Ask HN: What did you do to recover after a herniated spinal disc?

After 3 decades of once or twice-a-year back injuries (that took a few weeks to heal), in 2015 it didn't ever get better.

MRI revealed bulging discs and herniation causing sciatica (which was a first) which varied from a mild, deep butt-muscle pain; to extreme, radiating all the way down to my ankle and sometimes my right testicle.

NSAID anti-inflamatory drugs didn't do much. I was very lucky to find a Physical Therapist who was said to be "good with backs."

After a few sessions we found a combination of stretches and exercises that provided relief.

Basically, my sciatic nerve was being impinged as it passed between vertebra as it exits my spinal column. The stretches were some specific rotations of upper body relative to lower body, which pretty quickly provided relief any time I needed it.

Then some core strengthening which took a lot longer.

Most important is to prevent re-injury through learning how to lift the right way (or actually more important - how to lift the wrong way so you know not to do it again).

I've spoken with plenty of people who've had surgical repairs. Some worked. Many of them didn't, and those people encouraged me to try every possible thing under the sun before considering surgery. I was prepared to pray, swim, stretch, exercise, acupuncture, yoga, learn ballet, become vegan, non-GMO, gluten-free, Santeria, voodoo - just about anything.

I got lucky.

August 2014 I was taking suitcases out of a vehicle and a few days later found myself in so much pain that I threw up while trying to get out of bed. Went the physical therapy and steroid route. Not very much results. To the point that three months later I bent down to pick up a piece of paper and could not get up. After 45 minutes of laying on the floor swearing in pain my daughter called 911 and I took the first ambulance ride of my life. I walk 5 miles a day, but for two months could not walk from my bedroom to the kitchen.

I have collapsed disk at L2/L3 and to a slightly lesser extent L4. Four doctors said surgery was the only answer. I went to that many trying to find a different answer as I had heard so many stories of failed back operations. Plus a few years ago a 25 year old kid that worked for me went in for “minor” back surgery. He left St Francis Hospital in a hearse. They cut a blood vessel, did not realize it and he internally bleed to death.

Instead of surgery I went with steroid injections in my back and a chiropractor. Both helped somewhat. The chiropractor suggested I try Yoga. Weird thing for a socially conservative midwestern kid (who is now 60), but at that point I’d try anything.

Yoga saved me. I started with restorative and now do mixed level. I can now keep up with many of the guys 20 plus years younger than me. A friend had a bad back since a car accident a decade ago. I convinced him to try Yoga and he has had similar positive results.

Is my back perfect now? No, but probably close to what it was before I realized it was damaged

You should talk to your doc about Yoga.

I had a severe L4/L5 herniated disc. After several months of agonizing pain I was just about ready to get on the surgery schedule with an orthopedic surgeon (Microdiscectomy). I had tried everything -- PT, prescription pain meds, acupuncture, supplements, bed rest.

The same day I saw the surgeon to schedule my surgery, I figured what the heck, I'll try anything before I get my back cut open. I went to a great, well-reviewed chiropractor, who gave me a thorough assessment and promised improvements in the next 2 months, such that I would not need surgery. I was very skeptical, but went along with it. Her adjustments and analysis did end up helping me a lot, and alleviated a lot of the pain coming from the sciatic nerve. But more than anything this bought me some time.

During this time, I read Healing Back Pain by Dr. John Sarno [0]. Many people recommended his work to me, but again, I was skeptical. I had an MRI scan showing very real structural damage to my spine and I truly didn't believe that thinking my way out of the pain would help. I read the book anyway, and I swear, the pain began dissipating. I began to adopt a new mindset -- my back is fine, the pain is arising out of my stress and awareness of the injury, not the injury itself-- and it truly worked. It's been over a year now since reading the book, and I feel leaps and bounds better. I'm back to doing the things I love (cycling, lifting weights, running), and I'm about 90% pain free. I still have some off days and I listen closely to my body when they happen. I stretch a lot, don't sit for hours at a time, and do basic mobility work every day -- these are things I want to be doing anyway, but my disc issue is even more impetus to do them.

If you're seriously considering surgery, do yourself a favor and read this book first. If you're anything like me, you'll be wildly surprised and completely grateful you did.

[0]https://www.amazon.com/Healing-Back-Pain-Mind-Body-Connectio...

