# Lumbar Disc Herniation



## DF

Lets talk about lumbar disc herniation:

A lumbar disc herniation is a condition affecting the lumbar spine that can be caused by lifting injuries.  This occurs when there is a tear in the outer, fibrous ring (annulus fibrosus) of an intervertebral disc this allows the soft, central portion (nucleus pulposus) to bulge out of the tear beyond the outer rings. 








If you were to picture pushing down on a jelly donut with the jelly oozing out of the side this is the action that is being described.  

Tears almost always occur in the postero-lateral direction, where the annulus fibrosis is relatively thin and is not reinforced by the posterior or anterior longitudinal ligament.  










You are most prone to a disc injury during the action of flexion and rotation of the spine (bending over & twisting at the waist).  This action places a large amount of pressure on the anterior (front) portion of the disc.  As a result this forces the inner part of the disc to the posterior (back).  When the spine is straight internal pressure is distributed throughout the whole disc.  

While sitting or bending to lift, internal pressure on a disc can move from 17 psi (lying down) to over 300 psi (lifting with a rounded back).  




I’m sure that I don’t have to tell you that this is why form on heavy lifts is very important.

A tear in the disc will most often result in the bodies inflammatory chemical response, which may cause severe irritation/pain, even in the absence of the disc fragment causing direct nerve root compression. I would say that about 50% of the lumbar MRI’s that I read indicate that the fragment is not impinging upon the nerve.  Yet, the patient will still have symptoms.  There is evidence that points to a specific inflammatory mediator of this pain. This inflammatory molecule, is called tumor necrosis factor-alpha (TNF).  

*symptoms*

Symptoms of a herniated lumbar disc can vary depending the severity and on the location.  They can range from little or no pain/symptoms, to severe pain that will radiate into the regions served by affected nerve roots that are irritated or impinged (pinched).  Other symptoms may include numbness, tingling, muscular weakness and paralysis.  You may also experience sciatica, which is a set of symptoms that can run from the back into the butt down the leg to the foot.  The symptoms can include numbness, tingling, burning, pins/needles and muscle weakness ect. 

Herniation at the L3 or L5 level also have a high chance of experiencing decreased sexual performance (Limp dick ) and also altered sensation in the female counterparts. 

Symptoms typically are experienced only on one side of the body. If the herniation is very large and compresses the spinal cord or the cauda equina (the bundle of nerves that comes off the end of the spinal cord) affection of both sides of the body may occur.  

*Compression of the cauda equina can cause permanent nerve damage or paralysis. The nerve damage can result in loss of bowel and bladder control as well as sexual dysfunction.  This is an emergency situation.  If you are crapping & pissing yourself get to the ER asap.

*Nonsurgical Treatment of disc herniation*

Ice to limit and/or reduce inflammation and muscular spasms
	With any acute injury *DO NOT USE HEAT*
Chiropractic adjustments
-	I am very partial to this type of treatment.
Physical therapy
Non-steroidal anti-inflammatory drugs (NSAIDs)
Oral steroids (e.g. prednisone)
An epidural (cortisone) injection






Symptoms of disc herniation will usually gradually improve with nonsurgical intervention.  The most common reason to have surgery is to alleviate pain, which has not improved within a reasonable amount of time. Another reason is because their pain will limit them from being as active as they would like.  

*Lumbar Herniated Disc Surgery*
A microdiscectomy is designed to take the pressure off the nerve root by removing the portion of the disc that is pressing on it.  Using microsurgical techniques and a small incision, a microdiscectomy can usually be done on an outpatient basis or with one overnight stay in the hospital, and most patients can return to work full duty in one to three weeks.  This surgery is minimally invasive.  

The success rate of the microdiscectomy is about 95%.  In my years of clinical practice I have seen many patients lead an active life style after having this surgery.  

Lumbar fusion surgery is usually the result of severe degenerative disc disease with multiple levels of disc herniation.  This is a very invasive surgery, which can involve screws, plates ect.  I would recommend that if you can avoid this type of back surgery then do so.  I have seen very few of these with even fair outcomes.


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## Lulu66

Sticky thIs thread.


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## Mrs P

Awesome read Dfeaton !, thanks for posting this... I'm having micro surgery in October, can't wait.... living with back pain is no walk in the park, it takes so muh out of your life... I can't wait to get it done.


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## DF

Mrs P said:


> Awesome read Dfeaton !, thanks for posting this... I'm having micro surgery in October, can't wait.... living with back pain is no walk in the park, it takes so muh out of your life... I can't wait to get it done.



Your welcome Mrs P.  I work on a lot of people that have had this surgery.  All of them have had very good results.  I'm sure that you'll do really well with recovery.  Your in great shape & Gh is always good while healing.


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## Pikiki

This is just like what I got on my back Dfeaton, my L5 is just like one in the picture or even worst. Thnx for posting this man.


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## HH

Awesome post broham


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## DF

Pikiki said:


> This is just like what I got on my back Dfeaton, my L5 is just like one in the picture or even worst. Thnx for posting this man.



