Herniated Discs Healed up ( fully ) still have pain though

[zprime]

Well 1 year ago I had the following.

L4L5 Disc Prolapse Pushing on Thecal Sack
L5S1 Herniated, Enroaching on Right Nerve Right
Disc Dessication in Both

Yesterday I got my MRI results back

L4L5 Discs Perfect
L5S1 Discs Perfect

I was in tears when I heard the good news, It appears after months of agony my Back had finally healed.

Howevever I'm not out of the woods yet, I've been trying to keep my posture good, always stretch sitting and stretch lying ( Stack sitting hurts me and brings on instant pain for some reason ).

Anyways I still have daily pain and nerve issues ( pain that jumps around from toes to calves, to certain muscles ), Is this normal for someone who's healed up? Does it just take the body a while to get over injuries like this?


Keep in mind the pain is 1 out of 10, but its still enough for me to go ' oh why am I in pain ? '


Thanks

- Paul

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[zprime]

No Physiotherapist in the world seems to be able to answer this...

[mancia28]

Can i just ask- did it all just heal by itself or you had an op, physio or something else? i mean i would kill for such news and would be in tears too... ask your doc for amitriptyline, it works on nerwes pathways and is supposed to be really good for such pain. don't expect results within days though, more like weeks, worth a shot

[Musculoman]

To be the first physio in the world to attempt an answer! What an honor!

When you have discal injuries, especially after months of pain / symptoms, it is likely you have developed secondary changes. These may include muscular and postural changes which are compromising your nerve pathway giving referred pain. It may be due to constant neural irritation or the nerve root leading to local scarring, thickening of tissue and central / peripheral hypersensitivity. It may be due to the fact that during the first MRI you had a lack of lumbar lordosis (flattening of the back) which was causing increased posterior protrusion of the L4/5, L5/S1 discs therefore impacting the nerve root. During your months of pain you may have developed an increased lumbar lordosis (you note your improved posture!) which caused decreased posterior protrusion of the discs, so when you went for your new MRI no nerve compression was noted! However at work / during ADLs you will likely find your posture fatiguing occasionally leading to nerve root compression / referred symptoms?

There are lots of ways to answer your question but the answer is likely a combination of all of them.

Suggestions: Continue working on your posture, doing postural exercises, stretching, staying away from aggravating activities and possibly look at your ergonomics at work and home. (Basically the things we tell all our clients!) It looks like it is working for you.

If it does not resolve any further, you could look at light neural flossing / desensitisation techniques or going to a good physio to assess any further postural / muscle imbalances

[physiobob]

I tend to agree with musculoman. Importantly MRI's are highly over positive for what they show in relation to what is causing your issue. They are just a sign (something you see). They are not a symtom (something your feel). They may be a sign of instability between two vertebra and that instability may have been causing referred pain secondary to other issues like facet joint loading. Also muscle spasm or holding about those areas may have an effect on normal flow (blood and otherwise) to the surrounding tissues. That tissue stasis could relate to the pain. Hence take the advice above. Back pain is normal, 85% of a working age population get it at some time and it is recurrent by nature. So not having it is ornshouod be considered abnormal. Your longterm goal should be to increase the time between acute episodes and reduce the time or duration of any episod when it does occur. A physio can help a lot with that management.