Damaged disc(s) in the lower back - what to do and what not ;) Answered
I got diagnosed with a damaged L5 and L6 disc in my lower back about 8 years ago and I thought writing about my experience might helps others facing the same problems.
Keeping your back straight when lifting or moving heavy things was a thing I already learned and followed during my school times and as you might have guessed it helped to keep my back healthy - at the expense of my knees...
But the knees are a different story, today I want to help you understand lower back problems caused by damaged or bulging discs and how this will affect your life.
For me it began with a little shock.
One day I got out of bed, wanted to grab something I dropped and got stuck half way up.
Knowing that there are some nerves that can cause the same issue and that a simple injection will fix me I called a cab to be dragged laying down on the back seat to my GP.
As you might have guessed his diagnosis was a bit worse than what I wanted to hear...
Many painful hours and some scans later it was confirmed that my L5 and L6 disk have collapsed on one side and started to push on the nerves next to it.
Funny side not that I never really checked was that my doc said not everyone has a L6 disk...
Anyways, as with most first "accidents" involving your lower back the so called recovery was long and painful.
Sure the painkillers help to numb the worst, the anti inflammatory stuff covers some pain too but actually I did not want the full pain free package deal.
Pain is the bodies way to let you know something is wrong, so I kept the pain medication at a level where I got that information when making a wrong move...
The first 6 months I was literally confined to my bed, the shower and the toilet.
I tried to keep a position with the least amount of pain for as long as possible and for obvious reasons was not too happy that my body not only required food intake but also the disposal of the waste products - getting out of bed and onto the toilet meant experiencing huge amounts of pain every time.
But after those 6 months I started to adjust, to the pain as well as what my limited body was now capable of in terms of movement.
Needless to say that all this time of not doing anything really meant my scale started to scream tripple digets at me one day...
Luckily around the same time my pain levels went to a level that allowed my to walk around 500-600 at slightly slower speeds than normal before the pain got too much.
My doctor also got quite concerned about my blood work and body weight recommending to loose a lot if I every intent to get back to a more normal life.
So I started to walk several times a day, no matter how bad the weather was, just a bit up and down the street.
The distance got longer, the fitness a bit better and the pain levels a bit lower too.
Using my old weight lifting belt to keep the back supported helped me a lot during these times, especially when driving or doing housework.
During those times I was still on 6-8 panedine forte tablets (paracetamol and codein) plus 2-4 tablets of 20mg oxicontin and not happy about the last anyway.
Despite the added levels of pain I started to reduce the level of oxicontin and started to exercise more.
My focus was getting the core muscles stronger and to get better support for my back.
Also started riding my bike again, although I had to replace it for a bigger model to allow me a more upright position with less stress on the lower back.
The kilos started to tumble very slowly but I was already quite proud when I got bak to 90kg. :(
Good thing was that I got motivation to continue as every kg I lost and every little bit more on distance I got out of my walks and rides without getting too painful also meant that my average pain level went down too.
Two years after it all happened I got rid of the oxicontin completely and reached the 80kg mark.
My doc was happy too, my blood work looking good but of course he still suggested to loose a few more kg.
Being able to move around again also meant being able to work again and with that came more food, less exercise and a lot more stress.
I did manage to hold my 80kg but after about 6 months or working I noticed my back problems started to limit me again.
My back belt covered for me and I was able to keep going a while longer but in the end I got hit by another attack on my back.
The diagnosis was not good at all as now on top of the pain goind through the back and leg I also hab numbness and a feeling like ants crawl over the leg and chew on it every few mm.
As with most lower back "revenges" this one only needed strong pain killers for a few weeks until I was back to something more normal in terms of pain and movability.
Sadly the ongoing side effects did not go away the way they did the first time.
This meant especiall finding the right position to sleep with the least amount of pain was becoming a nightmare on it's own.
Either you got pins and needles keeping you awake, you lost your feeling in the leg to the point where it becomes useless or the pain in the back is just stabbing you all the time.
Starting some projects here on Instructables kept my mind busy and gave me some welcome distraction from the daily routine.
Eventually I manged to find a job again that allowed me to have enough different movements with only a bit of lifting so things started get back to normal.
My doc put me on some amitriptyline to help with the pain at night and although it took some time to get used to the stuff it really started to help after about two weeks.
