L3-4 herniation, anyone dealt with this? And what has your experience been? Please share.

My back gave out about three weeks ago and after long process of insane pain at times (radicular pain down to my right knee and consistent numbness), Yesterday's MRI is showing impingement of nerve by the protruding disc tissue between L3 and 4.  After two weeks of meds, I can still walk but my legs feel weak, lethargic, kind of disconnected.  Hard to explain.  The night time pain was the worst I have ever experienced, and ironically, it was not in my back, but in my right hip, upper thigh and knee.  The numbness is still there, although the pain has abated considerably.  

I am scared and wondering if anyone has had this or something similar happen to them.  I am seeing a spinal specialist in a few days.  I do not want surgery.  My 58th BDay was yesterday...

We are all vulnerable, some more than others.  But still share the same love of climbing and the mountains.  

The best of health to all my fellow climbers!

Ivan

Oof Ivan. I feel your pain. Literally. Although my herniated disc  was L4-L5 I lived in pain for years while ignoring it, until I could hardly walk. I had to have surgery.  I Had a microdiscetomy and hemi-laminectomy and my pain relief was instant.  it was quick, walk in, walk out 6 hrs later. Obviously in a brace and with limited activities for a couple months. I was literally in tears of gratitude , taking my first steps in years without pain. The surgeon remarked in surprise that she had never seen someone with such major scar tissue on the nerve. Walking with a cane and Back brace and doing PT. I was back climbing in 3 months almost where I was before.  

One piece of advice  I can offer for the short term- Ice is your friend. Ice your low back as often as you can. I still have pain and still use ice regularly. It really helps reduce the inflammation at the nerve site and offers relief in minutes.  I also use an inversion table from time to time, but you need to be careful with those if you are in real distress. You can over do it hanging upside down. Just a gentle 10-15 degrees inversion at first.  Static hangs from rock rings can help. Keep your core engaged and powered up at all times. No sit-ups. Do Planks or leg raises. I also often use ThC/CBd ointment/ liniment locally on the site and I find it’s equal to if not better than the 1600 mg of ibuprofen and 1000 mg of Tylenol I was taking daily just to function.
And I can’t stress this enough- drink water! Water, water, water! Stay super hydrated. It helps a lot!
Also an anti inflammatory diet- limit alcohol and coffee.
if you can convince the disc to back in, you may avoid surgery.. I could not, I waited too long. I don’t know what your MRI shows.. my disc was out 7mm and down 10 mm. It was huge and I had scar tissue on the nerve and the offending tissue had to be removed. All in all I’m glad I did the surgery. Make sure you vet your surgeon.
An aside- A friend had a similar injury and was treated by a chiro on a machine that Astronauts use when returning to gravity after space station duty and claimed results. They strap you in and do thousands of micro stretches and compressions over many treatments. I think he forked out close to 10k. He swore it convinced the disc to return to position.
I can also say, I found  climbing was good for my back injury. Pulling steep jugs, stretched me out a bit, and the adrenaline I’d get helped! I think it is often underrated as THE best pain reliever of all time, and naturally produced. But you have to question and answer and move as your body allows. Back pain is often for life , just finding the way to mange it and set different goals. I hope you find a way forward and step out of pain and into recovery.

Best, Geoff

Ivan, 

I had the same thing, and put off surgery through PT and fear for about a year.  I finally hit a tipping point and had microdiscetomy surgery. When I woke up post, I was crying with joy from being able to stand up straight and walk again.  I still had 2-3 months of recovery post surgery, but my only regret was not doing it much, much sooner.  

Good luck mate, but get cut. It was worth it for me. 100% 

I fully ruptured my L5 in 1998 And had the surgery to remove the disc material that was pressing on my spine. Surgery is usually a last resort for discs.  

I would exhaust every PT possibility before surgery. I have had serious complications since the surgery in 1999. My back is very vulnerable and I have to be careful or the discs down there will bulge. And still do. 

And you for sure have to do the same PT forever if you get the surgery. Not saying don’t have surgery but don’t rush into it. 

Start doing the mcgill big 3! 

search squat u on youtube. 

Millions of people have had this experience.  I've had herniations a half a dozen times. You say two weeks of meds but not what you are taking. If it's an OTC NSAID, your doc may prescribe a different one, not so much for effectiveness as for the side effect profile.  I personally have found that I tolerate diclofenac (Voltaren)  the best.  But more typically with a severe case not improving on NSAIDS a back doc would give you an RX for methylprednisone oral.  6/5/4/3/2/1 pills.  if that doesn't work, as an alternative the doc will give you a steroid shot directly into the spine. Depending on the type of herniation, they will sometimes do this ultrasound-guided, injected in an outpatient office setting, or sometimes under light anesthesia in their surgicenter.  Last summer my husband went through the oral steroids and wasn't progressing and did the spine shot and had almost immediate relief. It still took him a month to gain normal activity back but the pain was much better.

They will often also prescribe a muscle relaxer like cyclobenzaprine.  Most of them won't prescribe opioids for the pain with a new patient, but there has recently been a new non opioid (and non-addictive) pain reliever approved by the FDA, so they may be starting to prescribe that.

After a short time, they will start you on PT and you absolutely positively have to do it and then continue doing your maintenance exercises for the rest of your life.

Don't be too freaked out, I've had degenerative disk disease in my neck and lumbar spine and facet damage in the thoracic spine for 40 years and probably severe flareups half a dozen times. When I had a desk job I had chronic pain for years. But once I no longer had to sit all the time, things got better.  Most of the time I can function great and with no pain but I always have to be cognizant of how I use my back.  

Thank you all for your thoughts and stories.  I really appreciate it.  I can add more once I have a clear idea of a directive.  Somehow it helps to know I am not alone in this and that there is always tomorrow.  Tough subject.  So incapacitating.  And from the sound of it I am not so badly off right now, compared to others' experiences.  Cheers and happy climbing!

Hi!   I’m sorry to hear you are suffering. I had the same injury and it was pretty miserable for a while.  For me what worked was the combination of a series of injections with a pain specialist doctor and an excellent physical therapist.  I think if I actually had listened to my PT and rested for a couple weeks, I would have healed much faster.   I kept climbing when it was acute which kept aggravating it.  

I wish I could say it went away forever, but  even though it is MUCH better, it does flare up 1-2x a year when I push too much or get lazy with my maintenance exercises.  It is key to listen to your body; once healed, you can find different ways to move/climb to avoid triggering it.

Try not to get too discouraged.  I’ll be thinking of you!

Wishing you the best,

Jen 

Geoff's post is 100% spot on. 

Only thing I would add is to find a good PM&R (Physical Medicine & Rehab) physician, they specialize in neuromuscular pain and will give you a far better treatment plan than just seeing a surgeon or primary doc.

Also, I wouldn't be afraid of Microdiscectomy's. The procedure has come a loooong ways even in just the last 10 years. Once the pain/feeling is to your knee or past it your treatment options are limited.