and weakness kicked in.

It is hard to say for definite as nerves are v sensitive so can stay painful for a while after surgery, however the leg symptoms you describe, especially with arm movements sound typical of radiculopathy (nerve compression) and should settle once the disc has been removed from the nerve.

I'm not sure what tension treatment is, is it traction? If so there is limited evidence for this and isn't recommended in the NICE guidelines. It's not something that is offered on the NHS usually for this reason. Unfortunately no amount of physio can move a disc back in, they can resolve naturally or if that doesn't occur then surgery. Keep gently active, walking the dog, painkillers etc., they are really important for recovery and keeping spirits lifted. With the symptoms you describe and the relatively short time it has been there it sounds like surgery could help in your case.

Hi OP, can I ask of you went ahead with the surgery and how you got on? I am in a very similar situation now. Thanks x

OP are you on painkillers? It's an important part of your treatment because the more you can move the quicker/better your body will heal. The shooting pains you describe are from the sciatic nerve, I was on amitriptyline for nerve pain. Like you, mine we t really bad at end Nov. I was helpless for about 6 weeks, I couldnt walk to the end of my road. It was awful. I'm now mostly better and going on long walks. I was treated on the NHS and they preferred to watch and wait provided I was improving and numbness/weakness wasn't increasing.

Sorry didn't realise this was an old thread!!

This is a zombie thread but resonated with me
i had a micro discectomy and decompression and it changed mh life
I had back pain, sciatic and terrible leg pain for years
my disc actually ruptured and caused agonising pain
the surgery was a huge success although recovery was long
I’ve had one episode of pain since