r/Firefighting • u/sreylas843 • 2d ago
General Discussion L4/L5 Herniated Disk - looking for advice
Any fellas in here dealt with a herniated disk, specifically at or around the L4/L5 area? Pain started Saturday morning 8/23 when I woke up at the station before shift change and progressively got worse throughout the day to the point I couldn’t sit, stand or lay and could barely walk. Decided to go to a small urgent care/ER that night and had an xray done which showed nothing, they gave me a steroid injection and muscle relaxer injection and prescribed me Methylprednisolone and Orphenadrine. No relief whatsoever from the injections or the meds. Woke up the next day (Sunday), same amount of pain and symptoms. Went to a chiropractor that afternoon, did some twists and pops and told me to up my water intake and keep icing it. No relief. Monday (8/25) I decide to go to an actual ER for CT scan or MRI just to at least get some answers. Did the CT scan which showed the herniated disk. Gave me a dose of Vicodin and a lidocaine patch which didn’t touch the pain. Physical therapist came into the room afterwards and did some stuff, actually felt a bit better after that. Getting up from sitting or laying still hurt but walking was actually less painful. Hospital switched me from methylprednisolone to prednisone and continue taking orphenadrine, but neither seem to help.
Fast forward to today, pain comes and goes but when it comes it’s rough. I start physical therapy this afternoon and hoping for some progress from that. But just posting to see if anyone here as some insight or advice on what worked for them. Just looking for some light at the end of the tunnel.
P.S. take care of your backs.
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u/Vad4444 2d ago
That sucks. I dealt with same thing 1.5 years ago but my back never hurt. My left leg and foot hurt from the nerve pain. Felt like I was walking on a broken foot. Took a long time for a proper diagnosis. Did everything I could to fix it. 2 shots, prednisone, gabapentin, chiropractor, physical therapy, acupuncture. You name it. All while still trying to do the job. After a year I finally gave in and had a microdiscectomy. The surgery at least helped getting my foot back to working properly but I still had a lot of nerve pain. I got fat and depressed. Then I found yoga body 21 day happy back challenge. Changed my diet to an anti-inflammatory diet. Also did the Dr McGill big 3 everyday. Those things helped overtime. I’d say I’m 80% back to normal now. It was a long shitty road. Hope any of this helps
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u/throwingutah 2d ago
A good PT can do magic. A chiropractor can kill you. There's no way to push through a back injury, generally—rest is a huge part of it.
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u/camthegrey 2d ago
Dude I feel for you, that sucks. I’ve got a L5/L6 herniation I’m dealing with right now too.
Right out of the gate though, be careful doing too much when it’s really fresh! Heat/ice, IMS, and massage have all helped calm things down for me after a big flare up, but rehabbing too much too soon has only sent me backwards. I found any twisting motions to be especially aggravating, so I avoid the chiropractor except for using a decompression table if that’s available at first. I bet it’s really frustrating, but NSAIDs and rest (and gentle walking) are your best friend at first.
I’ve been working on my back issues since a bad rugby injury in 2019, and just burning through benefits going to physio, chiro, etc. I’ve found a few things have helped for short-term relief like stem cell injections and the McKenzie protocol (worth a google). Long term, trying to figure out an imbalances like hip flexor or glute weaknesses are a good path to follow. I’d recommend checking out Squat University on Instagram, or looking into the “McGill Big 3” exercises, iso holds, 90/90 drills, etc. Realistically, it’s a really slow and steady road to get your back feeling decently stable and relatively pain-free again. A good morning/evening routine can do wonders once the pain has calmed a bit. I’ve been diligent about it for years and still managed to have a major setback this month. So at a certain point you may have to see a neurosurgeon and discuss other options, like I am now.
Without having dealt with it themselves, so many people will tell you quick fixes or act like it should be back to normal after a block off, which is obviously not the case. These folks have never had 7/10 pain from slightly leaning over a sink brushing their teeth. These people can kick rocks.
Good luck, and I hope you’re back on the floor soon buddy.
