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Old 05-19-2006, 02:04 PM   #1
Adam McCollough
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I have an appointment with an orthopedic spine specialist. Don't really want surgery, any experiences with conservative treatment?
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Old 05-19-2006, 03:02 PM   #2
joseph elberti
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My understanding is that sequestered material can irritate just about any form of tissue, that its dangerous to just let it hang out. It can cause stenosis, or lean up on the chord and cause chemical radiculitis.

Chiropractors are generally against invasive surgery- specially for many forms of back pain that make Osteopaths typically want to cut, this is an instance where surgery is DEFINATLY reccomended.

The sequestered material cannot be 'controlled' or managed- who knows where it will go, or what it will touch- and think about what is in that area (spinal chord, spinal nerves, etc...)

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Old 05-19-2006, 03:47 PM   #3
Elliot Royce
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I have experience with herniated disks. Is that the problem? Don't know what a sequestered one is....
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Old 05-24-2006, 08:55 AM   #4
Adam McCollough
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The sequestration is sort of the next step after herniation. Basically the part of the disc that is protruding out from under the vertebrae breaks free and is now floating around in the spinal column. I have read that with some folks it "dissolved" with cortizone shots and treatment similar to herniation.
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Old 05-31-2006, 10:10 AM   #5
Nick J. Kline
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I think that is the same thing as a disc extrusion. This is exactly what I have. I have done everything, and have been living with pain for the past 5.5 months.

The first surgeon that I saw didn't identify the extrusion and he told me to quit training BJJ and lifting. That was a horrible day.

Make sure you see at least a couple of Doctors. I have a Doctor that I like and trust, and he said that there is a 70% chance that the extrusion will heal itself. The only problem with that is 30% isn't exactly rare. I am waiting and trying to avoid surgery. In the meantime I let pain be my guide for activity. Don't get the corizone if you can live with the pain, because it doesn't dissolve anything. It just takes the inflammation away.

Cortizone works great for your average office dweller, but it is better to let your body tell you what you should and shouldn't do. In your situation the pain is there for a reason. If I got the shots I would likely be doing cleans with everybody else.
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Old 05-31-2006, 10:55 AM   #6
Elliot Royce
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Nick:

With respect, I don't think you're right. An extrusion is also a herniation -- my doctor used both terms for me. With a herniation there is a chance that the disk will shrink with age and retreat back away from the nerve. Also, keep in mind that millions of people show herniations with no pain symptoms at all. Almost everyone over a certain age is going to show a herniation, from what I understand. Why some people suffer nerve pain or not is not fully understood. A medical study that a doctor friend of mine sent me involving quite a large population indicated that the medical outcomes over a 5 year period were identical whether you got the surgery or not. In other words, you might as well wait as long as the pain is not too intense or you are not losing muscle function or you don't have pressure on the spinal column.

This sequestration sounds like there is a risk to the spinal column since it's floating around in there. I think that's the concern.

I would also disagree with the cortisone. I did two shots and it reduced the pain to the point where I could go back to doing cleans. Cleans, and deadlifts and all the rest are exactly what most (not all) sufferors need to keep their spines in alignment so the herniation doesn't worsen. Read Dr. John Sarno's Healing Back Pain -- it's very enlightening.

I'm at 3 years plus from my initial herniation. At first, the pain was 6 out of 10 and I really was finding it difficult to support. After cortisone shots and a variety of other treatments, it had dropped to 1 out of 10. With Crossfit, it's actually gone away. I think what's happened is that my back muscles are now stronger and are better aligning my spine.

Let me add, though, that everyone is different so you may not be able to work through the pain without causing damage. Your doctor is your best guide.
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Old 06-02-2006, 12:27 PM   #7
Nick J. Kline
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Elliot,
I agree with you. I have read Dr. Sarno's book, and it was you that recommended it to me. I like what the book has to say. I have several herniations(bulges) throughout my back, and none of them have caused any pain, except the small extrusion hitting the L5 nerve. This injury happened after a ridiculously bad lift in Jiu-Jitsu this January.

An extrusion is a complete herniation where the nucleus breaks through the outer disc. A sequestration is more extreme than an extrusion, but in both cases there is contact with the spinal column. My surgeon explained that the cortisone would be a bad option for me because I would resume my usual routine.

Your knowledge has been very helpful through this injury. I have been told by everyone that has looked at my films that I should not return to lifting, but I re-read Dr. Sarno's opinion on degenerated discs and I feel better. I also read posts like yours and feel that I will be back to Crossfit without limitations.

Taking it easy has been crucial for me. I had little to no recovery for 4.5 months, and I am finally getting better. I can train BJJ and do certain lifts (kettlebells).
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Old 06-03-2006, 06:26 AM   #8
Elliot Royce
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Appreciate the compliment, thanks! Injuries seem to be my particular area of competence...

I believe that spinal stability is the key. If your doctors are saying that your spine is instable, then I think there is a big risk of resuming lifting.

If you're willing to spend a lot of money, go see Dr. Sarno in NY. I don't think he takes insurance but a friend of mine went with lower back problems and found it very useful.
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Old 06-04-2006, 02:39 PM   #9
joseph elberti
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'Sequestered' is the furthest stage of a herniation- the material WILL NO LONGER suck back into the disc, it has lost contact with the rest of the nuclear materialit is now disconnected.

Just remember- cortisol shots will actually weaken tendons, bone and the like, it causes gluconeogenesis- taking local proteins (guess where they will come from?) and turns them into sugar.

Makes the local area even weaker.

Just be aware of the side effects of whatever avenue you choose to pursue. Ask your doc to walk you through all the fine points.... ask lots of questions.
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Old 06-16-2006, 03:30 AM   #10
Adam McCollough
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Thanks for the feedback. I saw 2 doctors (I was home for R&R from Iraq) and am now back. Basically they both said the same thing. 90% of the time your body re-absorbs/dissolves/takes care of the loose disc material on its own over time, usually at least a year for the whole thing to go away. It broke off of the L3 L4 disc. I don't have a lot of pain on a regular basis but if I move the wrong way it lets me know. My limitations were not to do any running or high impact activities and not to do any heavy lifts (basically don't lift anything over about 50 pounds)for at least 3 months, and avoid wearing my gear as much as possible. I'm also supposed to avoid any exercise that requires a tightening/downward pressure of the abdominals like you have in a deadlift. They perscribed a medirol (not sure on spelling) dose pack. Basically a diminishing corticosteroid dose over a week and then a much less potent non-steroidal anti-inflamatory until they tell me I can quit. The meds helped a lot. I was only in really bad pain for about a week after it initially happened (still not real sure how) but my right leg wasn't working right at all. I had numbness on my shin, no knee jerk reaction, and noticable weakness in that leg. The numbness is still there but the area is smaller. I can still tell my right leg is weaker, but not nearly as much, and I still don't have a knee jerk reaction. They told me to be smart. It wasn't likely to get worse, the fragment seems to have lodged itself into a nook, but I could definitely keep it from getting better. This is definitely not a situation that I can just suck it up and work through the pain, which sucks and it's hard to do less than what I'm used to do. Just for anyone who might read this later they both told me to avoid back surgery if I can, one seem's to continually need surgery once they start.
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