UKH

I have a nasty disc bulge in my lower back that has been giving me problems on and off for 18 months, but has become significantly worse for the last three months. Mainly sciatica in left glute and lower left leg/ankle and localised back pain at the source. I have been seeing a musculoskeletal physician and physio since October with not much effect. I had an MRI just before Xmas which clearly shows the bulge and the doctor has now sent me to see a spinal neurosurgeon. Meeting went well and he said I have a case for microdiscectomy, but he advises to try epidural steroid injection first.

He put me on some new pain killers (gabapentin 100mg) for the sciatica and those have been effective, although I do feel a little bit spaced out on them, but able to work which is good.

The idea is to have the injection, hopefully be pain free for a period of time in which I can see a specialist physio who will give me  exercises to try and relieve the bulge and get the disc to reform.

If unsuccessful I have the microdiscectomy as next step.

Surgeon told me that outcomes for surgery vs non surgery are almost identical over 18 months, so the surgery might be a quicker fix, but with the added risk, it is not suitable for all cases . Mine is uncomfortable every day, effecting quality of life and very annoying, but not extreme with foot drop and real weakness...so I am prime contender for just the epidural only apparently.

Part of me wonders if I should just stick with the painkillers I am on and ramp up the physio?

Has anyone been down this route, or decided against and have any advice of what to expect? Did it work ?

Thx

Been there, got the t-shirt etc etc

I had sciatica on and off since 2011, but I had it insanely badly due to bulging L4/ L5 on and off for 9 months in 2018/ 2019. 

I had a microdisectomy in April 2019. Amazing result. Go for it.

I had 2 injections before then, first one (2014) worked a treat. Second one didn't work. 

Best pain killers I found was diclofenac suppositories. 

Good luck.

"I had a microdisectomy in April 2019. Amazing result. Go for it."

Glad to hear you're fixed What was the recovery time like? 

When you say first injection worked a treat, did you just re injure the disc much later on afterwards which put you back to square one?

I’ve had the exact same conversation with my surgeon for a herniated disc. I’m going to give it 3 more months of conservative action before taking the injection. 
 

I think active people can be given poor advice sometimes in regards to chronic conditions, as we tend to still be active and just get in with it in spite of the same level of pain which would render the rest of the population more sedentary. My doctor couldn’t get his head around how I was still surfing and climbing with my injury and why I wasn’t in pain. I told him I was, it was terrible but it would be worse stopping. 
 

please do let us know how it goes if you get any treatment. 

Thx for your reply. Yes I have remained active throughout. The surgeon was pleased when I said I was still cycling. His opinion was that although laying down might reduce the pain, it is paramount to maintain motion in the spine even if it is painful. Makes sense to me

My biggest issue is walking and standing still. A dog walk of 20 minutes can really kill me, but an hour on the wattbike is absolutely fine. So I have adjusted to doing more swimming and cycling and zero running and very little walking. I no longer sit in chairs when I can lie on floor instead and do pelvic floor exercises

I have been amazed though at how persistent this flare up has been. The surgeon is sending me to a different physio who I am hoping will give me some new and more effective exercises specific to my injury. 

If the gapapentin is working, and if the advice is that 'that outcomes for surgery vs non surgery are almost identical over 18 months, so the surgery might be a quicker fix, but with the added risk', then I personally would not risk the surgery.

Good luck with whatever you decide though: it's a debilitating condition.

I was climbing again after 3 months. Very weak but pain free.

10 months later and I am back to full strength. 

The injection worked when the bulge was not so bad I think. I spannered it really badly the last time playing with my daughter on the trampoline.

Just thought I would come back on this and maybe give you a little hope/ ideas to help yourself. 
 

I’ve had a major improvement in my sciatica symptoms over the last week. I have been following a protocol of anti inflammatory meds (naproxen), traction (hanging off my stairs) and spinal extension (cobra raises). 
 

This seems to have shifted enough of the offending material away from the nerve so that my pain has all but disappeared. Im left with a numb foot and a severely weak leg but I’ll take that over the terrible pain. I guess this is a hangover from having a disrupted function for the last 6 months

I’ve gone from a bulge at L5 and hernia at S1 causing me sleepless nights and searing pain to virtually symptomless within 2.5 weeks which I am massively chuffed with. 
 

I’m still going to physio to hopefully protect my gains and future Proof myself. 

My son had this surgery done over ten years ago, and it was not a success. His pain after the operation was a least as bad as before and has continued on and off ever since. He has another disc bulge higher up the spine, which has got worse and he has been advised that he should consider surgery on that. He is adamant that he is not going to do that. 

Sorry for the negative feedback. Back surgery is very primitive, in that all they can do is remove bits, and it seems to be very hit or miss whether it works or not.

The wife has had one recently.

Initial flare up was Sept 18. This left her with a numb foot and a lot of pain. Off work for 6 months and pretty useless functionally and unable to walk. She had lots of gabapentin and tramadol.

Eventually listed for microdosc after quite a fight. Epidural was offered but it’s a short term fix in some instances. 
Each case is different and some discs respond to physio or reabsorb into the body.

Hers wasn’t. 
Touch wood she is a lot better now and off her meds which was a major hurdle. 
She still has some sensation loss but the foot drop has resolved.

Personally we consider the 12 month delay in removing the bulge as the cause of her sensation loss.

I can’t advise you on how to proceed but my wife is currently better with having surgery rather than conservative measures.