Very informative. After all these years of back pain and one major surgery, no one ever explained the nucleus pulposas not having its own blood supply an getting reabsorbed by the body. Thank you.
Awesome explanation of a herniated disc. I herniated my L4/L5 and L5/S1. I have been doing decompression at a chiropractor and pool exercises 5 days a week. Seen a lot of improvement in 4 weeks. What are your thought on PRP(platelet rich plasma ) injections? Do you think that can be beneficial into the back?
Sorry to hear about your discs! PRP and other stem cell-derived growth factors (SCDGF) are increasingly being used for the treatment of back pain due to facet joints. In those patients, the injection is done into the joint, as the problem is not the herniated disc. Very few pain management doctors are doing PRP or SCDGF injections in the epidural space. Back when I was in practice I tried several SCDGF injections into painful discs for chronic discogenic pain with surprisingly great results; however, those people had pain for years and MRI showed inflammation around the disc space (modic changes). Overall, given the lack of solid data and a great prognosis (94% of people with non-specific back pain resolve in 12 weeks), I'd hold off any alternative injections for now.
I'm definitely in the 4%. I've had lower back pain for maybe 15 years (I'm 41 now) and last year only had an MRI and got told I had degenerative disc and also lack curvature in the spine (lumbar). I also have another condition which I've had most of my adult life - overactive bladder - hospital have told me years ago they can't find anything wrong with me (all tests clear). When I had some physio for my back initially I had a week free of back pain (maybe 6 days or so) and I couldn't believe it but my overactive bladder also cleared up during this period. I never even noticed they were linked but I replicated the relief around 4-5 times, each time the same result. I'm a year down the line however and have been doing regular exercises and decompression stuff (at home) but it's still very bad. My osteopath told me it was coincidence and that the only bladder issue is Cauda Equina - I know it's not though and wonder how many others' have had this experience and not linked the two?
@silkee Did you check whether the anxiety that causes the OAB? I experience frequent urination and did all the tests, everything was fine. Later I found it's my anxiety/stress that causes it. Also confirmed with my psychiatrist
@Best Practice Health I was looking into this a bit more - as to why others' don't have this over active bladder - I was wondering if it was due to me having an L6 extra vertebrae? Would it cause the nerves to take a different route?
@Best Practice Health Thanks for the reply. Yes I spent a lot of time at the urology department at Kings College London and all my tests were clear. No infections, prostate and the cystometrogram all were fine. That was before I linked with my back condition but no one ever asked if I had back pain. I have my MRI scan I'd be happy to share if it helps others'.
Hmm. The test that determines if an "overactive bladder" is due to a nerve root problem is called a "cystometrogram." They put a catheter in your bladder and record the pressure as it fills. Not fun, but it is a definitive test done by a urologist. If you go that route, you want one who specializes in neurological urology. Or, come on my show, and let's look at your images together. It takes really severe stenosis to cause a neurogenic bladder. phoenixspineandjoint.com/best-practice-medical-questions-and-answers/?fbclid=IwAR1-EAG1KG0ltuYtM3pKQuLW3Q6pzf9DHfDfsoJJzo-YmWAS7GFnWF9c6DE
So lets say you are part of the 94% where the nucleus is re-absorbed in the body. Does the annulus repair so the nucleus doesn't keep leaking out? What would be the range of time for the annulus to repair? And If so, I would assume the annulus would be weaker (much like when you badly sprain an ankle - it is truly never back to 100 percent and is slightly more likely to be re-sprained, but can get close to 100 percent).
Yes. The outer part of the annulus does have a blood supply and is capable of limited healing. While there is no strong data, many neurosurgeons believe the annulus heals for around six weeks after it is torn whether that is by injury or surgery. It's likely that you are correct the healed annulus will never be 100%, but hopefully it will be enough to protect the nucleus from your body's immune system, and prevent further nuclear disc herniation and more inflammation around the adjacent nerve root causing sciatica.
Thank you for the clarity. I have been suffering with back pain for more than 2 years now. It's at it's worse now, but I grit my teeth and carry on with my chores. In this 2 years I have had injections and some relief . I am getting ready to have the epidural injection and looking forward to some relief . I have a couple questions that I should have asked my pain management doctor. How painful is this epidural injection without having the pain med? Should I be taking it easy at this time? I live on a farm and do some chores that are quite painful to do, but I carry on. Housework, vacuuming the worse. never realized how many times you bend over in a day, I have this painful catch when I try to straighten up. Should I be do this work at this time or carry on? Now the last injections I had I gained 25 lbs. I've managed to lose 15 lbs since the injections worn off. Now the nurse told me I didn't gain the weight from the steroids. Is this true? I'm a 69 year old active female, that still thinks she 25 years old. Any answers you can give me will be quite appreciative .
Epidural injection is not super painful without pain meds; I have done a thousand of them without any pain meds myself in the past. Rest is important but not too much; think water aerobics instead of running on cement. Work or activity, farm or otherwise, that causes paint that continues after you stop should be avoided. Steroids can cause weight gain, but you have to eat the extra calories; watch the diet carefully after steroid injection. Hang in there. Watch facebook for our new show where we go over your MRI with you. Sounds like that may be helpful for you.
Doctor, I have a herniating at C6-7 with numbness/tingling in my right index and middle fingers. Happened back in April. Confirmed via MRI in May. I’ve held off on surgery while trying several conservative methods, but no luck yet. I decided to lose 25lbs because, well, that’s never unhealthy and figured might help my mobility and pain level. And it has. My question: when is it time to throw in the towel and go get the scalpel? I have been researching photobiomodulation therapy and wondered if a Diowave 60w high power therapeutic laser would be worth it. Your time and response is appreciated in advance. 🙏🏻
Hey, Brent. Here's a link to BP Live. I answered your question today. The discussion of your case begins around 40 min in. kzclip.org/video/zb9UGqWtjf4/бейне.html. If you have not already please subscribe! Thanks for the great question. I think many of our viewers have the same issue.
Hi, Brent. Sorry for the slow response. I'm sorry to learn of your neck troubles. I'm going to answer your question on my live show tomorrow at 10 AM (12 PM Central). If you would like a review of your MRI included call my staff at (602) 256 - 2525 to upload the images to our confidential online drive. I will send you a link to the discussion afterward.
Thank you again for your insight. I had surgery one year ago, discectomy/laminectomy on my l5 s1. Never gave relief. I have a disc extrusion, so a tear in the outer disc. I get flare ups that swell my lower back( mostly left side). Is there any way to differentiate between scar tissue and the actual herniation that is causing the sharp pain? Is scar tissue inflammatory? Can’t bend or something catches. I took prednisone and that helped my ability to bend. Any insight on how to differentiate between scarring from surgery, or the herniation? I understand every case is different. Any input from your expertise would help. Thank you again for your work.
@Jason Shamoon You're welcome. Thank you for the comment! A caudal injection is when a doctor places a needle under the sacrum and injects something, typically steroid. The rationale is that the epidural space connects with the space under the sacrum. The advantage of a caudal injection is that it’s easy to do and does not require x-ray guidance. In my opinion, caudal injections really have no role in modern pain management. What you want is a doctor who can look at the MRI, identify a potential problem related to a compressed or inflamed nerve root, confirm with a physical examination targeted to the nerve root involved, then if appropriate do a transforaminal injection of steroid to reduce inflammation on the affected nerve root. A transforaminal block requires fluoroscopy and training, but it’s better because it focuses the treatment on the problem. The second advantage of a transforaminal block is that it confirms your doctor’s theory about what’s wrong. A doctor may have their own reason for doing a caudal, but the reason I see most is that the doctor is not qualified to figure out what’s wrong and offer specific treatment. We are putting out a new video on how to pick a pain management doctor next week. Please subscribe and look out for that when it's released.
@Best Practice Health thank you for the response. I got a caudal injection 2 weeks ago. Didn’t do anything. Like you said, difficult to decipher what exactly is the cause.
Unfortunately, pain after spine surgery is common. The question is whether that pain is coming from the torn annulus, inflammation of a nerve root, or the adjacent facet joints. The only way to know for sure is to have diagnostic injections of those structures. A medial branch block is an injection that temporarily numbers the pain fibers to the facet joint. If you were pain-free for a few hours after a medial branch block then the problem is the facet joint and not the annular tear or nerve root. Similarly, a transforaminal epidural steroid injection numbness the nerve root and not the facet joint. These blocks are done by pain management physicians. The trick is to find one who will help you work out exactly what hurts. Until you know the problem, the solution is impossible to figure out precisely.
Much discussion on KZclip about Sciatica but I am having femoral nerve compression secondary to a disc herniation at L3. Any resources for non-surgical intervention for femoral nerve entrapment without saddle anesthesia or incontinence or foot drop?
Being at a healthy weight helps. Ya see, I was about 175 pounds in may of 2021. A physiatrist suggested I be out on a mood stabilizer, called abilify. I didn’t think anything of it, but before about 2 years before this I was on Paxil, and much like abilify I gained a significant amount of weight. The first time 50 pounds, and this most recent time 75+ pounds putting me well into the 240s. I may have had this herniated disc for a couple years but starting in early 2021 I had a lot of back pain. And for the last 8 months we’ve done scans and therapy and I’ve gotten myself down to 233 as of today. 2 weeks ago I got a steroid injection and within a couple days up to the present I’ve had extreme loss of mobility and function of my lower spine and left hip. The same day I got the injection I was moving a lot of heavy items at work, after I did this I went and got the shot and they numbed me up. I’m wonder if the numbing medication blanketed the aggravation of my already injured back more from moving the heavy items. Not sure what to do now. Might lose job. Moral of the story is so not ever let someone put you on a controlled substance without knowing all the side effects because they have a high probability of affecting your weight. Which can lead to more health problems such as liver, pancreas, cholesterol and LFTs along with type 2 diabetes. Please please please don’t let anyone out you on medication just because “somebody feels safer with you on it” your overall health is more important than appeasing people.
Went to the doctor yesterday. He checked how far he could move my leg. Left side was very painful almost immediately, right side was way less. He diagnosed L4-S1 compression, left leg is weaker and i have an MRT this Saturday. Thing is i always had a similar kind of pain when I.e. sweeping the street or anything that makes me take a similar stance. Just this time it's the 3rd week and it doesn't go away. Why did i wait so long? I have a high pain tolerance and idiot me went to work last week despite the pain and numb leg...
@Best Practice Health I haven't been walking much since yesterday, just inside the house. The pain i had having to walk to from the parking lot to the doctor and back already gave me a lot of pain for the day. Is it normal for the pain to decrease this much in 2 days? While i hope it's gone it's probably not because if whatever inflamation that was pressing on the nerve is gone by tomorrow i wasted a lot of people's times....it's most likely still there, i feel a bit of pressure in my lower back and the sole of my left foot feels weird. Thanks for the link.
3 weeks in and having numbness and weakness--- I agree with the MRI. Learn more about herniated discs with this playlist: kzclip.org/p/PLsYo8ENYsvpz8bmjf5QkF5IdaX6UPZrPk
im curious about the pulp. You said that the body digests the part that has "escaped" the annulus. Does the body make more pulp to replace the dissolved amount? If not, how does that affect the stability, strength, or cushion of the discs?
Oh, man...that would be great. Sadly, no. Our bodies do not replace the nucleus pulposis after it herniates and is digested by our immune systems. That's why we get "degenerative disc disease."
Great video! Im 24 and got a herniated disc i had back spasm or back problems since i was younger doctor says it does not look very good ive lifted heavy stuff in a bad form not so much this past year but i started playing soccer and looks like i have back pain every time i play so i decided to get an mri to see what was going on hope its not to late . And hopefully it can heal on its own with physical therapy after this last injury almost a week ago the painful part was the first two days o could hardly walk and stand up but only pain was on my back But very sharp now im doing much better still feel little pain not much just feels sensitive 6 days after i can walk great but i would some advice or opinions i love soccer sports running and training with my daughter and i wonder if im ever going to be able to do it again . Im in texas but i would love to go to Phoenix for a consultation i would like to know the cost for an opinion I can make it to phoenix in next week or so hope to hear a response soon. Im a bit worried i just want to go in the right path.:(
Hi Bryan! We were able to answer your question on last week's Q&A episode of Best Practice LIVE. You can view it HERE: kzclip.org/video/7WHPRbIoVCM/бейне.html
Thank you for this very informative video. Just a quick question. After the body eats the herniated part up, does the broken annulus heal itself aswell?
@Best Practice Health That's really interesting! I guess the macrophages eat up only the herniated part of the nucleus pulposus, thus leaving space for the annulus to heal! But now I 'm wondering how do the microphages know when to stop destroying the nucleus pulposus? Why don't they go as far as eating up the innermost part aswell?
Yes it does! The fibers of the annulus knit and heal together. No one knows the exact time, but I think it is mostly healed after 6 weeks if the nuclear disc material is not in the way.
Hi doctor , I am waiting for results of MRI, I believe I injure my back while doing very heavy hip thrusts . I have been taking it easy at the gym however I have been doing machine leg extensions but my pain comes back . Is this exercise not recommended ? What type of exercises should I do? Thank you
Exercise and therapy have been studied a lot and have not been shown to be effective in the treatment of herniated discs. What works are natural healing over time, epidural steroid injection for temporary nerve root pain relief, and microdiscectomy surgery when all else fails. The gym is awesome and critically important for your long term health; but it won't help with your herniated disc. Let me know when your MRI is back and we can review it together if you like!
Hi! I'm 17 years old and I suffer from hernaited disc L4/L5 since september 2021. It happened because of lifting heavy, training soccer a lot, and maybe genetics from one of my parent. I have pain mainly in my left leg especially the calf! I don't use any pain relievers. I do core workout 3times a week. What are your suggestions for healing it? How to speed up the process? Is it good to take Collagen, Glucozamine, Chondroitin and etc.?
