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Injuries and Medical Advice

Options for Disc Herniation

Spinal surgery has come a long way, but you’d do well to avoid it until that Mack truck is so close you need to look left and right to see its headlights.

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Right now I’m in so much pain my doctor lets me inject pure opium (just kidding). Seriously, though, I’m experiencing some pain around my quadratus lumborum muscle in the low back. I’m taking Gabapentin and it helps, so a lot of the pain must be nerve related. The pain goes away while I’m lying down or sitting. Standing and walking cause the pain to ramp up. Do you have any advice? Drink 18 Red Bulls a day, take five grams of vitamin C? Anything? MRI’s show mild herniation, but zero doctors out of four have recommended surgery. Muscle relaxants help with my symptoms but not the problem.

—Chris Dylan/El Paso, Texas

Pure fantastical opium …those were the days. I remember when people used a concoction containing opium to calm their crying children.
Lucky for me, I was a fussy baby. The problem here is that your QL spasm is a response to your disc herniation, and no amount of pharmaceutical placation
will resolve that.

Eighteen Red Bulls these days will probably just give you some funky heartbeats. Back in the mid 1990s when you could only buy them in Asia and they contained
some truly potent amphetamines, 18 might have been fatal!

Five grams of vitamin C is a long shot even for hippies. Although research suggests high doses of C can reduce the duration of a chest infection, I’ve
seen nothing to suggest it operates as an analgesic.

Spinal surgery has come a long way, but you’d do well to avoid it until that Mack truck is so close you need to look left and right to see its headlights.
The different surgical options depend on the severity of your disc issue, where it presents, and if it puts pressure on the exiting nerve root. Not
least of all, it depends on how much pain you are in. Sometimes a bulge that appears moderate or even small can produce an inordinate level of discomfort,
which, even without neural symptoms like numbness and weakness in your legs, can be rather debilitating in terms of life’s finer pleasures.

Although I think cortisone is bandied around like fairy floss at the carnival it does have some use in pain control if the bulge looks like it may resolve.
Mostly they do, given enough time. Patience might allow you to avoid the risks of anesthetic, surgical malfunctions and issues associated with fused
vertebra.

That you have to at least try conservative management is a given. Osteopath, PT, chiro, acupuncturist, blah blah, whatever humps your camel. Do it, and
if it doesn’t work try something else.

If all fails and life has lost its fun, see a surgeon, but don’t book anything this side of six months unless you’re in paroxysmal pain or need a catheter
to pee. Ride it out as long as you can and give your body every opportunity to do what it does best—heal thyself!

This article was published in Rock and Ice no. 213 (October 213).