[Steve_Roths]

I noticed the other discussion on knees and thought this group would be a great resource for back issues.


I have herniated disc in L4 and L5. 

I have dealt with it with chiropractors, physical therapy and taking a Tramadol for each round that I play.


It has gotten to the point where the above doesn't work with having thrown my back out twice in the last month and having to cancel golf and thinking my golfing days may be over.


Has anyone with similar issues found any luck in:


- Spinal fusion


-epidural steroid


- micro disc surgery


Thanks in advance.

[cary lichtenstein]

I'm about to have my 4th back surgery. Put it off as long as possible, try steriod injections on both sides of the offending problem area as your 1st line of attach. Seek out the opinion of a qualified neurosurgeon in your area.

[Mike Sweeney]

Steve,

I am 59 years old (ouch!) 6'6" tall and currently 209 pounds. I have been very lucky over the years with back/knee issues considering the years of golf, bball, and triathlons. I get the occasional 2 week spasm from time to time, but no structural issues in my back.

This Spring, I had the silly notion that I would keep up with my Dustin Johnson-ish swinging 26 year old son off the tee. I went to the range, made a big turn/change in my swing, and BAM - I was barely able to get to the bathroom for 2 days due to back spasms.

I finally went to a professional fitness/phsical therapist, and he really taught me about "My Core". Yes, I was in good walking golf shape, but his specific knowledge (works with a number of golfers) about how to strengthen my core has worked great so far. He also got me to swing a weighted golf club almost everyday so that I have the "muscle memory" and the back is not surprised by a once a week trip to the course. These "booty bands" really work areas that traditional workouts just never reached - https://www.amazon.com/GYMB-Resistance-Band-Set-Exercise/dp/B09NCKMVC3

I also try to do Yoga once a week and/or Yoga stretch out every morning.

Finally, my younger son with Autism follows a very strict anti-inflammatory diet and I now do it with him, or at least 95% - https://www.medicalmedium.com

I have actually gone the "other way" since my back event in the spring. I dropped the double strap bag and went to the one strap lightweight - not much in the bag - no stand - golf bag to play.

I know the thought is "great Mike, but I have a bad back already". The physical therapist knew how to build up around those issues, and I have learned from my son how much inflammation causes health issues for all of us. Obviously this path is a process, and it takes time and commitment.

Hope that helps.

[Kalen Braley]

I'm trying to get back into playing again after a couple of rhizotomys in the last few years to treat arthritis of my lower back.  And unlike some of you hardcore fellas, i don't love playing enough to play in pain...

[Peter Pallotta]

I'm glad that Cary, who speaks from experience, suggests to Steve that he hold off from surgery as long as possible. One man's opinion only, but I think that is good advice.

[Jim Hoak]

Try the epidural steroids first.  I have done it twice--great success the first time, less the second.  But put off doing more till you have no other choice.

[Mark Mammel]

I have had 2 back surgeries, microdissections,- but my issue was spinal stenosis at L2-4. My outcome has been excellent. As regards the different approaches, I have done a bit of research and had many discussions with orthopedists (I am also a retired MD so it's easier for me to have frank discussions with other professionals). My opinion: epidural steroids, though worth a try, give relief for longer than  a few days maybe 50% of the time, and do nothing to attack the underlying issue. Regarding surgery, the best way to decide you need it is when you can no longer live your life in an acceptable way without pain. That point is different for everyone. If microdissection  is an option, it is by far the best one as it produces the least change to the architecture of the bony spinal column. It must be done by a surgeon that does it regularly. Fusion, often the recommended option, is a last choice IMHO as it is basically 50-50 for pain relief. As always, find a good surgeon and trust their recommendation.

[Steve_Roths]

Jim - How long did the epidural provide comfort ie pain free?

[cary lichtenstein]

I'm glad that Cary, who speaks from experience, suggests to Steve that he hold off from surgery as long as possible. One man's opinion only, but I think that is good advice.

My standard advice to friends is to hold off going under the knife until you can either no longer walk or the nerve pain is a screaming 10. Everybody reacts to surgery differently. I was told I would be back on the golf course in 4 months, that was 14 years ago, .

[Kalen Braley]

I'm glad that Cary, who speaks from experience, suggests to Steve that he hold off from surgery as long as possible. One man's opinion only, but I think that is good advice.