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u/BikiniBottomFD 2d ago
Look at Ultimate Back Fitness and Performance by Stuart McGill. https://a.co/d/4gemVsF Stuart McGill has done a great amount of work on lower back injury rehab and prevention. He also has an entry level book with Bryan Carol (powerlifter) who broke his sacrum in half and had multiple herniated disk. That book is called the Gift of Injury https://a.co/d/6tIce4V
Back injuries are the worst but there is hope. I’m not a PT so take all this advice with a grain of salt.
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u/JohnnyBravo011 2d ago
Ice, PT, injections. If that doesn't work after 6 months, look into getting a microdiscectomy. You'll be out of work for 3 or 4 weeks but feels like night and day
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u/altahiker Career FF/ACP 2d ago
Hey, I've had similar pain from a herniated disk. If this pain is made worse by flexion(bending forward), I have found cobra exercises to give me great relief.Its basically a sloppy push up where you leave your hips on the ground. Push your chest off the floor until you feel some stretch in your low back, hold for 5 seconds. I will do 2-3 sets of 10 reps of these every hour when my back is bothering me. Last time I threw it out, I was barely able to walk or move. I forced myself to get on the floor and start doing cobras. Within a couple of days it was feeling better. When you first start you may only get a couple inches off the floor, but in a day or two you might be able to fully extend your arms. Obviously stop if you feel pain. Hope it helps
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u/18SmallDogsOnAHorse Do Your Job 2d ago
PT, PT, and more PT. Go at it slow and steady for a long time and continue it afterwards, don't be afraid to cut things out of your life like deadlifting, squatting, etc. and replace them with other more complex movements/exercises.
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u/AdmirableDouble5 2d ago
L4/L5 herniation here. Unbelievable sciatic pain. First injury was 1.5 years ago. Epidural steroid injections along with PT helped the most for me. Most Docs anymore are against diskectomy unless you have motor deficits, due to down the road leading to more surgeries. Biggest advice I can give is that getting through the first 2 years without reinjury is super important. I re injured it twice shortly after steroid shots cause I felt back to myself again and started doing too much to fast. Baby steps as it heals and time. Luckily for me I have an awesome crew that is helping to protect my back and doing most the heavy lifting. I am back to about 70 percent now as far as the pain goes. Stretch as much as you can, walk a few miles everyday, and do your PT.
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u/Strict-Canary-4175 2d ago
I fell out of a window and broke several bones and herniated 4 disks. They said I needed surgery right then, but I’m a very tough fireman, so I put it off for 7 years. Once I finally had the surgery I also had developed several bone spurs that no one knew about that were almost cutting my sciatic nerve in half. Aaaaaaaanyway, the whole time I was running distance. And doing long-ish distance tri. After my surgery my surgeon said he thinks the only reason I could still walk is because I was running. Even now, 4 years out from the surgery, if I have like a rot day, or even if I sleep for a long time a little too soundly I’ll have pain getting up. I have to keep moving, and when my pain DOES flare up, I try to take an easy walk (with good shoes) and it helps a lot. Pain medication, epidurals, steroid shots just don’t touch it.
My only regret is putting off surgery. Admittedly I did not get the surgery I needed (a fusion) but the “bandaid surgery” that we agreed on was almost unbelievably helpful. As soon as I woke up, I was about 75% out of pain. I felt like I could do a backflip.
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u/ResponsibleBrain2446 2d ago
My husband dealt with his herniated for 5 years, and he finally ended up in so mixh pain he had a micro discetomy. Idk if that is an option for you. His recovery was 12 weeks
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u/Biglava1 2d ago
Rest until healed. Once healed: PT exercises + Cardio, Core Work, & Stretching 3-4 times a week for the rest of life. Non negotiable.
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u/Adventurous-Knee3180 2d ago
I blew my back out on a call in 1995. Ended up with herniation of L4,5,6. Between it going out and the sciatic pain in my leg, I had a microdiscectomy about 13 years later. I still had to get epidurals for the pain but the sciatic pain dropped way off. Everybody recovers differently and finds a way that works for them. You’ll have to do the same. But the one thing I think that we can all agree on is you have to have and maintain a strong core to support your back. I’m still on the job, but I’m driving a desk now so that has bought me a few extra years. Best of luck.
