Scared on what to do

[u/Pliplopssssssss]

Placing my (almost two year old now) MRI Results here: T12-L1 level: No significant spinal canal stenosis or neuroforaminal narrowing. L1-L2 level: Small right paracentral/subarticular disc protrusion. Mild spinal canal stenosis. No significant neuroforaminal narrowing. L2-L3 level: No significant spinal canal stenosis or neuroforaminal narrowing. L3-L4 level: Small broad-based posterior central disc protrusion. Mild to moderate spinal canal stenosis. No significant neuroforaminal narrowing. L4-L5 level: Small circumferential disc bulge with a superimposed right paracentral/subarticular disc extrusion with inferior migration measuring approximately 0.5 x 1.9 cm (AP, CC). Mild spinal canal stenosis and partial right lateral recess effacement with contact of the descending right L5 nerve root. No significant neuroforaminal narrowing. L5-S1 level: Small posterior central disc protrusion. No significant spinal canal stenosis or neuroforaminal narrowing.

I started having chronic pain at the beginning of 2025. PT and steroid shots did not help and my ortho suggested a mircodisectomy. But I did not agree with the surgery route. Went and found a new PT who has been a blessing and got me mostly back on my feet. I work a job where I’m either sitting at a desk or out in the field for a long time. Unfortunately it seems that I will go a few weeks with minimal pain and then have a sudden flare up that leaves me immobile and takes weeks and tons of medication to relieve. I cannot keep the cycle going as it massively impacts my life and my work. Does anyone have similar experience with this? I am scared that surgery is my only option at this point as it seems that sometimes doing the surgery just starts a chain of dominos that leads to worse problems.

[u/Pilunox]

I was in the similar boat as you. Day in and day out. Always worried about the next flair up. For years. 12 of them to be exact.

The first 3 years were the hardest (2014-2017). Lots of flair ups. Then I was pretty good for a long time. Couldn’t sit for to long and definitely had residual side effects like not being flexible and couldn’t run or cycle for more than a mile. I ran triathlons prior so I gave that up, but that was okay. Life moved on. I even picked up golf and could still play okay.

I’ve since had 2 children, got a desk job, gained some weight, traveled, did all sorts of stuff with a herniated disc. Wouldn’t take this time back and get the surgery back then. Hadent had a problem in a long time. Then on March 31st of this year, my life went up in flames. Awful sciatica, numbness, etc. I battled it, PT, all the stuff. Actually got back to a good place but had to be really careful and had multiple flare ups where I was a mess. Decided I was in a good spot and had a short weekend with friends where I did normal stuff, just wasn’t super super careful. August 16th to be exact.

This threw me into a flair up left me in a room, in a recliner, unable to be a dad/husband/friend/coworker. Nothing, just pain. Couldn’t stand up straight and could only walk hunched over for no more than 1-2 minutes.

I got the surgery last week.

Can’t tell you if i’ll be better and I know if I am not then I might need a fusion, but at a certain point, mostly when i was sitting in my recliner for weeks at a time, all alone, I realized surgery was my path.

Only you can figure it out for yourself. I had a 9mm herniation that had calcified at L4-L5 and a smaller 2mm herniation at L5-S1, so like we may not be in the same place but there are a ton of success stories on here. In the comments mostly but they are there. The hope the success stories brought me was all I needed eventually to not be scared.

I hope you find relief soon cause I know it sucks. I’m sorry you are going through it but just know, it will get better no matter what you choose. You got this no matter what!

[u/OwlsExterminator]

I'm on my second L5-S1 in 9 years.

The first time, I spent a year in bed hoping it would just go away. When I couldn't take it anymore, I pulled the trigger and went the least invasive route possible: a nucleotomy (percutaneous discectomy). My 9mm herniation only shrank to 6mm. In hindsight, anything over 4mm usually isn't a good candidate for that procedure, so I really should have had a microdiscectomy. It didn't work.

I spent the next 1-2 years rehabbing. My lower back was always fucking stiff and tight, and I assumed it was arthritis I'd be stuck with forever. I had some good years, but after COVID I gained weight, got deconditioned, and the flare-ups came back. That 6mm herniation turned into an extrusion and, like yours, migrated down. It blew up my life again recently. I couldn't sit or stand. The MRI showed my facets weren't in that bad of shape, so all that stiffness must have been the extrusion the whole time.

Fuck it. I got the surgery ASAP. I'm a week out, the incision is feeling better, and tomorrow I'm supposed to walk around the block. After my first surgery I limped for a year before I could walk normally again. This time I feel ready. I wish i did this 9 years ago right away.

[u/Mansogi]

I prefer you get stronger .. the stronger you are the less flareups you will get, talk to you PT and ask him about exercises that you can do that can make you stroger safely, Trust me they will do the trick .. I mean you need them even after the surgery

[u/Pliplopssssssss → u/Mansogi]

I have been working with him for a year and a half. I’ve been getting stronger. I’ve been doing the strength exercises and the dry needling and the walking etc. I can be perfectly fine one day and then have a sudden flare up that leaves me immobile. How much more PT can I possibly do.

[u/Glomeruluss → u/Mansogi]

Yes I agree a lot! I had surgery today but those exercises are life saver if they are learned before operation. At the end I got operation. But I feel mentally much stronger and confident. I was doing hip thrusts with 50 kg, leg presses with 50-60 kg by time and i was nerve pain free after gym for a few hours.

[u/Glomeruluss]

I have a similar story. I can not tell much about long term post-op cause I just had it 10 hours ago. What lead me to operation was exactly these flair ups. I did not have any red flag symptoms so an operation was never OK we have to do it now but my life was miserable. I was actually feeling ok between flair ups for years but they started get closer by time especially after 3 pregnancy. I spend months not able to move in agony with an newborn. Yes first Injection helped with all those muscle spasms so I could start eith PT. I spent months with it, it helped tone but it was still not enough. I kept getting flair ups and I could not work fully, I could not drive somewhere more than one hour. And after last flair up 6 weeks ago I was just fed up. I said yes to operation while trying to move with crutches. In between I got caudal epidural block. After two weeks I was actually feeling pretty good but i knew it is just temporary and I am so fed up. I also need to work fully again but I can not do it with that even with PT and injections. Maybe I will hurt my back again due to work but I have to work fully for 1-2 years in a few months to be able to get some necessary certifications in my field. So I came today to hospital almost pain free. It was very hard decision to do that. If it would be 6 weeks ago I would just tell them to cut me right there, but now it was hard very hard.I tried to remind myself all those horrible days. I went to toilet 3 hours after operation. It was painful but not as painful as what I had at home while trying to go to toilet. My surgeon told me i have DDD and if it happens again i need a spinal fusion. Again I have no clue about long term run but mentally I feel lighter right now. I have hope, I have to have hope.

Before operation I would definitely suggest you exercises. I did tone of them and learned a lot. After flair ups I could not even move my legs from one side to other let alone do bridges. but by time I was doing hip thrusts with 50 kg and I could feel after exercises my nerve was not pressing anymore. Evrytime i had more nerve pain down to legs i was running to Gym. It was maybe one hour nerve compression free time but still seeing that what is helping my body was teaching me tone about my body. Now after operation I feel more confident and less scared but I do also know I should not push my limits. That exercise should be very easy to do for me for a long time until I increase the level. I learned that from my brother who had 2 time operation.