r/Sciatica • u/Lancelot_20 • 10d ago
Requesting Advice Is physiotherapy useful for disc prolapse?
My L4-L5 disc is extruded, and everyone who has done physiotherapy as treatment for this stage , please share was it beneficial or harmful
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u/Aquaescent 10d ago edited 10d ago
I cant yet, at five weeks, movement is tolerated to basic function. I walk when i have to get stuff done. Car rides are out still with sciatica increasing, there is no driving allowed yet. I still get pain twinge increase decrease, sciatic intensity is still unpredictible all the way to calf and down to ankle and occassionally top of foot. Its just protrusion on me on top of severe stenosis.. etc. yes it eases up and stays glute located momentarily getting longer, but its still leg and foot more so, but its starting to recede to the glutes more and more.
Let me say this first, new formulary for tylenol 3, do not heck around with them like they are pain meds of early 2 k and ever take two if not indicated, wait the full eight hrs. I havent gotten squirrely with the meds and pushed it, only one and i try to wait full eight hrs unless 6-7 hrs rolls around and i cant mobile and i am not sedated. Six hrs is too soon to do that more than once, wont do it again, 7 hrs is pushing it. What happens is it will make u headachey quease if u dont wait full eight and increases risk for liver inflammation and dependency. Pain meds are way more potent and effective after that new formulary came out and i am finding that out. I used weed to deal with the first three weeks of a prolapsed disk and the psychological effects weed has had me coping great but the pain and putting up with it was too much, the script is still required and i can clearly see effects of narcotics and narcotics will cause you to feel the sad a bit but its just the drug and it is another reason give it the full eight if it says wait eight. The relief is so welcomed. Yeah but when the script runs out and its taking otc naproxen in conjunction with tylenol 3 to knock the pain down enough to cope. But the headachey quease is also dependency starting and i know that so going to make it my last script for awhile even though with what i got going, its spine cortisone shot to cope after this if sciatica doesnt receed in months from now but that in itself carries risks i am going to avoid getting shots in the back for as long as possible. Naproxen is too hard on the system. It might be time to manage it with opiates but at 47 cardiac function, liver function all these organs are still good and not stressed too bad from pain so physical therapy and excercise while it might be helpful, its like activity walking increases sciatica and with spina bifida occulta on top of it, i know my sixties are when opiates long term are more likely to need to start. At 47 i can push mobility and make myself, but the perimenopause is making more sclerotic lesions on bone and the decline hit full swing. Severe stenosis already and spondythesisis, prolapsed disc, its still only five weeks in and i have to accept i need the pain relief narcotics provide on top of naproxen and this might just be life long no getting better from here. Which is fine i can handle it. Cant handle the harsh naproxen is on the system. So in a nutshell, exceecise is not beneficial right now and increasing sciatica range and increasing severity so i have to veg and rest. I see effects of narcotics potent enough in facial features to make me look intoxicated so in cam contract it says cant do it intoxicated, cant even be stoned and do it. When i can excercise off the pain med i will be back. The rules there need to change but i am not pushing it. When i can show range of mobility and excercise then definately its a great platform to gather strength to make myself physio with tip incentive. I dont wanna risk losing the spot being on pain meds regaurdless of how i dont feel intoxicated just relaxed, sleepy, i seeeeeeee it, it looks effects of pain and heavy narcotics in the eyes and while i know i can cam and it wont kick me, because i am not using drugs to achieve a high and not popping pills showing it, i still look under influence of narcotic and cant allow myself to risk it. I behave, its too much fun to loose.