No problem Piki.  I figured that there were a few guys/gals on SI that had this problem.  I see it fairly often in my practice.


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## Mrs P

Dfeaton said:


> Your welcome Mrs P.  I work on a lot of people that have had this surgery.  All of them have had very good results.  I'm sure that you'll do really well with recovery.  Your in great shape & Gh is always good while healing.



That's good to know, It's really gonna kill me to have to take time off to recover   but just to know I will be pain free & not have to restrict my workouts anymore puts a smile on my face... I might start going to chiro again after the surgery.


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## Zeek

Yes plz sticky this thread mods

 Fantastic DFeaton


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## DF

Mrs P said:


> That's good to know, It's really gonna kill me to have to take time off to recover   but just to know I will be pain free & not have to restrict my workouts anymore puts a smile on my face... I might start going to chiro again after the surgery.



I don't believe that the recovery time is bad with this surgery.  As far as surgery goes this is minimally invasive.  Some surgeons have different ideas though as far as resuming your regular activities.  I do recommend that you visit your chiro once you are healed up.


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## Gt500face

Great post bro, I'm currently suffering from a herniated disk. This shit sucks


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## old git

Gt500face said:


> Great post bro, I'm currently suffering from a herniated disk. This shit sucks




I had one about 20 years ago, most painful thing I have ever had, sorry to hear about your shit, rest, and pain killers, hope it gets better soon!


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## thisisfromwork

quick question. just got home from my ortho. he did mention that the jelly/blue thing in between my l4/l5 is gone. is it the same as what is mentioned here? thanks


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## DF

thisisfromwork said:


> quick question. just got home from my ortho. he did mention that the jelly/blue thing in between my l4/l5 is gone. is it the same as what is mentioned here? thanks



No,  that would be degenerative disc disease.


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## ron1204

This is great info. I have a question though. In the fourth picture showing your spine bent over and then over stretched (if thats what u call it), when you over stretch like that would it cause damage? for example i see people dead lift, with good form, but then go over regular posture and end in a position like that. Is that harmful? should u finish deadlifts at a straight angle?


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## thisisfromwork

Oh I see. I have the MRI results as written:



> Findings:
> 
> L5 is sacralized.
> 
> There is disk desiccation, mild posterior disk bulge and focal bright signal posteriorly at L4-L5 with associated thecal sac indentation.
> 
> The rest of the disk materials are within normal confines without canal senosis.
> 
> 
> Impresion:
> 
> Sacralized L5
> Desiccated disk with mild posterior disk bulge and annualr fissure, L4-L5




Would like to confirm if this is indeed degenerative disk disease.  Thanks


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## Noreaster

Old thread I see but,  Thank you for the diagrams and some explanation.
I'm in my 8 or 9th week of sciatic disc I don't know what hell.
Insurance is garbage now at my age for me, it's fine for my family but they don't want to hear it from me.
I know I need an X-ray at this point after trying to heal myself for over 2 months.
It really sucks  blew it out years ago lifting a boat motor. It's come back this time with a vengeance 
finally found a way to get a half day of no pain through an old weightlifting habit. 
Guess it just helps seeing how many guys here have gone through this.
Wish I could say more

Maybe this thread will give me a boost.


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## Mythos

I think I herniated a disk. Felt a pop coming up in a squat, knew something was wrong right away.
Basically ****ed, cycle blown, last three months of work out the window, can't even take a drive. Good ****ing times.


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## Jin

Mythos said:


> I think I herniated a disk. Felt a pop coming up in a squat, knew something was wrong right away.
> Basically ****ed, cycle blown, last three months of work out the window, can't even take a drive. Good ****ing times.



Man that sucks. I’m so sorry.


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## Mythos

Jin said:


> Man that sucks. I’m so sorry.



I appreciate it.. It's early so I guess there's a chance it's not going to be catastrophic


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## Gadawg

Just a thought here but I think it's worth mentioning.  If youre having back pain and considering back surgery, it's worth your time and a couple bucks to read Dr. John Sarno's book "healing back pain, the mind body connection".  His career proved that MOST back pain is psychosomatic and can be treated without any surgeries or medicines.  

Feel free to flame away but Ive personally seen people end years of debilitating pain just by reading the boom.  They all had crazy looking MRI's and surgeons wanting to do all kinds of shit too.  My step dad was one of em.


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## CJ

Gadawg said:


> Feel free to flame away but Ive personally seen people end years of debilitating pain just by reading the boom.  They all had crazy looking MRI's and surgeons wanting to do all kinds of shit too.  My step dad was one of em.



Dr Stu McGill would agree with you too.


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## Gadawg

CJ275 said:


> Dr Stu McGill would agree with you too.



Ill have to look him up. My preliminarily impression is that that name is made up like "Pat McCrotch". Lol


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## CJ

Nope, he's one of the leading back experts. Very highly regarded, and well respected.