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u/MuscleRelaxerEnjoyer 2d ago
Herniated my L5-S1 a couple of months ago. Definitely have good days and bad days, but pt has 100% been the biggest factor in me returning to work.
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u/Bmac_13 2d ago
Same injury from the Army, full time and part time FF. Find a good physical therapist, and i mean a really good one and go to therapy regularly. Stay active, movement is medicine. Find what works in therapy and continue to do it outside of therapy also. Start treatment now instead of waiting like I did (did not know the severity of my injury at the time)
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u/4machineguns 1d ago
I ruptured a disc in 2001 and had a couple herniated ones. This I don't believe was from my mis stepping going up a set of stairs with rails, but an accident I had years earlier that weakened something and had been problematic for the previous 2 years with muscle spasms and at one point leaving me unable to stand and laid on the floor for a solid week unable to walk. I'm a contstruction worker in drywall and framing industry....so the herniated disc I may have had for a couple of years giving me a fit off and on until finally rupturing....believe me when I say it's a game changer when you have that happen....a few months of percocet and I said just do the operation, I can't take those pills anymore they make me so damn hyper I couldn't stand it. Surgery and I was back to work in 3 weeks! Don't ignore it like I did as it could evolve into a rupture. Best wishes, it sucks to feel the pain of this no doubt! No matter how you lay, sit, stand bend....the pain persists...losing sleep and ability to focus on what you're doing.
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u/10_96 1d ago
Been there, done that.
Did Arrosti for a bit, which is like chiropractic meets physical therapy with actual science behind it. It helped in short term, but long term I needed surgery. Took years, but when my legs started giving out at random times it was time. I'm dealing with foot issues now too, which is keeping me from finishing up the back. I will say that getting the surgery was the best decision for me. It's scary, but the difference (even now when I'm still not 100%) is astounding. I didn't realize how much pain I had been in for so long.
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u/PerrinAyybara All Hazards Capt Obvious 1d ago
Chiropractors aren't medical doctors and their entire system is based upon something that isn't true: non surgical subluxation and has no good evidence to support their process. You will end up making your herniation worse, they should never have been allowed to mess with it.
Stop what you are doing and go through PT/Ortho as appropriate. The faster you do this the right way the better.
My agency hired an Athletic Trainer and it was the best decision we've made in regards to preventative and rehab care. We are adding in a PT now too. It's awesome.
Be careful with steroid injections, they are temp fixes and repeated doses cause bone degradation. There's a reason they stopped doing them in athletes as much as they used to.
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u/testingground171 1d ago
After an unsuccessful micro discectomy. I finally had an L4/L5 fusion and that completely resolved my issue. I'm 100% now with no deficits or pain. But that was obviously a risky solution that doesn't always work and had a long recovery. Fortunately I was able to promote to a support battalion for the duration and went back to suppression when I was fully recovered.
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u/Northmscouple662 19h ago
Micro discectomy definitely helped mine. That was in 2018. I’m not saying my back doesn’t still on occasion hurt, but when it does it’s because I did some stupid twist while lifting something. I still do my fire department job and construction.
I had tried a Chiropractor, 6 weeks of physical therapy more than once, pain management with back injections and none of that touched my pain. I felt like it was my only option and it definitely helped mine.
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u/jomar99 2d ago
I’ve been dealing with a herniated L4/L5 for 10 years. First advice I can give you, stop going to the chiropractor. They made it much worse for me. Look into cortisone injections. This was by far the best treatment I received for my pain. It took a couple of weeks until I was able to start training again, but the cortisone allows you to strengthen your core. Stretching is the second best thing you can do. Loosening up your quads, glutes, and hamstrings makes a huge difference as well. When you’re at home, lay on the floor and rest your legs on a chair or sofa. This helps alleviate the strain on your lower back. Good luck.