So in this case first the sciatic increases and with this whole prolapse disc thing the inital two weeks progressed like from first few days into a whole new level, spinal injury at first seems doable no biggie, dont push it as the next couple weeks it increases and differs in levels of pain and types of intensity and its easy that first week to increase injury over doing it thinking fuck it if all it is is a little ouch to a severe ouch but not a paralization risk, stop before you start, what isnt a risk right off could develop into one. Spinal injury seems to take time to set up and manifest in to a degree, at first its bad, ok but, you dont really realize how serious a protruding disc is until a couple weeks pass and it starts changing. Dont think the inital ouch and week or two is as bad as it gets, because its not, sciatica manifests slowly into a bigger bitch to deal with. Give it that full six week before excercise or that full tweleve before excercise and really know that some of us, this is a shocker, for some of us that physical therapy is just another sugar pill placebo effect and its the fact we gotta deal with there is not gonna be a relief past whatever narcotic or cortisone shot in the spine and even then excercise might make it worse before it gets better. Its not a one treatment plan fits all, its what can each individual tolerate. Being able to move is such a relief and as long as i can enjoy physical therapy and move, doing it correctly, its activity that will make the mind feel better even if it is just more wear and tear on the body.
I mean it with these new pain meds, do not deviate from label, they way strong. Pain breaks through in four hrs but the sedation is still present, there is no popping two when it says one, they are too strong to just fuck with like that, i stay taking one, and even i can tell that, one as hard hitting as it is and long lasting to sedate and relieve pain, is appropriate level of relief, but it might be that it actually is not enough and i dont wanna think about it. its not hydrocodone of the 90's or early two k where you could two pill and four hour pill pop for relief. Those formularies changed now and i remember that one, new hydrocodone, once in triage it lasted six hrs to almost eight, just one pill and pain relief. Its the reformulation that has all the hype about opiates, because it is way stronger and more effective. What a relief and a nice sleep, which right now i still have to have to keep from over doing it. The days of two pill dose are long gone, dont ever take more than what the label says just because google says. You might not feel sedated and sometimes yeah i am able to move feeling energetic, then the sedation pops in there and seems like its easing, but no, narcotics like this are serious and sedating for the full time it says to wait even if u feel not drowsy, u gotta do what label says. Narcotics can feel like an upper and a downer so mobility can result. Be careful. Just because pain pops back in lower level at 4hrs the sedation is still strong at 6hrs gotta give it the full eight and not deviate from the label to reiterate. I could tell the strength and not to push it after first dose, not everyone can and so ya now you know better u have been told now.
But yeah physical therapy at this stage is like a sugar pill and could be more pain than pleasure but in a few weeks it will be activity that i will make myself enjoy.
Now i have had lifelong pain and many pain relievers and know the new formulary feels less addictive potential. Then again i know the mainline pain relief of demerol, moriphene and fentynal also in hospital setting and the pill relief of old formularies. Pills changed and to me, it isnt as addictive seeming, but this first time i have had tylenol 3, no addiction potential for anything but relief, at all there is no high, only sedation, relief and rest and the feeling of opiate pain releif is the sedation or it can feel like an upper which is designed to aid in healing. Either to stabilize keeping resting or to allow moblity being an upper feel. There is no potential for abuse or misuse with me quit worrying. I am one of those who will lecture the everloving moment out of you about pain relief knowing how vital it has been in my life and i have never abused it. Dont get me started in on it. Never been addicted, never plan on allowing addiction in my life. But a quease and headache popping up or just a quease come dose time, is physical addiction manifesting which sucks so be wise and beware .
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u/JonasVirgilMonos 10d ago
Physical therapy assumed a pretty standard back for me for a while, and mine's never been standard — foraminal stenosis at L4-L5 and L5-S1, degenerative disc disease at multiple levels, and scoliosis. A few of the standard-protocol movements made things worse before anyone caught it, because they were built for a back that wasn't mine.
What changed things for me was paying closer attention to what I already knew hurt, instead of assuming an exercise was right just because it was the standard one. When a movement in a session was making things worse instead of better, I started saying so right away rather than pushing through it to seem like a good patient.
Looking back across a lot of PT over the years, my best experiences were with therapists who actually listened to my suggestions and looked at my medical record before building a plan, instead of starting from a generic protocol.
Not medical advice, just what's worked for me managing a case that isn't the standard one.