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## 956Vette

*Total disc replacement*

Texas Back Institute offers an alternative to discectomy and fusion to repair herniated discs. This spring I received an artificial disc replacement at L5-S1. Secret to successful back surgery is to operate asap to repair the nerve. Spending months fighting with insurance cucked me hard, compounding physical therapy burden. 

Video of ADR lvl 1: https://youtu.be/hGfQn5Q1PnM


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## snake

Glad to see they still use a hammer during back surgery.


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## DF

956Vette said:


> Texas Back Institute offers an alternative to discectomy and fusion to repair herniated discs. This spring I received an artificial disc replacement at L5-S1. Secret to successful back surgery is to operate asap to repair the nerve. Spending months fighting with insurance cucked me hard, compounding physical therapy burden.
> 
> Video of ADR lvl 1: https://youtu.be/hGfQn5Q1PnM



Thanks for sharing.  How has your recovery been since the surgery?


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## quackattack

Monday morning I woke up with some mild back pain that that felt like an overstretched rubber band running to my toes.  This is odd because the prior week was deload week which most workouts consisted of light movements and cardio.  I have been icing my back every night and taking ibuprofen but it does not seem to be improving.  

I would like to get back to squatting and deadlifitng but I'm afraid that it will further aggravate this.  Does anyone have any stretches or exercises that can help?  Any tips would be appreciated.


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## 956Vette

DF said:


> Thanks for sharing.  How has your recovery been since the surgery?



Hasn't been easy. While I have been able to enjoy the gym again and have added 35-40lbs lbm ~2 yrs after lumbar spine surgery, lost significant muscle/usage of my left leg...nerve activity never returned as I once hoped.


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## 956Vette

*Bird-dogs*



quackattack said:


> Monday morning I woke up with some mild back pain that that felt like an overstretched rubber band running to my toes.  This is odd because the prior week was deload week which most workouts consisted of light movements and cardio.  I have been icing my back every night and taking ibuprofen but it does not seem to be improving.
> 
> I would like to get back to squatting and deadlifitng but I'm afraid that it will further aggravate this.  Does anyone have any stretches or exercises that can help?  Any tips would be appreciated.


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## blundig

Not to be discouraging, because I may have done it all wrong, but I never really got back to deadlifting after lower back herniation. Cervical disc herniation I found easier to work around by switching to lat pulldowns to the front for back, and easing back on overhead presses in favor of other shoulder work.


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## Bridgestone

I fucked up my back at 24 presumably due to a combination of car accidents, improper form on deadlifting and squatting (tight hamstrings, rounded lower back) leading to a degenerative disc disease diagnosis.  MRI showed that the annulus was completely gone/dessicated in the lower 1/3 of my back and had bulges/herniations/etc from L4-S1.  Worst pain of my life.  10/10.  Painkillers for years were effective in making me 'feel' okay but leading to a shitty hormonal profile and withdrawal/side effects all the time.  Not a fun way to live.

Eventually I decided to build myself back up, albeit slowly and correctly.  Noticed imbalance in my lower trap on one side and a number of other imbalances that took years to fix.   Only rowing I can safely do (i workout in garage) is incline DB row with my chest supported on the bench.  Back is thicker than ever, haven't had any pain or discomfort in years. 

This is all while being told from 3 separate doctors (2 ortho sugeons, 1 neurosurgeon) that "you have back of 70-year old", "fusion or disc replacement?  pick one".   Neuro wanted to do some crazy ablation or nerve-block.  These people....I just fucking hate most doctors after working with them for so long as a researcher.

But I will never deadlift or squat again because I tried putting them back in my routine with low weights but the damage is obviously still there - I've just enough muscle around the weakened area and the discs are hopefully getting relief from that.


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## blundig

Bridgestone said:


> I fucked up my back at 24 presumably due to a combination of car accidents, improper form on deadlifting and squatting (tight hamstrings, rounded lower back) leading to a degenerative disc disease diagnosis.  MRI showed that the annulus was completely gone/dessicated in the lower 1/3 of my back and had bulges/herniations/etc from L4-S1.  Worst pain of my life.  10/10.  Painkillers for years were effective in making me 'feel' okay but leading to a shitty hormonal profile and withdrawal/side effects all the time.  Not a fun way to live.
> 
> Eventually I decided to build myself back up, albeit slowly and correctly.  Noticed imbalance in my lower trap on one side and a number of other imbalances that took years to fix.   Only rowing I can safely do (i workout in garage) is incline DB row with my chest supported on the bench.  Back is thicker than ever, haven't had any pain or discomfort in years.
> 
> This is all while being told from 3 separate doctors (2 ortho sugeons, 1 neurosurgeon) that "you have back of 70-year old", "fusion or disc replacement?  pick one".   Neuro wanted to do some crazy ablation or nerve-block.  These people....I just fucking hate most doctors after working with them for so long as a researcher.
> 
> But I will never deadlift or squat again because I tried putting them back in my routine with low weights but the damage is obviously still there - I've just enough muscle around the weakened area and the discs are hopefully getting relief from that.


Excellent compensating though


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