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Lumbar disc herniation (L5-S1)

      Re: Lumbar disc herniation (L5-S1)

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Posted by CCF Neurosurgery MD on December 02, 1997 at 10:11:03:

In Reply to: Lumbar disc herniation (L5-S1) posted by Tom on December 01, 1997 at 17:49:05:

: Due to weight lifting incident I have herniated L5-S1. I am 38yo WM. In good phsycial shape.. workout 4-5 days / week.
  This herniation was verified by MRI. One MD wanted to do surgery. But i went to a Physical Therapist, and thru the therapy exercise
  which consisted mainly of stretching... i did fine!.. now 6 mos later.. i am having similar symptoms. following heavy aeroibic (class) activity
  Is this a recurrent problem? I have heard it is. and can i just rework the PT exercises.. or does there come a time when I will and should have surgery.
  I have heard that there can be complications with surgery.. neurologically, scar tissue. etc.. so i dont want to have surgery.
  will it be a chronic problem that i can live with w/o surgery?
  i have heard the standard of care for surgery is only with intractable pain, loss of bowel or bladder control, or
  gerneralized muscle weakness.. I have non of those...
  my PT is willing to work with me on this thru stretching.. is this enough
  Im anxious and scared as u can tell!
Dear Tom,
Herniated lumbar discs are common.  Symptoms include pain, numbness and weakness
in a particular distribution of the leg, depending on the level of the disc.  
One may encounter bowel and bladder incontinence if the herniation is severe,
though this is unusual.  Herniated discs can be caused or exacerbated by
weightlifting or excessive straining.
Much of the material in an acute herniated disc is composed of water.  If left
alone, the body will resorb much of the water from the protruding disc.  For
this reason, many acute discs are simply observed with bedrest and pain medication.
Quite often the protruding disc will shrink enough to take pressure off the
nerve roots, relieving the pain.  
Surgery is considered for disc herniation when pain persists beyond a period
of conservative therapy, usually about 4-8 weeks.  Often the issue of lost
productivity at work becomes a factor pushing surgery.  More severe disc herniations
causing bowel and bladder incontinence require urgent decompression for optimal
Your symptoms seem to be related to activity.  Surgery is always an option,
but the best thing you could do now is to rest.  Vigorous aerobics can aggravate
a disc and possibly cause further herniation.  Take it easy for a while and
reasses the situation.  If you must work out, use lesser weights with higher
repetitions.  Talk to your surgeon and see if he doesn't agree.
Good luck.

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