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For the last year I have been fighting with a herniated L5-S1 disc that's pushing on one of my nerve roots. It's just slowly getting worse, and my doctor says that at this point (we have tried everything else) surgery might be the only way to fix this problem. I am worried that after I have surgery - a microdiscectomy - that I will not be able to lift my baritone anymore or play. Has anybody around here ever had back surgery? Please let me know.
 

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I had a microdiscectomy in 2008 at L4-L5. I also have a 20 year old herniation that healed itself at L 5-S1. The surgery will likely help with the pain down the leg. If you're having back pain ( pain in the area around the disk ) surgery isn't likely to help. In my case the leg pain is better but I'm left with chronic pain in the low back. If lifting your instrument is causing pain down the leg then the surgery will probably help. If it's low back pain then probably not.

Research is showing that most herniated disks heal themselves with time. You might consider waiting it out for a year or so and see if it gets better on its own unless your doc is telling you waiting might cause nerve damage.
 

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I would never get surgery I had 3 herniated disks in my neck in 2000 from a car accident , found a amazing chiropractor . The doctors wanted to do surgery I met Jody and after a year of hard work with him get stretching and traction I was healed . My herniated disks were now healed . I had before and after shots that I took to my orthopedic surgeon and he was shocked. Now I ma a believer of alternative ways . Good luck
Doug
 

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I had a herniated disc about 3+ years ago. At that time I had a cortisone shot which fixed the problem. About a year later it returned and I had terrible sciatica which made just about anything impossible. I could barely walk, sitting was only somewhat bearable, lying down or sleeping was virtually impossible. The only sleep I got was done while sitting upright on the couch once I found a somewhat tolerable position. I was on Vicodin which dulled the pain only slightly at best, but sometimes helped me sleep the couple of hours I managed on any given night. This went on for close to 2 months while we tried a few approaches including a couple more cortisone shots. I was reluctant to try surgery as I had never had surgery and had heard stories from folks about difficulties, long recoveries and ongoing issues.

A little over 2 years ago I had a discectomy. When I awoke after the surgery the pain was gone. I went home the following day. Recovery was pretty easy overall and involved taking a few walks a day to keep things moving. I avoided lifting anything more than a gallon of milk for a while. As the weeks went on I gradually returned to regular activities and began to practice.

At this point most things are fine. I do have to avoid overdoing things or straining the back. I do have some back pain from time to time if I am not careful. I am currently going for some physical therapy to strengthen things. Overall, all is good. I do have some nerve damage in my left toes, but it is relatively minor with little ill effect. If I had to do it over again I would have gone for the surgery much sooner. I had a great surgeon. It was pretty easy and very successful. I would not hesitate. From my experience, it was not worth all my worrying. Good luck!!
 

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I had lower back surgery about 10 years ago. I don't regret it at all. I had two badly herniated discs and was in severe pain for 6 weeks before. After the surgery I was back to normal.

I will also add that last year I was told I needed surgery on my upper back because of a lot of pain,numbness and tingling. Instead a student of mine gave me an inversion table. I started using that and all my problems went away over a few months of daily use. I would suggest at least giving it a try or asking your doctor about it.
 

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I had global fusion at L5-S1 and S3 12 years ago. If you elect to have a simple lumbar dysectomy, you should recover fully. Make sure you follow and exceed the physical therapist's instructions. I was supposed to walk a mile after being home for 1 week. I was doing 3 miles by then. Work your butt off and you will be fine. Don't play bari for at least 3 months, sorry! I would play alto for a while to keep the Eb chops up.
 

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I had a herniated disc in my lower back about 20 years ago. I had to sleep on the floor, couldn't sit in a chair- I used a kneeling type chair developed somewhere in Europe.My wife had to wheel me around in a wheel chair while I was teaching school. The worst pain occured when trying to wipe myself after using the toilet or taking a shower. :faceinpalm: I opted for physical therapy and haven't had a relapse or similar event since.
 

