DDD / Lumbar - Try Physical Therapy?

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F / 33yrs old

Is there anyone who can provide any advice to me regarding physical therapy after a L5S1 disc bulge flare up? I hear that sometimes PT helps but sometimes it makes it worse. What is your experience?

My situation:
Disk Bulges in: L3,L4, L5/S1
L5/S1 bulge is severe w/ canal narrowing

I have had great healing experiences with my chiro during pregnancy and after. (I have a two year old). He has been treating me with my most recent disc bulge flare up. I keep messing it up because i am stubborn and start feeling better...then WHAM square one. I avoided the epidural shot and managed the pain. After 3 weeks, I finally broke down and got some pain killers to help me work. I was standing at my desk for about 3 weeks. I am now sitting.

I also saw 3 different spine doctors. They all told me the same thing as the chiro. My L5/S1 is shot. (But it is still there..there is space between the vertebrae).

I am in good physical contidion. (5'6 @ 115 lbs). In fact, i am a bit underweight. I have not worked out in a year and have been losing some muscle tone. I have bad posture but am working on it.

Anyway, I am getting decompression at the chiro. It helps.

Since the doctors and the chiro agree that i have a degenerate disc, I know that is the case. But what they do not agree on is PT. I want to try physical therapy. My chiro does not want me to try it. (He says I am in good physical shape and to do core exercises like plank, etc. ) I have a consultation next week at the Dr. They will recommend physical therapy for me. I'm not sure what to do.

I am requesting your experiences.

Has PT helped any of you?
hurt any of you?

I am really scared because I have never had a medical problem. Always been healthy. So, i am in a depression over this. I am trying to get out of my funk. I know it could be much much worse.

I just don't want to make it worse by going to PT when the only guy who has helped aleviate my pain told me not to.

What would you do based on your experiences?

[Billy Bob]

My situation is not nearly as bad as yours.

However I have had dozens of PT visits...

For me they made me more limber and that made me feel a bit better. I get pretty stiff because I don't want to do much. So over time my flexibility goes to shit.

However the PT never fixes the problem.

There are some really smart people on this board though. I am sure they can give you more sound advice than I can.

Good luck!

[stars]

Thanks for your response Billy Bob.

I do understand that nothing will "fix it". That is probably why i can't stop crying. haha.

Anyway, I am a good weight but I know that I am weak. Especially after having a baby. I worked out the first year, but not the second. You CAN be out of shape and be skinny. I think my chiro thinks i am "in shape" because i have a nice figure (am not overweight). I think my core could definitely use some strengthening.

I have always been a 0% or 110% kind of gal. This SLOW healing and "can't fix this" has been a hard bite for me to swallow.

Thanks again Billy Bob and I hope that you are not having too much trouble with your spine issues. I feel so sorry for anyone who has to deal with this.

[Maria]

In the US before anything is done surgically usually insurance will require a trial of PT before moving on to authorizing other types of more invasive treatment. Myself PT was never that helpful for my spine except with my SI joint stuff and even then it took one PT out of a number to treat my injury really well and it's difficult to find that "one" person. I think core exercises are definitely key but there are some things that one will find that aggravate or flare a bad disc up so you kind of have to work with what doesn't flare things up.

If you do go to PT don't let anyone push you if your spine starts hurting.. stop doing whatever makes things hurt because you can worsen the situation so be careful with that. I think you could probably work out your own exercise regime on your own though again if you see a doctor and are considering surgery then you will likely have to go thru a course of PT and it will have to fail before anything more invasive surgically would be recommended. PT might be helpful to you though again don't let anyone push you when your back hurts more because it's probably not going to make it better and might make it worse. A little pain when first beginning is normal if you're out of shape but nothing that really aggravates that disc which is far too easy to do.

An ESI might be very helpful and I would reconsider this. I had ESIs over a 10 year period of time and was able to avoid more surgery. They don't work for everyone but when they do work they're pretty awesome.

If you develop the following get seen ASAP(emergency): loss of bowel or bladder function (incontinence), numbness in the saddle area (perineum), numbness or loss of use of your extremity, extreme unrelenting pain that isn't alleviated with any method of treatment such as rest, etc.

Good luck with everything and keep us updated if you feel like it~ Maria

[stars]

Thanks Maria.
That is very helpful.

I have PT scheduled next for monday. A co-worker of mine referred me to his PT at the Spine&Neuro center who also happens to be the director of PT. He said he was the "best". I took a chance and emailed the director, and I am scheduled to work with him. My chiro specifically told me not to "twist" and avoid touching my toes in my pilates and yoga classes. So, I will be careful at PT. I am just really scared it will start to flare up again.

I am a graphic designer so I sit all day. My employer purchased me a really nice chair with memory foam and a cut out at the place where my sacrum hits. It is so much better than my other chair. I have a sit down/stand up desk on the way. I guess I am lucky because they didn't have to do that. (My production has been down since my flare up).

I will start PT on Monday against my chiropractor's suggestion. I will stop any exercise that aggravates it (although it might be too late). I suppose there is always ESI if I go down in flames from it.

Re: ESI
I WILL get one next time. I was regretful I did not do it this time. I have just been really scared since all this is being thrown at me so quickly. I have not had ample time to do research. I do feel grateful that Mark has started this site so we all have a place to go for help. I wanted to post immediately since all of you have way more experience than me. I really welcome opinions and information from those who have gone down this path.

Thanks again Maria. I will let you all know how it is going.

[Maria]

Stand at your desk? If so get a mat that absorbs shock like hair stylists have at their station and have a chair so you can sit if needed though can stand and move around a bit. I did that the last 5 years I worked as an "advice nurse/telephone triage" with a modified work station. Maybe wear shock absorbing and supportive shoes as well. I have not been able to ait for long periods even after 2 discectomies (L5S1 and L4) so the standing station helped greatly. I didn't start getting ESIs until after I retired on perm disability tho I wish I had.

Good luck with your PT consult and all