Great question. We have a live show every morning where we answer questions like this and tomorrow I answer your question and afterward I will send you the link! I can give you an even more thorough answer If you are able to / willing to upload your MRI or call into the show live so I can talk to you directly. If that is something you are interested in please call +1 602-256-2525 with a parent or guardian and our staff will give you directions!
I was lifting far too heavy weights and with poor form when I heard and felt a terrible crack in my lower back which left me in severe pain(sciatica) for around 2-3 weeks. 2 years later I have no sensation in my upper right thigh and constant pain between my shoulder blades. My lower back cracks and pops the whole time when I move and lift things etc and I’m constantly living in fear that my back will go again and suffer from sciatica. Will my situation eventually correct itself because it’s gradually having an effect on my mental health?
You are welcome! Yes. There is a great chance it will heal over time. The key is to figure out what kind of pain you have, and then you have the imaging you will see if you get confirmation. Check out this blog: phoenixspineandjoint.com/is-ozone-a-good-treatment-for-the-low-back/. Try to figure out if you are A, B, or C.
@Best Practice Health thanks for replying. Yes I have a doctor, I am in fact in the UK and on the NHS waiting list for a MRI scan which has already taken 3 months due to a backlog. If it is what you say most likely a annular tear with herniated disc does this eventually heal itself over time or will it require some sort of surgery as it has been over 2 years since my injury?
Sciatica is such a severe pain is can cause a fear of it recurring that is like post-traumatic stress disorder. The way to overcome that fear is to know the risk. You can only know the risk through imaging. The crack you heard in your back was most likely an annular tear. Depending on the weight and your bones it could also have been a compression fracture or traumatic injury. Given the thigh numbness the most likely problem is a L3/4 annular tear with herniated disc. The next step is an MRI of your lower back. That typically requires a prescription. Do you have a doctor?
Hi doc, not sure if you still reply to comments here but I have a 7mm disc extrusion on my l4/l5 since January 2022 until now (December 2022) the pain from the sciatica has been present since March 2022 and there is still no progress of recovery. I’m 21 years old this year and my herniation came from deadlifting
I have disc herniation since 2013 ,L4L5 ,,suffering but now I am okay ,from Africa Algeria,,last week ,I did auriculotherapy ,it's good for pain ,,Chinese traditional,,technical .
I had a inflammation back in 2021 and couldn’t bare to get up for the first 4-5 days and close to a month I got better. I stopped going 6 to 5 days to the gym now. Now In 2022. I decided to go onto 4 days a week but heavy setting on a Dailey. I was deadlifting and next thing I knew I felt like I got struck by thunder dropped the weight mid-set. I fell but got back up right away and confused in what just occurred (in shock) I tried to get on my feet but couldn’t! I sat on knees it’s like I couldn’t feel my legs for the first few 3 minutes. I drove back home got tingles and numbness on my lower body (nerves). 2 weeks in now my lower back feel better and the inflammation on my lower body hasn’t occurred today! Thank goodness it was a hell week! I just have trouble sleeping. I tend to wake 3 to 4 times a night. I’m having more left leg pain but some of the pain went away and feeling better but still in pain if you get the memo😅 I’ve been icing and taking meds as well to help with my pain. I did sleep well for 4 days this week which felt great but now waking up 3x a night which is odd cause I had 4 good days .. Right now it’s my lower body just hurts to walk and sometimes I tend to crash down if I’m in a odd position like squatting really low and I can’t do nothing about but fall the pain is unbearable and can’t really do nothing about it. It happens not just squatting but like just walking the pain will hit me but today I feel like the pain slightly reduced but not really much it kinda feels the same. My worst pain I’ve yet had was last Saturday night that it occurred for like 45 min and I even cried when it finally went away and it was behind my thigh on my left. The worst pain I ever felt! I made the mistake of taking hot showers as well so now I will reduce my hot water to more of a cool water temp. I’m 25 right now and fit and active and hope for this pain to go away soon. I pray week 3 I get some good reduction of pain and walk slight better. I appreciate the info thank you! 🫱🏼🫲🏽
Yikes! I'm so sorry this is happening to you. Sadly, you give a perfect description of what it feels like to have a herniated disc. I'd be happy to answer your questions on youtube, like we do. Your experience is so important to share with others... are you willing to do an interview?
I have a moderate herniation at my L5-S1 with a measurement. It's been a long 4 months but I am slowly getting better. Is this herniation too large to heal on its own? (See MRI details below) Thanks! (Been doing PT weekly & 2 epidural shots so far that were not very effective unfortunately) At the level of L5-S1, there is a moderate size left posterior paracentral disc protrusion that measures approximately 7 x 5 x 13 mm. This causes mild ventral effacement of thecal sac and moderate left lateral recess effacement. There is displacement of the transiting left S1 nerve root. Minimal hypertrophic facet arthrosis at this level.
The key to taking the right step in the treatment of a disc protrusion is not usually the size of the disc; it's whether or not the patient has a functional weakness, numbness, or uncontrollable pain. The s1 nerve root provides sensation on the outside of the foot and works the calf muscles. A good way to test for functional weakness caused by damage to the S1 nerve root is to walk on your tip toes. One can test for S1 numbness by gently touching the outside of the foot, by the pinky toe, and comparing it to the other side. Disc protrusions do heal, as they are exposed to the epidural space, as opposed to bulges. I'm sorry you're in pain. I hope you feel better soon.
I had this issue started almost a year ago and in the beginning the spinal canal diameter between my L4/5 was 6mm and now it’s 9.5mm also the pain i feel is lesser these days as compared to months ago. Doctors are recommending me surgery but i want to recover it without any surgery, could it be healed in some more time as one year had already passed or surgery is the last option I have?
Oh, no! Sorry to hear you are suffering. Unfortunately, spinal stenosis only gets worse, and the only treatment that actually restores the spine and protects the nerves is laminectomy surgery. What you have to consider is the timing. I've seen so many patients wait too long, until they were not healthy enough to have it, and then suffer for the remainder of their life with something that could have been addressed.
Doctor. I did my MRI and it looks like I have herniated disc at L4-L5 and L5-S1. I dont have any numbness but the pain radiates through my right leg all the way down. This pain is only felt if I sit down for long. When I stand up and do some walking, it slowly reduces. Do you think it will heal by itself? I’m willing to wait.
Hi there! We were able to answer your question on last week's Q&A episode of Best Practice LIVE. You can view it HERE: kzclip.org/video/7WHPRbIoVCM/бейне.html
@Best Practice Health thank you for your quick reply. Actually my pain is more towards right leg (from hips to calf) with very minimal pain at the back. If I sit for long, the pain will start to come. Once I stand up and start walking, the pain reduces significantly so I wonder, it is this a good sign.
Hi, SadiQium. Nice to meet you. If I have this right your pain is more in the back, worse when sitting. That kind of pain is more typical of an annular tear or a facet. The first step is to figure out what's causing your pain because the treatment---if any is needed at all---depends entirely on the cause and severity. Check out this blog to help understand what is causing your pain. Pick A,B,C, or D based on how it feels. phoenixspineandjoint.com/the-3-things-neurosurgeons-recommend-for-new-low-back-pain-spoiler-alert-panic-isnt-one-of-them/
@Lars Hinkel I have bulges at l1 l2 l4 and l5. Also mold at c5 c6 c6 c7. No stenosis. Am just 39 too. I really was active and fit too all these years. No idea all this just happened 8 months back. Just don't know what to do
@World i am 53 years old . I loved to do Sports , had a physical demanding Job … nie i can ”t do anythinh of That . Can"t find a Job That im Able to do . Thats the worst I have ist in the low back . L3 -l4 , l4-l5 , l5-s1 . I was once a fit guy
Is it possible for a protuded disc (L5-S1), to produce swelling and pain when touching that particular point at my back? If not, what injure or desease could produce that effect? Thanks!!
@Best Practice Health Thanks so much for your answer. It gives me an important clue. It was a little confusing at first because at the same level (L5-S1) the MRI show a disc protution, (not herniation), that has never gave me any symptoms.before. After your answer, I am pretty sure that the swelling and palpation pain when touching, must be produce from some muscle spam or ligament sprain. Big thanks from Argentina!! ☺️
No. You can't touch your discs from the surface. But you can reach your muscles. Usually, radiating back pain caused by palpation is due to severe muscle spasm.
Hi, I am 25 yr old female , and have a L5-s1 disc protusion and diffuse disc bulge, as per report by radiologist. Some doc say its extrusion and some protusion. Having sciatica pain while walking more than 20-30min. Doc has advised bed rest for 2 weeks with limited exercise.On medications also. In my case is resorption possible?
Because disc material has no blood supply and is "foreign" even to your own body, all disc protrusions are reabsorbed into the body by inflammation over time. If either the compression by the fragment or the inflammation is causing damage to the neighboring nerve root, then microdiscectomy surgery should be considered. The way to know there is damage to the nerve root is from the presence of 1) functional weakness, 2) numbness, or 3) unbearable pain. If 1,2,3 are absent, then the traditional advice is to wait it out. During the waiting period, you can get temporary relief with a transforaminal injection.
I just herniated my disc at L5/S1 and i'm pretty insecure now if i will ever be able to Box again.....my question is. Will the disc fully recover and also heal the outer Part?
Would the disc not completely collapse later (after the healing phase)? I have a (missed) spondylosis after trauma, then only after about a year the pain increased dramatically... Now we discovered that I have a disc that is disintegrating (small herniation)...but my specialist made it sound very soon & gloom...that I will eventually need surgery.
Sorry to hear about your accident. It's common for an annulus to be torn in an accident, and then heal back up. During the healing phase the body often reacts to the foreign nucleus material and digests some of the disc. Depending on the size and extent of the tear, the disc injury may heal fast and easily, or it may take longer and require more healing. Disc spaces do often collapse as a result of the injury and healing process. It's a hard thing to predict. I would not assume surgery would be required at all! The vast majority of these type of cases heal without it.
Hi doc! My MRI report says L5-S1 level -- Disc desiccation, diffuse disc bulge causing indentation of anterior thecal sac and narrowing of left neural foramina resulting in compression of left exiting nerve roots... Please help me on this... what's causing sharp pain in my low back and left leg I'm 23 year old and having this pain from almost more than a year first it was in low back and then it entered my in my left leg.. I'm taking medicine written by neurologist and doing PT daily but it's not getting well only temporary relief form exercises 🥺
Let's look at your MRI together and find out! Stay tuned to Phoenix Spine and Joint on Facebook. We are starting an interactive show to review MRI together.
Sir,i have l4 to l5 and l5 to s1 disc bulge and every doctors said to go for surgery but i am delaying also sometimes my left leg are numbness and heavy pain in back bone what shall i do? please tell me sir
I am 35 years old and have feeling sciatica pain for more than 5 years but I didn’t know anything about herniated disk.I just had severe pain in low back and went to see doctor and after MRI ,the test result showed that I had herniated disk between L2L3,L3L4 and L4L5.the L4L5herniated disk is the one that seems to be touching the sciatic nerve and causing the pain.the doctor I went to only suggested me to take pain killers.what should I do
Yikes! Five years is a heck of a long time to be in pain. Clearly this is not getting better on it's own. That means you need someone to help. I'm sorry you are going through this thing. I strongly recommend you get informed and then find a new doctor. The choices are going to be pain management or spine surgeon. The right doctor depends on the imaging. So, long story short, I recommend recent x-ray, bending x-rays, and MRI for people who have been in pain for a long time without a real diagnosis. Once the imaging is done they can pick the right doctor, and get on with getting better!
I’ve had bad sciatica for 11 months; meaning I can only walk for 30-45 min until I have pain in my leg, buttocks and lower back to the point my hips become shifted, I’m walking crooked and in pain and have to lay down. Just recently (few days ago) I went for a walk in a park that was vey hilly, after that my pain became substantially worse and I can’t walk not even for a min or sit on the toilet without being in extreme pain like someone is stabbing me in the lower back. I cannot sit much if at all. I don’t know what’s happening. When this all started Initially a year ago, my MRI showed ruptured disc at l4-l5. That’s what was Initially seen at least. I’m loss for words…
@Best Practice Health Yes, I just saw the video. Very insightful. Thank you for passing my situation on to the Doc. I think surgery is good option for anyone under the circumstances,I’ve just read some info that surgery could be not so good of an option. Everyone is different I guess. I’ve got some thinking to do!
@Best Practice Health Thank you for your response. I will go ahead and do that. I just came out of hospital today for this issue. Doctor wants to do surgery. I have improved a little and pain calmed down a bit but still worse over all than before. I am seriously considering my current options.
It sounds like you had a progression (recurrent) disc herniation. If you have any red flags then you need medical attention now. Otherwise, consult the matrix and decide what to do. It's been 11 months...sounds like you need help. Feel free to submit a video question and a pic of your mri here: bestpracticehealth.tv/
Sir I have L5S1 disc herniation due to that my left leg is numb from January MRI shows central canal stenosis diameter of canal at L5S1 is just 3.6mm in February but now ok by phisiotherapy But a little bit pain in glute area Both . Will I be cured with this way
Hi, 👋🏽 I hope you can give me an answer. I have low back pain and sciatica Since about 2 months ago . Well It actually started like 8 months ago. I felt tingling in my left foot while laying on my back. I wasn’t able to lay on my back but didn’t had crazy leg or back pain. But then hell started the back pain and very bad sciatica a month ago. Some days hurt more than other days. Not sure if it started as a bulging disc and then it erupted months later? I Can’t stand or walk for more than 10 min and I get leg pain. I walk hunched over. Some days I can’t lay at all. Will this heal on its own? (See below my issue) I am also doing now spinal decompression. I’m concerned, exhausted and sad! 😩🙁 Sciatica really sucks! L3-4: Small circumferential disc bulge L4-5: Small/moderate partially inferiorly extruded posterior disc herniation L5-S1: Moderate/large posterior disc herniation favors the left. Partially inferiorly extruded. compresses the left S1 nerve root. Anterior bulge/osteophyte.
