Prolapsed/Slipped Discs - What A Pain In The Buttock!!!

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For Anyone Suffering From A Prolapsed Disc

Here is a lens specifically for anyone who is a fellow sufferer like me of a prolapsed disc, particularly the discs in the lower back. You'll find helpful information and useful links here. I should point out that I'm not a clinician or medically qualified in any way. This is based on my own personal experiences and learning.

What Is A Prolapsed Disc? 

The spine is made up of many bones called vertebrae. These are roughly circular and between each vertebra is a 'disc'. The discs are made of strong 'rubber-like' tissue which allows the spine to be fairly flexible. A disc has a stronger fibrous outer part, and a softer jelly-like middle part called the nucleus pulposus.

When you have a prolapsed disc (commonly called a 'slipped disc'), a disc does not actually 'slip'. What happens is that part of the inner softer part of the disc (the nucleus pulposus) bulges out (herniates) through a weakness in the outer part of the disc. A prolapsed disc is sometimes called a herniated disc. The bulging disc may press on nearby structures such as a nerve (sciatic) coming from the spinal cord. Some inflammation also develops around the prolapsed part of the disc.

Any disc in the spine can prolapse. However, most prolapsed discs occur in the lumbar part of the spine (lower back). The size of the prolapse can vary. As a rule, the larger the prolapse, the more severe the symptoms are likely to be.

What Are The Symptoms Of A Prolapsed Disc 

Back pain

The pain is often severe, and usually comes on suddenly. The pain is usually eased by lying down flat, and is often made worse if you move your back, cough, or sneeze.

Nerve root pain (usually 'sciatica')

Nerve root pain is pain that occurs because a nerve coming from the spinal cord is pressed on ('trapped') by a prolapsed disc, or is irritated by the inflammation caused by the prolapsed disc. Although the problem is in the back, you feel pain along the course of the nerve in addition to back pain. Therefore, you may feel pain in the buttock and down a leg to the calf or foot. Nerve root pain can range from mild to severe, but it is often worse than the back pain. With a prolapsed disc, the sciatic nerve is the most commonly affected nerve. (The term 'sciatica' means nerve root pain of the sciatic nerve.) The sciatic nerve is a large nerve that is made up from several smaller nerves that come out from the spinal cord in the lower back. It travels deep inside the buttock and down the back of the leg. There is a sciatic nerve for each leg.

Other nerve root symptoms

The irritation or pressure on the nerve next to the spine may also cause pins and needles, numbness or weakness in part of a buttock, leg or foot. The exact site and type of symptoms depends in which nerve is affected.

My Personal Journey With A Prolapsed Disc 

Up until November last year, I was a recognised Birth Doula with Doula UK (a woman who supports pregnant women and their families before, during and after birth). I awoke one Friday morning in November at 6am to my son who was teething. I leaned over his cotbed to tend to him and I felt my back 'go'. An hour later, I got a call from my client saying she was having regular contractions and could I come.

A gorgeous baby boy was born 22 hours later however by this point, I was in excruciating pain with my back and I hobbled back to my car and drove home.

The following day, the Saturday, I was still in agony, my back went into spasm walking down the stairs and I couldn't move for about 5 or 10 minutes.

By the Sunday, the pain had moved from my back into my left buttock/leg and foot and I felt this strange numbness. I've never experienced anything like it and the pain, well, I've always said and will always say, I'd rather give birth than experience that pain!!!!

I managed to get an appointment with my osteopath on the Monday, relief all round as I thought he would take the pain away as he has done on the few other previous occasions I've been to see him with lower back pain.

My dad drove me there, I was lying in the back of his car and after seeing the osteopath I hobbled back to the car still in as much agony. Phone call to my GP on the Tuesday, prescribed Volterol, Diclofenac and 2 days worth of Diazapam. I took them all, I just didn't care as I was constantly writhing on the bed or settee - I couldn't sit down, I could only lie or stand.

The tablets really knocked me out and I finally got a little sleep. On Thursday my husband travelled to Germany thinking that I was improving. By early hours of Friday morning I was writhing in agony again. Being on my own, my first call was to my mum. My mum and dad came to the house at 1.30am, called for an ambulance and off I went to hospital.

By this point I couldn't sit down to go to the toilet so in the end they had to catheterise me. I had an X-ray and MRI scan the same day and was told I had an L5/S1 prolapsed disc and I remained in hospital for almost a week. At first I was on morphine but then this fantastic Pain Specialist prescribed me Gabapentin - a tablet that epileptics take everyday of their lives but found to help specifically with nerve pain. If I could shout from the rooftops about how this tablet can really help nerve pain I would!!!!

And so, once home, the pain was being managed much better and I tried to keep moving. I had physiotherapy for 3 months and 2 sessions of hydrotherapy.

At the end of January, however, because my recovery had plateaued, the physiotherapist suggested I go back to see my Consultant which I duly did in early February to be told I had a sequestrated prolapse compressing my sciatic nerve, large disc and it's unlikely to recover without an operation.