The job was only for a fixed term but it gave me back some confidence that not all is bad or lost.
Life went on and I actually manged to get down to just 75kg and only used some painkillers once or twice a week if it was really bad.
Then, a few weeks back I started to notice that the top of my foot and the outside of my leg felt different to touch, especially in the shower with some brush or rough sponge.
Not being happy already I agreed to some new scans to check if the discs started to cause problems or if the nerves are just inflamed.
You might have guessed already, the scan confirmed that my two discs desintegrated further putting more pressure on the already suffering nerves.
With the "help" of some quite strong anti inflammatory stuff, cortisone and other meds my doc managed to get me back to "normal" but he also informed me that this won't last forever.
The current outcome (without surgery but more on that later on) I have two choices to keep going:
a ) I continue with pain killers and other meds to keep the problems at bay.
b ) I limit myself to basically not doing anything involving the movemnt of my lower back, keep to a strict calory intake and hope for the best.
The first option won't do me any good in the long run except liver, kidney and digestive problems.
The second option will allow me some sort of a normal life at the expense of never finding a job to support me again.
So once again we soldier on knowing that it will only make things worse as giving up and relying on social services is no option for me.
Hoping that you might just had your first encounter with lower back injuries and pain I will give some advise on the things that helped my most so that you might not have to suffer as much I did and still do.
So read on please...
Diagnosed with a damaged or bulged disc in the lower back - what does it acutally mean?
If you check all the available images of the human skelleton you will quickly notice one thing:
Our lower back is not really straight and not designed to carry a lot weight when it is put on the wrong way or direction.
Noone with a sane mind would use a support beam shaped like that but the human body adapted to this problem caused by changing from using all four limbs to walking on just two legs.
The muscles and tendons in our back work in such a way that they support the fragile construction of discs and bones that keep us upright.
Sadly modern life, personal decisions and only too often a busy work shedule prevent us from using our body the wa we should.
Be it too much lifting, being far too short for your weight or simply laziness the factors causing our muscle to degrade are too many to count.
But once you are in the worst pain you ever felt and your doc tells you that there are damaged discs you suddenly wish you had it all done differently years ago - trust me, I have been there and I have done it ;)
Or it might be like in my case that a healthy and fit person just cracks one or more discs for no obvious reason.
Either way it means you have to change your life to be able to keep going.
Pain killers help to ignore the problem and pretend all is good but they should be used with great care as most are highly addictive and the long term side effects are no fun either.
The one thing you must never forget is although being a life sentence it must not mean you will be crippled forever!
What can I do once it happened to help the pain and my sanity?
Nerve pain is one of the worst pains there is and there are only two more or less working medications to deal with it.
The first meds are opiates to literally numb the pain but due to source of the pain very high levels are required until the body adapted to deal with the wrong pain information.
The second group of meds that offer help and that are often used together with pain killers are old sty anti depressants like the try-cyclic (was that right?) amitriptyline.
Back in the days they were not really good for the advertised job but one of the common side effects was how they worked on the pain centers of the brain.
In much lower dosages as used to treat depressions these meds help the brain to deal with the pain caused by the damaged or pinched nerves.
As a long term solution they should be prefered over opiates so that the strong pain killers are only taken when really needed.
If you are anything like me than not getting enough sleep over weeks on end will take a toll on your mood.
So being able to sleep at least a few hours in one go is a real thing to aim for unless you prefer to harm your body with pain killers.
What is there to help with the pain so you can sleep? I know that you now already think you tried it all and that nothing good comes out of here but keep reading as you might be surprised...
The first thing that jumps into mind when it comes to sleeping is a bed - be it you by yourself or with a partner.
And here also is the first point to improve!
In many countries a bed for two persons has one bad feature: A single mattress!
Any movement from the person next to you is transfered more or less onto your body - you don't want that!
So if you own a big bid that you share with someone think about investing into a bed with seperated matresses and support frames.
That brings us to the mattress itself.
A lot of people think being soft and flexible is a prefered thing, not so much if you have back problems.
You want enough support to keep the back straight without everything feeling like you sleep on wooden floorboards.
Keep in mind though that when changing from soft matress to something much firmer you will need to adjust.
Really the best option is to seek professional advise in a bedding studio or similar.
And no, you don't have to go to the most expensive place to buy a mattress, you just try them out, get expert advise and use that new knowledge to find a suitable mattress to fit the budget.