Ayurveda. Come to Kerala, India. I am only writing this because I would do it myself if I were in that situation. Not based on scientific evidence. Just a few personal observations of close relatives like my mother and aunt.

My aunt had a spinal injury that basically left her not able to move her body below the waist. As a last resort she was taken to a Ayurveda practitioner who bascially fixed her back up. She even goes fo zumba lessons now.

You basically have to give up everything else for several months and go through painful therapy and massages and also follow a strict terrible tasting diet.

I'm not a doctor but I've had a herniated disc for 23 years. Your mileage may vary.

Let me tell you what didn't work first. Pain meds didn't work. NSAIDs will tear your stomach up even with short-term use. Don't use them for more than a few days.

Being careful didn't work. No amount of being careful works because your muscles will always atrophy to make you a little weaker than you need to be to go about your daily routine.

It took me, 10 years to figure that out. You need to go full tilt the other direction.

As another fellow said here, walking, and then running. Will build strength gently. But even with diligence, I would still injure my back twice a year during the course of normal life activities.

Then, someone told me about a TENS machine. Get one that can output 100mv (I can recommend one if you'd like), and use it when your back is hurt. They are miracle workers.

The thing that freed me from pain was this-- the "stiff-legged deadlift". I very slowly worked my way up from no weight, to about 125 which seems to be all I can reasonably do.

You can't do this in a vacuum, you need to do it as a part of a whole program.

Let me know if I can be of any assistance.

Build core strength while avoiding spinal flexion as explained in Stuart McGill's book "Back Mechanic".

I had a herniated disc last fall. It took a good 2 months to get to a point where I could walk and sit properly again. It still hurts my tailbone to sit for more than a few minutes. I can sit for longer if I use an ergonomic chair. My chair's seat is shaped to take pressure off my tailbone. I can further reduce that pressure by tilting the chair back so the pressure shifts to my back. It's tough when I have to be in places that aren't at home or work. Even if I'm tired and just want to rest, I can't do so for very long. Sitting on pretty much anything incurs mild to moderate pain and I always have to explain it to people. It's been almost a year and it seems to just stay this way without improving any further. Doctors are surprisingly inept when it comes to back problems.

Similar to what some others have said - I found a good therapist (in my case I was referred to a very good exercise physiologist by a physio who checked that I was basically otherwise healthy).

I learned to fix up some movement patterns. Some changes were surprisingly small - just a few degrees difference in how I held my pelvis made a huge difference. I had to learn when to "tighten" my core when moving and lifting and when it is safe to let it relax a bit. The difference has been dramatic. I had back pain even as far back as highschool basically just because of bad mechanics. I do somewhat wish I'd learnt better biomechanics sooner but I can't really complain - I've never been in less pain since my early teens.

I went the surgery route, I had a Microdiscectomy. It was a minimally invasive surgery which I felt relief immediately after. Before the surgery I was barely able to walk and couldn't sit down for more than 10 minutes at a time. After about a week of taking it very easy I was able to return to work where I sit in a chair most of the day.

I was given the choice of physical therapy or surgery, I couldn't stand the pain much longer and wanted to stay away from opioids, so I chose surgery.

Sometimes after heavy activity it flairs up and gets sore but it's completely manageable, enough where I don't have to take anything for the pain.

Lay on my back for about 3 months and became reliant on tramadol and neuropathic pain medication (gabapentin).

I'm still taking the later and I have a sneaking suspicion that it's still keeping some discomfort at bay, it doesn't work for everyone.

Once I felt well, I very slowly returned to the gym, took up swimming on a doctors advice and am even at a point where I do quite light deadlifts and low back exercise (with great care and attention to form). I believe swimming was paramount in my recovering along with a lot of care over my posture and using a McKenzie roll in my car whilst driving.

Running (I started when I felt absolutely well). It increased my core strength. I spend 5-6 hours running every week. And to reach that point took me approx. 3-4 years. On a way I have found a physiotherapist who consults me on every injury I experience on the way. After getting into the shape I have not experienced any setbacks.

To start running I have invested a lot of time into my core strength and muscle stretches.

There is no silver bullet. If you want to have a free pain life you have to invest into your health at least 1h per day in a form of exercises. It must become your life style. Very few people do that.