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Pretty well all discs heal eventually (though leaving all kind of mayhem behind on scans to confuse the innocent). But not all stop hurting, and that's because a major component in a proportion of cases is neuropathic pain, which you can picture as a software problem at spinal cord level - crudely, the pain pathways forget to switch off and even become more extensive, so the blighter keeps hurting, or gives recurrent bouts of pain, often with little provocation.

The character of neuropathic pain tends to be different from somatic pain, but 25 years treating backs in general practice and 2 years running a back clinic, with direct access to scans and all the specialists, taught me that it isn't clearcut.

The bottom line is that a demonstrable disc herniation affecting nerve roots that's giving referred pain after a year is getting overdue to be fixed, but also increasing in uncertainty of outcome. Depending on what's available and the awareness of your docs with these different aspects, you could consider a chronic approach either prior to surgery (could save the knife!), or afterwards if the results aren't as you hoped (could save time!).

In either case the right physical activity is the remedy for chronicity - after the acute stage, pain is not an indicator of damage, but just a hindrance to getting mobile - Catch 22, which is why doing nothing is a bad option.
 

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I have had 3 lumber herniations over the past 30 years. One resolved itself over time and other 2 were repaired - one micro- and one old-style diskectomy. I think docs today will try a LOT of conservative therapy--PT, rest, steriods, etc.--before considering surgery. My surgeries immediately solved the intolerable pain. What I learned in last several years it, that is I want to avoid little tweaks to my back by lifting grocery bags, e.g., I needed get real about prevention. I finally got serious with a PT person on "core strengthen", basically a set of exercises to strength the abs, gluts, and low back muscles. It has a made a HUGE difference. I am currently at 100%. (fingers crossed...)

So.. the bottom line is that the bari will have to be put down for a few months. Do you play flute? Might be a good to do some flute shedding. Lots of fun! Best of luck!

Tom
 

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>>>>Pretty well all discs heal eventually (though leaving all kind of mayhem behind on scans to confuse the innocent). But not all stop hurting, and that's because a major component in a proportion of cases is neuropathic pain, which you can picture as a software problem at spinal cord level - crudely, the pain pathways forget to switch off and even become more extensive, so the blighter keeps hurting, or gives recurrent bouts of pain, often with little provocation.<<<

You just described my chronic pain problem precisely. The physical damage healed long ago but the pain just keeps on coming. It's lead to a dependence on opiates to maintain some semblance of a normal life. That and a radical lifestyle change. My weekends used to consist of long training runs or swimming workouts or golf. Now it's maybe some light work in the yard or a light swim and an ice pack afterward while I watch the golf tournament on TV. Oh, and I can amuse myself with my music. A poor substitute for an active life.
 

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Thanks so much for all of your input. The baritone I have is a Yani B992 bronze, and it's kinda heavy. I haven't weighed it next to a milk jug, it might be comparable. However, I also have a T992 tenor, and I play drums and congas. Sitting down is the biggest problem for me; drumming is actually the pain-causing instrument. I use a spinstrap with the bari and it's not too bad. If I get the surgery maybe it would be a good time to work on my latin rhythms on the congas since I can play while standing and wearing a back brace. Hopefully I can get by with the tenor. What worries me more is the abdominal breathing with the horn; if that will put pressure on the surgical site.

I have tried lots of Yoga and abdominal strengthening exercises, and I think some of those exercises may have pushed my disc over the edge. The pain is in my perineum and butt, which is concerning for me. The consensus here and other places I have read say that the discectomy is not that bad, but get with a PT program. I never knew discs could heal themselves. I'm tempted to get another MRI and see how it looks compared to the one 6 months ago. (I'm an x-ray technologist, so I have an in if I need a quick picture of my back) Thanks again for all your feedback. Please post any links to informative websites if you have them.
 

