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S1 L5 Broken Disk Question regarding treatment/surgery
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S1 L5 Broken Disk Question regarding treatment/surgery

I had Harrington Rods installed when I was 17, and now 41.  Went to the dr. 3 weeks ago and after MRI it has been determined that I have a broken disk that is herniated.  Instead of surgery, it has been suggesed by my Neurologist that I get an injection (to be honest I am not sure what the injection is as I am to meet with that doctor early next week).  
My question is that if the disk is indeed broken, is it possible to heal back together and this is just a step in the process for a surgical fix or what?  I have had little or not back issues since my harrington rods were installed and have always just dealt with a certain degree of back pain from time to time.  It is impacting my work because some nights I can sleep okay and other nights I only get a few hours of sleep and can't seem to get on a good schedule.  Muscle relaxers help sleep sometimes, but if I don't get enough I am very groggy when the alarm goes off...:)

Only have pain when sitting and sleeping and remain active coaching baseball and other activities with my boys.  When I am more active with baseball practice and such the pain at night seems to be reduced.  Pretty hard sell with my work, telling them that I can get out there and coach baseball, but can't sit in my office all day...:)  Any input is appreciated as this is all relatively new to me.  
Other symptoms:
Muscles in both of my legs are deteriorating slowly as well.  
Nerve test concluded that muscles in both legs are affected but left calf is noticebly smaller.  
Tingling in both feet periodically at night.  Primarily right foot, but both from time to time.
Shooting Pain (not severe) periodically down the leg to the knee, but mostly to the lower buttocks.  (left side)

I currently go to Physical Therapy twice a week.

Thanks for any help or advice.
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Avatar_dr_m_tn
Thanks for using the forum. I am happy to address your questions, and my answer will be based on the information you provided here. Please make sure you recognize that this forum is for educational purposes only, and it does not substitute for a formal office visit with a doctor.

Without the ability to examine and obtain a history, I can not tell you what the exact cause of the symptoms is. However I will try to provide you with some useful information.

In most people, the pain of a herniated disk resolves over 4-6 weeks. The most severe pain actually eases up within 1-2 weeks. Only a minority of people ever require surgery. With time, the amount of disk that has herniated shrinks and with time resolves completely in most people. Therefore, for the majority of people, non-surgical treatment is the first option. This treatment may include medications (non-steroidals such as advil), sometimes steroids if there is swelling (edema), temperature therapy (hot or cold packs), stretching and controlled physical therapy, muscle relaxants, and so on, these are best prescribed by an experienced physician, each has its own indications. Additionally, various interventional pain therapies, such as “injections”, may be used if the above fails.

In a minority of patients, surgery needs to be done urgently. This often is the case when the herniated disc is pressing on the spinal cord itself. Surgery is emergent so that permanent spinal cord injury does not occur. Another indication for urgent surgery is if there is evidence that a nerve is being compressed on to the point that its function is impaired. Symptoms suggesting the need for urgent surgery includes muscle weakness, loss of bowel or bladder control, loss of sensation, particularly in the pelvis and severe and progressive pain.

You should discuss the non-surgical options with your physician. A referral to a chronic pain specialist is an option to discuss the various interventional pain therapies.

Thank you for this opportunity to answer your questions, I hope you find the information I have provided useful, good luck.

2 Comments
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Avatar_m_tn
Thanks for the information....but if the disk is indeed broken, is there an injection that will help heal the disk back together?  Actually get to meet with the Dr. tomorrow, and plan to ask that question.  Just don't want to bother with an injection of any kind if it cannot result in a fix of the disc.
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