L5/S1 Herniated Disc - My Road to Surgery

My journey to surgery was such a windy road my my mistakes, having to fight for my care, ups and downs (mostly downs) of my mental and physical health. In the end, I’m happy with my decision to get surgery. With my headspace early on, I don’t think any one could have changed my mind from the mistakes I made, and I’m now happy looking back at what I’ve learned about myself and my body. I tried to graph a tldr of my pain and experiences here and will continue this graph throughout my recovery.

Over 10 years ago - Priming my low back for an injury

My chronic back pain started all the way back in my senior year of High School while I was playing tennis. While doing a conditioning workout, I remembered feeling a pop in my back and fell to the ground. I couldn’t get up for what felt like hours and I could barely stand straight as I walked to my car. I went home, rested for the weekend and in general felt ok enough to go back to school Monday. The pain slowly went away over the next month and I went back to tennis (a lot of bending and twisting which are awful for an injured back) and ever since then, never was able to sneeze without back pain, would have regular flare ups, try a ton of PT that really never worked and didn’t realize it until now, but primed my back to get seriously injured over 10 years later.

September 2022 - The leg pain started

I never had one moment something popped at the gym or I bent over and was in a ton of pain. In early September, I woke up the day after a workout that wasn’t even that tough and I thought I had pulled my right IT band (I don’t even know if thats possible). I felt a ton of pain in my hip down through my hamstring. I couldn’t bend over without triggering pain and I could no longer touch my toes which I used do daily as a morning stretch. However, I still pushed through. I continued working out despite prior to this, I was also dealing with a knee injury that I had a hunch was my 3rd torn meniscus - working through pain has been a constant trend throughout my life that finally caught up to me in the last 6 months. If you take anything from this - DON’T DO THIS! I honestly look back at this time like I was such an idiot. I was still squatting up to 250lbs for reps, I was deadlifting, I was working out until I was exhausted on the floor almost daily. I craved it and to be honest, at the time no one could have told me to stop.

To no surprise, my pain got worse throughout the month and eventually lead to my foot going numb, shooting pain down my leg. I tried watching Youtube videos to see what I needed to do and found Bob and Brad and their wealth of content. I started doing all the exercises they recommended, but continued to sit a lot of the day at work not knowing I was making things worse. I was stubborn, I had been to so much PT for my back and knee that didn’t work, doctors always dismissed my pain, but my boyfriend, Jon, was worried of what would happen since it kept getting worse and made me make an appointment.

October 2022 - Finally speaking to a doctor & making bad decisions

October 3rd, I finally saw an orthopedic. I just did a yelp search of best sports med doctors in my area and this doctor came up that was taking new patients that I could see quickly. Once I saw him, I learned he only treated knees but would order an MRI on my back as well and if he saw something, he could refer me. I got an MRI and it came back that I had a torn meniscus and cysts in my right knee, and at the time 2 disc bulges that were 4mm at L4/L5 and 7mm at L5/S1.

My MRI from October highlighting my L5/S1 bulge

I needed to speak to a spine specialist before going forward with knee surgery since my back was a greater limiting factor at the time. He referred me to a Neurosurgen that was well reviewed and I was able to see her the next day (I have no idea how because later this was not the case). After speaking with her, she wanted to take a conservative approach since I still was able to move around so much and sit, and recommended I go ahead with the knee surgery. I told her how much PT I’ve been to already for my back and what I was doing things at home to help based on what I saw on the internet. She was actually supportive of me continuing to do at home PT that I found and encouraging me to stay active (also because I’ve been to all the PT near me that my insurance covers and it was going to be very expensive) and she said the rest from my knee could help my spine.

During this time between waiting for my knee surgery, I was still stubborn and went to Disneyland for 3 days… looking back I very much should not have done this. The jerkiness from the rides, and walking for over 10 hours a day, and slouching over in lines for hours was a recipe for disaster. In addition, I continued to workout and the only modifications I made was squatting to a box and taking out deadlifts. I was still incredibly dumb for doing this, but at the time, I still could not have understood what true rest meant and thought a break from the gym was it. I’ve always powered through pain so I didn’t see this as anything different.

November 2022 - Knee Surgery made my back pain worse & Starting chiropractor treatments

I got my knee surgery in early November and part of the recovery is a lot of sitting and doing leg lifts. In that first week, I sat a TON, could not walk, and did leg lifts despite it triggering my back and leg pain. My symptoms for my herniated disc continued to get so much worse; however my knee was healing! I was getting more frustrated with my leg pain and started going to a chiropractor weekly. I kept doing leg lifts at home, sitting all day at my desk for work, and my chiro sessions for a few weeks. I wasn’t doing any lower body exercises at the gym except step ups for my knee. By the end of the month, I started having more serve sciatic pain and foot numbness that would cause me to lay down for a couple hours a day. I’ve been really grateful throughout this whole process to be able to work from home and not have a physically demanding job. I didn’t get much relief from the chiropractor but since I had reached my deductible from my surgery, I kept going weekly through the end of the year.

