Herniated discs, history of injections, is it time for surgery?

Hello @quickray, and welcome to Mayo Clinic Connect. It sounds like your doctor feels that because you can manage your pain without meds, you are likely not at the stage of needing to consider an invasive surgery at this point. How fabulous!

You will notice I have moved your post into an existing discussion, which you can find here:
- Herniated discs, history of injections, is it time for surgery?: https://connect.mayoclinic.org/discussion/herniated-discs-history-of-injections-is-it-time-for-surgery/

I did this to allow you to review others' thoughts given their circumstances and will enable you to respond to the members who have replied to you already, like @katcollins and @vincescs.

Have you started taking your doctor's advice and seeing how your neck does with some light activities?

I had a nasty "severe" herniation of the L4/5 discs one year ago in October. Dr. had me see surgeon who said I "completely blew it out." What I still did not understand was their terminology and how bad it was. In retrospect would have done the surgery. My family Dr. said to give it some time as I was scared by the surgeon's comments about the angle/complication a surgery would be for me so I suffered 9 months. I also "broke out some cartilage that looked like shredded chicken lying in the vertebral space" between those lower back joints. Needless-to-say, I was in horrible pain from Oct until April and it was difficult to work at a computer all day...sitting was rough, tried a standing desk, but couldn't stand long either, concentration on all the meds was hard. At first they did an injection into the joint, didn't work. Had a set-back in January where it a few Prednisone helped w/the inflammation. They did a 2nd injection right into the spine this time in the disc area, was awful for 2 wks, then a little reprieve for 2 weeks, then it ended. The end of the year is busy @ my job, so I was working long days, came home and dropped...was miserable. By February/March, I asked for something, even small, to be removed from the desk but was denied.

Any way, I did some "physical therapy" if you can call lying on your stomach and pushing up to elbows, then hands and hip stretches therapy. I was disappointed with Baldwin PT. I spent a few trips lying on the back seat of our van on ice. You name it, I tried it. Massage therapy was a godsend! To get the muscles around the discs to relax really helped, but it takes time as the area is easily irritated. You can't snap muscles back into place, especially if it's been awhile. I did daily icing of my back and Epson salt baths before work, then ice during the day and evenings (only 20 minutes or it can backfire). Heat felt good but only made the swelling worse, so don't use heat unless you are over the main inflammation stage.

Once the inflammation was down, I still iced daily but started a gentle chiropractic treatment getting my upper back and neck to the mid-back lined up again. I was nervous, but my chiropractor was gentle and stretched the muscles. What helped was a doctor telling me to GET OFF from sitting, and to walk, but also let it heal by laying flat on my back with my knees straight up at a 90 degree angle, then bent over 3 pillows so a whole week. He said it would bring blood flow to the area and give the vertebrae a break, stretching out that area, and it did work. Doesn't fix the vertebrae problem, but allowed me a break to heal, which wasn't happening due to my job, then I'd go home exhausted hurting and sit on ice at night. Sleeping on my back with a pillow under the knee was key also so my spine wasn't angled putting more pressure on those vertebrae.

One chiro said maybe enzymes to help your body absorb the herniated part of the disc. I tried a few different kinds, but I did by a Co-enzyme called CO q10 with a HIGH dose of turmeric (is a natural anti-inflammatory) with Cucurmin and black pepper extract (supposed to make the cucurmin absorb 2000 times more). My husband thought I was crazy, and the doctor just smiled at me saying with how bad mine was, it wasn't just touching the nerve, it was out and down alongside the nerve the entire space! Well, it eventually worked... In July, it had reabsorbed to the surprise of my spine doctor and family doctor.

I had also tried acupuncture, walking as much as I was able, moving around at work/standing desk, a tilt table, massage, physical therapy stretches, and sitting in a hot tub running the jets up and down my muscles on the weekends at an athletic place. I was finally feeling better early August, but unfortunately because my "core" trunk muscles are weak, I turned funny and landed in the ER with a compressed the L3/4 above the original (like squashing it down but not too bad) and herniated the L5/S1 disc (when it protrudes way past the vertebrae and usually touches the nerve or goes beyond the disc and down alongside the vertebrae at an angle like mine). This time because I have the 3 vertebrae that are no longer separated like they should be, but the facet joints (bones) along side those vertebrae did not compress, those facets are touching. A 3rd set of 4 shots into the facet joints were miraculous and worked! Takes the edge off. The problem with cortisone is, while you can feel better and it numbs up the pain, those bones are still rubbing, so you can end up worse...they are not a final solution.

What I was told is I need to do physical therapy, starting slowly, but need to do it consistently to first strengthen my muscles deep inside my stomach and back, then I can start to strengthen the rest of my core, otherwise it will continue to happen. I am watching my posture, sleeping and sitting better as well. Hope this helps.

Bottom line once the inf

Greetings Helen - There are things you can do before resorting to surgery. I have had severe lower back pain for 10 years, off and on. It's been especially bad over the past year. I used to get by on cortisone injections every few months, but they stopped working and I decided to see a pain specialist, NOT an ortho/spine specialist. He did a procedure called a nerve ablation. It has helped for a while but the pain is returning so I don't know what's next. I do know I'll go to my pain doc instead of my ortho for this.

Interestingly, I recently had a revision of a total knee replacement and was given opioids. They worked on my back, of course! But try getting them from anyone. One of my pet peeves is the fact that people who have a legitimate need for pain meds are having them withheld due to the abuse epidemic! Sigh.

Babette

I guess that is the same as a nerve block?I was told it could last a few weeks or more. Didn't get it done but need to do something for back pain. How long did the ablation last?