My standard advice to friends is to hold off going under the knife until you can either no longer walk or the nerve pain is a screaming 10. Everybody reacts to surgery differently. I was told I would be back on the golf course in 4 months, that was 14 years ago, .

Cary is exactly right on this one.

I've been evaluated by 3 different neurologists over the past 15 years, and they can't find a single thing that would explain why I get nerve pain down my legs and into my feet.  Its certainly in the neuropathy category at this point, but how it presents is the unusual part.  My current Doctor is one of best in the area, and says he's never encountered my scenario and neither have any of his colleagues when he consulted a few years back.

At this point it is what it is, and I've figured out how to manage with little to no pain for the most part, but playing golf is currently not included in that equation.  I hope to get a few rounds in before the end of the season, but I'm taking it slow...

[Jason Topp]

Not recommending this one way or another but the procedure used by this client of my wife is supposed to be far less invasive than traditional surgery and quite effective.  Worth at least considering:


https://www.inspiredspine.com/?gclid=CjwKCAjwquWVBhBrEiwAt1KmwrusDnU-X_N7HLT3dFtlPRGwyeQE4H-0sR0KYQUSbhukDA7CHGMOwBoCLEMQAvD_BwE

[Jim Hoak]

Steve--My first epidural injection gave me almost total relief for a year (it was incredible).  My second one gave me less relief, and only lasted for 6-9 months or so.  But it definitely has pushed things out for me and was worth it.  I'm told you can have up to 3 per year.  I'll do another this fall.
I also know friends for whom the epidurals totally stopped working who have had ablations (basically, as I understand it, burning the nerve endings as opposed to hitting them with steroids) that have worked well.  But I am not a doctor.
I think the goal is to give yourself more time before any surgery.  At least that was my goal.  Again, I am no doctor, but most of my golfer friends past 70 have had back issues--and as I hear it, no surgery is foolproof and 100% guaranteed, and all back surgery should be avoided as long as possible.

[JLahrman]

Steve,

I am 59 years old (ouch!) 6'6" tall and currently 209 pounds. I have been very lucky over the years with back/knee issues considering the years of golf, bball, and triathlons. I get the occasional 2 week spasm from time to time, but no structural issues in my back...

I finally went to a professional fitness/phsical therapist, and he really taught me about "My Core". Yes, I was in good walking golf shape, but his specific knowledge (works with a number of golfers) about how to strengthen my core has worked great so far. He also got me to swing a weighted golf club almost everyday so that I have the "muscle memory" and the back is not surprised by a once a week trip to the course. These "booty bands" really work areas that traditional workouts just never reached - https://www.amazon.com/GYMB-Resistance-Band-Set-Exercise/dp/B09NCKMVC3

I also try to do Yoga once a week and/or Yoga stretch out every morning.

I am 47 years old, 6'6" and around 210 pounds myself. Being tall is basically a recipe for back trouble and I've had my share. I've never had to contemplate back surgery but my first criteria for basically every activity is "how will this affect my back?"


Mike's advice is good. Yoga has been great for me, I need to do it more consistently instead of just when I start to feel a bit of stress on my back. Don't sit at a desk all day, alternate between sitting and standing. Strengthen your core - don't ask your back to do the work that your core muscles should be doing. Monitor your weight.


And honestly, working from home instead of commuting a total of 60-75 minutes per day has made a HUGE difference for me. From long car trips I knew that riding in an automobile stressed my back, but didn't realize how big of a difference getting rid of the daily commute would make.

[Jim_Kennedy]

The lower vertebrae in my back look like molded silly putty. This procedure has worked wonders for the past decade.   https://mayfieldclinic.com/pe-rf_ablation.htm#:~:text=Radiofrequency%20ablation%2C%20also%20called%20rhizotomy,pain%20signals%20to%20the%20brain

[Philip Caccamise]

Agreed with the comments on avoiding surgery. I was told that surgery would likely end my golfing days and I said that's not happening. I decided to go with physical therapy.


Long story short I got hit by a drunk driver 20 years ago and broke my back (T4) and neck. I broke my back again skiing in 2010. Swinging around the injury made it progressively worse, building up more and more scar tissue, and my body finally said enough on the 18th hole of Leven Links in April 2019.


First I went to a golf-specific physical therapist. He didn't recognize the severity of the damage and nothing was accomplished. I then went to a well respected general physical therapist, who was straight with me- he took a look at my MRI's and said I don't know if we can reverse everything but we will give it a try. He does a combination of PT and chiro work when I am in for a visit, as well as sending me home with exercises.