@Kproc It depends on the person. If the weakness would prevent you from doing normal activities then it's a functional weakness. So, if you never ran a day in your life, and your weakness didn't bother your walking, then it would not be functional weakness. On the other hand, if you were a dedicated cyclist, and you couldn't ride due to weakness, then it would be a functional weakness.
@Best Practice Health how bad would you consider functional weakness? I haven’t been able to walk or stand straight and at the 6-7 week mark. My numbness is more around just my ankles but i have muscle weakness and buttocks hurts like crazy.
Hi!. So sorry you are having trouble. I hope you have good support from friends and/or family. Pain from herniated discs is a lot to deal with! I'm going to assume the leg pain is on the left. If that's not right, please let me know. It's really common to get a tear in the annulus of a disc, which causes stabbing back pain, and then note progression. Sometimes the soft part of the disc "herniates" through" the tear and irritates the nerve root. When this occurs you feel pain down the leg and into the foot. In the case of the S1 nerve root, one gets numbness on the outside of the foot, weakness standing on your toes, and loss of the Achilles reflex. All of this goes away on its own more than 90% of the time within 12 weeks. An epidural injection is good for 100 hours or so of pain relief along the way, but it doesn't change the outcome. If one develops functional weakness or numbness along the way then it's time to consider microdiscectomy. These three options are the "matrix" of treatment options. Check them out here: kzclip.org/video/6EuJba0i8uI/бейне.html
Hi, the depictions of herniations in this video explicitly show the nucleus bursting through the annulus of the disc. I have seen other depictions that show the annulus being deformed outward but still containing the portion of the nucleus that is protruding. If I have a Protrusion but not a Sequestration, is my nucleus hanging out totally exposed or is there a layer of stretched out annulus still surrounding it?
@Best Practice Health my MRI report did not mention any modic changes, just a foraminal hernation pressing on the nerve. At first I was worried I would always have this herniation unless i get surgery but after reading more and watching videos like these I'm more optimistic about this resolving without surgical intervention. With that being said it is confusing for a layman like me to understand what's happening with my body and what the possible outcomes could be. It also seems like there is still a lot left for scientists and medical professionals to learn in this space.
@GeneralJoey747 The annulus is an outer layer or wrapper of the nucleus pulposis. If a tear in the annulus heals over then the nucleus pulposis is again shielded from the body's immune system and the cycle is over. Since the nucleus has no blood supply there is no route for the body's immune system to attack it. Doctors see this battle play out on MRI all the time. Inflammation at the junction of a torn annulus and the vertebral body bone is called "Modic changes" on MRI reads. If you have an MRI of your back check the report for that language. "Modic change" is the evidence of a long-term tear in a disc causing inflammation in the adjacent vertebral body.
@Best Practice Health if the nucleus is still confined for a given herniation, is that herniated nucleus material still eaten away by the body or can it migrate back to where it should be? Thanks for the info!
Yes, you are exactly right. The annulus can tear, but the nuclear stays confined. The good news is that the nucleus is not compressing and irritating the nerve root. The bad news is that pain fibers grow into the disc and can cause a painful annular tear.
Hello doctor.. I am from Afghanistan...two days ago I injured my back at the gym... I did MRI the report says I have slipped disc at L5 and S1.. I have slightly numbness at my legs... And extreme pain at my back I HAVE two Questions What should I do or avoid now at acute slipped disc to prevent further problems in future.? Q.2 will I be join army and perform hard activities after recovery?
What were you doing when you were injured? That was clearly too much. Most people are able to return to normal activities after they recover. Core strength is key. Consider yoga, pilates, or tai chi. To avoid another episode maintain your core. If it happened in the gym it ways going to happen anyway, I'd keep going once you are better but modify your workout. A trainer can be a good investment in this situation.
I have L4-L5 disc bulge two months back. I have undergone naturopathy treatment for a week. I got relief from pain.Do I really require surgery to be done sir?
Which surgery? If you mean microdiscectomy, it's virtually never appropriate for a bulging disc. Microdiscectomy is for people with 1) functional motor weakness, or 2) functional sensory deficit, or 3) uncontrollable pain. If you do not have one of those then microdiscectomy surgery is not generally indicated. Check this out: kzclip.org/video/Wfycmdtd3xE/бейне.html
I have herniated disks at T12/L1 and L1/L2. The pain in my hip and most of my thigh is unbearable. Cannot walk for more than a few steps. Do you have any info on this problem? Thanks
@Best Practice Health thanks. I have had an MRI. They are pushing on the nerves coming from those disks. It has been about 3 months and it's starting to ease. My white blood count is high so from what you say, it is probably my body trying to heal it. Doc made a referral to physio
Pain in the lower thoracic and upper lumbar spine can actually radiate into the groin. So does hip pain. Your doctor will want to test passive movement of your hip with you laying down to be sure this is not a hip issue. If the pain is coming from one of the herniated discs, you have the usual choices for treatment outlined in the video. If you need more help come on my show. phoenixspineandjoint.com/resources/best-practice/
Am I hearing this correct that Dr. Lieberman is not promoting surgery and informing us that disc herniations get better on their own? Dr. Lieberman has stated on all of his past videos lumbar stenosis will never heal without surgery and that excise as a treatment was a waste of time.
Yep! Herniated discs typically get better on their own and stenosis gets worse. Dotors call this the "natural history" of the condition --- AKA what would happen if you didn't do anything. One caveat, exercise can help keep you going in the early stages of stenosis ("motion is lotion") but does not in any way reverse the stenosis which will in fact get worse and some rate.
I am confused. If someone has a herniated cervical disc, it often causes myelopathy. Everyone says that this myelopathy usually progresses, why do they say so if 97% of people get better by their own?
I'm not glad you're confused, but that is why I'm here! This stuff is confusing. And serious. Myelopathy refers to any disease or disorder that affects the spinal cord. It can be caused by a variety of factors, including: Spinal cord compression: While this can be due to a herniated disc, it is much more often due to spinal stenosis (narrowing of the spinal canal). There are rare causes of compression as well, such as epidural abscess and tumors. Trauma: Myelopathy can result from trauma to the spine, such as a car accident or a fall. Inflammatory diseases: Certain autoimmune disorders such as multiple sclerosis or transverse myelitis can cause myelopathy. In short, herniated discs do typically get better on their own. But myelopathy is not typically caused by a herniated disc.
4 months now and still numbness in right index finger due to herniated c6 area. No longer need pain meds so it seems to be healing bit very slow and I have to be careful what I do to avoid flaring up more pain. Unable to work so thank God for insurance but hoping it heals within 6 months...
reduced physiological lumbar lordosis almost eliminated.. absence of focal bone lesions. height of vertebral bodies preserved: absence of intra-cancellous edema. signs of l4, l5 and l5 -s1 disc disease. annulus fibrosus in the posterior median area with hint of minimal subligament herniation. At the l5-s1 level, median-paramedian and right posterolateral disc herniation is present with foraminal involvement. The other disc spaces were normal. Vertebral canal and conus medullaris normal.
I have spondolysthesis. My l5 has moved a bit. My pain in my leg and hip area has increased and my feet at night feel like they are hot. I am 26. What do you suggest I do? I was trying acupuncture. Do you think it can help? I have been having loxoprofen 60mg and mecobalamin 500 for the past 6 days and my pain has reduced. Please suggest what can be done!
Burning or strange sensations in your feet at night are often due to neuropathy, and not related to your back. Some neuropathy runs in families, so as your parents if anyone else has it. Leg and hip pain is usually facet mediated pain. Watch this video to figure this out: kzclip.org/video/rBmHQ7VCDIk/бейне.html. If your pain is more than 12 weeks old and due to a facet injury then medial branch block done by a pain management doctor is the key to finding out what is wrong. If the medial branch block is positive then radiofrequency ablation is the next step. Learn more about spine problems here: kzclip.org/p/PLsYo8ENYsvpxyo-QrlRIROPJ3TNWP882b
So I have an 8 mm herniated disk causing secondar stenosis. Do I need to get surgery or should I wait? It's been 3 months I get mild leg radiating pain but nothing apart from that.
There are choices for treatment of a herniated disc. Wait for natural healing, epidural, or microdiscectomy surgery (MDS). MDS is for those with functional deficits or uncontrolled pain. You don't sound like you need MDS. Epidural is for temporary pain relief as your body heals. Your pain is mild now. So, the last choice is wait it out.
@Nirmali Bhuyan Finding the right doctor is often the key to getting better. We listen to your story and help get you into the right doctor. If you need help call us at 602 256 2525.
So sorry to hear about your pain and suffering. Everyone deserves someone to help them when they are sick; I hope you have a good doctor. People with back pain are generally treated by pain management or physical medicine and rehab PM&R doctor initially, and then a specialist as needed. Are you getting the help you need?
Week 1 down...on crutches..can't put weight on right leg ibuprofen 1000 mg a day ( 200 x5 ) take 1 pill 💊 every 5 hrs as needed..warm bath ..I had massive sciatic pain ..had to get .5 mg corticosteroids in glute..some relief .. will update week 2 .
Oh, goodness! So sorry you are going through this. Keep you chin up if you can... most pain of this type resolves by itself. See a doctor right away if you have intractable pain, functional weakness or numbness, or any bowel or bladder dysfunction. Hang in there and let us know how you are doing.
Hi Freddy, my name is Phebe, Care Coordinator with Phoenix Spine & Joint. I'm sorry to hear you're experiencing a lot of back pain & numbness/tingling. I can connect you with Dr. Lieberman who would be happy to discuss why this may be happening & next steps. Please feel free to contact me 602-385-0435.
Hi, Abdullah. I'm sorry to hear about your herniated disc. The decision between therapy and surgery depends on type of pain you have and for how long. I just made a short video for another person to review their options which may help. If you want, you can check that out here: kzclip.org/video/lHx-ylN35Ww/бейне.html. A couple of other things to consider... The first thing you need to decide is if your pain is coming from a nerve root. If so, the traditional treatment would be to start with epidural injection unless the pain is unbearable, or causing functional weakness, in which case microdiscectomy surgery would be the way to go. Physical therapy works by mobilizing joints; so, it's a good tool for facet mediated back pain that does not resolve with rest, moist heat, and NSAIDs (when safe) 6-12 weeks after the pain begins. I hope this help! And I hope even more you get better soon. Remember that 94% of low back pain goes away within 12 weeks by itself without any intervention.
Hello !!! I just received my MRI and talked to my doctor she recommended surgery for my herniated disc , i want to heal naturally i think i can handle the pain for 12 week more but the pain started since February . Is there a better way i can talk to you for recommendations im 21 years old
Hi German! We were able to answer your question on last week's Q&A episode of Best Practice LIVE. You can view it HERE: kzclip.org/video/7WHPRbIoVCM/бейне.html
Im 14 years old and i have herniated disc. Im playing basketball and im resting 4 months but its still same. I try to do exercise but its even worse. What to do now?
No basketball! It's too rough. Light exercise like swimming, walking in water, or elliptical bike. You are so young, it will take time to heal. But it will likely heal. You may need to see a surgeon. You may as well start looking for one in case things do not improve. Did mom or data have disc issues?
Hi sir you told nucleus pulposus will get digested, my question is what if nucleus pulposus not comes out and just bulging then how our body reacts will it gets heal in this case ?
That's a bulging disc. If the annulus in intact and the nucleus of the disc is not in contact with the blood supply there should not be an inflammatory reaction.
Dr can you please reply my question Is bulging disc heal or not? I have bug disc but not compression to nerve as ct scan showed I really scare and cry a lot I have sciatica pain within 4 weeks, so l cried a lot because really l scare about the permanent problems. I did CT scan and the Dr diagnose l have budging disc on S1 and L5 but the disc does not pressure on the nerve. So l have pain in my calf and ankle I don't have any idea because my both legs have problem, one of them too much and next is sometimes As l am young and student, l am very worried and cry alot I do pray for all people to recover from sciatica 🙏
I'm so sorry you are suffering. Sciatica pain is really severe and naturally frightening. The first step is to figure out what is wrong. Then you will know how to fix it. A bulging disc typically does not heal on it's own. A herniated disc heals because of an immune reaction between the soft "nuclear" contents of the disc being exposed to the rest of the body. In a bulging disc the nucleus of the disc is still behind the annulus and doesn't heal in this way. In any event, a bulging disc shown on CT without nerve root compression is unlikely to cause sciatica. However, most of the things that do cause sciatica should have "shown up" on a CT. Absent a really large problem or narrowing (stenosis), sciatica is rarely present in both legs. Not all nerve problems are sciatica in the first place. A neurologist would consider nerve problems like neuropathy in evaluating a nerve problem in the leg. The test to separate nerve problems from nerve root problems is the electromyogram (EMG). The EMG test is typically done by a specially trained physiatrist, or historically by a neurologist. I can't give you medial advice over internet. But the key to figuring out what is wrong is the right doctor. A spine surgeon is typically a good choice if you need surgery; if you want to find out what is wrong a pain management doctor, or physiatrist are typically the doctor with whom people start. *** Pain management doctors are *board certified in anesthesia or physiatry; ** subspecialty certified in pain management; and *** don't abuse narcotics except for cancer or surgical pain treatment. I hope this helps. Please let me know how you do.
@Hector Bruh my neurologist said to avoid chiro as this can make a herniated disc worse. Hope that helps but refer to your neurologist as everyone's case is different.
