Disc compression on left S1 nerve root

[raggar]

Hey fysio.smith, got any advice on my case? Read below, thanks

[physio.smith]

I am not sure what 'isjias' is in English either! Obviously without assessing you / knowing the full diagnosis it is difficult to suggest what your best course of action is.

I have treated a lot of young fit males that have developed prolapses for various reasons and it is difficult know which way any of them will go. If caught and treated quickly enough some recover well and continue strenuous exercises all be it with the knowledge they must be aware of their back, others have resulted in surgery however.

If you imagine the middle of the disc a bit like tooth paste that has squeezed its way out through a crack to press on a nerve, or like a cake with jam in the middle, if you squash one side the jam moves to the other. Anything that you are doing day / day that increases the pressure on that disc, squeezing the paste / jam more will increase the pressure on the nerve and thus the pain.

Obviously having seen various specialist they have probably given you advice on how to manage your back....a good book that you may find useful is 'Treat your own back' by Robin McKenzie. Seeing a McKenzie trained physiotherapist may be useful.

You need to look at all the activities you do day to day, the cumulative effect that these may have on your disc. Often people tend to naturally adopt a postion that eases their symptoms at the time that are actually aggrevating their problem.

I would always suggest surgery as a last option, especially if there are things that you can do / positions that you can use that improve the symptoms and that the compression is not causing weakness or other symptoms that may indicate things are deteriorating.

Good luck

[elinwee]

Hi
I am a physio with a 7 month old waiting to be fed so sorry I havent got the time to trudge through the extensive responses already posted - apologies for any repetitions!

However, I just wanted to quickly post a response based on my experience with treating back patients.

Of course its hard to make a diagnosis with an assessment in person to determine the extent of signs and symptoms. But I do agree that surgery should be a last resort decision due to - (1) it being complex surgery with variable outcomes; (2) your young age; (3) you dont seem to have given different conservative treatments a try yet to see if any of them will work.

With disc injuries, due to the mechanism of injury, my experience has been that they respond best to an extension-based program to try and resorb the protruded disc material. Therefore it would explain why cycling aggravated your symptoms, because during cycling, you prob put a flexion load on your spine which would tend to push the disc material out further. Same with sitting for a long time with legs out or with trying to touch your toes. These actions flex the spine and I would avoid them for now.

The above is based on McKenzie-theories, so yes a Mckenzie-based practitioner could help.

The initial progress could be slow - the main aim is to reduce the bulge and reduce the symptoms first. Once the injury is stabilized, then I will build on strength and movement and flexibity.

I gotta to go feed!!! Hope that helps.

Elin

[sepet]

The suggestion by the last contributor is indeed the same thing I will ask you to follow. McKenzie technique is very useful for resolving this type of back presentation. Giving that you usually feels better after walking and worse with bending down, it is even already becoming evident that you may be an extension responder. Visit this webpage The McKenzie Institute - Welcome to the McKenzie Institute International and go to the link for your country to access the specific website for that country to check for practitioners in your area.

I wish you all the best. In the interim avoid heavy lifting, avoid lifting with your back (use your leg muscles!), sit with good posture, avoid sitting for prolonged period till you see a practiotioner, avoid long car ride (which is also sitting!), stop all bending related stretches for now (it may make u worse), avoid recliners and soft sofas etc.

Sepet