This question goes out to all you that are still training after injuring a disc. I received my second epidural injection about 3 weeks ago for a herniation of the L5S1 disc, and I have to say it felt great, sciatica was gone, no tightness or any of the accompanying symptoms. The only issue I have now is from time to time I experience what I can only describe as feeling the nerve in my butt.
What Im trying to figure out is if it is truly pain due to gentle pressure still on the nerve, or if its all in my head, much like an amputee who still occasionally feels sensation from the limb. Now obviously nobody on the internet can tell me for sure, but Im curious as to the experience of others who have had injections.
Has anyone else experienced this phantom pain after the disc has mostly healed? I have read many stories where the injection did not help much but how about some people who it really did help.
My back ground is that I got this injury being a fool, I ego squatted, and I squatted incorrectly, coupled with just bad lifting habits in general I was asking for this to happen. I lifted for over a year with after the injury, being the genius internet doctor I was I diagnosed myself with a bad spinal erector strain lol, if only I had read an article on sciatica I would have thought differently.
When I finally got my MRI the disc was really just bulging, not a true herniation but still gently pressing on the nerve, however Im not sure how bad the initial injury was since it was well over a year since it had occurred. What finally got me to the doctor was after completing the first week of the I-bodybuilder back phase, it aggravated the sciatica enough to the point that it extended to midway down my left buttock.
So for the time being I am no longer squatting or dead lifting, back extensions, hack squats and lunges have become my staples for lower back and legs. Thanks for any replies
Sorry to tell you this but, the injection dont last for too long. I would think about the surgery if I were you, well if the pain is that bad and think about it its not worth the risk with backs.
A couple questions first:
What size was the bulge? Where did you initially feel the neurological symptoms? Any weakness in the extremity? Where do you currently feel the neurological symptoms? Do you currently/still have weakness in the extremity? Any formal rehabilitation done for the disc injury other than the two ESIs?
It is common for some lingering neurological symptoms to remain for a while, depending on the size of the bulge. Also, you should remember that whenever a physician prescribes a series of ESIs, that you can get up to 3 injections. Generally though, if you are at 90% improvement or better, I’d recommend holding off on that 3rd ESI. Yes, the shots do not last forever, but the shots are not just for pain relief, they are meant to help decrease inflammation and help shrink the disc bulge a bit and allow it to scar down.
IMO, I think it is misguided to jump to recommendations of surgical intervention, especially without knowing the degree of the bulge and exact remaining symptoms. Unless your bulge is 10mm or greater, I do not think surgical intervention would be in your best interest.
I’d strongly recommend, especially if you haven’t already, making some lumbar stability rehabilitation and hip mobility exercises and everyday part of your life. Once you answer the above questions though, it will give a better idea of what you have going on.
The pain is nowhere near enough for surgery, from my understanding surgery should always be the last resort. The injection is not meant to cure the disc this I know, I thought of it more as a tool for stopping the cycle of inflammation and irritation.
Thanks for your response levelheaded, I dont post often but I linger so I have read many of your previous posts and I appreciate the input. The bulge as of my last MRI is certainly less than 10mm, as I said before it may have been larger previously as I put off getting it treated for sometime. But im sure from the amount of neurological symptoms I had it couldnt have been to large, and was most likely gently touching the nerve as the extent of my symptoms was sciatica down to the middle of my left glute. There was never any weakness or pain beyond that point, I actually increased my freeweight squat after the injury to over 400lbs, however my deadlift and yes I was doing them would never go above 425 and I kept wondering why heh.
As far as rehabilitation it was initially rest and cessation of squats and deadlifts, but it seemed to actually hurt more when I did nothing for it as opposed to exercising it, so I have relied on back extensions for the past month to keep my lower back strong. At this point my main concern is healing and retaining what I have gained in the passed 3 years, I am only 27 so im to damn young to have a bad back.
Occasional light/mild symptoms are normal, especially only after 3 weeks since the 2nd epidural injection. I’m actually recovering from a disc injury (resulting from some MMA training) and our situations are very similar (age, timeframe from epidural injections, etc). I still occasionally get a pulling sensation into my calf, but nothing to be majorly concerned about. With the people I have done rehabilitation work with for disc injuries, those annoying, “worry-some” symptoms can linger on and off for a bit. The nerves take a while to “calm down” and the inflammation needs to settle still.
My best advise to you is to start working on some lumbar stability exercises and figure out where your mobility deficits are. I would assume that you probably have some tight hips and have some poor tissue quality just from the initial injury, if not from before the injury. Address those mobility and soft tissue deficits and look to control and settle the symptoms. Key in a proper technique and correct posture throughout the day.
I personally started with just single leg work to avoid too much spinal compression and am progressing to more double leg work. I have avoided heavy load deadlifts for now and stick to glute bridges and hip thrusters, weighted and unweighted. Being that you are only 27 years old it is a positive note. Generally, the younger you are, the better you recover from these types of injuries. Best of luck!