@Hector Bruh brother in my MRI also it's showing mild disc bulge but nothing regarding how much mm it's coming like that, do you remember which MRI machine you went mine was 0.3T MRI machine that means an older machine
@Best Practice Health Thank you Doctor I'm visiting the neurologist again in a couple days I just wanted to know if it would be a good idea to visit a chiropractor or if a chiropractor would help in any way. I have constant stabbing pain on my right thigh. I can't even sneeze
Microdiscectomy surgery is not necessary for bulging discs that are not causing sciatica, uncontrollable pain, or functional numbness/weakness. That does not mean it does not hurt! I hope you feel better soon. Come on the show if you want to discuss. phoenixspineandjoint.com/resources/best-practice/
What? No. Ninety four percent heal on their own. No one runs forever: my dad ran marathons for decades and even he had to stop in his sixties. But dancing is great for you and is actually associated with longer life. Just be careful on who you choose as a partner!
You are welcome! Thanks very much for the comment. This video is an FAQ for our KZclip series The Clinic. Have you seen any of the episodes? It's kind of cool... like sitting in on someone else doctor visit. The Clinic episode this video references is here: kzclip.org/video/gbGSWGOL1_8/бейне.html. There are 2 other FAQ videos from that episode, here kzclip.org/video/2iXy6KWpP50/бейне.html and here kzclip.org/video/X6qCrROoKYo/бейне.html. I hope these videos help!
Yes. L5/S1 is the lowest disc in the low back. Nerve root pain (sciatica) that is caused by compression or irritation of a nerve root by a herniated disc usually gets better on it's own. Epidural injection provides good temporary relief. If the disc is causing functional weakness, numbness, or uncontrollable pain then micridosciectomy surgery should be considered. But most get better on their own. For more on the decision making for a herniated disc check this out: kzclip.org/p/PLsYo8ENYsvpz1yIhgup7d7Yv92HWMz7ja
Hi doctor I have 3 hernation in my thoracic and 1 hernation in my low back whit schmoll noods I have a severe pain almost in 7 months .just disc small ptroution can heal I started some exercise and walking every day my pain 10/8 change .but still pain .I can sit more than 3 minutes .I don’t know what can I do .
The right solution depends on understanding the problem. Schmorl’s nodes are a beak down of the vertebral body endplate that allows a disc to herniate into the bone. They are n to typically painful unless there is a lot of inflammation at the site. If there’s is inflammation at the site a radiologist will describe it as “Modic changes.” If an MRI report specifies modic changes then the treatment staircase is core strengthening, followed by consideration of disc injection with growth factors, followed by enervation of the endplate with the DENERVX procedure, and if all else fails spinal Interbody fusion with disc removal. I hope this helps. Let me know if the MRI report mentions modic changes, and please describe your pain. Watch our video “types of low back pain.”
Hey doc was wondering how smoking marijuana effects the healing of disc ? I smoke to get rid of pain but sometimes after I feel like I’m im more pain than before
I am not an expert, but my understanding is that THC in your blood binds to specific receptors for cannabinoids and should not greatly affect inflammation.
Great question. I did an interview with Dr. Kong this week and learned a lot about MHC's, intravenous infusion, and other stem cell topics. It will be out on the channel soon. But in terms of stem cell therapy for the treatment of herniated discs with sciatica, the jury is still out on this one. The idea behind stem cell therapy is to use stem cells, which are undifferentiated cells that have the ability to develop into many different types of cells in the body, to regenerate damaged or diseased tissue. In the case of herniated discs with sciatica, stem cell therapy involves injecting stem cells directly into the affected disc to promote healing and reduce inflammation. The stem cells can differentiate into disc cells and help to repair the damaged tissue. The hope is that this will alleviate the compression on the sciatic nerve, which can cause pain and other symptoms. While there is some evidence to suggest that stem cell therapy may be effective in the treatment of herniated discs with sciatica, more research is needed to fully understand the safety and effectiveness of this approach. Some studies have reported positive outcomes, while others have found no significant benefit. It is also worth noting that stem cell therapy is not yet widely available and is not covered by insurance in many cases. In addition, the cost of stem cell therapy can be substantial and may not be feasible for all patients. If you are considering stem cell therapy for herniated discs with sciatica, it is important to consult with a pain management doctor. Call first to find one who offers this treatment. They can also help you weigh the potential risks and benefits and make an informed decision about your treatment options.
Doctor I have been following your instructions of disc Spain sugary, l did Disc Spain sugary 6 month but still up to now pain and numbenss to my left leg please help me
Oh no! It sounds like you have persistent sciatica (nerve root pain) after microdiscectomy. If that is right the next step is a repeat MRI with contrast. Has that been done?
⭐⭐⭐Bro u go to ur nearest ceragem center ur herniated disc will heal in few days bcoz the disc which herniated is gel liquid which body will heal in 10 years but ceragem will in 10 days it will make herniated disc into dry leave n it will not bother u any more hope u understand👍👍👍
Hlo please reply I got injured while doing squats it's a mild disc bulge at l4-l5 it happened in April but i got to know about it july when the pain started radiating in legs I've been doing physio for this whole month but still I feel a little discomfort and actually drive and walk too can't be on bed fully am I doing wrongs pls reply will i be able to do gym again pls
I am 40 years old. 2012 I was mild left back pain in lumber. Then I took medication and one month exercise then I quit and back to normal life. Mild pain is there all the time. But it didn't bother me. Now few days back when I bend forward to take my 10 years daughter. I suddenly felt pain in left side. As a result I can't bend forward. I don't feel pain in my legs due to that. How I can get back normal life again ?? I consult with doctor. He said after pain gone. I can start exercise for back pain. Now taking ot medicine pain killer. I don't want to take pain killer. So I want to stop it. Can you suggest me anything how I can bend forward after sometime
Start with non-impact exercise like water walking or bike riding ASAP. When you have no symptoms gradually increase your activity to walking, then running as tolerated. Same thing in the gym. Start VERY light, and gradually work up.
@Best Practice Health thanks for your reply. In my country usually MRI don't recommend as its costly. X Ray has been given. Since me taking medicine OTC drug for kill the pain. Now I have no pain unless I bend forward. So I stop pain killer. My back stiffness is still there. But not that much. I can move for my office and others. Only don't take any weight or sometime. I would like to do MRI. To make sure what's the condition about my lumber left side. As you are expert, can I ask you, when pain and bending is normal , can i start exercise for loosing weight. My height 5 9. Weight of 10 kg overweight. Now 87kg.
If you have no red flags the guidelines state the initial treatment for non-specific low back pain is rest, moist heat, and (if they're safe for your body) non-steroidal anti-inflammatory drugs. Are you doing these things?
Great question. It's a bad group to be a part of... I recommend surgical consultation as a piece of the puzzle. You can also submit a video and a pic of your mri and get my input here: bestpracticehealth.tv/
It doesn't. Great point. Disc bulges are behind the annulus, and have no blood supply. The "healing" comes from cells in your blood. Bulging discs re stuck.
Is and my neck I had an MRI and there it was bulging. I'm not having numbness and weakness or anything just queasy. And my blood pressure been up kind of lately they put me on blood pressure pills. I'm assuming my pressure coming up from chronic pain
Sorry for the late response, I somehow missed this last week. The best treatment for mechanical neck pain is therapy/chiro followed by NSAIDs. If that does not work then x-ray should be done with flexion and extension views. If those are negative then MRI is next. Surgery is very rarely needed and works poorly for neck pain. Radiofrequency ablation is a great treatment for mechanical neck pain due to facet joint arthritis. A diagnostic medial branch block is done first to see if the procedure is right for you. This procedure is done by pain management doctors. Make sure you find one who is a perfect *** (board certified in anesthesia or rehab, certified in pain management, does not prescribe dangerous drugs for chronic pain).
I had disc herniated past 12year, now I got operated, I just want to know that tared annulus is that also fixed and nucleus shouldn't come out with the tared annulus for ahead right?. If not , how to fix the tared annulus?
A torn annulus is not typically repaired during a microdiscectomy surgery. In a microdiscectomy procedure, the surgeon removes a small portion of the herniated disc that is pressing on a nerve root, which can relieve the associated pain and other symptoms. However, repairing the torn annulus is not always necessary, as the annulus is expected to heal on its own over time. Some surgeons make an effort surgeon may choose to repair it during the microdiscectomy surgery. This is typically done by removing the damaged portion of the annulus and suturing the remaining edges together to promote healing. The decision to repair a torn annulus during a microdiscectomy surgery depends on several factors, including the size and location of the tear, the extent of the herniation, and the individual patient's symptoms and medical history. Your surgeon can provide more specific information about your treatment options and whether repairing the torn annulus is recommended in your case.
PRP and stem cells are very effective at moving a body's inflammation toward a positive healing response. We are in the early stages of using these for spine issues. However, both have been very effective for patients in the past; the best results so far have been with knee injection. If you are interested in more about stem cells may check this out: kzclip.org/video/QIGVfLAb69Q/бейне.html
Hi , I am Maged , and I suffered from sciatica due to lifting a heavy object , is there a wat yo consult the doctor ONLINE as I live in Oman , it will greatly appreciated ,
Yes! Come on our show. Fill out the contact form here phoenixspineandjoint.com/resources/best-practice/ and upload your MRI. WE can go over your options together.
It seems like a great fix. No data I'm aware of yet. One issue is that stem cell injection usually increases inflammation in the weeks after. That could be super painful for sciatica patients.
@Shaikh Arif Disc bulges don't typically heal on their own unless they go on to extrude or protrude; however, mild compression is not usually a source of nerve root pain. A pain management doctor is a good place to start for disc bulges, as the cause of pain is probably something else and needs to be worked out.
@Shaikh Arif Bulging discs causing mild nerve root compression don't typically cause a lot of pain. Oftentimes when the pain is a facet joint and not the bulging disc is the primary cause of pain. Check this video out: kzclip.org/video/rBmHQ7VCDIk/бейне.html.
A herniated disc injures a nerve root in 2 ways: by pushing against it and by causing irritation. If the compression is severe or the irritation goes on long enough then permanent nerve root damage may be done. Some damage to a nerve root can heal, but the healing of a nerve root is limited and really slow. It's also scary because a damaged nerve root may start sending out pain signals all the time even after the disc herniation heals; that's called neuropathic pain. Most of the healing is really the body reabsorbing the herniated disc. Note that the disc will be reabsorbed if it's herniated and exposed to the blood supply, not if it is just bulging. This was a bit of a rant! I hope it helps.
Good question. Size matters with discs. The larger the herniation the more nerve root compression, and the more inflammation your body must do to get rid of it.
@Best Practice Health It's Shame, also in 1764 Domenico Contugo said that he experiment on male cadavers to prove the free circulation between the cranial and spinal dural he found out The cerebrospinal water is in perenni statu renovationis, through exudation by minimal arteries and reabsorption by minimal veins. It penetrates into dural sleeves of nerve roots; hence is apt to accumulate in the sheaths of the sciatic nerve and so give pain along its course. Such pain, weakness, and limping may be cured; if necessary by vesicants and caustics to draw out the hydrops.
@Rey Cesar Cariño Hi! The first major report about a herniated disc was from Mixter and Barr in 1934. They helped figure out sciatica came from pinches nerve roots. But it's safe to assume that people have been suffering and miserable from herniated discs since we began walking upright.
The main thing someone can do to promote effective healing is to promote overall good health. A well-balanced diet, plenty of sleep,, rest, and self-care are all important. Some doctors believe stem-cell-derived injections can promote healing; I certainly hope they are right, but the jury is still out on that one.
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Very informative. After all these years of back pain and one major surgery, no one ever explained the nucleus pulposas not having its own blood supply an getting reabsorbed by the body. Thank you.
Awesome explanation of a herniated disc. I herniated my L4/L5 and L5/S1. I have been doing decompression at a chiropractor and pool exercises 5 days a week. Seen a lot of improvement in 4 weeks. What are your thought on PRP(platelet rich plasma ) injections? Do you think that can be beneficial into the back?
@Best Practice Health to
Sorry to hear about your discs! PRP and other stem cell-derived growth factors (SCDGF) are increasingly being used for the treatment of back pain due to facet joints. In those patients, the injection is done into the joint, as the problem is not the herniated disc. Very few pain management doctors are doing PRP or SCDGF injections in the epidural space. Back when I was in practice I tried several SCDGF injections into painful discs for chronic discogenic pain with surprisingly great results; however, those people had pain for years and MRI showed inflammation around the disc space (modic changes). Overall, given the lack of solid data and a great prognosis (94% of people with non-specific back pain resolve in 12 weeks), I'd hold off any alternative injections for now.
I'm definitely in the 4%. I've had lower back pain for maybe 15 years (I'm 41 now) and last year only had an MRI and got told I had degenerative disc and also lack curvature in the spine (lumbar). I also have another condition which I've had most of my adult life - overactive bladder - hospital have told me years ago they can't find anything wrong with me (all tests clear). When I had some physio for my back initially I had a week free of back pain (maybe 6 days or so) and I couldn't believe it but my overactive bladder also cleared up during this period. I never even noticed they were linked but I replicated the relief around 4-5 times, each time the same result. I'm a year down the line however and have been doing regular exercises and decompression stuff (at home) but it's still very bad. My osteopath told me it was coincidence and that the only bladder issue is Cauda Equina - I know it's not though and wonder how many others' have had this experience and not linked the two?
@silkee Did you check whether the anxiety that causes the OAB? I experience frequent urination and did all the tests, everything was fine. Later I found it's my anxiety/stress that causes it. Also confirmed with my psychiatrist
@Best Practice Health I was looking into this a bit more - as to why others' don't have this over active bladder - I was wondering if it was due to me having an L6 extra vertebrae? Would it cause the nerves to take a different route?
@Best Practice Health Thanks for the reply. Yes I spent a lot of time at the urology department at Kings College London and all my tests were clear. No infections, prostate and the cystometrogram all were fine. That was before I linked with my back condition but no one ever asked if I had back pain. I have my MRI scan I'd be happy to share if it helps others'.
