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Old 04-08-2009, 06:25 AM
 
Location: Southeast
175 posts, read 540,567 times
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Workers comp doctor seems to think that "conservative treatment" is my better option. Yeah, whatever, physical therapy isn't going to heal a lumbar disk injury......... I'd rather have the surgery.

I have a central annular tear/ miniscule protrusion at L5-S1
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Old 04-08-2009, 06:43 AM
 
Location: Sugar Grove, IL
3,131 posts, read 10,481,111 times
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most doctors always want to try conservative treatment first. the last thing you want to do is have back surgery. often, with therapy, a protruding disk will go back in!
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Old 04-08-2009, 10:27 AM
 
4,967 posts, read 10,999,448 times
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Originally Posted by sgresident View Post
most doctors always want to try conservative treatment first. the last thing you want to do is have back surgery. often, with therapy, a protruding disk will go back in!

This "can happen", resorption of a portion or all of the fragmented disc, but it is rare.

That being said, conservative treatment is always the way to go unless there is significant neurologic compromise. Often when a disc herniates, it fragments and there is typically inflammation at the site which compounds the problem and leads to compression of the spinal nerves. If the inflammation can be managed by conservative means: NSAID's, therapy, activity modification, epidural steroid injections, then surgery may not be necessary.

If symptoms resolve after conservative measures then no surgery is needed, even if the disc remains herniated. Most herniated discs are asymptomatic and many folks are walking around with them with no knowledge of the problem, its only when they press on a nerve root that people have symptoms.

Symptoms of a herniated disc will resolve in close to 90% of patients WITHOUT surgery.

There are reasons to consider surgery immediately, profound leg weakness, foot drop, extreme pain, bowel or bladder dysfunction (cauda equina syndrome) but most disc herniations do not require surgery.
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Old 04-08-2009, 07:42 PM
 
Location: SoCal
305 posts, read 1,073,783 times
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probably not............
at least not back to its original state prior to injury........

assuming that 'by itself' means you do nothing...........at all.........

if you incorporate either physical therapy or a very good chiropracter.........core strengethening and such............


maybe.........
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Old 07-29-2009, 07:42 PM
 
Location: At the Lake (in Texas)
2,072 posts, read 2,026,667 times
Reputation: 5032
Back surgery should always be LAST resort
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Old 07-30-2009, 06:58 AM
 
Location: Columbia, SC
1,860 posts, read 4,432,933 times
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Quote:
Originally Posted by bluedevilz View Post
This "can happen", resorption of a portion or all of the fragmented disc, but it is rare.

That being said, conservative treatment is always the way to go unless there is significant neurologic compromise. Often when a disc herniates, it fragments and there is typically inflammation at the site which compounds the problem and leads to compression of the spinal nerves. If the inflammation can be managed by conservative means: NSAID's, therapy, activity modification, epidural steroid injections, then surgery may not be necessary.

If symptoms resolve after conservative measures then no surgery is needed, even if the disc remains herniated. Most herniated discs are asymptomatic and many folks are walking around with them with no knowledge of the problem, its only when they press on a nerve root that people have symptoms.

Symptoms of a herniated disc will resolve in close to 90% of patients WITHOUT surgery.

There are reasons to consider surgery immediately, profound leg weakness, foot drop, extreme pain, bowel or bladder dysfunction (cauda equina syndrome) but most disc herniations do not require surgery.
Well said Blue Devilz, as someone who actually experienced cauda equina syndrome - my right foot/ankle was totally immobile, and my left foot had very limited movement (could basically wiggle a couple toes and that was it), had foot drop in both feet, calves constantly tightened up to extreme pain, etc. Yet, I'm thankful to say that 2 1/2 years later, I'm almost completely back to normal, think I had youth (was 25 when it happened), the Good Lord watching over me and lots of people praying for me, and fortunately a good surgeon who performed my operation as well as good therapy following it. I now jog 5 miles or so at least a couple times a week (I couldn't walk w/out some kind of assistance - a walker, crutch, braces, etc. - for almost 4 months after the surgery), am for the most part pain-free, and the only lasting symptom I have is I still have very weak eversion on my right foot, and at times (especially in the middle of the night) I'll wake up w/a muscle cramp in my right calf b/c my dorsey-flexors are still quite weak, and w/my right foot resting downward all night, can cause the muscle to cramp up which causes me to jump out of bed and immediately stretch it out.

If you have any of those type of symptoms, seek out a surgeon immediately. The sooner the pressure is relieved in the spinal column and away from the nerve, the better your chances at a full recovery are. I had basically severely herniated 2 discs at L3, L4 playing basketball, and they compressed the nerve in my spinal column.

If you are just having pain, as others have said, a lot of times doing exercises and physical therapy will rehabilitate you back to normal.

So I wouldn't say Back surgery should always be your last resort, b/c if you can't move your lower extremeties or have no control over your bowel/bladder, it should be your first resort!
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Old 07-30-2009, 10:09 AM
tao
 
Location: Colorado
720 posts, read 2,963,375 times
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Believe me, try the conservative treatments first. You don't want surgery unless it's the only option left. I had the surgery a little over a year ago and it was pure HELL. And just this December, I ended up re-herniating the disc, though less severely.
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Old 07-30-2009, 01:52 PM
 
4,967 posts, read 10,999,448 times
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Quote:
Originally Posted by tao View Post
Believe me, try the conservative treatments first. You don't want surgery unless it's the only option left. I had the surgery a little over a year ago and it was pure HELL. And just this December, I ended up re-herniating the disc, though less severely.
Yes and no....

Absolutely if there are no or only mild neurologic symptoms then by all means all non surgical options should be exhausted first.

There are a subset of patients with significant neurologic compromise where surgery should be the first option however and waiting may result in permanent dysfunction...
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Old 07-30-2009, 02:15 PM
 
Location: NJ
10,596 posts, read 21,260,509 times
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Quote:
Originally Posted by bluedevilz View Post
Yes and no....

Absolutely if there are no or only mild neurologic symptoms then by all means all non surgical options should be exhausted first.

There are a subset of patients with significant neurologic compromise where surgery should be the first option however and waiting may result in permanent dysfunction...
If I had to redo my decision, I would have searched out other options.
There are so many new advances now compared to when I was 1st fused; heck 2 months after my fusion a trial for a movable disk came out.

Research - artificial disk replacement - this is what I would do. It is not expensive - was $3,000 per level. I can tell you that fusing is not natural for your spine and that not being able to move hurts like heck.
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Old 12-10-2011, 08:03 AM
 
2 posts, read 14,710 times
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Hi

I agree with Tao, you need to try other treatments first. My dad had the same problem
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