Hi...have any of you had problems with a herniated disc? I had an MRI done last week, and they found that I have a herniated disc, as well as stenosis and sciatica. I'm on tons of medications, and I start physical therapy next week. I really just want to get it over with...and get the surgery done. I have an appt. with a neurosurgeon, so I'm going to suggest it. What are your experiences with the physical therapy...or have any of you had the surgery? Thanks for any info.

By Ginny~moderator on Tuesday, April 20, 2004 - 06:11 am:

Sciatica is a symptom of pressure on the sciatic nerve, causing pain down the buttock, back of the leg and into the foot. Stenosis is a narrowing of the spinal canal, and tends to happen to most of us as we get older. You will find that almost everyone over the age of 30-35 has the beginnings of spinal stenosis and I doubt that stenosis, in and of itself, is the cause of your problems. The ruptured disk is pressing on nerves and this is probably the main cause of your pain. Been there, done that - and it really, really, really hurts!

I had a ruptured disk in 1980. At that time they didn't do PT and I had a month of bed rest (as an alternative to being hospitalized in traction for a month, but with 3 young children at home and a single parent that wasn't in the cards). I had lots of meds, mostly Percoset and other codeine-based pain meds and anti-inflammatories (but tolerate them very well, which many don't). The pain gradually went away in about 9 months (not what you want to hear). I had two other bad pain episodes, in 1983 and 1984. In 1984 my ortho recommended surgery but I was reluctant so I sought a second opinion and wound up with the head of the ortho dept. at the Hosp. of the Univ. of Penna, who said as long as I tolerated the meds and had so few pain episodes he wouldn't do the surgery. He told me (at that time - 1984) that the general experience was a 50/50 chance of improvement with surgery, so I would ask your potential surgeon if the odds have improved. I would also want very much to know exactly what kind of surgery the doc is recommending, and would definitely get a second opinion.

I have been doing PT off and on for the past couple of years for developing arthritis in my cervical and lumbar spine, with exercises I can do at home, and it has been very, very helpful.

I understand your wanting surgery to get it over with, but understand that surgery is not a foolproof answer and there are no guarantees it will solve your problems. You should talk with the neurosurgeon in great detail about what s/he recommends and what results most people have.

Some questions to ask any surgeon? How often do you do this procedure? (more is, of course, better). How often is this procedure done at the hospital you will be using (more, again, is better)? Are you board certified? (requires extensive additional classes and training with oversight from experienced & board certified surgeons plus continuing education) What kinds of complications have you run into, what did you do to correct them, and what were the results?

Definitely, get a second opinion and ask the same questions. The second opinion doc should be at a different hospital and unrelated to the first and qualified to do this surgery, and you should ask the same questions.

If you decide to have the surgery, you should ask: Will you - the surgeon I am dealing with - do the surgery or will you supervise someone else doing it? What is the recovery period, both in hospital and after? What restrictions would I have on my lifestyle after the surgery?

Finally, if you are having the surgery, read the consent form very carefully. Often consent forms will say the procedure will be performed by Dr. X and/or anyone s/he designates. Cross out everything except your surgeon's name and add the word "only" after the surgeon's name and initial this change. Often the procedure will be described but there will be a clause that essentially allows the surgeon to do anything s/he thinks necessary once the surgery begins. Talk to the surgeon about how to narrow this very wide consent to limit the kinds of procedures the surgeon can do without consulting with your designated person (your dh or someone else you designate as your health care surrogate) - except, of course, in the case of a serious or life-threatening situation. The more narrowly the description of the procedure, the more certain the surgeon is that this is what you need and what s/he will be doing. (I'm a legal secretary in a plaintiff's personal injury firm that does some medical malpractice work, which is where this advice comes from.)