Decision about how to proceed L5 - S1 disappeared disc

by Sue Kennington
(London, UK)

Hi Sarah

I have a dilemma, I have been suffering from lower back and occasional leg and buttock pain since December (I did have a similar situation about 10 years ago, that eventually settled). I have been having physio for about 12 weeks now, with little improvement that I can see. My physio is trying to 'open' my lower spine with manual manipulation mainly, although I sometimes feel much better immediately after seeing her, this does not last, especially if I have to sit down straight after treatment - and this is often as I have to travel quite far to see her.

My MRI shows 3 problem discs in the lumbar spine (and 3 problem discs in the cervical spine, that give me little trouble apart from occasional stiffness) - L3- L4, L4 - L5, and L5 - S1 are all in trouble though, with the lowest disc having all but disappeared and the one above clearly taking the strain as it has a focalised hernia and the one above (L3) has a general disc protrusion. Yesterday I saw a famous orthopedic surgeon and he said, having seen this MRI scan of July, that I had an instable lower spine. I do have bone spurs on the lowest vertebrae, and that my best chance was to wear a corset and wait for it to fuse naturally.

So - the question is - do I follow him, or do I follow her, and continue to try and open up this almost disappeared disc space ? I am in mild to mid pain most days - and often have trouble sleeping, but it is not impossible and I do do mild pilates to try and strengthen my core and I walk a lot and also swim on my back.

Your advice would be so welcome, thank you !

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Sep 11, 2013
 Thank you Sarah
by: Sue

Thank you so much Sarah for your very helpful response, I am going to start the back block sessions this evening, and I will see where I get to. I am only concerned that if I let the lower disc fuse entirely then it will put huge stress on the adjoining ones and that my movement will be permanently limited - I guess this is better than permanent pain, but I am a young 57 and it is hard to accept as I love dancing and yoga and horse-riding and skiing and hiking... all curtailed at the moment, but hopefully not for ever ?
Thanks again !!
Sep 11, 2013
 to mobilise or leave alone
by: Sarah

Hello Sue,
This is indeed a dilemma-making decision.
You remind me of a patient I saw exactly yesterday with this very problem, here at one of my Back-in-a Weeks (Australia)!
He is a big man of 64 but his MRIs and X-rays look . . . well, scary!
He had almost non-existent discs at L5 and L3 with massive boney spur formation. In the past, he has been where you are at. Yet – and here’s the clue – he had virtually no pain today.
The secret is I’m sure [and excuse me if this sounds like a plug for my BackBlock] that he had been reading my books and using my BackBlock, though unknown to me, for eight years.
What is happening here is that he has been quietly fusing at the two non-existent-disc levels. This is Nature’s way.
You will know from watching the downloadable video that I have seen you just purchased, that as long as the outer ligamentous skin of the disc is kept fully compliant, you will feel little in the way of pain.
Of course, you may be getting pain from your facet joints flanking either side, because the disc has lost height, but I can’t tell this from afar. Even so, you need decompression to give the facets a reprieve.
The story is that you need decompression. You may NOT need mobilization because when you get to this stage you are going against what the body is trying to achieve.
I suggest we send you a BackBlock as soon as possible and that you watch all the information you can about the way to do it properly. This will ease the pain and make you more comfortable sitting.
In particular go to Scientific Evidence Base for Spinal Decompression
Hope this helps.
Sarah

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