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Comment by thelastgallon | Hacker News Reader

Go for surgery if you have neurological symptoms (loss of sensation, motor function, etc). If its pain, try your best to avoid surgery and find the right physiotherapist to help you be pain free. Spine surgery is risky and there is a risk of cascading failures.

Don't completely trust any anesthesiologist (pain management) or neurosurgeon (for surgery) or chiropractor or random folks advice to do yoga/stretch. Spend quite a bit of time understanding the anatomy, read up on everything and maybe you will find the right set of exercises to help relieve pain. Troubleshooting disk/spine/nerve issues is very hard and most doctors don't have any time to investigate it deeply. They just look at MRI. There are lots of people with the same problems showing up on MRI, but they are pain free.

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Have already tried chiropractic, PT, several back exercises daily for a year or more, got recommended by 2 customers to a doc who is a specialist in radio ablation of the sensory nerves in the lower spinal region (medicare requires 2 epidurals 2 weeks apart before they would approve the RA). The RA worked great for less than a year, had another RA, worked for several months. 1 month ago had my 3rd RA, after that is when the pain got rather serious, follows the sciatic nerve across the buttocks and down each leg to the foot. Lately it alternates from each side, several days on one side, then several days on the other side.

I have not requested serious pain pills, applying clove oil (eugenol) mixed with benzocaine all over the lower back and buttocks, (lidocaine 5% is useless) wait 10 to 15 min, then can arise in morning from bed for a day's work, yet nagging pain most of day. I refuse OTC NSAID's as they can damage the heart over time. My spinal X-ray looks like an F1 racetrack. Doc says scoliosis, yet no one in my family has this genetically. At some point it just get's so frustrating you start to realize that surgery may be the only way out. Spoke to an 80 year old once who said he had the procedure, they had him up and walking the hospital floors after he awoke from the anesthesia, let him go home next day (I guess his was uncomplicated and straightforward).

I have to cautiously agree with you, with the caveat that many physios don't seem to know what they're doing either and the effectiveness of therapy can differ wildly based on which therapist and what regimen they use. Speaking as someone with a herniated disc that went through a discectomy which re-herniated immediately following surgery. Frankly I've only just now started getting relief by reducing the amount of weight pushing on the disc by way of treatment with semaglutide. Could've saved myself thousands of dollars in medical costs and rehab if I'd just done this a year ago.

> Speaking as someone with a herniated disc that went through a discectomy which re-herniated immediately following surgery.

Sorry to hear about re-herniation. Thats what I am concerned about. I have multiple disc herniations, one with cauda equina. Multiple neurosurgeons have recommended surgery, but each is going to do a different procedure. I understood as they don't fully understand whats the root cause, everyone wants to do the procedure they are comfortable with and what they've been doing. One wants to cut the disc, another remove lamina, another fusion and something else. I decided its not worth taking the risk when they don't know what they are doing. There are so many reports of failed back syndrome, revision surgeries, cascading failures (because it increases pressure on adjacent discs).

> with the caveat that many physios don't seem to know what they're doing either

Yes, this is true of nearly any profession. We just have to spend significant time researching and troubleshooting with an engineering mindset.

While I have no medical opinion to back this up, I place a significant portion of blame on the mechanics of being released. I was upright in a wheelchair, then forced to stand up to get into my wife's car, then had to drive home upright, then had to stand up again to get into a wheelchair to get into my house. I believe the fact that my back was forced to take weight immediately following surgery did a lot of damage. If I could do it over again I would have insisted on remaining prone for at least the first 24 hours.

Indeed, most physiotherapists (and people in any profession) are completely useless. They don't have any understanding of the body as a system, don't investigate, and just give you some cookie cutter exercises from some app that they have.

But there are some good ones. I had one 15 years ago - a lady from Japan who was an absolute wizard. She changed my life completely - not by "doing" anything, but instead teaching me how the body actually works and helping me to awaken many dormant muscles. The closest I've found since then is moveu.com - weird guy, but he knows his stuff and has the right approach (that only we can fix ourselves, and he can only educate us on how to do so).

why "not" yoga/stretch ? I understand it may not be the right thing for every kind of pain but the way it is usually presented (your body needs movement) sounds convincing. (I don't practice yoga but taichi)

I don't understand the downvotes. If you have any counterpoints, please do share so I can learn instead of downvoting.

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