L5-S1 disc space is reduced

July 2, 2018

I have ongoing sacroiliac pain due to sitting down for 5 months and not getting up much.

Following an Xray my physio has just spoken to radiology: your L5-S1 disc space is reduced which does indicate that disc as I suspected but we need the MRI to see exactly what is happening with that disc I.e if it has degeneration (wear and tear) or if damaged (bulging or herniated) I doubt it is herniated as you don’t get leg pain or pins and needles or numbness…defo need to cut down on activity though at the moment no running, gentle swimming maybe static bike as long as it doesn’t aggravate symptoms…wouldn’t be wise to try and do marathon this year… ”

I have been referred for an MRI, meanwhile my physio is continuing with treatment but said I need to cut down my activity…..she says if disc bulging very treatable but we don’t want it to get worse by continuing running etc…so it’s just a warning for you to slow down…

Ive got Nicolflex from the dr , ibuporfen and panadol & an MRI booked for 3 weeks.

What would you recommend I do rest wise, work wise and is swimming ok at this stage or aqua walking or do I need a few days total bed rest ?

Thanks, Nic

July 2, 2018

Yes – lots.

You’ve had a X-ray taken which is great at looking at bony structures and then you assume something about the soft tissues ie disc.

The MRI will tell you more but unless you know why you’ve got a discal issue (and you may or may not have) treating the symptoms won’t really do much in the long (marathon) term.

So by all means get in the pool, go for a walk and take active rest (don’t just do nothing) but get you Physio dealing with the cause, and with your run training, which’ll be a stiff, flexed thoracic spine.

Get them to do nothing apart from that. Get them to give you the ability to move better (quality) not just more (quantity).

Have a look a some of the videos here https://www.sixphysio.com/videos/back-pain get your thoracic spine moving, call up your glutes, swing your arms more and get out there.

The Guru

Nic then replied:

So I have degeneration of the L5 disc thing. Surgeon said it could get better on its on but if it gets worse then fusion surgery… Which I dont know how long to leave it before making that call, he was not that helpful.  I am getting pain on both sides now and not just the left so I think maybe I need to get the surgery done?

How to manage it in the mean time I am not sure. Panadol and what kinds of exercises to take some of the pain away.. So running is not out and that leaves stretching and cycling and swimming?  What would you recommend from here? Thanks heaps

The Guru responded:

Hi Nic – what a horrendous word “degeneration” is without the right context being set….like it or not we are all degenerating BUT it absolutely doesn’t mean that it has to be painful. With regards to what your OS has said about fusion surgery, I’d suggest finding another (better!) opinion. Fusion doesn’t really help (at all, often) and not so with a degenerative condition.

Some pain docs can be worth there weight in gold and often pain is not always a product of something going wrong or even relative to the severity of what’s wrong – a paper cut feel like you’ve sliced your finger off, but in fact there is little if any damage…

So, no to surgery but yes to some decent physio that can start to load you up (respectfully) and give you the ability to move better.

What part of NZ are you in – I’ve still got quite a few contacts handy…

The Guru

Guru Responded

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