how to treat bulging disc in 16 year old boy

[vixtir]

My son suffered a football injury to his back on 9/3/04, original dx was lower back strain, 10 days later after being cleared for football, he was hurt again, which an MRI was then ordered.
MRI shows mild posterior protrusion of the L5-S1 intervertebral disk which efface the ventral epidural fat slightly.  I have heard that bulging disks never go away, is that true?  He has started Physical Therapy 2 times a week, at his first session the therapist said his hamstrings were very tight (35 out of 70 scale range) and that isn't helping his back injury.  She said the prognosis is very slow and he can't take direct trauma to his back ever.
All he wants to do is play football, (he is fullback position) we havent been told officially yet, but will he ever be able to play or would a brace during football help for those crushing blows he has been taking.
We will be working with back strenghting exercises, etc....but will they ever receed, or is he looking at a life of back pain.  I have been told by several people, that bulging disks at his age is VERY uncommon.  Please help, Vixtir

[CCF-Neuro-M.D.-CS]

Discs bulges can decrease in size over time, and for this reason conservative therapy with anti-inflammatories and physical therapy is recommended first. It is uncommon for children to have disc problems, but is not unheard of. Regarding his ability to play football, without evaluating him and reviewing his scans I cannot make this determination. I would recommend obtaining a consultation with a sport medicine doctor, who should have more experience with this. If you are in the area we have a wonderful sports medicine department. Good luck

[ColeyNewt]

Hi.  I am a 22 yr old female.  In September of '03, I took an 18 hour drive to see my younger brother graduate Basic Training.  After returning home, I had severe pain in my left leg, and ended up going to the ER.  After seeing my family doctor the next day, he advised me that I have a case of "Sciatica" and that I should start taking advil to help with inflamation (inflammation).  Advil helped a lot with pain, but didn't cure it... so a few months later they sent me in for an MRI.  The MRI showed 2 herniated disks at my L4/L5 and L5/S1.  Being so young, they made it clear surgery was not an option.

The first thing we tried was physical therapy.  They gave me an oral dosepak of oral steriods about 2 weeks before... then I met with them 3 times a week for 4 weeks.  Like your son, my hamstrings were extremely tight.  Unfortunetly, physical therapy only made my pain worse.  Instead of most of my nerve pain being in my left leg, it now fluctuated from my left leg to my right leg depending on how I was standing or laying down.

After physical therapy left me in more pain, we tried epidoral steriods.  These steriods are injected straight into the spine where the herniation is.  The idea is that the steriod, in such close proximity, will ease the inflamation (inflammation) of the disks... giving nerves a relief from pressure.

I've had 2 of these... the first one worked for about 3 months.  I wasn't pain free.. but I was able to do normal exercises to try and build muscle tone in my back.  The second one only lasted about 1 month.

My father is a Chiropractor.  He told me the chances were good that my disks would cure themselves.  You should have your son really work at the exercises they give him at physical therapy... he should do them at least 3 times a day.  Have him ask about possible traction excercises.  You might want to talk to your doctor about epidoral steriods, they gave me a lot more relief than the oral dosepak.

I ended up changing spine specailists due to a scheduling conflict.  My current doctor gave me the option of one more epidoral, or surgery.  I opted for the surgical procedure since I had lived a year with pain.  I had the lumbar laminectomy/microdiscectomy 9/20/04.  Upon waking up... I had no more pain in my legs.  I feel 110% better and look foward to building up my lost muscle mass.

From what I understand, the condition is beatable.  I am sure your son will do fine.  God bless   :)

[vixtir]

thanks for your help.  After we went to the Ortho MD who is also the school MD and does sport medicine, he said that my son also has lumbopelvic dysfunction?!?

He was more concerned about that, than the bulging disks.  He said that bulging disks are common, no matter what age??  He is continuing w/therapy and the pain is getting better, except when he sits in school for hours at a time on those hard chairs.