December 2022 - Another spine appointment, losing hope, and a trip to Thailand

I had my knee and spine follow up appointments. My knee was progressing wonderfully. I was walking, I had great range of motion again and for the first time in a VERY long time, my knee pain has been essentially gone! However, after that great news, I had my spine follow up appointment.

This time I met with a PA rather than the main doctor. I told her how my pain was getting worse and explained how the exercises from my knee rehab triggered my sciatic pain to be a lot worse. I told her what I normally did prior to the injury, how I’ve finally cut back a lot at the gym and she was incredibly discouraging of lifting or bodybuilding of any kind for the rest of my life. She said I should never lift more than half my bodyweight for the rest of my life, I had to pick different hobbies, and my life would never be the same. Towards the end, she just prescribed me pain medication of Celebrex 200mg/day and Gabapentin 300mg (up to 900mg)/ per day. I was so discouraged, I left the appointment sobbing and just felt deflated. My pain wasn’t constant, and I was able to still sit, walk and do most normal activities at the time, but almost daily, I have sciatica flare ups that would cause me to lay down. I was limiting myself so much at the gym and just wanted to get back to working out so bad. Throughout all this, I was going to the Chiropractor and had no improvements. At the end of the month, I left on a two week trip to Thailand that we had planned with 6 other friends over 6 months ago. I was taking the maximum amount of pain meds the entire trip to get through. I was grateful for an upgrade on the way there that let me recline, but unfortunately the way back started a serious down turn for my symptoms.

January 2023 - The sharp decline & COVID

The flight back was agonizing. I was in a middle of 4 seats for almost 15 hours and was unable to get up and walk the entire time. A couple days after I got back, I could barely stand throughout the day even with the pain medication. Throughout all this, I was still going to the gym. While I stopped lifting anything too heavy and doing really any lower body exercises, I was doing a ton of shoulder press and bench just to get some lifting in that I though wouldn’t hurt me. I now know I was wrong, but the only time I wasn’t in pain was when I was working out, which led me to start working out twice a day! (VERY bad idea). A week after I got home from Thailand, I tested positive for COVID. I had the worse cough I’ve every had. I almost felt I was choking at times and would bend over to cough. One day my cough caused a pop in my back. I was on the ground on the bathroom floor in agonizing pain. In that moment, I realized I had seriously injured my back again and might have to start the whole journey over again. I was very wrong. I got over COVID but my symptoms got worse daily and my journey was only going downhill.

February - Finding a new Doctor & Steroid Injections

I could no longer walk, I couldn’t do anything around the house, I had to lay down on a couch all day for work. I was losing weight quickly because I could only eat off the floor and in short bursts. I had to brush my teeth on the all fours on the ground, I felt that I couldn’t even take care of my basic needs anymore. My mental health was deteriorating quickly. I called to make another appointment at my spine doctor and there wasn’t another availably for 3 months. I felt so deflated and just didn’t know how to even fathom going through that pain for 3 more months.

My amazing boyfriend remembered he knew someone with the same injury and asked for help. They recommended a doctor that does injections and got me in quickly. While I just had to wait two weeks for the appointment, I was in awful shape. I could barely walk to the bathroom, I was crying on the ground in pain daily, I was taking edibles just to sleep. I had to miss so many major life events for my friends. I truly didn’t want to be alive during this time. The pain was just getting worse daily and I felt like the body I though could power through anything was failing me forever. The days and weeks were SO long. Once I finally got into the doctor, I was able to quickly get an epidural steroid injection and waited the full 2 weeks to see if I got any relief -I felt no change at all.

Again, I was so defeated. I could barely find motivation to get out of bed because I knew the second I got up, I’d be in excruciating pain. At this point, I wanted surgery ASAP. The last 6 months, everyone said avoid surgery at all costs, but honestly I never asked why. I just feared it and tried to avoid it because people said so and even at times, accepted the rest of my life might be from a bed. I had read that doctors made you try at least 2 injections before getting surgery. The thought of waiting another 2 weeks for the injection to kick in and and then the time to find a surgeon felt endless. I was incredibly thankful that the doctor immediately said lets stop the injections and get you into a surgeon. I had that appointment on a Monday, got an updated MRI on Tuesday and met with a surgeon on Thursday.

March - Surgery Time!

The Physiatrist that did my injections helped me get care immediately and I for the first time truly felt taken care of. If my neurosurgeon wasn’t taking the following week off, I could have had surgery the following week after meeting my surgeon! That Thursday, I met with my Neurosurgeon and had an incredibly appointment. He was so kind, talked me through everything, the injury, the surgery and what would happen before and after. In reviewing my new MRI my L4/L5 bulge remained the same but my L5/S1 increased almost 4x. It was now 25mm bulge and close to completely cutting off my nerve. He spent over an hour talking to me and my boyfriend and I never felt rushed or as if he was talking down to us. I genuinely felt hope for the first time in this process. It seems like most do not have this same experience, but I just wanted to share because there ARE good doctors out there! Throughout all this, my pain stayed constant and probably continued to get incrementally worse despite me being completely bed bound. In those 2 months, I only left my apartment to go to the doctor. I was scheduled for surgery March 14th and while I’m still less than 2 weeks out from surgery, I’m incredibly happy with my decision to do so.