L4 and L5 disc prolapse doesn't add up!

Hi, I'm a bodybuilder who is used to lifting rather heavy weights, so it's no real suprise that i have a prolapsed L4 and L5, however, aren't these normally associated with lower leg pain? so why am i experiencing EXTREME sciatica with the pain centralised in my left glute. it wasn't so bad for the first few months, but after my mri i was sent to NHS physio and after stretching for about 10 minutes it felt exactly the same (wasn't expecting 10 minutes to work miracles). the next day though, i could barely walk, with the pain being crippling. this has been going on for 3 days now, i've not done anymore stretching because i am simply in capable of doing so, not even pelvic tilts!!

another thing that has me quite puzzled is that i am able to stand up straight, provided that my head is facing down, as soon as i lift my head, the pain in my glute becomes very intense. surely looking up would be putting less strain on the nerve.

all in all it is a very depressing situation as i've just dropped out of college in order to join the police, then this happens, and i'm incapable of working.

any suggestions as to what could help, or simply anecdotes of how YOU coped.
thank you for your time.

Dear PhilXD,

I would recommend you went to a physiotherapist who could run all the necessary tests on you to figure out if your pain is somatic referred or radicular and to what extend neurodynamics are involved. Obviously you can not perform these on your own or instruct others to perform them.

Your case sounds like it could be a series of things and at least for me, with my experience, it's hard to tell without more details (ie slr, what stretches you were doing, sensation/strength/reflex, condition of C/S and many more)

I know this doesn't help much but it's better than nothing Good luck and let us know how it goes

Suggest going to a private physio who can give you ample time and assessment. Head movement vaires the tension distally in the spine so perhaps one of the bulges is large? Also L4 L5 bulges will still give you distal leg pain, even sciatic. Often that is due to secondary compensatory strategies in the body such as piriforim and pelvic issues. Overall you need further assessment and I would not wait for to long.

The nerves adjacent to the disc prolapses are very sensitive and it sounds as though you need some very careful examination eg neural tension tests, slump tests

So if your physio is not sure what these are....find another one who does.

Sounds like the direction that he/she stretched you were increasing the disc prolape not reducing it. It may need some antiinflammatories and rest to settle before you have another treatment.

Hi

I am also a bodybuilder and had a clinic dealing with atletes.

I had a very similar problem, as you train with heavy weights i assume that you abs and lower back muscles are very strong as well as your legs.

I suggest rest for a while, anti inflammatories and maybe muscle relaxants.

You dont have to stop lifting or even stop lifting heavy weights, you just need to adjust your training accordingly. I still lift heavy and have a L4 and L5 prolapse.

I would not worry about it too much at this stage but if the pain continues for more than a week then you should see your doctor and get him to recommend you to a physio who has experience with athletes.


Let me know how you get on

Ik
I

I think the advice to continue with your weights training is ill advised. A prolapsed disc will not like the compressive forces of body wieght and certainly not when loaded with additional unstable loads. Discs will tend to take 12 weeks or so to heel and become more stable. i would deffinatley follow physiobobs advice and see an experienced physio (privately if you cant wait). In the meantime you could try laying on your front with a couple of pillows under your chest and stick a CD on. This unloaded position may help to encourage the prolapse back into position. You need to experiment a little with maybe adding slight side bends in you back to find the most effective position. An effective position will bring the symptoms back up towards your back - although the back itself may have an increase in symptoms. Basically the less pressure is on the nerve the less it will transmit down the leg.

Also keep a very close eye on your lower back position in sitting as its easy to fall into lower lumbar flexion especially in car seats/sofas etc. So keep a cusion/pillow/ rolled up towel in your back to help maintain this if you need to.

I hope this helps if you have not seen anybody in the meantime. It would be nice to know how your getting on.

I would agree with pt8am Doing heavy weight lifting with a known disc prolapse is a good way of prolonging the recovery time. Find a position in lying that relieves the buttock pain and stay there for 20 to 30 minutes would be a good idea. THen do some gentle spine movements in lying for another 10 minutes before loading your spine. The longer you can take the pain out the better at the acute stage.

It would be important to get back to normal everyday activities without pain befor even thinking about weight training.

Let us know how you are progressing. good luck.

my sis is 35 years old and she has fallen down from a table and has L2 compression fracture, she is not able to move her body from sholder to waste , she able to pass urine. this is 2 day its been 48 hours now she has not passed motion . suggest me what best i can do. doctor has suggested abosulte bead rest for 6 weeks. please suggest.

To Venkzzz - I am wondering what has happened since your post regarding your sister? Has all turned out ok?? Sounded like cauda equina which can be quite nasty so am hoping things have worked out ok.

To PhilXD - look in to the McKenzie Institute and their approach to dealing with your condition and then find a physio who has trained in McKenzie theory and techniques. This really is the best approach for what you are describing. Continuing to lift heavy weights is not advisable!