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Whatever you decide - know there are stands you can put a Bari on that let you play standing without having to bear the weight. I recently started playing Bari and I immerdiatly got a stand for that sucker. It's heavy! What's really cool is that I can leave my alto or tenor hanging around my neck and catch the solo on the smaller sax...good luck with the back thing...
 

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A big shame to have to use opiates - especially as they're often not the most effective drugs. In theory, if one can find a way to switch off the pain pathway, one can potentially cure, rather than just relieve the pain. Part of that, of course, is that it frees one up for intensive exercise/stretches/physio etc. So one is talking often about medium term use (a few weeks/months) rather than forever. Unlike opiates, though, addiction is not an issue.

In terms of drugs, there's a heirarchy in terms of potential side effects (mainly sedation) starting with the cheap and cheerful tricyclic antidepressants like amitriptyline (which is not to say the back pain has anything to do with depression, except to cause it sometimes), then through hijacked andi epileptic drugs like gabapentin and derivatives specifically developed for neuropathic pain like pregabalin. There are a few others I've used with some success - the limiting factor being that people insist on being unique!

Non drug methods also have variable outcomes, and go from the relatively cheap and innocent like acupuncture (low success rate unless you're Chinese, but great when it works), to more invasive (= expensive) things like caudal and lumbar epidurals, facet nerve injections (need to be Xray controlled to hit the spot), and even cutting edge stuff like implanted nerve root stimulators.

Worth chasing up - even after years sometimes lives get restored!
 

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My advice is to find the best neurosurgeon in your area and have him order a new MRI and advise you on your present condition and your options. Those, depending on how badly the disc is herniated, will range from conservative therapies to microsurgery. Whatever you do, don't go to an orthopedic surgeon. They are bone doctors and may do a great job with knees and other joints, but you definitely don't want them messing with the nerves in your spinal column.

In my own case going to a orthopedic doctor delayed my treatment by 6 weeks because he misdiagnosed a severely herniated lumbar disc for a simple pinched nerve and put me on a course of treatment that did nothing to cure the problem, but rather delayed the proper treatment that the neurosurgeon I finally went to provided me. This resulted in 6 weeks of delayed treatment and unnecessary pain, 2 useless epidural cortisone infiltrations, 3 weeks in a wheelchair, and almost complete atrophy of my right quads. My lumbar disc had ruptured and the inner gel material had gone down the spinal canal all the way to the disc below and was of course pressing on my spinal nerves. I had no pain as long as I sat, but lying down and standing/walking were instant torture. The microsurgery removed the sequestered disc material and although it took me 5 or 6 months to fully recuperate, in the more than 2 years since then I have not had a bit of pain.

My recuperation would have been much shorter if I had seen the neurosurgeon right after the initial serious attack and had the surgery then. My surgery would then not have come just before our yearly trip to the US and I would have avoided the long plane flights and all the driving I had to do once there, all of which was counterproductive to correct recuperation.

But I delayed because I listened to all the people who told me to avoid surgery at any cost, and also because I had the bad luck of an incorrect diagnosis from a doctor who totally missed the problem on the MRI. He did a great job on my knee 8 years earlier, but he sure didn't know squat about discs and couldn't read a spinal MRI that was as plain as the nose on your face to a specialist in that area. Both those errors in judgment caused me needless pain, suffering and organ damage from all the extra meds I was forced to take.

Clearly surgery of any kind has its risks, but people who warn against disc surgery are often doing so out of a knee-jerk old-wives reaction to the highly invasive scalpel jobs of 20 years ago, which today's highly accurate, highly successful micro surgical techniques have nothing to do with whatsoever.

But this is based on my personal experience, and you will have to decide for yourself based on your own circumstances.
 

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....my doctor says that at this point (we have tried everything else) surgery might be the only way to fix this problem
What kind of doctor? I know plenty of great doctors, but also have met a couple who seemed to know less about back pain than you would hope.