Not so much recovery but making sure I don't get a slipped disc again. Don't slouch!

Even though it can get uncomfortable, make sure you sit up properly. And if it starts to ache, have a stretch and/or go for a walk around. Go get a cup of tea, ask your co-worker a question, anything that gets you up for a 3 minute walk.

And one thing I've learnt the hard way while swimming, if you've pulled a muscle in your back, do not push yourself until you feel 100% better. Thinking that you feel 90% better and you can probably get back to swimming or lifting etc. quite often makes things worse.

My MRI showed a herniated disc and an epidural of steroids briefly helped but I also had an undiagnosed case of Ulcerative Colitis that was actually the real problem (I think). Anyway, the pain is real and profoundly debilitating but, despite occam’s razor, it is possible that a herniated disc is a red herring and the underlying problem is something else. In my case, managing the colitis solved 90% of the pain, etc. If pt and gabapentin and steroids aren’t helping, spur your doctor to consider investigating non-spinal culprits before submitting to the knife.

I had a 15.5 mm herniation and had to get surgery, my sciatic nerve was pinched to the point I had numb feeling in my left leg. I'm two years removed from surgery I'd say I'm 97% squared up but at times I can still feel it.

Please get an MRI if it's less than 8 mm, you should be able to avoid surgery, but see a specialist (neurologist specializing with back). Ice it don't heat be careful lifting heavy weights or deadlifting (thats what caused mine). Good luck

I've been in it for 20 years now.

My advice:

- when an acute period kicks in, take painkillers and try to keep as active as you can. No lying in the bed all day long, that will make things worse

- don't sit too much. Buy yourself a standing desk. I've been working 9 to 17 at a standing desk for 3 years. No acute periods since then!!!

- swim and walk a lot

- don't lift heavy things at all. Let others do that for you

- keep calm

Make sure you get an MRI to understand the severity. I tried PT, electro therapy, spinal injections, yoga, deep tissue massages, but nothing was long term. I eventually needed to get a microdiscectomy which proved to be a life changer.

C5/C6 herniation about 10 years ago. Did the standard range of NSAIDS and PT. Useless and wound up needing prescription pain meds to get+stay asleep. Declined steriod injection because I wanted to debug.

What fixed it (on first treatment though I did 8 sessions) was the DRX9000 traction machine. The VAX-D probably would have worked too. Had to go to a physiatrist who insisted on doing homeopathy/BS saline injections so he could bill insurance. Though I had a cervical issue, these machines at their core are designed for spinal and the cervical treatment is an extension, I believe. What they do is slowly stretch you for 20-30 mins as you watch TV.

No relapse in the last 10 years though I've been careful about posture, use 4 wheel roll-along luggage, and sleep with fewer pillows - generally try to keep my head more aligned.

I was about a month away from doing ablation to have the goo sucked out of the offending disc. That probably would have worked, but I am related to a number of doctors, all of whom recommended staying away from surgery except as very last resort, especially near the spine.

Interestingly, internationally they have silicon and other disc replacement techniques as well whereas in the US generally treatment still tends to be NSAIDs+PT, then steroid shot, then fusion despite the collateral stress that can ensue from that on adjacent vertebrae.

Post 'fix' MRI looks almost the same as 'pre', which is interesting and gets to the micro tolerances involved.

2 non-standard treatment notes:

Tried Chiropractic as 1st treatment on common friend recommendation but never again. The practitioner started yanking before xray even though it was pretty clear (I now know) from my specific pain sites what was going on. An interesting question to ask a potential Chiro is "what diseases can and can't be cured with Chiropractic?"

Interestingly, along the way, I went once to an accupuncturist recommended by my Tae Kwon Do master and with 4 pins all symptoms went away instantly - for a few hours. Successive treatments had much less effect so I only went twice.

Good luck with your recovery!

In the grand scheme of things it was minor vs. other medical stuff, but I was unhappy about pain meds (and fingers starting to get numb after many months) so it seemed a huge deal at the time.

Big lesson for me was - with the human body, even more than the internet (but true for both), the amazing thing is not that they break but that they ever work well in the first place.

Happy to discuss my course if anyone is caught up in this, but I have no formal medical background and my case probably differs from everyone else's. Email avi at freedman dot net