My Consultant at that particular hospital only carried out open discectomies so I asked to be referred to a spine specialist in a different hospital who was experienced with the micro-discectomy procedure.

And so in March I saw this new Consultant at Hope Hospital in Manchester, fantastic bloke, explained everything including the risks and so I went on the waiting list for the operation.

I had my micro-discectomy on the 14th May 2008, a very positive experience for me - the surgeons, the nursing staff, even the food I could rave about! The pain was almost gone, it took me about 6 weeks to wean myself off the Gabapentin tablets. I still had numbness down my leg and foot however I knew that because the sciatic nerve had been compressed for so long, this would take a lot longer to recover.

And so, some months later, my mobility began to come back much better, I could walk without much of limp and things were looking great, I felt very positive about the outcome.

However at the end of July 2008, I started to have back pain again and some discomfort in my right buttock, so I contacted the hospital and got an urgent letter of referral from my GP. I had another MRI scan on the 30th October 2008 and I'm awaiting the results.

Facing A Discectomy - The Operation, The Risks, The Recovery 

The Operation

A discectomy is a surgery done to remove a herniated disc from the spinal canal. When a disc herniation occurs, a fragment of the normal spinal disc is dislodged. This fragment may press against the spinal cord or the nerves that surround the spinal cord. This pressure causes the symptoms that are characteristic of herniated discs.

The surgical treatment of a herniated disc is to remove the fragment of spinal disc that is causing the pressure on the nerve. This procedure is called a discectomy. The traditional surgery is called an open discectomy. An open discectomy is a procedure where the surgeon uses a small incision and looks at the actual herniated disc in order to remove the disc and relieve the pressure on the nerve.

There is also the choice of a micro (key-hole) discectomy, a smaller incision, use of small cameras and special instruments to remove the affecting disc. With this type of operation there is usually a speedier recovery time from the operation but it's not always feasible in all situations so this should be discussed with your surgeon.

How Is A Discectomy Performed?

A discectomy is performed under general anesthesia. The procedure takes about an hour, depending on the extent of the disc herniation, the size of the patient, and other factors. A discectomy is done with the patient lying face down, and the back pointing upwards.

In order to remove the fragment of herniated disc, your surgeon will make an incision over the center of your back. The incision is usually about 3 centimeters in length. Your surgeon then carefully dissects the muscles away from the bone of your spine. Using special instruments, your surgeon removes a small amount of bone and ligament from the back of the spine. This part of the procedure is called a laminotomy.

Once this bone and ligament is removed, your surgeon can see, and protect, the spinal nerves. Once the disc herniation is found, the herniated disc fragment is removed. Depending on the appearance and the condition of the remaining disc, more disc fragments may be removed in hopes of avoiding another fragment of disc from herniating in the future. Once the disc has been cleaned out from the area around the nerves, the incision is closed and a bandage is applied.

What Is The Recovery From A Discectomy?

Patients often awaken from surgery with complete resolution of their leg pain; however, it is not unusual for these symptoms to take several weeks to slowly dissipate. Pain around the incision is common, but usually well controlled with oral pain medications. Patients often spend one night in the hospital, but are usually then discharged the following day. A lumbar corset brace may help with some symptoms of pain, but is not necessary in all cases.

Gentle activities are encouraged after surgery, such as sitting upright and walking. Patients must avoid lifting heavy objects, and should try not to bend or twist the back excessively. Patients should avoid strenuous activity or exercise until cleared by their doctor.

What Are The Potential Complications Of A Discectomy?

The most common problem of a discectomy is that there is a chance that another fragment of disc will herniate and cause similar symptoms down the road. This is a so-called recurrent disc herniation, and the risk of this occurring is about 10-15%.

Most patients find relief of much, if not all, of their symptoms from a discectomy. However, the success of the procedure is about 85-90%, meaning that 10% of patients who undergo a discectomy will still have persistent symptoms. Patients who have symptoms for long periods of time, or severe neurologic deficits (such as significant weakness) are at higher risk of incomplete recovery.

Other risks of surgery include spinal fluid leaks, bleeding, and infection. All of these can usually be treated, but may require a longer hospitalization or additional surgery.

Microdiscectomy Using Hyrdro Surgery 

This is new to me, I've never heard of it in the UK but it does seem like a more non-invasive surgery.

Microdiscectomy

Hydrocision

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curated content from YouTube

"What are the ALTERNATIVE THERAPIES available for prolasped/slipped disc sufferers?"

The Alexander Technique 

The aim of the Alexander Technique is to set up the best circumstances with which the body can function, at each individual's natural optimum. The hands-on element in the work is important because it gives you the experience of how a movement can be different from your normal, habitual ways. This would be very difficult to learn from a book. Pupils come for lessons so they can learn the skills and tools for themselves. By looking at the general pattern of thinking and moving, you can alter and alleviate the specific symptoms.

The Alexander Technique has been in the UK for over 100 years. FM Alexander discovered that we translate everything, whether physical, emotional, mental or spiritual, into muscular tension. This technique can help anyone with physical, mental or emotional conditions resulting from ingrained habits.