....I am worried that after I have surgery - a microdiscectomy - that I will not be able to lift my baritone anymore or play. Has anybody around here ever had back surgery? Please let me know.
I have had three back surgeries, the most recent in 2004. All were "partial laminectomy and microdiscectomy" operations, which is the technical name for what I believe is the most common type of back surgery to relieve a herniated disk. After the 2004 surgery, I found a PT who is unlike any other, who really understands what happens inside your body. He got me recovered, and then helped me adopt a flex/stretching and light weight program which I still follow, and which has kept my back healthy even though I am now older and weigh 20 pounds more than I did before 2004, and even though I am now much more active. I suggest you ask lots of people for recommendations a PT, and keep asking until someone describes their PT as being like the Messiah.

.......I have tried lots of Yoga and abdominal strengthening exercises, and I think some of those exercises may have pushed my disc over the edge. The pain is in my perineum and butt, which is concerning for me.
It is difficult to adopt the strengthening and flexing exercises you will need to make your back healthy when you already have a disk herniation, without making the herniation (and your pain) even worse.

......I never knew discs could heal themselves.
Some can, and some can't. Some herniations are so large that, even though they might reduce enough to eliminate or reduce the pain, even then you might still be on the verge of pain, and unable to live the life you want to live.
I suggest you look for a neurosurgeon. The best one will seem not to be anxious to perform surgery, and will ask what you want to do. Avoid any hasty suggestion from any surgeon to do a joint fusion. These are more complicated surgeries, are overprescribed by some surgeons, and cannot be undone.
 

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I had a herniated disc about 3+ years ago. At that time I had a cortisone shot which fixed the problem. About a year later it returned and I had terrible sciatica which made just about anything impossible. I could barely walk, sitting was only somewhat bearable, lying down or sleeping was virtually impossible. The only sleep I got was done while sitting upright on the couch once I found a somewhat tolerable position. I was on Vicodin which dulled the pain only slightly at best, but sometimes helped me sleep the couple of hours I managed on any given night. This went on for close to 2 months while we tried a few approaches including a couple more cortisone shots. I was reluctant to try surgery as I had never had surgery and had heard stories from folks about difficulties, long recoveries and ongoing issues.

A little over 2 years ago I had a discectomy. When I awoke after the surgery the pain was gone. I went home the following day. Recovery was pretty easy overall and involved taking a few walks a day to keep things moving. I avoided lifting anything more than a gallon of milk for a while. As the weeks went on I gradually returned to regular activities and began to practice.

At this point most things are fine. I do have to avoid overdoing things or straining the back. I do have some back pain from time to time if I am not careful. I am currently going for some physical therapy to strengthen things. Overall, all is good. I do have some nerve damage in my left toes, but it is relatively minor with little ill effect. If I had to do it over again I would have gone for the surgery much sooner. I had a great surgeon. It was pretty easy and very successful. I would not hesitate. From my experience, it was not worth all my worrying. Good luck!!
This pretty much describes my condition since last Tuesday. I've had bad back pain since February and have been seeing a chiropractor but it hasn't gotten better. Last week, I was on vacation in Disney and in retrospect was doing things that weren't good for my back. Rides,swimming,safari ride.........anyways on Tuesday night my pain changed from being located in my back to now being in my right hip and all the way down my leg. I can't straighten my right leg or I get a lot of pain. The last 3 days at Disney my girls were pushing me around in a wheelchair because it was so painful to walk. It's a chore to even walk down my driveway to get the mail. I can't find a position that I can sleep in without pain either which really stinks. I do feel some numbness in that leg and the weird thing is that that leg feels much colder than my left leg and foot which I find strange.

I went to the emergency room on Sunday when I got back and they gave me a muscle relaxant which does nothing for me and some Vicodin which doesn't do much either. If I take two I can get by but still feel the pain pretty sharply. I have trouble playing my alto and tenor because I feel it in my back and leg when I play. I've been playing soprano all week.

