So, this week has sucked. It all started with finishing physical therapy and putting in my routine of stretches and exercise for a left knee problem I had for the last three months. This has kept me from getting out and hiking and doing some other things. Starting on Monday, at the beginning of the month, I started to have some worsening low back pain which gathered steam and started shooting down my left leg, causing numbness and tingling in my foot and calf, then on Saturday, the pain went to 10/10 and was unbelievably horrible. After a few hours of trying to deal with it, I went to the ER, got my pain under control, started steroids, and had an MRI completed, which showed a lumbar disc herniation compressing the nerve. Since my reflexes were poor in the left lower leg with weakness which was almost foot drop, they kept me over night and then after consulting with a neurosurgeon, I was shipped by ambulance to a different hospital and then waited 24 hours to see if my symptoms improved.

Then I was waiting in a hospital room for the neurosurgeon to help me decide between a surgical intervention, likely the least invasive microdiscectomy, or conservative management at home with PT and some medication management. That of course sounded much better to me, but the data on long-term outcomes definitely matters as well as time to recover in terms of getting back to work.

For the first time, I’ve had to experience the emergency room/hospitalization course, which is not particularly fun in our healthcare system. Clinical staff were excellent and treated me well. Given that my symptoms are improving, especially the pain, I think I can avoid surgery.

Two weeks later: Well I dodged that bus. The steroid treatment controlled my inflammation, and pregabalin was helpful. Icing has been key. I saw the neurosurgeon for follow up at exactly two weeks after discharge and he was very hopeful and helpful. Basically, no surgery, but proceed cautiously. I started PT this week with some restrictions on lifting, bending and twisting, and short distance driving only. I am thankful!

What caused this? We don’t know. It is probably a complicated combination of factors: back history, genetics, exercise history, workload history, weight, and just bad luck.

Eight weeks later: I had a flare up about 4 weeks ago, then more steroids and other medications, and took a few steps back in terms of my progress. Back to the hard work of physical therapy I went, and now I have improved a ton! Feeling great with no radiculopathy (sciatica) symptoms. I saw the neurosurgeon again and he feels there is no need for surgery or a steroid injection, and I can start exercising again, and keep working on PT until I am close to normal.

Could I have avoided this? Maybe I just delayed it a long time with good exercise habits. The takeaways I have held onto are the following points:

• Low back pain is no fun and sciatica symptoms are way worse!
• Exercise is key with strengthening of the core muscles to protect the back
• If it happens to you, it’s probably bad luck as opposed to too much good lifestyle

Off I go to stretch and do some PT exercises and recover some more!