I herniated my l4-l5 and l5-s1 discs in early Sept. 2022 that also resulted in the formation of a “discal cyst” and caused the most excruciating sciatic pain imaginable. I treated early with a systemic steroid injection and oral steroids along with extensive postural adaptations(avoiding sitting or spinal flexion/twisting like it’s the plague and strictly monitoring, safe lifting techniques) along with self-guided pt(I’m an exercise physiologist) mostly following Stuart McGill’s approach/recommendations(from his book Back Mechanic).
4 1/2 months later my symptoms have certainly improved, but are still very present and I still can’t spend any time on the bike without radiating pain in my glute/hamstring and calf. I just had a follow up MRI and the herniation appears to have resolved, but the cyst has not gotten any smaller and continues to press on my nerve root and is the source of the continued pain. I’ve scoured the research and had a consultation with a surgeon this week, and it does seem that if the cyst hasn’t gotten smaller at all by now, and most likely isn’t going to go away on its own.
Having never had surgery in my life before(37 years old) the thought of needing spinal surgery is obviously a bit terrifying for not only the potential immediate complications, but also any potential long-term complications like segment instability, etc.
At this point it does seem like the surgical option is an inevitable since I’ve exhausted my conservative options, but it would certainly help to hear about other’s success or positive experiences amongst my active peers. Cyclocross is my discipline and choice and the thought of mounting dismounting and running makes me a little worried about future re-injury even if the surgery is successful.
So I guess what I’m asking is who’s had experience and what suggestions advice tips do you have things to watch out for? Would you do it again?
Had 3. Surgery itself is easy. Recovery is raspy variable, depending on specific anatomical factors.
Biggest thing to remember is nerves heal very slowly, and you might (probably will) have residual symptoms, and often after an initial period of them being gone. It doesn’t mean another problem though.
Anyway, if you’re still having symptoms that interfere with your activities, I’d say go for it
I had an L5-S1 microdiscectomy and then later a fusion (at the time of the first surgery, the surgeon opined that it would probably be necessary based on how much of the disc was left). I rode my bike a little before the surgery, but not very much. I took up running and then triathlon after the fusion (well, after recovery from the fusion). I also took up strength training afterward, although I am conservative in my loading and my choice of exercises (I don’t intend to ever do Olympic weightlifting because of the spine flex).
I think the fusion was 9 years ago, so I would call it successful and don’t feel at risk of re-injury. My tips would be to take it slow to start, and do what the doctor tells you re: recovery. Being too conservative might mean you are not ready to race as soon as you would like, but not being conservative enough might mean re-injury. I found doing yoga very helpful, and in-person yoga classes very accommodating as I slowly regained range of motion (there’s still a lot of yoga and “core” work that is basically variations on crunches that I don’t do, for the same reasons re: spinal flex).
I can’t predict how yours will go, but I think those are strategies for minimizing the risk of re-injury or severe limits on your activity. I outlined a few things I feel restricted from doing, but it’s a much smaller list than the restrictions I had before surgery when I could barely control or feel my right leg.
I’ve herniated L5-S1 at least 3 times and had 2 microdiscetomies. I’ve also had a total of at least 13 surgeries at this point for numerous orthopedic issues. So from experience I can say the surgery itself is not a big deal. Recovery from the surgery itself is not a big deal, but healing can be slow and variable… I’m talking in regards to the pissed off nerve that can variably give you problems on/off with no rhyme or reason. Since your problem now is from a cyst that is unlikely to go away sounds like surgery may be the only option. IMO if the doc says the cyst is unlikely to go away on its own I wouldn’t get too worked up over the surgery itself. the longer the nerve is compressed the harder it is for it to heal (that’s what i was told) so waiting just causes you more suffering. for me the best thing after a sufficient period of recovery is to just get back at it and don’t let it slow you down. with back issues overthinking things and worrying about what you can/can’t do in my experience is more debilitating than the injury itself.
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