Hmm. The test that determines if an "overactive bladder" is due to a nerve root problem is called a "cystometrogram." They put a catheter in your bladder and record the pressure as it fills. Not fun, but it is a definitive test done by a urologist. If you go that route, you want one who specializes in neurological urology. Or, come on my show, and let's look at your images together. It takes really severe stenosis to cause a neurogenic bladder. phoenixspineandjoint.com/best-practice-medical-questions-and-answers/?fbclid=IwAR1-EAG1KG0ltuYtM3pKQuLW3Q6pzf9DHfDfsoJJzo-YmWAS7GFnWF9c6DE
So lets say you are part of the 94% where the nucleus is re-absorbed in the body. Does the annulus repair so the nucleus doesn't keep leaking out? What would be the range of time for the annulus to repair? And If so, I would assume the annulus would be weaker (much like when you badly sprain an ankle - it is truly never back to 100 percent and is slightly more likely to be re-sprained, but can get close to 100 percent).
Yes. The outer part of the annulus does have a blood supply and is capable of limited healing. While there is no strong data, many neurosurgeons believe the annulus heals for around six weeks after it is torn whether that is by injury or surgery. It's likely that you are correct the healed annulus will never be 100%, but hopefully it will be enough to protect the nucleus from your body's immune system, and prevent further nuclear disc herniation and more inflammation around the adjacent nerve root causing sciatica.
Thank you for the clarity. I have been suffering with back pain for more than 2 years now. It's at it's worse now, but I grit my teeth and carry on with my chores. In this 2 years I have had injections and some relief . I am getting ready to have the epidural injection and looking forward to some relief . I have a couple questions that I should have asked my pain management doctor. How painful is this epidural injection without having the pain med? Should I be taking it easy at this time? I live on a farm and do some chores that are quite painful to do, but I carry on. Housework, vacuuming the worse. never realized how many times you bend over in a day, I have this painful catch when I try to straighten up. Should I be do this work at this time or carry on? Now the last injections I had I gained 25 lbs. I've managed to lose 15 lbs since the injections worn off. Now the nurse told me I didn't gain the weight from the steroids. Is this true? I'm a 69 year old active female, that still thinks she 25 years old. Any answers you can give me will be quite appreciative .
Epidural injection is not super painful without pain meds; I have done a thousand of them without any pain meds myself in the past. Rest is important but not too much; think water aerobics instead of running on cement. Work or activity, farm or otherwise, that causes paint that continues after you stop should be avoided. Steroids can cause weight gain, but you have to eat the extra calories; watch the diet carefully after steroid injection.
Hang in there. Watch facebook for our new show where we go over your MRI with you. Sounds like that may be helpful for you.
Doctor, I have a herniating at C6-7 with numbness/tingling in my right index and middle fingers. Happened back in April. Confirmed via MRI in May. I’ve held off on surgery while trying several conservative methods, but no luck yet. I decided to lose 25lbs because, well, that’s never unhealthy and figured might help my mobility and pain level. And it has.
My question: when is it time to throw in the towel and go get the scalpel? I have been researching photobiomodulation therapy and wondered if a Diowave 60w high power therapeutic laser would be worth it.
Your time and response is appreciated in advance. 🙏🏻
Hey, Brent. Here's a link to BP Live. I answered your question today. The discussion of your case begins around 40 min in.
kzclip.org/video/zb9UGqWtjf4/бейне.html.
If you have not already please subscribe! Thanks for the great question. I think many of our viewers have the same issue.
Hi, Brent. Sorry for the slow response. I'm sorry to learn of your neck troubles. I'm going to answer your question on my live show tomorrow at 10 AM (12 PM Central). If you would like a review of your MRI included call my staff at (602) 256 - 2525 to upload the images to our confidential online drive. I will send you a link to the discussion afterward.
Thank you again for your insight. I had surgery one year ago, discectomy/laminectomy on my l5 s1. Never gave relief. I have a disc extrusion, so a tear in the outer disc. I get flare ups that swell my lower back( mostly left side). Is there any way to differentiate between scar tissue and the actual herniation that is causing the sharp pain? Is scar tissue inflammatory? Can’t bend or something catches. I took prednisone and that helped my ability to bend. Any insight on how to differentiate between scarring from surgery, or the herniation? I understand every case is different. Any input from your expertise would help. Thank you again for your work.
@Jason Shamoon are you fine now?
@Best Practice Health will do. Thank you for your time
@Jason Shamoon You're welcome. Thank you for the comment!
A caudal injection is when a doctor places a needle under the sacrum and injects something, typically steroid. The rationale is that the epidural space connects with the space under the sacrum. The advantage of a caudal injection is that it’s easy to do and does not require x-ray guidance.
In my opinion, caudal injections really have no role in modern pain management. What you want is a doctor who can look at the MRI, identify a potential problem related to a compressed or inflamed nerve root, confirm with a physical examination targeted to the nerve root involved, then if appropriate do a transforaminal injection of steroid to reduce inflammation on the affected nerve root. A transforaminal block requires fluoroscopy and training, but it’s better because it focuses the treatment on the problem.
The second advantage of a transforaminal block is that it confirms your doctor’s theory about what’s wrong.
A doctor may have their own reason for doing a caudal, but the reason I see most is that the doctor is not qualified to figure out what’s wrong and offer specific treatment.
We are putting out a new video on how to pick a pain management doctor next week. Please subscribe and look out for that when it's released.
@Best Practice Health thank you for the response. I got a caudal injection 2 weeks ago. Didn’t do anything. Like you said, difficult to decipher what exactly is the cause.
Unfortunately, pain after spine surgery is common. The question is whether that pain is coming from the torn annulus, inflammation of a nerve root, or the adjacent facet joints. The only way to know for sure is to have diagnostic injections of those structures. A medial branch block is an injection that temporarily numbers the pain fibers to the facet joint. If you were pain-free for a few hours after a medial branch block then the problem is the facet joint and not the annular tear or nerve root. Similarly, a transforaminal epidural steroid injection numbness the nerve root and not the facet joint. These blocks are done by pain management physicians. The trick is to find one who will help you work out exactly what hurts. Until you know the problem, the solution is impossible to figure out precisely.
This was so well put and reassuring to hear and informative to the very end. You need offices on the east doctor. Thank You!
Much discussion on KZclip about Sciatica but I am having femoral nerve compression secondary to a disc herniation at L3. Any resources for non-surgical intervention for femoral nerve entrapment without saddle anesthesia or incontinence or foot drop?
Being at a healthy weight helps. Ya see, I was about 175 pounds in may of 2021. A physiatrist suggested I be out on a mood stabilizer, called abilify. I didn’t think anything of it, but before about 2 years before this I was on Paxil, and much like abilify I gained a significant amount of weight. The first time 50 pounds, and this most recent time 75+ pounds putting me well into the 240s. I may have had this herniated disc for a couple years but starting in early 2021 I had a lot of back pain. And for the last 8 months we’ve done scans and therapy and I’ve gotten myself down to 233 as of today. 2 weeks ago I got a steroid injection and within a couple days up to the present I’ve had extreme loss of mobility and function of my lower spine and left hip. The same day I got the injection I was moving a lot of heavy items at work, after I did this I went and got the shot and they numbed me up. I’m wonder if the numbing medication blanketed the aggravation of my already injured back more from moving the heavy items. Not sure what to do now. Might lose job.
Moral of the story is so not ever let someone put you on a controlled substance without knowing all the side effects because they have a high probability of affecting your weight. Which can lead to more health problems such as liver, pancreas, cholesterol and LFTs along with type 2 diabetes.
Please please please don’t let anyone out you on medication just because “somebody feels safer with you on it” your overall health is more important than appeasing people.
@John Borris because if i dont ill get fired?
Why are you moving heavy things at work if you know you're injured?
What an important story. Thank you for sharing it.
Went to the doctor yesterday.
He checked how far he could move my leg. Left side was very painful almost immediately, right side was way less.
He diagnosed L4-S1 compression, left leg is weaker and i have an MRT this Saturday.
Thing is i always had a similar kind of pain when I.e. sweeping the street or anything that makes me take a similar stance. Just this time it's the 3rd week and it doesn't go away. Why did i wait so long? I have a high pain tolerance and idiot me went to work last week despite the pain and numb leg...
@Best Practice Health I haven't been walking much since yesterday, just inside the house. The pain i had having to walk to from the parking lot to the doctor and back already gave me a lot of pain for the day.
Is it normal for the pain to decrease this much in 2 days? While i hope it's gone it's probably not because if whatever inflamation that was pressing on the nerve is gone by tomorrow i wasted a lot of people's times....it's most likely still there, i feel a bit of pressure in my lower back and the sole of my left foot feels weird.
Thanks for the link.
3 weeks in and having numbness and weakness--- I agree with the MRI.
Learn more about herniated discs with this playlist: kzclip.org/p/PLsYo8ENYsvpz8bmjf5QkF5IdaX6UPZrPk
im curious about the pulp. You said that the body digests the part that has "escaped" the annulus. Does the body make more pulp to replace the dissolved amount? If not, how does that affect the stability, strength, or cushion of the discs?
Oh, man...that would be great. Sadly, no. Our bodies do not replace the nucleus pulposis after it herniates and is digested by our immune systems. That's why we get "degenerative disc disease."
Great video! Im 24 and got a herniated disc i had back spasm or back problems since i was younger doctor says it does not look very good ive lifted heavy stuff in a bad form not so much this past year but i started playing soccer and looks like i have back pain every time i play so i decided to get an mri to see what was going on hope its not to late . And hopefully it can heal on its own with physical therapy after this last injury almost a week ago the painful part was the first two days o could hardly walk and stand up but only pain was on my back
But very sharp now im doing much better still feel little pain not much just feels sensitive 6 days after i can walk great but i would some advice or opinions i love soccer sports running and training with my daughter and i wonder if im ever going to be able to do it again . Im in texas but i would love to go to Phoenix for a consultation i would like to know the cost for an opinion
I can make it to phoenix in next week or so hope to hear a response soon. Im a bit worried i just want to go in the right path.:(
Hi Bryan! We were able to answer your question on last week's Q&A episode of Best Practice LIVE. You can view it HERE: kzclip.org/video/7WHPRbIoVCM/бейне.html
Call us at +1(608) 602-4022 asap!
Thank you for this very informative video. Just a quick question. After the body eats the herniated part up, does the broken annulus heal itself aswell?
@Best Practice Health That's really interesting! I guess the macrophages eat up only the herniated part of the nucleus pulposus, thus leaving space for the annulus to heal! But now I 'm wondering how do the microphages know when to stop destroying the nucleus pulposus? Why don't they go as far as eating up the innermost part aswell?
Yes it does! The fibers of the annulus knit and heal together. No one knows the exact time, but I think it is mostly healed after 6 weeks if the nuclear disc material is not in the way.
Hi doctor , I am waiting for results of MRI, I believe I injure my back while doing very heavy hip thrusts . I have been taking it easy at the gym however I have been doing machine leg extensions but my pain comes back . Is this exercise not recommended ? What type of exercises should I do? Thank you
Exercise and therapy have been studied a lot and have not been shown to be effective in the treatment of herniated discs. What works are natural healing over time, epidural steroid injection for temporary nerve root pain relief, and microdiscectomy surgery when all else fails. The gym is awesome and critically important for your long term health; but it won't help with your herniated disc.
Let me know when your MRI is back and we can review it together if you like!
Hi! I'm 17 years old and I suffer from hernaited disc L4/L5 since september 2021. It happened because of lifting heavy, training soccer a lot, and maybe genetics from one of my parent. I have pain mainly in my left leg especially the calf! I don't use any pain relievers. I do core workout 3times a week. What are your suggestions for healing it? How to speed up the process? Is it good to take Collagen, Glucozamine, Chondroitin and etc.?
Can I have the answer to that question please ?
So I can buy those stuff too
Thank you!
Great question. We have a live show every morning where we answer questions like this and tomorrow I answer your question and afterward I will send you the link! I can give you an even more thorough answer If you are able to / willing to upload your MRI or call into the show live so I can talk to you directly. If that is something you are interested in please call +1 602-256-2525 with a parent or guardian and our staff will give you directions!
I was lifting far too heavy weights and with poor form when I heard and felt a terrible crack in my lower back which left me in severe pain(sciatica) for around 2-3 weeks. 2 years later I have no sensation in my upper right thigh and constant pain between my shoulder blades. My lower back cracks and pops the whole time when I move and lift things etc and I’m constantly living in fear that my back will go again and suffer from sciatica. Will my situation eventually correct itself because it’s gradually having an effect on my mental health?
You are welcome! Yes. There is a great chance it will heal over time. The key is to figure out what kind of pain you have, and then you have the imaging you will see if you get confirmation. Check out this blog: phoenixspineandjoint.com/is-ozone-a-good-treatment-for-the-low-back/. Try to figure out if you are A, B, or C.
@Best Practice Health thanks for replying. Yes I have a doctor, I am in fact in the UK and on the NHS waiting list for a MRI scan which has already taken 3 months due to a backlog. If it is what you say most likely a annular tear with herniated disc does this eventually heal itself over time or will it require some sort of surgery as it has been over 2 years since my injury?
Sciatica is such a severe pain is can cause a fear of it recurring that is like post-traumatic stress disorder. The way to overcome that fear is to know the risk. You can only know the risk through imaging.
The crack you heard in your back was most likely an annular tear. Depending on the weight and your bones it could also have been a compression fracture or traumatic injury. Given the thigh numbness the most likely problem is a L3/4 annular tear with herniated disc. The next step is an MRI of your lower back. That typically requires a prescription. Do you have a doctor?
Hi doc, not sure if you still reply to comments here but I have a 7mm disc extrusion on my l4/l5 since January 2022 until now (December 2022) the pain from the sciatica has been present since March 2022 and there is still no progress of recovery. I’m 21 years old this year and my herniation came from deadlifting
Hi Brandon, Dr Lieberman responded to your question today on our live show. Here is a timecoded link: kzclip.org/video/R4VqsA0RmNM/бейне.html
I have disc herniation since 2013 ,L4L5 ,,suffering but now I am okay ,from Africa Algeria,,last week ,I did auriculotherapy ,it's good for pain ,,Chinese traditional,,technical .
