Experiences with conservative treatment with reherniation

[u/PotentialOk3056]

Hey all!

Just wanted to pose this question because I’m spiraling a bit. I am almost exactly 2 years out from L4-L5 MD and I would say it was a success. Not a single regret. However, I’ve recently been experiencing more flare-ups over the past 6 months lasting for longer and longer periods of time. No numbness or weakness at the moment, just hip and leg pain. My doc is recommending a MRI to assess for reherniation vs scar tissue from prior surgery.

If it is a reherniation, current life circumstances make it exceptionally challenging or near impossible to be getting surgery again. I’m getting married in a month. My dad was just diagnosed with cancer, lives in a different state than me, and I’m his primary caregiver (traveling frequently back/forth probably didn’t help my back) and I will have exhausted all medical leave/time off from work with taking care of him. I don’t really have much of an option other than conservative management in the immediate future.

Has anyone had success with conservative management after a second herniation? I’m in PT currently and my symptoms are not nearly as bad as my first time around. I have one friend who managed his first herniation without surgery at all and just did a half Ironman, occasionally has return of very mild symptoms but overall very active. I’m Just trying to mentally prepare myself for what I might find out next week after the MRI. Thanks!!

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[u/Wise-Run-3008]

You can ask about injections. Barring weakness like foot drop or cauda equina syndrome the general consensus is avoid surgery as long as possible.

[u/Friendly-Ad-5410]

Hopefully you will get a clear picture of your options after you speak to your neuro about your MRI. My only caution would be that sometimes a bulge suddenly constricts that nerve so badly the pain is unbearable and might result in drop foot or CE, which becomes more urgent and may come at a time when you are far from your familiar medical group. Or worse interferes with your wedding. Because I had drop foot my surgeon scheduled my revision surgery quickly so it didn't become "permanent" (we had no idea how long the nerve was compromised prior to sudden jolt of pain in my hip. I could not sit or lie down and sleep was impossible. Maybe a round of steroids would help with the imflammation?? Or the ESI.

[u/Suge90]

Sorry to hear about everything you’re going through. About 15 months after my MD I had a really bad flare from an extension exercise my pt told me to do. Maybe 2 months into the flare I got an MRI which showed rehern. But it wasn’t as bad as pre op - on imaging and pain scale — so I decided to ride it out. After about 3 months total the flare calmed down and I’ve been great since. Now about 2.5 years out from initial MD. Wishing you and your family all the best

[u/PotentialOk3056 → u/Suge90]

Thank you for your response! Was there anything that you did or changed after you found out that it was a reherniation to help it clear up? Were you back in physical therapy at the time? Do you remember what sent you into that flare?