advice needed please
After several weeks with a slight niggle in my lower back and having had a sharp shooting pain running from my hip througfh my thigh when i bent down i thought i had pulled a muscle but a few days ago i went to the doctors as it was not getting any better despite the rest.
i was shell shocked when after a few reflex tests he said i have a herniated disc and the disc is leaning on a nerve which is causing the sharp pain through the hip/thigh, he has arranged for me to see the computerized aided tomography team at my local hospital and has ordered me to have a MRI scan asap.
due to the christmas break i dont have a date yet and i have so many questions to ask.... please if anyone has had this or knows about the injury can you advise me on what are the ways to repair the problem ? can i still run with a herniated disc ? if i cant run is there any other cardio work i can do to keep my fitness ? if i cant run how long can i expect to be out for ?
this has been a big blow to me as i was all geared up to start marathon training next week as i have places in brighton and london 2012.
any advice would be very welcome... thanks mark.
Hi Mark - don't panic! What you possibly have is quite a common injury - you will know more after your MRI. The MRI is just to back up the GP's findings. If you have a damaged disc it means that the disc is bulging out of it's normal boundary and pinching a nerve. This can be caused either by a traumatic event or by repeated straining on the spine. Your question "can I run?" - did you not speak to the Dr about this? TBH - I had traumatic disc injury 3 years ago and there is no way I could even think of running - I actually passed out due the pain the day after I hurt my back when I tried to get out of bed! So, this suggests your injury is less damage!
Have you tried to run? I suspect you will not be able to - it will hurt more and all your muscles will tighten up to protect the injury. What you can do is rest or modify your aerobic activity - try cycling, but there again I couldn't cycle. Swimming possibly? Be careful because if your back muscles go into spasm... believe me - you will know about it. Heat and ice application to the area helps as does lumbar stabilisation (core strength) excersises which do not affect the herniated disc. A physio would help you with this as you do not mention which vertaebra the damaged disc is at.
I don't know how old you are or if the damage is caused by wear and tear on the disc. We all get minor changes to the spine as we age. My daughter damaged a disc earlier this year - she is 24 and was in agony. It took a good 8 weeks to put her right but then she did too much (she is a talented track athlete), came on too strong too soon despite her Mum telling her(!!) and she put herself back to square one at least twice. Five months on she only just starting to fully train again - again I think she was in much more pain than you describe.
When you've had your MRI and discussed it with your Dr - I'd definately get into some core strength work to give your spine all the support you can give it. Both my daughter and I are avid Pilates fans - it's made a huge difference to us both for our running and in day to day life. We tend to take our spines for granted - something I wil never do again!
Mark- don't panic- most episodes of sciatica settle on their own, and most are quite quick to do so.Core excercises, pool running, but no weights are probably the best way forward until things really settle. It might be useful to get yourself to a physio while you're waiting for scans- physio should almost always be the first line treatment for disc problems anyway.Some places have an open- access back pain physio service, or you could go to a sports physio if you know a good one.
Even if it doesn't, and you end up needing surgery , it is possible to get back to running at a high level, but obviously not in time for a spring mara.
Hi Mark, i agree with all the above advice. Wont bore you with the details but i had disc injury to 2 discs about 3 years ago. Took 3 cortisone injections and about a year of walking before I got back to regular running. I had lost strength in 1 leg, little bit of muscle loss in calf etc as nerve was not firing and usual sciatica. Took just over a year to be back to 'normal', though some symptoms may not fully clear up, you will learn to manage it. I have completed 27 marathons this year, so cant be too bad can it ?Listen to your body, if you feel good one day, do a bit more, if you are feeling sore or not right then take it easy or have the day off. it will heal eventually. A lot of it is learning to recognise normal pains from bad pains, what is ok to run with, and what is not. Part of it is also about regaining confidence in your back and knowing that if it gets sore you are not necessarily going to fall apart or have another prolapse which is excruciating believe me. Keep as active as you can. - and my personal experience is that gentle stretching of back and legs is one of the most beneficial things you can to to help recovery, though get advice from a professional first about what stretches are ok for you given the nature of your injury.
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It depends what is actually bulging! If symptoms are intermittent or 'relatively minor aching' it's probably unlikely to be a herniated disk. Are symptoms aggrevated by running or by periods of activity (particularly twisting/bending movements??) This is most likely caused by poor 'core' muscular strength and hips that are tight.
Poor core strength and bad technique when running or hours sitting at your desk or driving maybe creating instability inbetween vertabrae (commonly inbetween L4/L5 or L5/S1) and putting excessive presure through your discs. Movement between vertabrae (and across discs) is controlled by deep spinal and abdominal muscles. Some movement across each vertabrae is normal and the discs are designed to 'bulge' slightly with movement but factors like age/activity levels/muscle strength/flexability will all make a difference to how much movement/instability the deep spinal muscles can take before they 'lock-up' and go into spasm. In the short term, this is much more likely to be/have caused your pain. Its your bodies own self-protection mechanism trying to stop you moving and risk herniating your discs!
Most of my clients with chronic low back pain have had stiff hips. My thorey, is lack of movement in the hips means your lower back has to compensate by bending and twisting more than it has/should do (especially in L4/L5/S1 area...) A stretching programme for your hip flexors and hip rotators will ease/remove low level chronic back pain caused by this.
A careful programme of progressive core strengthening (like pilates) and then exercises like squats and lunges and low level plyometrics would also help strengthen & stretch legs/hips and hopefully help get you back running!
If pain is worse the day after a run, radiating down your legs, I would defineatly look at stretching your hip muscles - especially piriformis and glut medius. When these tighten, as well as impinging on the sciatic nerve they could be locking indirectly locking up your lower back vertebrae.
I would expect to see improvements in a week of exercising 2/3 times a day. Trouble might be that core strengthening exercises do not train your body to run. In addition to core exercises you chould now be incorporating 1 leg squats, lunges and jumping/hopping exercises to get your body more used to the impact type movements of running.
I cannot stress the importance of making time to stretch your hips/thigh muscles every day as well, especially after exercise. Hold each stretch for 45-60 secs.
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