It's been a long and painful and difficult three years. But the routine has been working and I am almost to full strength. The program I have been on:
1) Core exercises. Start small with basic bridges and other yoga poses which focus on core muscles. As they strengthen you will feel the spine take on less weight and pressure, creating extension. Slow rotation movements with a medicine ball will help with turning.
2) Stretch bands. Start with lightweight resistance and use different anchor angles to change the muscles working. Work a few sets slow each day for a while and add in fast movements later.
3) Foam roller. An essential part of any golfer's toolkit. Do a session in the morning and evening, plus before and after your workouts.
4) Theragun Wave Duo. This is the only massage gun that has been effective for spinal issues for me. The others don't have the right 'hit' or 'grab'. It really helped to undo the spinal compression.
5) Epsom salt baths. If it worked for Hogan it could work for me? Very hot water plus epsom salt has been the most effective recovery method from all of the workouts.
6) Now that I've started playing again, I realized riding in carts was especially torture and damaging. Still can only walk 9 holes so I bought a golf scooter which has made a huge difference on course, since I'm standing and engaging my core the whole time. There's a few brands out there but I got the Cycleboard and it's phenomenal.

Hopefully some of this helps you too.

[jeffwarne]

Evry single back and every single opinion is different.


I had several years where I couldn''t even play, and years where I could play but only gingerly and carefuly.
I'm 6 foot 5 and have weighed as much as 220-am currently 190-195.


Every doctor I have seen has made me worse, leading me down all kinds of expensive, delaying paths, with muddled, inconsistent advice, and ridiculous physical therapy that is a once size fits all fit for perhaps a disabled 80 year old.
One recommended one year of bed rest, another surgery.
The only medical person that ever helped was a chiropractor who has treated me when things got really bad (can't walk, etc.)
He also gave me a stretching/strengthening program which has been essential to my recovery and prevention.


For me, it was a series of strengthening and stretching exercises-most of which I googled off the internet, some of which my chiropractor gave me. Controlled lunges were the last secret ingredient, or last missing link(my chirpractor had told me, I jus had missed that piece).
And doing the work-5-10 minutes a day-consistently.
Always feel better after.


I'm no doctor, but every single doctor I saw made me worse or no better, and far lighter in the wallet.


I have had no debilitating incidents since Feb 2020, right before I went to Australia for the Renaisance Cup, where by the midlle of the trip I could play with 50-70% swings.
been good ever since, I think mainly because I lost 35 pounds during the pandemic and continue my daily routine.

[Mike Sweeney]

Controlled lunges were the last secret ingredient, or last missing link(my chirpractor had told me, I jus had missed that piece).
And doing the work-5-10 minutes a day-consistently.

Jeff,


Nice post. What do you mean by "controlled lunges"? Not questioning, just trying to understand. I went through a "my stupid" phase where I was wearing a weighted vest while doing lunges UPHILL!!. Let's just say that was a lost two months of golf...    Thanks

[Cal Carlisle]

Just my anectdotal two cents.....



Twelve years ago I had back pain so bad the three smallest toes on my right foot went completely numb. My foot eventually begain to flop and I developed a noticeable limp. After three weeks of maddening pain and very little sleep it was suggested that perhaps I try acupuncture. I went in a complete skeptic. I did the treatment. I walked out and was more relaxed but was even more beat up than when I went in. I woke up the next morning and I felt relief from the pain. I don't pretend to understand it. I STILL don't understand it, but three days later I drove from Cleveland, OH to Westchester County, NY.


I've had flareups a couple of times, but have gone back to acupuncture for treatment. It works for me.


This book has also helped me quite a bit. Sounds stupid. A book. A friend recommended it to me and it, too, has helped get over the fear of reinjury (especially during golf).

[jeffwarne]

Controlled lunges were the last secret ingredient, or last missing link(my chirpractor had told me, I jus had missed that piece).
And doing the work-5-10 minutes a day-consistently.

