Bulged Disk with extruded cartilage

[Brick]

Well actually that's the counter-intuitive part of all of this, and something I didn't learn at medical school but only after actually entering this area:

It's actually much more common for a bulging disc to repair itself and then go essentially back to normal. It doesn't always result in an area of weakness that will continue to cause problems down the track.

The reasons are not entirely clear to me why some people recover really well and others go on to have chronic pain and trouble, but nonetheless that is what happens.

Keep in mind that people who have terrible trouble and ongoing pain are much more likely to get an initial scan and then follow up imaging, so maybe that warps the view that the bulge will never get better? There are published studies on people who have recovered clinically and their follow up scans return to baseline.

And spinal surgery is far from a risk-free thing and can cause chronic pain in itself - I would never advocate surgery just on the "what if" that the bulge may return and cause pain again - each episode has to be assessed on its merits before a fairly serious procedure is undertaken.

Never underestimate the body's capability for self-healing. And never underestimate the medical profession's ability to worsen things by intervening (despite good intentions). The evidence in backs is clear - there is only a small minority of people who need intervention, and the whole point of this whole line of chat is that most people can avoid even the MRI scan if there's no clinical features of nerve compromise. It's a terrible thing to over-investigate, find a disc bulge that was never going to cause problems, and then perform a risky inappropriate procedure to 'fix' it.

Interesting.. Now it's been a few years since I bought one, how much is a script pad worth and would you prefer PayPal or cash up front

 

[DocSpachemmen]

Interesting.. Now it's been a few years since I bought one, how much is a script pad worth and would you prefer PayPal or cash up front

Haha "Here's a script for your antibiotics and a blank one for the weekend".

 

[Firey1]

Brick, a few years ago, you PM'd me that fusion was the 'gold' standard of treatment. Now it's artificial disc? If someone has a L5/S1 issue an artificial disc is most likely not going to hell them. Why? Look at the position of that vertebrae. I spoke with a top neurosurgeon in Sydney about this several years ago because that is where I had my issue and he himself said that most of his artificial disc replacements are done at L4/5. So do a little research first before you shoot your mouth off ay?

 

[ride29er]

hey guys back again, posted this drunk and completly forgot about it, back has healed up really well, deadlifted 10x5 at 100kg yesterday with no pain at all, still going to keep all weights under 100kg for a few month and work on form and movement, it feels to me at about 95% healed but I know if I push it to much ill be back to square one, day to day I dont even feel injured, only doing certain stretches I can feel it, If I didnt get a scan and know the full extent of the injury I would be back doing heavy weights already, I think a few month and ill be back doing most things, Im just going to stear clear of 1rm stuff and work on rep based movements with neat form

 

[ride29er]

Just FYI:

This may be an example of why doctors should not arrange MRI without clinical signs of nerve compromise - firstly, there is no way of telling whether the L5/S1 bulge is new or old (and if it's old then it's completely unrelated), and secondly no competent surgeon would perform surgery for pain alone.

Even if you had good going pain in an L5/S1 distribution (which might suggest it's acute), without objective signs on examination the MRI, and then the surgeon visit, may have been unnecessary.

Of course, maybe your GP found signs when they examined you and everything done was completely appropriate, but it's increasingly common for patients to demand MRI scans when often many doctors don't understand how to interpret the results. This inevitably leads on to referrals to either surgeons or people like me (Neurology).

It's a big expense on our health system, so even if this doesn't apply to you I hope it helps someone else be investigated rationally.

At the end of the day, the natural history of acute disc prolapses is variable - some will recover really well (with follow up scans showing disc almost completely back where it should be), and some do worse or somewhere in between.

I think following the advice of your physio sounds sensible, and just avoid activities that exacerbate it.

Hope some of this helps.

appreciate the advice, wish I came across this earlier, MRI was my idea I just wanted to know the extent of the injury, I spent over $500 on the scan and a 5min session with a surgon but I now know exactually whats going on and without it I prob would be doing stuff I should not be as I feel quiet good

 

[ride29er]

8 month post injury and back is feeling good, not keen on going super heavy with squats or deadlifts yet, but did a few sets of 10 DL at 130kg and felt fine, snatch is back to 8kg off my PB, I just need to build my squat back up now, first time in over 12 month Im injury free, finally can train normal again,

 

[simo74]

Good to know you are healthy and training again, if you dont mind me asking what did your recovery consist of ?

 

[Goosey]

Yes!
do tell.

 

[ride29er]

Good to know you are healthy and training again, if you dont mind me asking what did your recovery consist of ?

I rested for I think 4ish weeks or something then physio basically said to do anything that didnt aggravate it and steer clear of deadlifts squats and anything back related, so i was doing lots of strict pullups and benchpress, then after 12 weeks start working on the back with hip extentions and real light stuff, then slowly built weights up over the next few month, before christmas it would flare up at night after a workout but next day it felt fine, over the chrismas break that went away and has been feeling good, I still need to build up my back as much as I can

 

[spartacus]

welcome back rider

 

[billymackes09]

I will check some chiropractor near me open now and I can refer to some people I know.