L5 - S1 posterolateral disc bulge

Discuss issues relating to your back injury, including work and sports injuries.

L5 - S1 posterolateral disc bulge

Postby Todd Smith » Tue Jul 26, 2005 2:51 pm

Hello All ,
I injured my back at work in July of 2004 , the onset of pain was immediate when twisting an engine hood (Bonnet) of a car , this requires a-lot of force to manipulate the hood . My pain was in my Lower back and as I walked to the Medical Centre the pain moved down my left leg . The nrxt day when I awoke and got out of bed my leg and foot was tingling and I had hot flushes raditating down my leg into my toes . After seeing my GP a C.T scan war ordered and revealed a annular disc bulge at L4-L5 and a broad based posterolateral disc bulge at L5-S1 , after undegiong Physiotherapy and no chabge in my conditions my GP ordered an MRI which revealed that the L4-L5 disc was touching my L5 Nerve root and Impinging The L5-S1 nerve root . My work organised a Foraminal Nerve root block which has had little relief and after a Second MRI there has been no change in 9 Months from the first MRI .
I have been reffered to A Neurologist by a work appointed Job Fit Occupational Physician , to which my GP agrees with , after having no reflex in my left knee and still experiencing pain on my buttocks leg and foot . I would assume I may need a Micro-discectomy , and have been told I would benifit from this .
Any comments from anyone who has had this procedure or has the same or simmilar injury , would be appreciated .
Todd Smith
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Joined: Tue Jul 26, 2005 2:24 pm

Getting good answers at same time good treatment?

Postby azkid68 » Wed Jul 27, 2005 1:20 am

I doubt that I can be a any great medical advice but I did have a L5/S1 caused when I bent over to lift a box of wine in the market I was setting up a display in. That was about 30 years ago. I had a long reovery and several painful episodes..like I was looking into the sun and step off a 4" curb which jarred the daylights out of back. I was in therapy for about 4 months.

Now I am fighting W/comp because I injured the L3/4 while lifting a chair off the table while on crutches from an earlier injury of a broken foot at the workplace.

I have had neuro's tell me all kinds of different symptoms but none supported the injury (mid back cramping, buttock burning into the crotch, both hamstrings cramping, right leg to ankle burning etc). W/comp court does not accept the testimony of my GP who has treated me for 8 years..he is not a "specialist". The use the EMG as an benchmark to disapprove treatment but in fact you can have/may have nerve damage not consistent with EMG findings.

I have been fighting W/comp and the courts since Aug 2003. Not sure I getting ahead. Read my back injury entry.

It takes alot of work to get anything done but at least you have a GP that supports eventual treatment and does think the injury is real.

Healing is not the problem, however, finding someone who is willing to understand your problem and provide the healing solutions is the problem!
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Location: Phoenix Arizona Area

Postby tarrant » Wed Aug 03, 2005 5:02 pm

Hi Todd. I also injured by back in July 2004. Although it didn't happen at work, I know it was work related, as the pain had been building in my right buttock at work for a few months. I continued to work on it until the end of the year as, after having a CT scan, it showed that I had a L5-S1 bulge, but there was no nerve root compression. Although this suggests that I should have recovered reasonably quickly, I didn't. I have become very familiar with the pain that you both described, so much so, I tire of describing it myself. It seems more like "life" now than pain. I have recovered considerably, but my last flair up was only a month ago, and it put me on the floor for a while, so I've never really felt far from the pain.

As I don't have nerver root compression, any surgical procedures were not recommended for me. However, I have spoken to 4 people who have had a descectomy, 3 of which were very satisfied with the result. The one woman who wasn't got her injury from a car accident - after 2 discectomies she still wasn't any better, and was planning to go in for fusion treatment.

The other 3, however, said that the procedure made all the difference. One woman described the surgeon as having "magic hands" - that's how big a difference it made to her. However, the other two men that I met said that exercise, loosing wait, increasing abdominal strenghth etc. were still big parts of their life.

The other woman admitted to not caring for the physio approach, and she had no intention of changing her lifestyle to accomodate the changes in her back. Given that she is in her late 40s and that 50% of people develop sciatica due to disc degeneration after the age of 60, I doubt she will feel better in the coming years unless she considers exercise as a daily routine.

As for me, changing my lifestyle has been the only option, and this has been harder than I thought. I'm a sedentary person. I enjoy reading, using computers, drinking, smoking, watching TV, talking over coffee etc. I've become overweight and my body was underused and weak at the time of the injury.

I guess it's up to each person to decide how much they need to change, how much their previous lifestyle had to with their injury, and how much they can realistically do for themselves, rather than relying on medication and treatment.

On the other hand, there are plenty of people who's injurys have absolutely nothing to do with their lifestyle. Basically, there is nothing they can do to overcome the injury because the problems are 99% mechanical.

I would be very careful about considering surgery but, as you do have nerver root compression, I understand there is little you can do about the pain without a discectomy. Have you improved over the last year? Have you found certain activities beneficial, or visa versa? Does life seem manageable some times? Do you feel like you "can do it?" Or does it still feel as hopeless as when the injury first happened?

I think you would have to be prepared for the surgery not to work, or even make it worse. And, I guess, that's why surgery is always the last option. Have you run out of options yet?
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