Any of you had lower back surgery?

[hammertime]

Any of you guys had lower back surgery for a herniated disc before? Intrested to hear your training regime on your road to recovery.

I'm now 13 months post op from a discectomy and still struggle with pain daily. Move a certain way or suddenly and my whole body locks up.

Can workout relatively pain free by avoiding obvious no-no's like deadlifts but keen to find something that works to reduce pain and strengthen the lower back and also to just hear your story.

For the last 5 years docs have been treating the symptoms and loading me up with tramadol which i became dependant on rather than addressing the cause. Eventually this lead to me developing cauda equina syndrome and the emergency op. Im now down to just 3 tramadol a day from 8 but obviously this means the pain is murdering me so need to solve the problem once and for all and find out what has worked for others in a similar situation.

 

[Switcher]

After all the dust settled, I have had a lot of stuff done but no discs removed and no fusions. I started out doing basic exercises to get the back working for almost a year it seems. I moved up to some exercises to strengthen the back muscles after the first year. The next year, I actually moved on to back machines in the gym, lower back and rows. It was humbling to be using less weight than grandma (literally) but it was something and the gains came really, really slow.

I opted for TRT last fall. Since I started that, my back has really responded and I am doing very, very well as long as the pain stays away.

 

[hammertime]

After all the dust settled, I have had a lot of stuff done but no discs removed and no fusions. I started out doing basic exercises to get the back working for almost a year it seems. I moved up to some exercises to strengthen the back muscles after the first year. The next year, I actually moved on to back machines in the gym, lower back and rows. It was humbling to be using less weight than grandma (literally) but it was something and the gains came really, really slow.

I opted for TRT last fall. Since I started that, my back has really responded and I am doing very, very well as long as the pain stays away.

Yeah starting low weight stuff now too and hoping trt helps it along.

 

[AlphaDC]

There are different approaches to discectomys that resolve differently, but 13 months post op...you should not be having any residual pain; this should be re-addressed by your surgeon. It is safe to say that something along your path has failed.
What does the pre-op MRI report state? What disc level(s) underwent surgery? What type of procedure was used? Was any hardware implanted? What was your post-op PT? What does your post-op MRI report state?
Cauda equina syndrome is an emergency that should be taken care of asap! I recommend you go back to the surgeon and state your concerns. Your situation is not normal, and is not acceptable.

 

[Dr JIM]

For a variety of reasons anyone who develops QE is LUCKY to have nl bowel and bladder function in addition to an intact gait. Count your lucky stars all of these remain GTG.


Moreover bc the surgery used to reverse this process is aggressive requiring a wide incision and spine exposure most patients will continue to have a certain degree of pain thereafter and it's presence does not indicate something is wrong or missed by any means.

Unfortunately even considering the BRIEF history you have provided it's quite likely you will always have some degree of BP.

 

[hammertime]

There are different approaches to discectomys that resolve differently, but 13 months post op...you should not be having any residual pain; this should be re-addressed by your surgeon. It is safe to say that something along your path has failed.
What does the pre-op MRI report state? What disc level(s) underwent surgery? What type of procedure was used? Was any hardware implanted? What was your post-op PT? What does your post-op MRI report state?
Cauda equina syndrome is an emergency that should be taken care of asap! I recommend you go back to the surgeon and state your concerns. Your situation is not normal, and is not acceptable.

The op itself was a success in terms of removing the part of the disc causing the syndrome however they did say after the op that they couldnt remove the rest of it as i was bleeding heavily during surgery, which meant some sciatica symptoms remained although there was a huge improvement for 6-9 months post op. Issue was at l5/s1 and nothing was implanted

 

[AlphaDC]

Gotcha man. That is truely unfortunate. Is there discussion for another attempt? As for training routine, typical core & lumbar/hip stabilization exercises may help. Limiting lumbar flexion motion may reduce symptoms. Any advice may help, but you have a unique situation. Best path to take is trial and error with identifying what your limitations will be.

 

[hammertime]

For a variety of reasons anyone who develops QE is LUCKY to have nl bowel and bladder function in addition to an intact gait. Count your lucky stars all of these remain GTG.


Moreover bc the surgery used to reverse this process is aggressive requiring a wide incision and spine exposure most patients will continue to have a certain degree of pain thereafter and it's presence does not indicate something is wrong or missed by any means.

Unfortunately even considering the BRIEF history you have provided it's quite likely you will always have some degree of BP.

Yeah when i developed it initially i had bladder problems and one side of my groin and old boy was numb. Thankfully bladder problems subsided about 5-6 hours post op but those 5-6 hours were amongst the most scary i've went through, having a full bladder and busting to pee but standing/sitting for an hour trying to make it happen aint fun. So grateful that normal function has resumed and i consider myself very lucky to have recovered from such a rare and potentially life changing condition relatively scot-free.

Now feeling a similar disc bulge on the opposite side and want to do what i didnt last time, try and exercise/strengthen my way out of it.

 

[hammertime]

Gotcha man. That is truely unfortunate. Is there discussion for another attempt? As for training routine, typical core & lumbar/hip stabilization exercises may help. Limiting lumbar flexion motion may reduce symptoms. Any advice may help, but you have a unique situation. Best path to take is trial and error with identifying what your limitations will be.

No discussions yet, however they did say if there were any further issues to get back in touch with the consultant but id like to avoid another op if possible. when the cauds equina symptoms started i waited 3-4 days before going to the emergency room and was rushed to another hospital for emegency surgery the next morning. with this condition, waiting 3-4 days could have been so much worse so i know what to look out for if it happens again and get straight to hospital.

