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Ruptured disks are a very common problem. I've had one myself. The disk forms a tiny hernia that presses against the nearby nerve root. Pain can be intense, and constant. 

There usually isn't a specific time that you can look back on and say, "That's when I ruptured my disk." Usually you have an ache, then it goes away, then you have an ache again, and then maybe you experience aching, burning, electrical shock, stabbing, or shooting pain. Depending on which disk has ruptured in your lower back, you might also have pain in the groin or the front of your thigh (if you have a herniated disk at L3 or L4) or you might have pain in your calf or even the bottom of your foot (if you have a herniated disk at L1 or L2). In my case, I ruptured the fifth disk, L5, and I had pain in all of those locations plus the sides of my legs. 

One of the peculiarities of sacral pain is that if you can get up and move around, usually the pain diminishes. On the other hand, sitting still in the same place, as you would have to do when you take a trip by plane or car ride, makes the pain worse. Although a little activity relieves pain, a lot of activity makes it intensely worse. Your back will "let you know" when you are exercising too much. Walking on your toes, or on your heels, typically makes all of your symptoms a lot worse.

There are certain situations in which your doctor is almost certain to recommend surgery:

  • If you have a condition called cauda equina ("horse tail") syndrome, which involves pressure and swelling around the lower spinal cord, you're probably going to be offered surgery and urged to have it soon. Failure to treat this kind of inflammation can result in permanent loss of bladder or bowel control, or both, sexual dysfunction, and difficulty walking.
  • If you have progressive loss of sensation over a period of several weeks, you will also be offered surgery. The criterion however, is neurologic deficit, not inability to move easily. Your doctor will be more concerned about nerve function than muscle function, at least at first.
  • And if you have had persistent pain for six to twelve weeks despite conservative treatment you are likely to be offered surgery.

What's conservative treatment? Most of the time, it's fair to equate conservative treatment with "no surgery." Before doctors offer surgery, they usually try to treat lower back pain with pills for the pain or injections for inflammation, and often a referral to a chiropractor. If you start presenting neurological symptoms, then, at least in the United States, your doctor is likely to offer surgery so you won't have grounds for a malpractice lawsuit later. In many states in the USA, avoiding lawsuits is another reason a surgeon will operate.

There are many more conservative treatments than doctors usually recommend. You should always discuss these options with your doctor before you try them, but there are a lot to try:

  • An inversion table, or a pair of "hang up boots," are designed to decompress your spine while you hang upside down. Many people swear by them, but be sure to ask your doctor first.
  • Trancutaneous electroneural stimulation, or TENS, offers pain relief by "zapping" your skin with low-amperage electricity. There are units you can use a home available from both doctors and chiropractors, often covered by insurance.
  • Moist heat, whether it's from a hot water bottle or a jacuzzi, can relieve pain. Cold therapy likewise relieves pain, but never apply ice directly to the skin.
  • Ask your doctor about exercises for your hamstrings or your core (abdominal muscles and lower back). Strengthening muscles takes pressure off damaged disks, but you do not want to try these exercises without approval from your doctor first.
  • Massage therapy often can relieve your pain and restore your range of motion, its benefits lasting for a month or two after your last session.

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