Recurrent Herniated Disc With Sciatica 

Recurrent Herniated Disc With Sciatica  1024 535 Best Practice Health TV

From our YouTube channel visitor:

“Hi Doctor, I had an extrusion of L5-S1 two and a half years ago and had a microdiscectomy. I didn’t have any pain after the surgery until 2 weeks ago when I felt my disc exploding again. I had severe back pain for 2 days and then the pain was gone. Now I have mild sciatica. I’m waiting for an MRI, but I’m sure my disc collapsed. I’m following the same procedures that I had to after surgery (no weightlifting, no bending, no twisting). I’m trying to be extra careful. My question is: can a re-herniated disc heal without surgery?”

Oh, no! I’m so sorry to hear your pain has come back. At least this time you have some experience dealing with this kind of thing.  The answer requires a little background on what causes recurrent disc herniation, and then we can get into your options.

What causes recurrent disc herniation?

Recurrent disc herniation is caused by the same thing as initial disc herniation —-a tear in the outer part of the disc which allows the soft inner parts to herniate out. Your body responds to the herniation with inflammation, which irritates the nearby nerve root (red in the picture above). The irritated nerve root is what we feel as sciatica.

Treatment options for recurrent disc herniation

I have seen many people get better on their own. You are fine to treat at home with NSAIDs, moist heat, and rest if you have NO:

  • Red flags
  • Functional numbness or weakness, OR
  • Unbearable pain.

If 3 weeks of home treatment fails or conditions worsen, then more invasive options may be considered.

Redo microdiscectomy by a minimally invasive spine surgeon is necessary if you have functionally limiting numbness or weakness or unbearable pain. If is not you then epidural steroid injections, done by a certified pain management specialist, may provide temporary relief. In other words, your options this time are pretty much the same as last time and are summarized in my herniated disc matrix:

How to prevent a recurrent herniated disc.

Once this episode resolves you need to think about your core strength. Normally weightlifting is one of the best things you can do for your core; however, your body is telling you that your core needs to do more to offload your discs. Look at doing more compound lifts, or even adding yoga or Tai Chi to your weekly regimen.