I have an appointment with 2 Orthopedic doctors who are well know to get their opinions. Should I see a Neuro guy also? Thanks, Steve
 

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I have an appointment with 2 Orthopedic doctors who are well know to get their opinions. Should I see a Neuro guy also? Thanks, Steve
Steve, I'm sorry to hear that! I have had all those symptoms and based on my experience I find it critical that you consult a neurosurgeon. Chances are the symptoms may get even worse. In my case, I couldn't even move or turn myself in bed or even stand up because the pain was unbearable. Good luck to you!
 

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I have an appointment with 2 Orthopedic doctors who are well know to get their opinions. Should I see a Neuro guy also? Thanks, Steve
Steve, I'm sorry to hear that! I have had all those symptoms and based on my experience I find it critical that you consult a neurosurgeon.
Steve, I agree wholly with jlima in that you need to see a neurosurgeon and not an orthopedist. Read my post #14 above about my awful experiences 3 years ago to see why you shouldn't waste your time with them. What you are experiencing is caused by the herniated disc material compressing the nerves coming from your spine, and from the symptom of numbness you describe it sounds fairly serious. If the pressure is not released you can quite quickly suffer atrophy of your leg muscles and eventually, if untreated, some deadening of the affected nerve(s). Treating this requires a nerve specialist and no orthopedic surgeon has the training in that area. They are bone doctors.

Nerve damage is one of the indicators for having surgery right away rather than doing a conservative wait-n-see, PT, stretching, chiropractic regimen. So get people to recommend the best neurosurgeons in your area (or look online) and then see at least 2. That way you'll have 2 opinions and can choose the one you feel most confident with. Not all neurosurgeons are scalpel happy, and as HarmonizerNJ said above, a good one will not counsel surgery if he doesn't feel it is really necessary. If they do counsel surgery you might want to check online or by asking them about their surgical experience so you can go with the most experienced and qualified guy.

Don't delay in this and don't let anyone sell you on cortisone shots. They're totally worthless because even if they kill the pain it will be back in little more than a week. That's what I got for going to an orthopedic surgeon.

Good luck and get well soon.
 

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Steve, I agree wholly with jlima in that you need to see a neurosurgeon and not an orthopedist. Read my post #14 above about my awful experiences 3 years ago to see why you shouldn't waste your time with them. What you are experiencing is caused by the herniated disc material compressing the nerves coming from your spine, and from the symptom of numbness you describe it sounds fairly serious. If the pressure is not released you can quite quickly suffer atrophy of your leg muscles and eventually, if untreated, some deadening of the affected nerve(s). Treating this requires a nerve specialist and no orthopedic surgeon has the training in that area. They are bone doctors.

Nerve damage is one of the indicators for having surgery right away rather than doing a conservative wait-n-see, PT, stretching, chiropractic regimen. So get people to recommend the best neurosurgeons in your area (or look online) and then see at least 2. That way you'll have 2 opinions and can choose the one you feel most confident with. Not all neurosurgeons are scalpel happy, and as HarmonizerNJ said above, a good one will not counsel surgery if he doesn't feel it is really necessary. If they do counsel surgery you might want to check online or by asking them about their surgical experience so you can go with the most experienced and qualified guy.

Don't delay in this and don't let anyone sell you on cortisone shots. They're totally worthless because even if they kill the pain it will be back in little more than a week. That's what I got for going to an orthopedic surgeon.

Good luck and get well soon.
This is REALLY the best advice anyone can give you. I agree 100%.
 

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Well, it looks like I'm going for surgery. I went to see a Orthopedic surgeon today. This guy has quite the reputation and I have to say I was blown away. This guy really knows his stuff. He sat with my wife and I for about 30 minutes and described exactly what was happening and why. He show me the herniated disc and where the nerve travels that is being squeezed. He answered all of our questions. I've never had such a thorough diagnosis from a doctor before. I went to see another Ortho guy and a Nuero guy and they agreed that I need surgery. Anyways, I'm hoping to be pain free in a few weeks. Wish me luck.
 
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