As lifters, i think we punish our backs and can sometimes underestimate the damage a herniated disc can do.

Thanks i'll look into the exercises you mention. I also think i have an imbalance between abs and lower back so havent trained abs for a few months while i try to strengthen the back. Also giving psoas stretching a go, i sit at a computer all day for work so it makes sense that this and my hammys will be tight. Only just found out the psoas is directly connected to the lower vertebrae so thats a red flag straightaway.

 

[Dr JIM]

If you like steak that Psoas muscle is referred to as the tenderloin, in cows.

Their functions are similar also but in cows the Psoas attaches to the transverse processes of the lumbar vertebrae and finally inserts about the sacrum. Moreover in cows the lumbar plexus is formed AROUND the P muscle.

Thus in cows or "ruminators" it's primary function is to prevent a "sway back" or L/S hyperextension.

What is different in humans, may help explain the rationale of LBP medical/surgical management

While the Psoas still runs it's course attaching to the vertebral body transverse processes the P muscle ends at the proximal (upper) inner aspect (medial) femur or "hip" region.

This difference is SIGNIFICANT bc as the Psoas follows it's course it is "joined" by the Iliacus muscle and these TWO MUSCLES are the only primary HIP flexors (the RF and ABS do flex the hip BUT that's not their exclusive function).

So what Jim, is there a point excluding this anatomy lesson?

Why I'm glad you asked, lol.

FINALLY as the Psoas extends toward the pelvic region, not only does it enlarge, BUT segments of the LUMBAR NERVES (after exiting the spinal canal) actually PASS THRU THE PSOAS to form the required PLEXUS (network) of nerves needed for BODILY FUNCTION.

So at least from a theoretical perspective Psoas muscle "spam" can create many of the symptoms of LBP. (EMG data also reinforces the importance of MUSCLE rehab for patients with LBP)

What may be equally important is those patients with weakened abdominal musculature or to a lesser extent the Quads (RF), increase the required stress of of Psoas muscular participation even during ADL.

It's for these reasons patients with LBP should include abdominal and RF exercises during rehab, IMO.

Those patients WHO DO NOT, (and have had three or more "corrective" surgeries) often develop "Failed Back Syndrome".

In summary for some of the reasons I've mentioned and some I have not, VERY FEW patients NEED surgery for isolated disk disease and in fact many don't even improve, or worsen, in spite of it.

The ONLY ABSOLUTE indication for operative intervention for disk disease involving the LS spine is CES or MARKED REDUCTION of motor function (can't walk for example) bc of MULTI-LEVEL disk disease.

Moreover those with ISOLATED PAIN, rarely if ever benefit from operative correction And again if they did "improve" it's very likely an improvement would have been noted regardless.

The latter improvement, is the result of DISK SHRINKAGE which normally occurs after complete herniations, thereby relieving the underlying nerve root compression.

So at least have greater appreciation for that "beef tenderloin" next time around

Good luck
Jim

 

[BLACKHAT]

I had a micro-discectomy on L5-S1. Had trauma on the nerve for a year prior, definitely tore up the myelin sheath. When disc finally let go I was not able to move, they carted me to the hospital and I waited for emergency surgery. Pain was 10/10 for sure. Nothing beats nerve pain. Post-op I was so much better I didn't need any drugs, which is crazy seeing I came off a cocktail of morph/dem/vic/perc. Doc said disc was totaled, trimmed it up. Cleaned the bone spurs off, enlarged the 'trough' where the nerves lay. Took at least a year for the twinges and odd pain to go away. Despite what they say, the nerves can heal themselves. I had an arch or pivot to my back which as you can see is pronounced. The key for me was fixing that posture. The bigger problem was I was a complete fuckin pussy post-surgery. I was scared to hit the weights again and didn't for years. Worst mistake of my life. And while I'm on my life story... I NEVER had back pain or problems when I was lifting. Don't get me wrong, I was sore, but never back pain in the problem sense.

There is a path to being pain free and for me it started at the gym. Losing the fat also made a difference. I never understood why and really don't care to know, cause I ain't going back to that.

 

[BLACKHAT]

I'll add to Dr JIM's excellent response, multiple ops are bad news if only for the potential for a lot of scar tissue. I understand scar tissue can be just as bad for creating pressure on the nerve and/or causing irritation. So I'm thankful the first round worked for me.

 

[Bubba8]

I can't explain a lot things but I can say this. I had laminectomy years back. I have never been pain free since it all started nor after surgery. I went back to the surgeon and after year fighting with him that something wasn't right they send me for MRI and the ones above and below were all herniated . They wanted to go in and put metal screws and all that. I opted not go surgery route again. Instead I do lots stretching and doing ton light weight, also I do lots of the exercises I learned at PT. I guess in few years when I get in a better position to have another surgery or I get so bad I can't walk I might consider another surgery but until then I just try be smart. Good luck to you bro

 

[biglumber69]

I broke my back I have L1-S1 fused. I had no choice but to get surgery. It helped with the pain alot. It took it from unbearable to manageable. But I did not exercise I used my back as an excuse. Before I broke my back I was 260lbs with abs. Anyway I star exercising. This past January and it has eliminated even more pain. Good luck with your back. Also I agree with Dr.Jin scar tissue does cause pain. I know first hand