My friend has recommended a chiropractor as he says that's what he needs for the bulge and lumbopelvic problem.  Apparently the lumbo pelvic can be adjusted back into place??

I have stressed how important the excersices are, especially for the hamstrings, and he does them everyday, but not the recommended 3 to 6 times a day.

MD has not recommended any type of oral or injectable steriods, only anti inflamatories.  Going tomorrow for recheck, we see what he has to say them.

Thanks for your suggestions.  Vicki

[ColeyNewt]

Yes, the sitting irritated my back a lot.  I found myself standing in classes because of the pain.  I took anti-inflamitories for about 3 months before the reccomended physical therapy or steriods, so your doctor might be following suit with that as well.  I took about 800mg twice a day, once when I woke up, and once when I went to sleep.  It seemed to help during the bulk of the day, and gave me a good nights sleep.

As for the chiropractor... my dad used traction exercises with me.  That's just basically trying to spread the spine apart to manipulate the disk back into place.  It did bring relief right after being adjusted, but would go back to "normal" after sleeping on it.

The lumbopelvic dysfunction might be due to the disk herniations themselves.  I know after my herniated disks, I would lean to one side to try and minimize the pain in my legs.  My spine was like a question mark, and my doctor told me the disks might have been caused by my poor posture and one leg being shorter than the other.  (I've always had perfect posture, my father is a stickler about standing up/sitting down straight. And my legs are the same length.  But, they hadn't seen me before the injury, so they couldn't know.)

I would definitely look into a Chiropractor.  It's a possible way to releive his pain without drugs or surgery.  I think it would be worth while in the long run, especially if it cures his pain.

[jleue]

I was reading ur comments on what had happend to u and I see that iam about in the same boat as u were.  I have three bulging disks and the L4-5 is laying on my sciatic nerve.  I have had this for about a year long now and they just finally found this out with an mri.  Iam in the army so a lot of the doctors dont really pay as much attention for the fact that a lot of the soldiers come in with aches and pains that are not really anything.  They have told me the same thing that iam to young for surgery and they are going to try the steriod shots in the back first.  I was wondering if u or anyone else could answer why the age factor is a big deal and why is surgery not a good opiton??  Iam glad to hear that u are pain free cause u obviously felt the pain, and I can tell from first hand that its the worst pain ive ever been through..  Maybe its not just the pain but more of an annoyance to not being able to do everything that u once could do.  To the person with the 16 old son I wish the best of luck for him cause I know how much it means to be able to play football and what a loss it would be to not be able to play...

[ColeyNewt]

I'm sorry to hear that you have been in pain for so long and just now finding out what is causing it.

I think the age factor is due to the fact that being so young, the disks should be able to settle back themselves.  Also, as with any surgery there are risks.  They cut off the bulging disks, and shaved some of the bone to make more room for the nerves, so further disk degeneration is a risk.  They also told me that the same thing could start happening further up the spine, leading to future surgeries.  

Building up muscle strength in your back and abdomen is key to help relieve some of the work for your spine.  Give the epidoral steriods a shot... you might be surprised by how much they help.  My doctor's limit for the epidoral was 3... he figured if it didn't work by 3, it probably wouldn't help you.  After 2, he gave me the choice to have a 3rd, do nothing or have the surgery.

I don't think surgery is something they will refuse to do for people who are younger, I think they want to explore all other options first.  I guess in the end, the less invasive the procedure, the less trauma on the body, the better the chances of recovery without complications.

I wish you all the luck, and a speedy recovery!  :)

[pdw]

i am 25 years old and experienced an intense pain in my left buttock shooting down my leg.  i went to the ER and they said i had a lumbar muscle sprain.  the pain has went away in the buttock but is now really intense in my outer left foot... as if the S1 disc is herniated.  i have tried massage and found temporary relief.  i am now planning on seeing a chiropractor for 3 weeks, twice a week.  we are going to try to stretch out my spine and hopefuly my bulging disc will not bulge.  the pain is annoying and intense at times.  does anyone have any other ideas to cure this problem?

thanks,
paul