Herniated Disc

[victorzamora]

Hey guys,

I've been fairly concerned about it but haven't given it much thought until the recent "pinched nerve or DCS" thread, so I figured I'd ask.

I've been suffering from a herniated disc since May 2013. L4-L5 is centrally herniated and not causing me any pain. L5-S1 is herniated rightward, touching the nerve root and causing sever pain in my lower back, right glute, and pain/tingling down my right leg to my toes. I also have a rare (but apparently benign) S1-S2 disc. The lifting doesn't hurt me, it's bending and twisting....but lifting doesn't necessarily help. I can do all things in the water, and most of the things out of the water, needed to safely dive....and I actually completed my Full Cave course in July 2013. I'm about to seek further deco training. I've done a few deco dives, and pushed NDLs heavily on other dives.

I've had a steroidal epidural (Betamethasone) but no surgeries to speak of. I did a lot of physical therapy and have consulted with nearly half a dozen specialists. I'm now seeing a Chiropractor, which actually seems to be helping (much to my disbelief).

Anyway, what are the thoughts/risks on the above? Is there anyone I should consult before further diving/training?

PS- I'm exclusively sidemount, so carrying tanks can be in spurts and doesn't have to be all on my back. I'm also limited in the boat diving I do.

 

[LeadTurn_SD]

If you can suspend your disbelief even further , ask your DC.

Seriously.

He/she is probably in the best position to answer this question since your DC knows your precise condition, is already helping you, and is more than qualified to provide an accurate answer about the risk of worsening your condition with certain physical activities.

Not all lumbar spine herniations are created equally. Many of us walk around (and dive!) with them, and have little or no idea we have them. They are quite often found as "incidental" findings on MRI's in large numbers of middle-aged folks who are symptom-free.

Core strengthening and flexibility are key to managing your condition long-term.... again, your DC can advise you.

If it were me.... I'd dive as long as I could tolerate it, and just use caution and common sense when lifting and moving gear, and climbing in and out of the water.

Best wishes.

 

[Dsix36]

I was diagnosed with a herniated disc and partial to full paralysis was indicated. My doc was in shock that I had any mobility in my arm at all. I put off surgery for 10 years by being careful and therapy. I continued to dive during this time. I did deep dives of 300' and deco of more than 2 hours. I was never put under any restrictions other than the weight I could lift. I don't know if my doc had a clue about diving, but he did clear me for 600' deep dives when he released me after surgery.

The biggest and possibly most important advice he gave me initially was this - if you find anything that aggrevates it, then stop doing it. this prompted several changes in my day to day activies.

 

[Kevrumbo]

http://www.uclahealth.org/workfiles/documents/clinicalupdates/95.pdf

 

[victorzamora]

Kev, I've looked into those kinds of surgeries. There's also a laser procedure I've considered. However, I'm 24 years old and don't want any surgeries yet. I've just not heard of many surgeries that are ACTUALLY better in the long term.

DSix and LeadTurn, that's good to hear. As far as lifting and diving physically hurting, that's not what I was concerned about. I know my physical limitations....I know how to bend and twist and lift to keep it from hurting as badly. I was more worried about getting bent.....or bubble formations.....or, whatever.

 

[Dsix36]

Kev, I've looked into those kinds of surgeries. There's also a laser procedure I've considered. However, I'm 24 years old and don't want any surgeries yet. I've just not heard of many surgeries that are ACTUALLY better in the long term.

DSix and LeadTurn, that's good to hear. As far as lifting and diving physically hurting, that's not what I was concerned about. I know my physical limitations....I know how to bend and twist and lift to keep it from hurting as badly. I was more worried about getting bent.....or bubble formations.....or, whatever.

My doc did not seem to think it was anything that I needed to worry about any more than if I did not have the herniated discs. As long as the diving did not cause my symptoms to be agrevated, then I was given the green light to dive. He could not (nor could I find the answers anywhere) tell me anything about the effects of high partial pressures of helium and nitrogen on the growth of new bone after the surgery. Pre surgery seemed to be all green and post surgery was a bunch of ????? I ended up waiting until full bone growth and release from doc before diving again.

 

[Kevrumbo]

Some experimental non-surgical pain treatments utilizing the medication Etanercept (trade name Enbrel):

Excess TNF [Tumor Necrosis Factor; a soluble inflammatory cytokine] is centrally involved in the pathogenesis of a variety of neuroinflammatory disorders, including Alzheimer's disease, other forms of dementia, intervertebral disc-related pain, and related disorders. TNF causes neuronal dysfunction, regulates synaptic mechanisms, and mediates amyloid-induced disruption of molecular mechanisms involved in memory. Perispinal administration of etanercept, a potent anti-TNF fusion protein, is a treatment modality whose rapid clinical effects may be related to modulation of these TNF-related mechanisms, particularly the role of TNF as a gliotransmitter capable of regulating synaptic transmission. This approach utilizes therapeutic delivery of etanercept across the dura via the cerebrospinal venous system, a confluence of the venous plexuses of the spine and the brain, in which flow is bi-directional owing to the absence of venous valves.

INR® Website: Disc-related Pain
Frequently asked questions | Institute of Neurological Recovery

 

[victorzamora]

DSix, what surgery did you have? As far as my diving, it doesn't make the symptoms any worse. There are some things in my diving that are harder, though. It's tough to don/doff my drysuit because I'm having trouble reaching my feet sometimes. I also used to have an issue maintaining good posture, but that now seems to have gone away (clenching my butt to get that arch used to put pressure on my back so I had to dive slightly "butt up"). I did a few minutes of deco and felt fine. I ran a fairly conservative profile and then extended my O2 stop....and I felt GREAT at the end of both of my dives this past Sunday.

Kev: Thanks, I'll contact my specialist about this. I had no idea Enbrel could possibly help. I've been limited to Aleve since my doctor thought it was better than cataflam and pulled that Rx.....which I'm still pissed about.

 

[Dsix36]

I had cervical discetomy with fusion. I still have two more discs that are herniated but not to the extent that they are causing any symptoms at all.

I had trouble with keeping my head tilted back to see without causing neck pain and other isssues. I had to dive a bit out of trim for a while, but now that is fixed too (thanks to surgery)