On January 14, 2006, I had surgery for a herniated disc. It’s worked well so far, knock on wood. It’s the same surgery Joe Montana had, and he played six weeks later, so the outlook is good. I’m writing this column because better work habits might have prevented the whole problem, and because it might be helpful for me to share several mistakes I made that contributed to the severity of my problem.
Here’s the high-level story. Around the beginning of November, I started feeling pain and stiffness in my lower back. I had just started a Pilates class and had been doing some aggressive Tae Kwon Do stretching, so I figured I had just jarred something loose in my back that would go away in time. Things were OK for awhile; I exercised through about the middle of December, but the problem persisted.
On December 14, I helped my wife set the stage for her ballet company’s performance of The Nutcracker. Mostly this involved standing on a 20-foot ladder, twisting to my left, and pulling a heavy backdrop up from the floor and tying it to a bar over my head. There were two backdrops, and each took about 90 minutes to hang.
The next morning, the hammer dropped. I had severe pain down my left leg, extending to the calf and foot, and couldn’t stand for more than five minutes without lying down to relieve the pressure. Sitting and working was barely tolerable—and even then, only after consuming copious amounts of ibuprofen.
I went online, did some research about my condition, and self-diagnosed sciatica, which seemed pretty benign to me. I seem to recall novels describing little old ladies talking about their “sciatica acting up,” which always relented after an afternoon of bed rest. Being male and as immortal as any fictional character, I knew it would soon run its course.
I visited a chiropractor several times, which initially helped, but as I continued to exercise, the pain worsened. After my final visit, I noticed numbness and slight weakness in my left calf. A visit to a physical therapist only made the numbness worse.
Pain I can tolerate, but numbness and weakness are scary. I researched some more and realized that sciatica is really a symptom, not an ailment. Something was irritating my sciatic nerve, which extends from the spine down each leg. Sometimes it’s a poorly placed wallet, sometimes a set of bad-fitting shoes, but often enough it’s a bulging or herniated disc. It was time to isolate the problem.
My general practitioner recommended a visit to a local orthopedic surgeon. After a brief exam, he diagnosed a herniated disc, which an MRI soon confirmed. We tried a direct steroid injection into the spine, but the pain persisted and the weakness and numbness became more severe.
I spent more time online, learning that 90% of all herniated discs get better without surgery, but that if numbness and especially weakness are worsening, surgery to remove the disc impinging upon the nerve may be required. I also read that surgery works best in the first six months; after that the risk of permanent damage to the nerve increases.
My orthopedic surgeon recommended surgery and sent me to a neurosurgeon who studied my history, taking particular note of my long working hours sitting in a substandard chair. He told me that truck drivers suffer a high incidence of herniated discs, because they, like video editors, sit for long periods of time without relief.
He said that a microdiscectomy procedure to repair the herniated disc had a 90%-95% chance of success, defined as immediate relief from pain, which was consistent with my research. He cautioned that the numbness and weakness would persist far longer and might never disappear. I was pain-free immediately after the surgery, and even though I still have slight residual weakness, I’m optimistic.
Unless you’ve been slammed in the back by a blitzing linebacker, it’s almost impossible to tell what causes a disc to herniate. But my surgeon pointed out that I was working 12-hour days in a $50 Wal-Mart chair and that the way I hung those ballet backdrops—twisting and lifting heavy weights over my head—is a classic, awful-for-the-back activity. He also commented that while intense stretching and Pilates were great in general, performed incorrectly (which, in retrospect, is what I was doing), both can cause serious problems.
And his post-op rehabilitation instructions are, well, instructive. Buy an ergonomically correct chair rated for the hours you sit in it (yes, chairs are rated for daily, hourly use). Use a standing desk, if possible—my doctor helped me put cinder blocks under each leg of my main worktable, and now I stand most of the day, even during extended editing and writing sessions. Don’t sit for longer than 30 minutes at a time without getting up and stretching backwards as a counterbalance. Don’t drive for longer than an hour without doing the same. That’s in addition to all the common-sense instruction about how to lift heavy weights properly to avoid back strain.
To these I’ll add don’t take sciatica lightly, especially if it extends below the knee. If I had it to do all over again, I would have gotten the MRI before any chiropractic treatment or physical therapy.
To be clear, I’m not advocating surgery—I’m advocating prevention. It’s easy to dismiss good advice like that offered by Todd Gillespie in his article, “Editing Ergonomics“, until something dramatic happens. I’m proof that it can happen to you.