I had a inflammation back in 2021 and couldn’t bare to get up for the first 4-5 days and close to a month I got better. I stopped going 6 to 5 days to the gym now.
Now In 2022. I decided to go onto 4 days a week but heavy setting on a Dailey. I was deadlifting and next thing I knew I felt like I got struck by thunder dropped the weight mid-set. I fell but got back up right away and confused in what just occurred (in shock) I tried to get on my feet but couldn’t! I sat on knees it’s like I couldn’t feel my legs for the first few 3 minutes. I drove back home got tingles and numbness on my lower body (nerves).
2 weeks in now my lower back feel better and the inflammation on my lower body hasn’t occurred today! Thank goodness it was a hell week! I just have trouble sleeping. I tend to wake 3 to 4 times a night. I’m having more left leg pain but some of the pain went away and feeling better but still in pain if you get the memo😅
I’ve been icing and taking meds as well to help with my pain.
I did sleep well for 4 days this week which felt great but now waking up 3x a night which is odd cause I had 4 good days ..
Right now it’s my lower body just hurts to walk and sometimes I tend to crash down if I’m in a odd position like squatting really low and I can’t do nothing about but fall the pain is unbearable and can’t really do nothing about it. It happens not just squatting but like just walking the pain will hit me but today I feel like the pain slightly reduced but not really much it kinda feels the same.
My worst pain I’ve yet had was last Saturday night that it occurred for like 45 min and I even cried when it finally went away and it was behind my thigh on my left. The worst pain I ever felt! I made the mistake of taking hot showers as well so now I will reduce my hot water to more of a cool water temp. I’m 25 right now and fit and active and hope for this pain to go away soon. I pray week 3 I get some good reduction of pain and walk slight better.
I appreciate the info thank you! 🫱🏼🫲🏽
Yikes! I'm so sorry this is happening to you. Sadly, you give a perfect description of what it feels like to have a herniated disc. I'd be happy to answer your questions on youtube, like we do. Your experience is so important to share with others... are you willing to do an interview?
I have a moderate herniation at my L5-S1 with a measurement. It's been a long 4 months but I am slowly getting better. Is this herniation too large to heal on its own? (See MRI details below) Thanks! (Been doing PT weekly & 2 epidural shots so far that were not very effective unfortunately)
At the level of L5-S1, there is a moderate size left posterior
paracentral disc protrusion that measures approximately 7 x 5 x 13 mm.
This causes mild ventral effacement of thecal sac and moderate left
lateral recess effacement. There is displacement of the transiting left
S1 nerve root. Minimal hypertrophic facet arthrosis at this level.
The key to taking the right step in the treatment of a disc protrusion is not usually the size of the disc; it's whether or not the patient has a functional weakness, numbness, or uncontrollable pain. The s1 nerve root provides sensation on the outside of the foot and works the calf muscles. A good way to test for functional weakness caused by damage to the S1 nerve root is to walk on your tip toes. One can test for S1 numbness by gently touching the outside of the foot, by the pinky toe, and comparing it to the other side.
Disc protrusions do heal, as they are exposed to the epidural space, as opposed to bulges.
I'm sorry you're in pain. I hope you feel better soon.
I had this issue started almost a year ago and in the beginning the spinal canal diameter between my L4/5 was 6mm and now it’s 9.5mm also the pain i feel is lesser these days as compared to months ago. Doctors are recommending me surgery but i want to recover it without any surgery, could it be healed in some more time as one year had already passed or surgery is the last option I have?
You can see Dr. Lieberman's full explanation HERE: kzclip.org/video/9Yi6NIJ86zo/бейне.html
Hello! Your questions is being answered on Best Practice LIVE! Check it out HERE: kzclip.org/video/9Yi6NIJ86zo/бейне.html
Oh, no! Sorry to hear you are suffering. Unfortunately, spinal stenosis only gets worse, and the only treatment that actually restores the spine and protects the nerves is laminectomy surgery. What you have to consider is the timing. I've seen so many patients wait too long, until they were not healthy enough to have it, and then suffer for the remainder of their life with something that could have been addressed.
Doctor. I did my MRI and it looks like I have herniated disc at L4-L5 and L5-S1. I dont have any numbness but the pain radiates through my right leg all the way down. This pain is only felt if I sit down for long. When I stand up and do some walking, it slowly reduces. Do you think it will heal by itself? I’m willing to wait.
Hi there! We were able to answer your question on last week's Q&A episode of Best Practice LIVE. You can view it HERE: kzclip.org/video/7WHPRbIoVCM/бейне.html
@Best Practice Health thank you for your quick reply. Actually my pain is more towards right leg (from hips to calf) with very minimal pain at the back. If I sit for long, the pain will start to come. Once I stand up and start walking, the pain reduces significantly so I wonder, it is this a good sign.
Hi, SadiQium. Nice to meet you. If I have this right your pain is more in the back, worse when sitting. That kind of pain is more typical of an annular tear or a facet. The first step is to figure out what's causing your pain because the treatment---if any is needed at all---depends entirely on the cause and severity. Check out this blog to help understand what is causing your pain. Pick A,B,C, or D based on how it feels.
phoenixspineandjoint.com/the-3-things-neurosurgeons-recommend-for-new-low-back-pain-spoiler-alert-panic-isnt-one-of-them/
Me at 3 years of dealing with pain from a herniation thinking 12 weeks doesn’t sound bad at all💀💀
What about a bulging disc ?
@Lars Hinkel I have bulges at l1 l2 l4 and l5. Also mold at c5 c6 c6 c7. No stenosis. Am just 39 too. I really was active and fit too all these years. No idea all this just happened 8 months back. Just don't know what to do
@World i am 53 years old . I loved to do Sports , had a physical demanding Job … nie i can ”t do anythinh of That . Can"t find a Job That im Able to do . Thats the worst
I have ist in the low back . L3 -l4 , l4-l5 , l5-s1 . I was once a fit guy
@Lars Hinkel how old are you?? And do u have it in ur neck also??? It's not easy I understand. I have 3 bulges too. It's painful depressive life
Is it possible for a protuded disc (L5-S1), to produce swelling and pain when touching that particular point at my back?
If not, what injure or desease could produce that effect?
Thanks!!
@Best Practice Health Thanks so much for your answer. It gives me an important clue. It was a little confusing at first because at the same level (L5-S1) the MRI show a disc protution, (not herniation), that has never gave me any symptoms.before.
After your answer, I am pretty sure that the swelling and palpation pain when touching, must be produce from some muscle spam or ligament sprain.
Big thanks from Argentina!!
☺️
No. You can't touch your discs from the surface. But you can reach your muscles. Usually, radiating back pain caused by palpation is due to severe muscle spasm.
Hi, I am 25 yr old female , and have a L5-s1 disc protusion and diffuse disc bulge, as per report by radiologist. Some doc say its extrusion and some protusion. Having sciatica pain while walking more than 20-30min. Doc has advised bed rest for 2 weeks with limited exercise.On medications also. In my case is resorption possible?
kzclip.org/video/2iXy6KWpP50/бейне.html
Because disc material has no blood supply and is "foreign" even to your own body, all disc protrusions are reabsorbed into the body by inflammation over time. If either the compression by the fragment or the inflammation is causing damage to the neighboring nerve root, then microdiscectomy surgery should be considered. The way to know there is damage to the nerve root is from the presence of 1) functional weakness, 2) numbness, or 3) unbearable pain. If 1,2,3 are absent, then the traditional advice is to wait it out. During the waiting period, you can get temporary relief with a transforaminal injection.
I just herniated my disc at L5/S1 and i'm pretty insecure now if i will ever be able to Box again.....my question is. Will the disc fully recover and also heal the outer Part?
Would the disc not completely collapse later (after the healing phase)?
I have a (missed) spondylosis after trauma, then only after about a year the pain increased dramatically... Now we discovered that I have a disc that is disintegrating (small herniation)...but my specialist made it sound very soon & gloom...that I will eventually need surgery.
Sorry to hear about your accident. It's common for an annulus to be torn in an accident, and then heal back up. During the healing phase the body often reacts to the foreign nucleus material and digests some of the disc. Depending on the size and extent of the tear, the disc injury may heal fast and easily, or it may take longer and require more healing. Disc spaces do often collapse as a result of the injury and healing process. It's a hard thing to predict. I would not assume surgery would be required at all! The vast majority of these type of cases heal without it.
Hi doc! My MRI report says L5-S1 level -- Disc desiccation, diffuse disc bulge causing indentation of anterior thecal sac and narrowing of left neural foramina resulting in compression of left exiting nerve roots... Please help me on this... what's causing sharp pain in my low back and left leg I'm 23 year old and having this pain from almost more than a year first it was in low back and then it entered my in my left leg.. I'm taking medicine written by neurologist and doing PT daily but it's not getting well only temporary relief form exercises 🥺
@Best Practice Health can't you tell anything here?
Let's look at your MRI together and find out! Stay tuned to Phoenix Spine and Joint on Facebook. We are starting an interactive show to review MRI together.
Thank you Doctor!
Sir,i have l4 to l5 and l5 to s1 disc bulge and every doctors said to go for surgery but i am delaying also sometimes my left leg are numbness and heavy pain in back bone what shall i do? please tell me sir
I am 35 years old and have feeling sciatica pain for more than 5 years but I didn’t know anything about herniated disk.I just had severe pain in low back and went to see doctor and after MRI ,the test result showed that I had herniated disk between L2L3,L3L4 and L4L5.the L4L5herniated disk is the one that seems to be touching the sciatic nerve and causing the pain.the doctor I went to only suggested me to take pain killers.what should I do
Yikes! Five years is a heck of a long time to be in pain. Clearly this is not getting better on it's own. That means you need someone to help. I'm sorry you are going through this thing. I strongly recommend you get informed and then find a new doctor. The choices are going to be pain management or spine surgeon. The right doctor depends on the imaging. So, long story short, I recommend recent x-ray, bending x-rays, and MRI for people who have been in pain for a long time without a real diagnosis. Once the imaging is done they can pick the right doctor, and get on with getting better!
Thank you all for giving a comprehensive answer ♥ ️ ♥ ️ ♥ ️ ♥ ♥
I’ve had bad sciatica for 11 months; meaning I can only walk for 30-45 min until I have pain in my leg, buttocks and lower back to the point my hips become shifted, I’m walking crooked and in pain and have to lay down. Just recently (few days ago) I went for a walk in a park that was vey hilly, after that my pain became substantially worse and I can’t walk not even for a min or sit on the toilet without being in extreme pain like someone is stabbing me in the lower back. I cannot sit much if at all. I don’t know what’s happening. When this all started Initially a year ago, my MRI showed ruptured disc at l4-l5. That’s what was Initially seen at least. I’m loss for words…
@Best Practice Health Yes, I just saw the video. Very insightful. Thank you for passing my situation on to the Doc. I think surgery is good option for anyone under the circumstances,I’ve just read some info that surgery could be not so good of an option. Everyone is different I guess. I’ve got some thinking to do!
Hey Joey, Dr Lieberman answered your question today on our live show. Here is a timestamped link: kzclip.org/user/liveLryTnQ3aC6I?feature=share&t=3001
@Best Practice Health Thank you for your response. I will go ahead and do that. I just came out of hospital today for this issue. Doctor wants to do surgery. I have improved a little and pain calmed down a bit but still worse over all than before. I am seriously considering my current options.
It sounds like you had a progression (recurrent) disc herniation. If you have any red flags then you need medical attention now. Otherwise, consult the matrix and decide what to do. It's been 11 months...sounds like you need help. Feel free to submit a video question and a pic of your mri here: bestpracticehealth.tv/
Hi Doc, question. If inflammation process is helping to eat away the disc. Would not anti inflammatories delay healing or eating up process
Great question! In theory anti-inflammatories would slow down the healing process. In practice I have never seen that.
Sir I have L5S1 disc herniation due to that my left leg is numb from January MRI shows central canal stenosis diameter of canal at L5S1 is just 3.6mm in February but now ok by phisiotherapy
But a little bit pain in glute area
Both .
Will I be cured with this way
Hi, 👋🏽
I hope you can give me an answer. I have low back pain and sciatica Since about 2 months ago . Well It actually started like 8 months ago. I felt tingling in my left foot while laying on my back. I wasn’t able to lay on my back but didn’t had crazy leg or back pain. But then hell started the back pain and very bad sciatica a month ago. Some days hurt more than other days. Not sure if it started as a bulging disc and then it erupted months later? I Can’t stand or walk for more than 10 min and I get leg pain. I walk hunched over. Some days I can’t lay at all. Will this heal on its own? (See below my issue) I am also doing now spinal decompression. I’m concerned, exhausted and sad! 😩🙁 Sciatica really sucks!
L3-4: Small circumferential disc bulge
L4-5: Small/moderate partially inferiorly extruded posterior disc herniation
L5-S1: Moderate/large posterior disc herniation favors the left. Partially inferiorly extruded. compresses the left S1 nerve root. Anterior bulge/osteophyte.
@Kproc It depends on the person. If the weakness would prevent you from doing normal activities then it's a functional weakness. So, if you never ran a day in your life, and your weakness didn't bother your walking, then it would not be functional weakness. On the other hand, if you were a dedicated cyclist, and you couldn't ride due to weakness, then it would be a functional weakness.
@Best Practice Health how bad would you consider functional weakness? I haven’t been able to walk or stand straight and at the 6-7 week mark. My numbness is more around just my ankles but i have muscle weakness and buttocks hurts like crazy.
Hi!. So sorry you are having trouble. I hope you have good support from friends and/or family. Pain from herniated discs is a lot to deal with!
I'm going to assume the leg pain is on the left. If that's not right, please let me know.