With no offence meant: If you are over the normal weight you really want to loose the excess and that means selecting a new matrress on your weight goal and not on your current weight!
It is also good to have adjustable supports under the mattress itself, this way you choose a thinner and bit softer mattress but still get the firmness your back requires - again seeking proffessional advise on the right combinations is highly recommended here!
Ok, your bed is sorted but still there is that nagging pain in certain positions or the tingling in your leg preventing you to go to sleep.
Believe it or not but what you do before you go to bed affects how you feel when you hit the sack.
So sitting like a bag full of water in front of your TV until just manage to crawl into bed won't do you any good.
Same for having your dinner and hour or two before bedtime...
What does help is to move your body and to burn a few kalories!
If it helps you use a weight lifting belt but just a walk around the block with a little bit of bending and flexing will get the tension out of muscles.
A nice partner giving you a proper massage might help too but I doubt you will get one every night ;)
And before you start to complain: Yes, I know there are times where simply can't do any exersise as you will be happy to make it to the toilet or to make some dinner.
For those times and especially during times of experiencing higher than normal pain level ther is something you can do to ease the pain.
Some doctors will tell you but a lot of them wont: Cold actually helps to numb the pain and the symptoms like tingling, pins and needles or the constant stabbing when you made a slightly wrong move.
But you need to apply the cold in the right way to get the benefit!
The key here is timing.
Using real ice in a suitable wrapper, so no vegetables or meat, you apply the cold where the damage is - not where the pain is!
You want to cool down the area around the damaged discs for about 5 to max 10 minutes.
Put the icepack back and repeat every hour!
Nothing will happen after the first two or three round but then you will notice improvement - how much depends on the individual and extend of the damage of course.
When I have bad days I usually start around mid-day and keep going every hour until either the pain is gone or it is time to drag myself to bed.
The worst you can do is o apply heat!
A warm (not hot!) bath can help to ease some muscular tension but hot packs or heat lamps will make your pain get worse quickly.
Just imagine and inflammation somehwere else, the area is already hot and painful so you really don't want to add more heat, do you? ;)
What can be done to keep mobile and improve?
As said earlier the key is support for the damaged areas and of course a limitation in movements that put additional stress on the damaged dics - this includes weight, be it from your own body in terms of excess fat or simply be lifting things!
You will have times of no pain and where you think you are 20 years younger again but never use that as an excuse to think your discs have improved!
Once damaged they stay damaged and everything putting more stress on you dsic(s) will make things worse.
A friend of mine loves to play golf - if you have back problems you want to find a different hobby!
Coming from three digits I can tell you without being offensive in any way that being fat means having problems that you don't want to add to your list caused by a bad back!
So like it or not you really need to loose all the excess you can find wobbling around your body!
For me every single kg I lost was a step forward to being more fit and being able to more things for longer before my pain got too much.
And no, there is no excuse for keeping those kilos if are able to leave the bed for more than a few hours.
Turst me, you will feel better, need far less medication and like yourself much better once the benfits of less weight kick in!
Exercise is the key to getting your life back to a more or less normal level!
If you are a "first offender" than you have a good chance that a change of habbit and maybe job will make sure it stays a single incident and that you can have a pain free life after the initial recovery!
Getting a higher core strenght and overall fitness level helps your body to heal but most importantly gives you the option to gain muscles where needed to support your back.
You might think there is nothing you can do if you are in pain and can't really move anyway but if you do then you are wrong.
I am not a personal trainer but I found a lot of ways to use my muscles without using my back for it...
There is enough info on the web for exercise methods without any training gear and if you think "really hard" you might notice you can use a lot of positions to exercise your arms and legs without stressing you back ;)
And even for the back you can do good without damage:
If you lay flat on your belly you just slightly lift your arms and legs off the ground - this will need the support of the muscles in lower back!
No need to actuall lift anything high, just enough to only slightly bend your back up - you might not even notice any bending at all.
What you don't want is exercise like running, jogging or even contact sports, really nothing that might force your back to move more than what is possible without stressing your discs...
Better fitness and more strenght means you will get better flexibility and movablity but never let that fool you into thinking the damage is gone!
I can not stress enough than even if you don't need medication and feel fine a single wrong move can make all null and void!