Yoga And Pilates For Lower Back Pain 

Both Yoga and Pilates are becoming progressively popular, which is possibly due to their increasing popularity with celebrities, choosing it as their preferred form of exercise. Yoga particularly, is now recommended by medical professionals as an effective method of treating and preventing back pain.

What is Yoga?

Practised for over 5,000 years in India, yoga engages the practitioner in developing spiritual and physiological well-being. Techniques include breathing exercises, maintaining correct posture and meditation.

What is Pilates?

Pilates was introduced in the early 20th century and is essentially encouraging the mind to take control of the muscles, aiding correct postural alignment and strength of the spinal column.

The use of yoga in the presence of back pain is particularly good as almost all movements work on both sides of the body at the same time. Stress can be put on the sacroiliac joint by exerting one side more than the other.

Yoga is believed to be beneficial in the treatment of back pain as it teaches balance, flexibility and strengthens muscles. By gradually building the complexity of movements, the body will learn how to distribute its weight effectively and will maintain balance and posture naturally.

The poses learned in Yoga are expected to teach the practice of body-awareness on movement and before repositioning. Frequent participation of Yoga will encourage a more supple body with less chance of injury occurring from sudden movements.

The use of pilates in the presence of back pain is more concerned with the improvement of the body's alignment by increasing length, flexibility and tone of muscle rather than building muscle density. The aim of Pilates is to gradually encourage the joining of mind and body by a series of daily exercises that develop core muscles within the body, particularly those surrounding the spinal column. Deep breathing techniques also encourage a healthy blood flow through the body aiding in the recovery of muscular or ligament damage. Movements taught in Pilates lessons teach how to maintain constant control of the muscles, thereby eliminating many risks of back injuries resulting from sudden movements.

Specialists believe that those suffering from degenerative disc disease, pain stemmed from sudden movements and joint complaints are the most likely to benefit from learning Pilates.

Physiotherapy 

Physiotherapy is very effective in the treatment of disc related problems such as Sciatica. Treatment by physiotherapy can relieve nerve root compression caused by fibrous scar tissue following a disc prolapse, or the build up of gas. A physio can also aim to prevent further episodes of sciatic pain through teaching correct postural techniques, and exercises to correct any muscle imbalance in the spine.

Most cases of sciatica tend to settle down with physiotherapy treatment, but severe cases of sciatica may require steroid injections or even surgery.

Aromatherapy For Pain Management 

A wonderful aroma is fabulous to uplift the spirit and create a positive mindset. Choose an oil or oils which possess aromas that you find pleasing.

Bergamot, Orange, Lemon and Grapefruit have light,refreshing and uplifting aroma's.
By using one or a blend of these oils, a glimmer of light can once again begin to invade the dark recesses of the mind.

Pain can seem to lessen depending on our mood, moments of happiness, pain is temporarily forgotten, even if only for a second. Lifting the heavy feeling of depression can make life and pain seem a little more bearable.

The best method is the one you are happiest with. I would recommend inhalation.

Apply a couple of drops onto a tissue and inhale or add to oil burners, aromatherapy diffusers or create your own room sprays. The oil molecules are released into the air for us to inhale.

Useful Links For Prolapsed/Slipped Disc Sufferers 

Lots of useful links for prolapsed disc sufferers. These are mainly UK based however, I'm sure all sufferers could benefit from the information.
Prolapsed Disc Social Network
A place for prolapsed disc sufferers to chat, share the stories and offer each other support.
Trophic Electrical Stimulation
This is a place that has been recommended to my friend by her physiotherapist. I'm not sure it's available on the NHS and I'm guessing it's probably private treatment. It's called Trophic Electrical Stimulation (TES)
Royal College of Surgeons
I would recommend undertaking research on the surgeon who is going to undertake your operation (UK only). This might be a good place to start, The Royal College of Surgeons, dedicated patient information.
Health Care Commission
In the UK, for quality and performance information on hospitals from the independent regulator of healthcare.

Great Useful Stuff on Amazon 

Useful books as information is knowledge is control of your situation!

Healing Back Pain: The Mind-Body Connection

Amazon Price: $10.07 (as of 12/27/2009) Buy Now

Yoga to the Rescue for Back Pain

Amazon Price: $13.49 (as of 12/27/2009) Buy Now

Lumbar Discectomy and Laminectomy (Principles and Techniques in Spine Surgery)

Amazon Price: (as of 12/27/2009) Buy Now

Aromatherapy for Back Pain

Amazon Price: (as of 12/27/2009) Buy Now

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  • Reply
    inkserotica inkserotica Dec 18, 2008 @ 6:17 am
    I always prefer to read or listen to personal accounts of health related issues (not that I like people to suffer!) but it's more interesting and informative to me to read about how people deal and overcome their difficulties. Love the honesty and the title! ;) 5*
  • Reply
    Web-Mums Web-Mums Nov 13, 2008 @ 4:16 pm
    Wow Jude - what a lens! Your personal story is really inspiring - it's well written, informative and thank you for sharing it with us all.

    Nikki
    x

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