re: L5-S1 herniated disk

Some shots have a diagnostic and a therapeutic component to them in that they'll give you the injection for pain relief, but if it works then they also know the symptomatic level of your spine.

Don't be surprised if the surgeon finds more significant damage when he opens you up.

I just wrote a brief for a client who was originally recommended to undergo a one level discectomy, then the comp doctor suggested a two level discectomy, then he ended up having a two level fusion.

Modern medicine is great, but it's not perfect. Hope you can find some relief anyhow. I'd echo what others have said about staying away from opiods if you can help it. Smoke weed before you start down that road

Mri shows slight bulge l4 as well but surgeon said the l5s1was a 9/10'as far as herniation a go. Both he and physiatrist were surprised I am not in worse shape. I expected the surgeon to push surgery, did not expect physiatrist to push surgery and get me a consult next morning.

I feel for you guys with long term back injuries.

you get what you pay for

I've been battling back pain for 16 years. Should I make an appt with a neurologist? Anesthesiologist? I wsnt to find out what exactly is wrong before the next step.

Back pain sucks. Good luck OP.

Yes, had rolling done too, by a pt.

Update: had cortisone injection yesterday, doc said 24-72 hours before it kicks in. 20 hours later I definitely have some relief, 25% or so. Immediatly after injection I had great deal of relief due to the lidocaine or whatever they use but it went away in a few hour.

Weird side effect last night, around midnight I had really bad spams in both calves and feet. My toes were bending with spams. Never had any kind of feet/ calf spams. I assume it's to to the amount of cortisone in the surrounding nerve roots?

Feel optimistic I will feel great relief in the coming days, just hope these spams don't hit agin tonight.

Update:

Yesterday, 8 days after epidural injection, I finally have significant pain relief---75% better. I am scheduled for surgery next Thursday.
I have a slight tingle along sciatic in buttock, no big problem sitting anymore. More pain in lower back as I assume the pain is centralizing.

What's OT's opinion, keep try the injections and postpone surgery? Or just bite the bullet.

Deductibles are an issue for me. Mine is met for the year due to previous surgery this year, so I would want surgery this year if I really need it.

Ultimately it’s something you need to decide on your own. You’ll find differing and varying opinions.

I had issues 4 years ago, tried PT for 6 months and it managed it but didn’t make much progress. Ended up blowing two levels out and couldn’t walk for a week (needed crutches because nerve pain was so bad). Ended up having microdisectomy and laminectomy on two levels. It was a last resort, but in my situation, it was so bad I needed to go under the knife

With back surgery:
1/3 improve some, rarely 'back to normal'
1/3 stay the same once they recover from surgery
1/3 are worse after surgery
and
1/3 die of AIDs.

Microdiscetomy