It's really common to get a tear in the annulus of a disc, which causes stabbing back pain, and then note progression. Sometimes the soft part of the disc "herniates" through" the tear and irritates the nerve root. When this occurs you feel pain down the leg and into the foot. In the case of the S1 nerve root, one gets numbness on the outside of the foot, weakness standing on your toes, and loss of the Achilles reflex.
All of this goes away on its own more than 90% of the time within 12 weeks. An epidural injection is good for 100 hours or so of pain relief along the way, but it doesn't change the outcome.
If one develops functional weakness or numbness along the way then it's time to consider microdiscectomy.
These three options are the "matrix" of treatment options. Check them out here: kzclip.org/video/6EuJba0i8uI/бейне.html
Hi, the depictions of herniations in this video explicitly show the nucleus bursting through the annulus of the disc. I have seen other depictions that show the annulus being deformed outward but still containing the portion of the nucleus that is protruding. If I have a Protrusion but not a Sequestration, is my nucleus hanging out totally exposed or is there a layer of stretched out annulus still surrounding it?
@Best Practice Health my MRI report did not mention any modic changes, just a foraminal hernation pressing on the nerve. At first I was worried I would always have this herniation unless i get surgery but after reading more and watching videos like these I'm more optimistic about this resolving without surgical intervention. With that being said it is confusing for a layman like me to understand what's happening with my body and what the possible outcomes could be. It also seems like there is still a lot left for scientists and medical professionals to learn in this space.
@GeneralJoey747 The annulus is an outer layer or wrapper of the nucleus pulposis. If a tear in the annulus heals over then the nucleus pulposis is again shielded from the body's immune system and the cycle is over. Since the nucleus has no blood supply there is no route for the body's immune system to attack it. Doctors see this battle play out on MRI all the time. Inflammation at the junction of a torn annulus and the vertebral body bone is called "Modic changes" on MRI reads. If you have an MRI of your back check the report for that language. "Modic change" is the evidence of a long-term tear in a disc causing inflammation in the adjacent vertebral body.
@Best Practice Health if the nucleus is still confined for a given herniation, is that herniated nucleus material still eaten away by the body or can it migrate back to where it should be? Thanks for the info!
Yes, you are exactly right. The annulus can tear, but the nuclear stays confined. The good news is that the nucleus is not compressing and irritating the nerve root. The bad news is that pain fibers grow into the disc and can cause a painful annular tear.
Hello doctor.. I am from Afghanistan...two days ago I injured my back at the gym...
I did MRI the report says I have slipped disc at L5 and S1.. I have slightly numbness at my legs... And extreme pain at my back
I HAVE two Questions
What should I do or avoid now at acute slipped disc to prevent further problems in future.?
Q.2 will I be join army and perform hard activities after recovery?
What were you doing when you were injured? That was clearly too much. Most people are able to return to normal activities after they recover. Core strength is key. Consider yoga, pilates, or tai chi. To avoid another episode maintain your core. If it happened in the gym it ways going to happen anyway, I'd keep going once you are better but modify your workout. A trainer can be a good investment in this situation.
Mee to same fucking gym issues
I have L4-L5 disc bulge two months back.
I have undergone naturopathy treatment for a week.
I got relief from pain.Do I really require surgery to be done sir?
Will the disc returns to its original place, if spinal exercises are done sir?
Which surgery? If you mean microdiscectomy, it's virtually never appropriate for a bulging disc. Microdiscectomy is for people with 1) functional motor weakness, or 2) functional sensory deficit, or 3) uncontrollable pain. If you do not have one of those then microdiscectomy surgery is not generally indicated. Check this out: kzclip.org/video/Wfycmdtd3xE/бейне.html
I have herniated disks at T12/L1 and L1/L2. The pain in my hip and most of my thigh is unbearable. Cannot walk for more than a few steps. Do you have any info on this problem? Thanks
@Best Practice Health thanks. I have had an MRI. They are pushing on the nerves coming from those disks. It has been about 3 months and it's starting to ease. My white blood count is high so from what you say, it is probably my body trying to heal it. Doc made a referral to physio
Pain in the lower thoracic and upper lumbar spine can actually radiate into the groin. So does hip pain. Your doctor will want to test passive movement of your hip with you laying down to be sure this is not a hip issue. If the pain is coming from one of the herniated discs, you have the usual choices for treatment outlined in the video. If you need more help come on my show. phoenixspineandjoint.com/resources/best-practice/
Am I hearing this correct that Dr. Lieberman is not promoting surgery and informing us that disc herniations get better on their own? Dr. Lieberman has stated on all of his past videos lumbar stenosis will never heal without surgery and that excise as a treatment was a waste of time.
Yep! Herniated discs typically get better on their own and stenosis gets worse. Dotors call this the "natural history" of the condition --- AKA what would happen if you didn't do anything. One caveat, exercise can help keep you going in the early stages of stenosis ("motion is lotion") but does not in any way reverse the stenosis which will in fact get worse and some rate.
I am confused. If someone has a herniated cervical disc, it often causes myelopathy. Everyone says that this myelopathy usually progresses, why do they say so if 97% of people get better by their own?
@Best Practice Health Thank you for clarifying
I'm not glad you're confused, but that is why I'm here! This stuff is confusing. And serious.
Myelopathy refers to any disease or disorder that affects the spinal cord. It can be caused by a variety of factors, including:
Spinal cord compression: While this can be due to a herniated disc, it is much more often due to spinal stenosis (narrowing of the spinal canal). There are rare causes of compression as well, such as epidural abscess and tumors.
Trauma: Myelopathy can result from trauma to the spine, such as a car accident or a fall.
Inflammatory diseases: Certain autoimmune disorders such as multiple sclerosis or transverse myelitis can cause myelopathy.
In short, herniated discs do typically get better on their own. But myelopathy is not typically caused by a herniated disc.
4 months now and still numbness in right index finger due to herniated c6 area. No longer need pain meds so it seems to be healing bit very slow and I have to be careful what I do to avoid flaring up more pain. Unable to work so thank God for insurance but hoping it heals within 6 months...
reduced physiological lumbar lordosis almost eliminated.. absence of focal bone lesions. height of vertebral bodies preserved: absence of intra-cancellous edema. signs of l4, l5 and l5 -s1 disc disease. annulus fibrosus in the posterior median area with hint of minimal subligament herniation. At the l5-s1 level, median-paramedian and right posterolateral disc herniation is present with foraminal involvement. The other disc spaces were normal. Vertebral canal and conus medullaris normal.
Hmm. No sign of what is causing the pain. Is it back pain? In my experience radiologists often don't comment on swollen facet joints.
I have spondolysthesis. My l5 has moved a bit. My pain in my leg and hip area has increased and my feet at night feel like they are hot. I am 26. What do you suggest I do? I was trying acupuncture. Do you think it can help? I have been having loxoprofen 60mg and mecobalamin 500 for the past 6 days and my pain has reduced. Please suggest what can be done!
Burning or strange sensations in your feet at night are often due to neuropathy, and not related to your back. Some neuropathy runs in families, so as your parents if anyone else has it. Leg and hip pain is usually facet mediated pain. Watch this video to figure this out: kzclip.org/video/rBmHQ7VCDIk/бейне.html.
If your pain is more than 12 weeks old and due to a facet injury then medial branch block done by a pain management doctor is the key to finding out what is wrong. If the medial branch block is positive then radiofrequency ablation is the next step.
Learn more about spine problems here: kzclip.org/p/PLsYo8ENYsvpxyo-QrlRIROPJ3TNWP882b
So I have an 8 mm herniated disk causing secondar stenosis.
Do I need to get surgery or should I wait?
It's been 3 months I get mild leg radiating pain but nothing apart from that.
Hi Steve, Dr Lieberman answered your question today on our live show. Here is a timestamped link: kzclip.org/user/liveLryTnQ3aC6I?feature=share&t=2624
There are choices for treatment of a herniated disc. Wait for natural healing, epidural, or microdiscectomy surgery (MDS). MDS is for those with functional deficits or uncontrolled pain. You don't sound like you need MDS. Epidural is for temporary pain relief as your body heals. Your pain is mild now. So, the last choice is wait it out.
I m suffering from back pain and sometimes leg pain since 2017. And I'm 29 years old now.. really I m suffering a lot
@Nirmali Bhuyan Finding the right doctor is often the key to getting better. We listen to your story and help get you into the right doctor. If you need help call us at 602 256 2525.
@Best Practice Health i went to orthopedic, neurosurgeon and pT also.. but my pain is not healing..
So sorry to hear about your pain and suffering. Everyone deserves someone to help them when they are sick; I hope you have a good doctor. People with back pain are generally treated by pain management or physical medicine and rehab PM&R doctor initially, and then a specialist as needed. Are you getting the help you need?
Thanks Doc.☺️
Most welcome!
Week 1 down...on crutches..can't put weight on right leg ibuprofen 1000 mg a day ( 200 x5 ) take 1 pill 💊 every 5 hrs as needed..warm bath ..I had massive sciatic pain ..had to get .5 mg corticosteroids in glute..some relief .. will update week 2 .
Oh, goodness! So sorry you are going through this. Keep you chin up if you can... most pain of this type resolves by itself. See a doctor right away if you have intractable pain, functional weakness or numbness, or any bowel or bladder dysfunction. Hang in there and let us know how you are doing.
I’ve had a herniated disc for a year now I’m 18 and the numbness and tingling went away but I still suffer from a lot of back pain what do I do
How long it took tingling to go away?
Hi Freddy, my name is Phebe, Care Coordinator with Phoenix Spine & Joint. I'm sorry to hear you're experiencing a lot of back pain & numbness/tingling. I can connect you with Dr. Lieberman who would be happy to discuss why this may be happening & next steps. Please feel free to contact me 602-385-0435.
Thanks for the info
Any time!
I’m curious how much bigger. Because my lower disc is herniated. And I have pain on my inner thigh and back. Shall I focus on therapy or surgery?
Hi, Abdullah. I'm sorry to hear about your herniated disc. The decision between therapy and surgery depends on type of pain you have and for how long. I just made a short video for another person to review their options which may help. If you want, you can check that out here: kzclip.org/video/lHx-ylN35Ww/бейне.html.
A couple of other things to consider... The first thing you need to decide is if your pain is coming from a nerve root. If so, the traditional treatment would be to start with epidural injection unless the pain is unbearable, or causing functional weakness, in which case microdiscectomy surgery would be the way to go. Physical therapy works by mobilizing joints; so, it's a good tool for facet mediated back pain that does not resolve with rest, moist heat, and NSAIDs (when safe) 6-12 weeks after the pain begins.
I hope this help! And I hope even more you get better soon. Remember that 94% of low back pain goes away within 12 weeks by itself without any intervention.
What about a protrusion that doesn’t get eaten away
Hello !!! I just received my MRI and talked to my doctor she recommended surgery for my herniated disc , i want to heal naturally i think i can handle the pain for 12 week more but the pain started since February . Is there a better way i can talk to you for recommendations im 21 years old
How you feel today bro
Is it ok now?
Or still pain
Hi German! We were able to answer your question on last week's Q&A episode of Best Practice LIVE. You can view it HERE: kzclip.org/video/7WHPRbIoVCM/бейне.html
Im 14 years old and i have herniated disc. Im playing basketball and im resting 4 months but its still same. I try to do exercise but its even worse. What to do now?
No basketball! It's too rough. Light exercise like swimming, walking in water, or elliptical bike. You are so young, it will take time to heal. But it will likely heal. You may need to see a surgeon. You may as well start looking for one in case things do not improve.
Did mom or data have disc issues?
Hi sir you told nucleus pulposus will get digested, my question is what if nucleus pulposus not comes out and just bulging then how our body reacts will it gets heal in this case ?
@Best Practice Health does bulging have better chance to heal?, Its giving low back pain for prolonged sitting for me
That's a bulging disc. If the annulus in intact and the nucleus of the disc is not in contact with the blood supply there should not be an inflammatory reaction.
Dr can you please reply my question
Is bulging disc heal or not?
I have bug disc but not compression to nerve as ct scan showed
I really scare and cry a lot
I have sciatica pain within 4 weeks, so l cried a lot because really l scare about the permanent problems.
I did CT scan and the Dr diagnose l have budging disc on S1 and L5 but the disc does not pressure on the nerve.
So l have pain in my calf and ankle
I don't have any idea because my both legs have problem, one of them too much and next is sometimes
As l am young and student, l am very worried and cry alot
I do pray for all people to recover from sciatica 🙏
I'm so sorry you are suffering. Sciatica pain is really severe and naturally frightening. The first step is to figure out what is wrong. Then you will know how to fix it.
A bulging disc typically does not heal on it's own. A herniated disc heals because of an immune reaction between the soft "nuclear" contents of the disc being exposed to the rest of the body. In a bulging disc the nucleus of the disc is still behind the annulus and doesn't heal in this way.
In any event, a bulging disc shown on CT without nerve root compression is unlikely to cause sciatica. However, most of the things that do cause sciatica should have "shown up" on a CT. Absent a really large problem or narrowing (stenosis), sciatica is rarely present in both legs. Not all nerve problems are sciatica in the first place. A neurologist would consider nerve problems like neuropathy in evaluating a nerve problem in the leg. The test to separate nerve problems from nerve root problems is the electromyogram (EMG). The EMG test is typically done by a specially trained physiatrist, or historically by a neurologist.
I can't give you medial advice over internet. But the key to figuring out what is wrong is the right doctor. A spine surgeon is typically a good choice if you need surgery; if you want to find out what is wrong a pain management doctor, or physiatrist are typically the doctor with whom people start. *** Pain management doctors are *board certified in anesthesia or physiatry; ** subspecialty certified in pain management; and *** don't abuse narcotics except for cancer or surgical pain treatment.
I hope this helps. Please let me know how you do.
Doctor I have a L5-S1 bulging disc 3mm would a chiropractor be a good idea or do I need to have surgery ?