What are the options if despite loosing weight and excercise my pain is not going away or syptoms get worse?
Well, we can ignore it, we can hope it all goes away but the sad reality for most is that sooner or later you reach the point where the damage is too much too handle.
The first one to tell you that your lower back is now due for a pit stop is your foot.
The pain might be more than what you ever experienced the pins and needles might drive you mad but as long as it just that you are fine, really :(
For me it was during some light gradening when I got my "first hit" so to say.
I brushed it off thinking I tripped over something that got kicked away while I struggled to keep my balance.
A few days later I noticed that I had to put some extra efford to prevent my toes from scraping the floor while walking.
It was there when I also realised that most of the feeling on top of my foot was gone.
Same story for the outside of my calf by the way...
For me, thanks to a non working medical system and no private health cover the story ends here...
Since you might have more luck:
Modern medicine has gone a long way when it comes to minimal invasive operations and they are the key to performing operations that otherwise would be impossible or require months of recovery.
For the "treatment" of damaged discs in the lowest part of the spinal area the old conventional treatment was to fuse the bones together using some steel or titanium rods.
To give the patient relief the dmaged disc was more or less mutilated to free the damaged nerve(s).
Several weeks of bed rest and great loss in movement was the price to pay for less pain.
Today we are much further and can use micro instruments to perform operations deemed impossible only a few years ago.
One of the operations with the greatest and fastest recovery rates is actually quite smart if you think about it:
A small portion of bone is removed to give more room for the nerve and to aid in the healing - without fusing the bones!
The next step is remove the part of the disc that is bulging out - without removing the strong support layers around it, only the mashed up bits are taken away.
The patient is literally pain free ( from the back pain) right after the operation.
Healing takes about 2-3 weeks but by then even the pain from the cut bones will be gone.
Some health insurers see these operations as a means to get a person back to work and into a normal life, so they support it.
Others use simple math and decide pain killers are cheaper...
In any case you should seek professional advice from your doc and health care provider before it is too late!
Diagnosed and operated early can mean you get the option to have an almost normal life again, or at least a few years of being able to enjoy life much more than before the operation.
There are of course risks involved and an opration might not be an option for every case but knowing your options and what form of treatment might be available for you can be reall life changing...
Ok, but what's the worst that can happen to me if a simple operation is no longer an option?
One of the first things you will notice after loosing control and feeling for your foot is a more or less contant need to go the toilet.
Despite having an empty bladder or just using the toilet minutes ago you can develop the feeling that you really must go the toilet again.
Sadly this is only the beginning...
If things get worse you can loose control over your bladder and bowel.
Simply put it means you no longer control the muscular tension required to keep you vital openings closed when required.
Usually at this point your doctor will recommend to operate one way or the other.
For you, if affected, this means you have to decide between the risk of an operation that might only last for a few months or years or wearing adult nappies...
If you already had one or more operation or the damage to the disc(s) is too severe it can mean that there is no other option but to fuse the bones into place to prevent further damage and allow for some healing.
But trust me, for your doc to even consider an operation you need to loose all the weight you can!
What are my limitations after having my back bones fused together?
Well, as it reads you will be fused together, meaning you level of movement will be severly limited.
It also means you beep all the time at the airport security or when entering a court or other place with metal detectors - but that is the least of the worries I guess...
The main problem after such operations is getting back to a life as normal as possible.
You get a lot of help in rehab and will learn what you can and can't do, plus of course how to keep you fit despite these limits.
Some people cope really good with the new limitations but others struggle a lot.
This especially true if before the person was really active and doing a lot in terms of sport and outdoor activities.
Learning to adapt to the changes allows you have many more years without too much pain or limitations.
Sure, Golf is out of the question, playing soccer or riding a normal bike too but life goes on and being a part of it is always better than just looking at it through your bedroom window ;)
In any case giving up should not be an option for you! No matter how bad it looks when the pain is too much, there are always more good days than bad days ahead of you!
Go ahead, share your experience with back pain, what you do keep going and handle the pain.
Share you information about what treatments helped you the most and share how you recovered to where you are now.
Be an inspiration for those facing what we already went through!
Real back pain based on nerve damage will only be understood by someone who experienced it - what did you do to make the people around you understand it?
Whatever helped you might help someone wha just started to learn how to deal with damaged discs and back pain, so sharing is caring! ;)