Jeff,


Nice post. What do you mean by "controlled lunges"? Not questioning, just trying to understand. I went through a "my stupid" phase where I was wearing a weighted vest while doing lunges UPHILL!!. Let's just say that was a lost two months of golf...    Thanks

Hate the word "lunge"
https://www.youtube.com/watch?v=vwToKziL5A4

pure magic-model not included

[David_Tepper]

Better lunge link!

https://www.youtube.com/watch?v=vwToKziL5A4

[JLahrman]

Better lunge link!

https://www.youtube.com/watch?v=vwToKziL5A4

David,


I like the yoga videos that Sean Vigue has on YouTube, they work for my back and he also incorporates a lot of corny jokes which of course I appreciate.


That lunge looks like one that is incorporated into my favorite Sean Vigue video: [size=78%]10 Min Yoga for Men Beginner Routine - Easy Men's Yoga Workout - Best Yoga Workout for Dudes - YouTube[/size]


I also try to do a set of good ol' fashioned lunges every day. To me it's such a good exercise and you don't need any weights or anything like that. Your body weight is more than enough resistance!

[cary lichtenstein]

Before doing lunges, go to a neuro surgeon, have him get X Rays and an MRI and have him give you an intelligent assessment of your spine and his recommendations. You don't want to do things that aggravate either a bulging disc or stenosis. Surgery as I've said twice before is an absolute last resort, but find out what you are dealing with.


Where do you live in case I can recommend you to someone?

[jeffwarne]

Before doing lunges, go to a neuro surgeon, have him get X Rays and an MRI and have him give you an intelligent assessment of your spine and his recommendations. You don't want to do things that aggravate either a bulging disc or stenosis. Surgery as I've said twice before is an absolute last resort, but find out what you are dealing with.


Where do you live in case I can recommend you to someone?

Please take a look at the first frame of the video.
It's a very simple, low, impact, hip flexor stretch that worked wonders for me over time.
No LUNGING is involved, though many call it that.

[Kalen Braley]

Before doing lunges, go to a neuro surgeon, have him get X Rays and an MRI and have him give you an intelligent assessment of your spine and his recommendations. You don't want to do things that aggravate either a bulging disc or stenosis. Surgery as I've said twice before is an absolute last resort, but find out what you are dealing with.

Where do you live in case I can recommend you to someone?

Please take a look at the first frame of the video.
It's a very simple, low, impact, hip flexor stretch that worked wonders for me over time.
No LUNGING is involved, though many call it that.

Jeff couldn't agree more, I do something similar and have no issue.

Before I watched the video, I assumed you all was talking about these kind of lunges, which I did in my younger days! 

https://www.youtube.com/watch?v=ci4rsmlOk24

[Chris Flamion]

Disclaimer - Not a Dr.


Background - I have broken my L4 & L5 vertebrae twice each, both times stress fractures as part of college athletics.  As a result of these injuries I was forced to take 10 years off golf as swinging was excruciatingly painful, this is also when my kids were slammed with activities, so golf would have been limited anyway.  I finally started playing regularly again last year, pain free.


I currently carry 3 different Strength & Conditioning certifications, and regularly work with people who have tight backs as well as other aches and pains.


In my time I have found that back issues tend to fall into 3 categories.  I will explain what those look like to me, and my general training model for each of these.  I won't be providing any specifics as I shouldn't since I don't know the fine details of your, or anyone else's, pain and limitations.


Category 1 - Caused by tightness in the connective area that manifest itself as back pain and tightness. 


Category 2 - Caused by a lack of centerline(core) strength, that forces the lumbar erectors to carry most of the load.


Category 3 - Caused by postural limitations that keep the lower back in a state of flexion at all times.


Category 1 - This usually looks like someone with tight hips, tight ankles, hamstrings that are constantly tight.  In all fairness this is 90% of the adult population and something that most people just ignore outside of a PT session.  A little bit of stretching and mobility work can go a long way. 


Category 2 - Every single muscle that keeps you upright works together.  If you have a weakness in one, then the others are forced to do more work.  It is especially common as we age for issues to arise as cumulative wear and tear start to compound as our chemical make-up changes.  Some light strength work under a professional eye would be recommended, not only for golf, but for life.


Category 3 - Ever see an elderly person using a walker who's eyes are always looking down?  Most of us have the same issue, just not to that extreme.  Stand up straight, shoulders back and under the ears.  There are obviously stretches and exercises to go with this, but just being conscious of posture will go a long way.


Finally, the discussion of Cortisone shots.  I have no personal experience with them ever and as such can not make any commentary.


Best of luck, I hope you were able to take something however small from this.

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