@Hector Bruh my neurologist said to avoid chiro as this can make a herniated disc worse. Hope that helps but refer to your neurologist as everyone's case is different.
@Hector Bruh brother in my MRI also it's showing mild disc bulge but nothing regarding how much mm it's coming like that, do you remember which MRI machine you went mine was 0.3T MRI machine that means an older machine
@Best Practice Health Thank you Doctor I'm visiting the neurologist again in a couple days I just wanted to know if it would be a good idea to visit a chiropractor or if a chiropractor would help in any way. I have constant stabbing pain on my right thigh. I can't even sneeze
Microdiscectomy surgery is not necessary for bulging discs that are not causing sciatica, uncontrollable pain, or functional numbness/weakness. That does not mean it does not hurt! I hope you feel better soon. Come on the show if you want to discuss. phoenixspineandjoint.com/resources/best-practice/
Great words
Thanks!
94% ? So i can't dance forever. I can't run forever? 😭 I'm still young.
What? No. Ninety four percent heal on their own. No one runs forever: my dad ran marathons for decades and even he had to stop in his sixties. But dancing is great for you and is actually associated with longer life. Just be careful on who you choose as a partner!
Thank you for this video. Wheres the second part?
You are welcome! Thanks very much for the comment. This video is an FAQ for our KZclip series The Clinic. Have you seen any of the episodes? It's kind of cool... like sitting in on someone else doctor visit. The Clinic episode this video references is here: kzclip.org/video/gbGSWGOL1_8/бейне.html. There are 2 other FAQ videos from that episode, here kzclip.org/video/2iXy6KWpP50/бейне.html and here kzclip.org/video/X6qCrROoKYo/бейне.html. I hope these videos help!
Sir..Can the protrusion of disc on L5 S1 that cause the sciatice nerve pain could recover itself ???
Yes. L5/S1 is the lowest disc in the low back. Nerve root pain (sciatica) that is caused by compression or irritation of a nerve root by a herniated disc usually gets better on it's own. Epidural injection provides good temporary relief. If the disc is causing functional weakness, numbness, or uncontrollable pain then micridosciectomy surgery should be considered. But most get better on their own.
For more on the decision making for a herniated disc check this out: kzclip.org/p/PLsYo8ENYsvpz1yIhgup7d7Yv92HWMz7ja
Hi doctor I have 3 hernation in my thoracic and 1 hernation in my low back whit schmoll noods I have a severe pain almost in 7 months .just disc small ptroution can heal I started some exercise and walking every day my pain 10/8 change .but still pain .I can sit more than 3 minutes .I don’t know what can I do .
The right solution depends on understanding the problem. Schmorl’s nodes are a beak down of the vertebral body endplate that allows a disc to herniate into the bone. They are n to typically painful unless there is a lot of inflammation at the site. If there’s is inflammation at the site a radiologist will describe it as “Modic changes.” If an MRI report specifies modic changes then the treatment staircase is core strengthening, followed by consideration of disc injection with growth factors, followed by enervation of the endplate with the DENERVX procedure, and if all else fails spinal Interbody fusion with disc removal. I hope this helps. Let me know if the MRI report mentions modic changes, and please describe your pain. Watch our video “types of low back pain.”
Hey doc was wondering how smoking marijuana effects the healing of disc ? I smoke to get rid of pain but sometimes after I feel like I’m im more pain than before
I am not an expert, but my understanding is that THC in your blood binds to specific receptors for cannabinoids and should not greatly affect inflammation.
What about Stem Cell treatment for herniated disc?
Great question. I did an interview with Dr. Kong this week and learned a lot about MHC's, intravenous infusion, and other stem cell topics. It will be out on the channel soon.
But in terms of stem cell therapy for the treatment of herniated discs with sciatica, the jury is still out on this one. The idea behind stem cell therapy is to use stem cells, which are undifferentiated cells that have the ability to develop into many different types of cells in the body, to regenerate damaged or diseased tissue.
In the case of herniated discs with sciatica, stem cell therapy involves injecting stem cells directly into the affected disc to promote healing and reduce inflammation. The stem cells can differentiate into disc cells and help to repair the damaged tissue. The hope is that this will alleviate the compression on the sciatic nerve, which can cause pain and other symptoms.
While there is some evidence to suggest that stem cell therapy may be effective in the treatment of herniated discs with sciatica, more research is needed to fully understand the safety and effectiveness of this approach. Some studies have reported positive outcomes, while others have found no significant benefit.
It is also worth noting that stem cell therapy is not yet widely available and is not covered by insurance in many cases. In addition, the cost of stem cell therapy can be substantial and may not be feasible for all patients.
If you are considering stem cell therapy for herniated discs with sciatica, it is important to consult with a pain management doctor. Call first to find one who offers this treatment. They can also help you weigh the potential risks and benefits and make an informed decision about your treatment options.
Doctor I have been following your instructions of disc Spain sugary, l did Disc Spain sugary 6 month but still up to now pain and numbenss to my left leg please help me
Oh no! It sounds like you have persistent sciatica (nerve root pain) after microdiscectomy. If that is right the next step is a repeat MRI with contrast. Has that been done?
⭐⭐⭐Bro u go to ur nearest ceragem center ur herniated disc will heal in few days bcoz the disc which herniated is gel liquid which body will heal in 10 years but ceragem will in 10 days it will make herniated disc into dry leave n it will not bother u any more hope u understand👍👍👍
Hi Akshay ?
Can you plz explain what to do exactly
I am having pain in my right leg since 2 year .
I have l5- s1 herniated disc
I hope you are right!
Hlo please reply I got injured while doing squats it's a mild disc bulge at l4-l5 it happened in April but i got to know about it july when the pain started radiating in legs I've been doing physio for this whole month but still I feel a little discomfort and actually drive and walk too can't be on bed fully am I doing wrongs pls reply will i be able to do gym again pls
Oh, no! Getting hurt in the gym is not fair. Check this out: kzclip.org/video/lHx-ylN35Ww/бейне.html
I am 40 years old. 2012 I was mild left back pain in lumber. Then I took medication and one month exercise then I quit and back to normal life. Mild pain is there all the time. But it didn't bother me. Now few days back when I bend forward to take my 10 years daughter. I suddenly felt pain in left side. As a result I can't bend forward. I don't feel pain in my legs due to that. How I can get back normal life again ?? I consult with doctor. He said after pain gone. I can start exercise for back pain. Now taking ot medicine pain killer. I don't want to take pain killer. So I want to stop it. Can you suggest me anything how I can bend forward after sometime
Start with non-impact exercise like water walking or bike riding ASAP. When you have no symptoms gradually increase your activity to walking, then running as tolerated. Same thing in the gym. Start VERY light, and gradually work up.
@Best Practice Health thanks for your reply. In my country usually MRI don't recommend as its costly. X Ray has been given. Since me taking medicine OTC drug for kill the pain. Now I have no pain unless I bend forward. So I stop pain killer. My back stiffness is still there. But not that much. I can move for my office and others. Only don't take any weight or sometime. I would like to do MRI. To make sure what's the condition about my lumber left side. As you are expert, can I ask you, when pain and bending is normal , can i start exercise for loosing weight. My height 5 9. Weight of 10 kg overweight. Now 87kg.
If you have no red flags the guidelines state the initial treatment for non-specific low back pain is rest, moist heat, and (if they're safe for your body) non-steroidal anti-inflammatory drugs. Are you doing these things?
I'm so sorry that happened to you. Fortunately, pain medication is not the only option. When you consulted your doctor, did they recommend an MRI?
Thanks dr
Welcome 😊
What about the other 4%?
Great question. It's a bad group to be a part of... I recommend surgical consultation as a piece of the puzzle. You can also submit a video and a pic of your mri and get my input here: bestpracticehealth.tv/
What about a bulge!? If there's no hernia, how does it heal!?
It doesn't. Great point. Disc bulges are behind the annulus, and have no blood supply. The "healing" comes from cells in your blood. Bulging discs re stuck.
Is and my neck I had an MRI and there it was bulging. I'm not having numbness and weakness or anything just queasy. And my blood pressure been up kind of lately they put me on blood pressure pills. I'm assuming my pressure coming up from chronic pain
Sorry for the late response, I somehow missed this last week. The best treatment for mechanical neck pain is therapy/chiro followed by NSAIDs. If that does not work then x-ray should be done with flexion and extension views. If those are negative then MRI is next. Surgery is very rarely needed and works poorly for neck pain. Radiofrequency ablation is a great treatment for mechanical neck pain due to facet joint arthritis. A diagnostic medial branch block is done first to see if the procedure is right for you. This procedure is done by pain management doctors. Make sure you find one who is a perfect *** (board certified in anesthesia or rehab, certified in pain management, does not prescribe dangerous drugs for chronic pain).
I had disc herniated past 12year, now I got operated, I just want to know that tared annulus is that also fixed and nucleus shouldn't come out with the tared annulus for ahead right?.
If not , how to fix the tared annulus?
@Best Practice Health thank you for the details information
A torn annulus is not typically repaired during a microdiscectomy surgery.
In a microdiscectomy procedure, the surgeon removes a small portion of the herniated disc that is pressing on a nerve root, which can relieve the associated pain and other symptoms. However, repairing the torn annulus is not always necessary, as the annulus is expected to heal on its own over time.
Some surgeons make an effort surgeon may choose to repair it during the microdiscectomy surgery. This is typically done by removing the damaged portion of the annulus and suturing the remaining edges together to promote healing.
The decision to repair a torn annulus during a microdiscectomy surgery depends on several factors, including the size and location of the tear, the extent of the herniation, and the individual patient's symptoms and medical history. Your surgeon can provide more specific information about your treatment options and whether repairing the torn annulus is recommended in your case.
I have had back issue for 7 years means I'm the 5 % ? My L5 is mess and disk look thin and blacked out in MRI
Hi Taran, I would be happy to go over your MRI and discuss further. Please give us a call to set up a time to talk. 602-256-2525
By saying what you are saying p.r.p or stem cell sounds like it could work.
PRP and stem cells are very effective at moving a body's inflammation toward a positive healing response. We are in the early stages of using these for spine issues. However, both have been very effective for patients in the past; the best results so far have been with knee injection. If you are interested in more about stem cells may check this out: kzclip.org/video/QIGVfLAb69Q/бейне.html
Hi , I am Maged , and I suffered from sciatica due to lifting a heavy object , is there a wat yo consult the doctor ONLINE as I live in Oman , it will greatly appreciated ,
Yes! Come on our show. Fill out the contact form here phoenixspineandjoint.com/resources/best-practice/ and upload your MRI. WE can go over your options together.
Will 'Stem Cells injections 'Help / Cure this ? Regenexx PRP ? ANYONE ?
It seems like a great fix. No data I'm aware of yet. One issue is that stem cell injection usually increases inflammation in the weeks after. That could be super painful for sciatica patients.
Thanks. Teşekkürler
You are welcome.
He must be talking about very minor injuries. This shit doesnt heal. It will mask itself but function never returns and re-injury is too easy.
did disc bulge heal compressing nerve ...u told about herniation ,what if its disc bulge ...did this heal ...
@Shaikh Arif Disc bulges don't typically heal on their own unless they go on to extrude or protrude; however, mild compression is not usually a source of nerve root pain. A pain management doctor is a good place to start for disc bulges, as the cause of pain is probably something else and needs to be worked out.
@Best Practice Health i am having disc bulge L4-5 thecal sac 5.4 mm compressing mild nerve root...will it heal
@Shaikh Arif Bulging discs causing mild nerve root compression don't typically cause a lot of pain. Oftentimes when the pain is a facet joint and not the bulging disc is the primary cause of pain. Check this video out:
kzclip.org/video/rBmHQ7VCDIk/бейне.html.
@Best Practice Health i am havinh posteroior disc bulge compressing mild nerve root
A herniated disc injures a nerve root in 2 ways: by pushing against it and by causing irritation. If the compression is severe or the irritation goes on long enough then permanent nerve root damage may be done. Some damage to a nerve root can heal, but the healing of a nerve root is limited and really slow. It's also scary because a damaged nerve root may start sending out pain signals all the time even after the disc herniation heals; that's called neuropathic pain. Most of the healing is really the body reabsorbing the herniated disc. Note that the disc will be reabsorbed if it's herniated and exposed to the blood supply, not if it is just bulging. This was a bit of a rant! I hope it helps.
i have no major pain litle pain in my back and leg
@Best Practice Health and i am not use any medicine
@Best Practice Health no always sometime in my back some in my leg some tim in my foot some tim in buttcus for little time
just 4 week ago
That's good news! How long have you had it?
What size was it?
Good question. Size matters with discs. The larger the herniation the more nerve root compression, and the more inflammation your body must do to get rid of it.
How to promote the dissolving of the Disc
@Best Practice Health It's Shame, also in 1764 Domenico Contugo said that he experiment on male cadavers to prove the free circulation between the cranial and spinal dural he found out The cerebrospinal water is in perenni statu renovationis, through exudation by minimal arteries and reabsorption by minimal veins. It penetrates into dural sleeves of nerve roots; hence is apt to accumulate in the sheaths of the sciatic nerve and so give pain along its course. Such pain, weakness, and limping may be cured; if necessary by vesicants and caustics to draw out the hydrops.
@Rey Cesar Cariño Hi! The first major report about a herniated disc was from Mixter and Barr in 1934. They helped figure out sciatica came from pinches nerve roots. But it's safe to assume that people have been suffering and miserable from herniated discs since we began walking upright.
@Best Practice Health Interesting, do you know how people dealt with this before modern medicine
The main thing someone can do to promote effective healing is to promote overall good health. A well-balanced diet, plenty of sleep,, rest, and self-care are all important. Some doctors believe stem-cell-derived injections can promote healing; I certainly hope they are right, but the jury is still out on that one.
Who can i feel good
Give the good suggestion
Come again?