Bogdan Baudis You may hand from your hands too :-) less cumbersome I think...

Keep you weight in check.
Exercise and stretch but always pay attention to the muscles around your waist but pay attention your body signals, they all have to be treated equally, and do not overdo.
They say that pain is good but there is the "good" pain and the bad pain, try to learn to distinguish between two of them.
Careful with torso rotations, you need to be supple and warm enough to do rapid torsions.
I think it is safer to bend forward than backwards or sideways, this may be individual though, no body is the same.
Basics: Lift with legs not your back. Jump down with your knees slightly bent, better not on your heels first and amortize, amortize!

If you run, do not pound the earth, try to improve your step: I rather run in very light thin-sole shoes but not on paved surface rather than use the amortizing shoes but that's me, may not work for others. It is likely that the knees will go bad before the back but this does not seem a lot of a consolation, does it?

Look at your body as a mechanic engineer would: try not to compress the spine, especially when bent or twisted!

Inflammation is bad, a sore back eventually will turn into a bad back.
Cold pads as soon as possible work better than heat pads later.
When it does not go away Ibuprofen may work, Naproxen may work better.
You cannot baby every minor pain, but trying to tough thru a really sore back may lead to a vicious cycle: pain causes muscles to contract, this irritates the nerves, nerves inflammation causes more pain and muscles and so on ...

Unfortunately the real good way to learn all of the above is practice living with a bad back ... this is how I learned.
And some of that is genetic, my father and grandfather had problems.
Then again I did not have to try to save the balance while having substantial weight on my shoulders...

Generally it always pays to be in good shape, recovery after the surgery will be much faster and outcomes usually are better if the patient is fit and physically active.

Before fusion there may be a chance for partial discotomy.
The current view is that is not effective but I think if you narrow the sample to the people who are otherwise fit, willing faithfully to undergo physiotherapy and later body-conscious, the success rate improves drastically.
It worked in my case, did not work in the case of my friend. Same lumbar area ...

Bogdan, congratulations from Brazil. I do share with your comments, inteligent approach, and it permit us to ask a the most important local question. After 15 or 20 years since the initial spine or even low back surgeries in Brazil, it is very hard to say how much we went ahead for eliminate pain or even to keep the pain under control, as well. After surgery procedure, and in case of not obtain good results, or desired results, what would be the next step? Good luck and thanks for your contribution. Nelson Herbst

John Sanchez Yes thank-you for your comment! I appreciate your time!!

Bogdan Baudis @Nelson
Well, if the discotomy does not work, I guess the spinal fusion would be next ... This of course will load adjacent joints and so on ... At least that's what I heard from my surgeon which was in 90s ... There may be some progress since then, but judging from my friend's case not that much ...

The problem is that scar tissue always will form.
And scar tissue may impinge on nerves.
Better surgeon, less scar tissue.
Better genetics, less scare tissue ...
But here the physiotherapy, exercise comes to play, as you can stretch the scare tissue and keep it elastic.

Jean Bigoney, RAC, CQE What an excellent answer Bogdan!

If I may add one thing, remember what your mother always said and don't slouch. Poor posture can also cause back problems, as I had to find out the hard way.

Bogdan Baudis Well, I am a software engineer, so I sit. I have an option of a standing desk, but standing actually does not work for me (my back reminds me of that quick). Since I had surgery my sitting position is the one which works best for me (and my back informs me when it is bad), probably NOT recommended for other people (good or bad backs, each case is different).

But sitting badly is tempting the fate for sure. Actually is the whole ergonomics. The height, the desk height, the displays' heights and so on.

Get of the desk periodically' anyway. We are built for 12 hours of hunting and gathering not 8 hours of sitting at desk + 4 hours of lazing on the couch ...

But back-breaking work can literally break your back. The farmer grandfather of mine never had a chance to sit much until he laid down, and one day he never gotten out from the bad ... there and then there was no surgeons too ...

Ken Lukes This is not a joke. I promise you! YOGA
It is best possible think you can do without drugs or expensive therapy. It is like a workout for your connective tissue, joints, nervous system and spirit. Yes, it will feel like work at first but you will soon want to do it.

Bahij Salman In 2001 I have an L4-L5 Discectomy and it was the best thing I ever did. For months I walked like a Hunchback. I had 3 then 4 epidurals but they all eventually wore off. I went in and within 4 months I was running around the soccer field like a chicken with my heead cut off.
March 25th, 2015 after a Car accident I started losing sensation in my left arm. I had the Cervical fusion, I feel my fingers, I can make a first, I feel better when on Percossets and Valium. Only pain remaining is from the surgery (scar tissue and inflammatio) and I still pain radiating from my should (left) to elbow and some to the upper part of my palm. I was T-Bined right on my side by someone going at least 30 miles an hour who did not stop at the stop sign. Right on my side, my door, my left shoulder by a VOLVO SUV. I still have shoulder pain which I could not separate from the pain caused or due to the cervical herniation. My Spine Surgeon who did both surgeries is amazing and is with the Blackstone Orthopedic Group in RI. Dr David Cicerchia.
I am happy I have both surgeries done. I can tolerate pain but those were unbearable.
PS: I tried Chiropractor, Massages, Acupunture, Yoga, Stretching, Injections, Physical Therapy, Meds (herbal and Pharmaceutical), rest and relaxation, you name it I tried it.

Best Wishes.

Bogdan Baudis @Bahij
"Chiropractor, Massages, Acupunture, Yoga, Stretching, Injections, Physical Therapy, Meds (herbal and Pharmaceutical), rest and relaxation, you name it I tried it."
Your experiences track mine.

I did all of them too.
And I still do some of it. The exercises are essential to keep me healthy.

But without the surgery they would not amount to much. I was mostly laying for more than 2 months rotating between various serious painkillers. Heroics wear off sometime after second or third week of constant incapacitating pain. Hard to actually count the time correctly.

Bahij Salman Someone mentioned scar tissue, I had with my lower back continious pain as if no surgery took place but an MRI with the dye revealed a small piece of tissue lodged itself right in the foramen. Option were to go in and remove it or give it time since there is not blood supply it will desintegrate. I did soon thereafter.
My advice ask for recommendations if you are in pain, find a Doctor with whom you are comfortable.
Injections worked, the first set of 3 gave me about 4 years of relief, the second set of 4 gave me 2 years only. So I thought resolving in once for all is best.
If you need to have cervical Fusion please feel free to reach me and I will give you some recommendations to insist on with your surgeon.

You know you are getting old when once you get your head together, everything else starts falling apart.
You are getting old when what does not hurt, does not work.

Bogdan Baudis "Someone mentioned scar tissue".
Well, that was me.
The problem is that the scar tissue always forms there after intervention. This really means the INSIDE scar tissue.
It depends on how extensive the cuts were (better surgeon, less damage, less scar tissue).
But it also depends on patients physiology (mostly: genetics, but also overall health).
The scar tissue may do as "good" job impinging on nerves as fragmented disk.
Not much can be done about it but exercises may keep it elastic enough.
Usually repeated surgeries carry the risk and suffer from diminishing benefits, but it all depends on a particular case of course...

Most of my knowledge is from my surgeon, my experience with my injury and these of my friends. Some ofthat may be dated. Any real spinal surgeon to weight in here?

Lower back issues typically stem from too much sitting which causes your hip flexors to be tight which causes your hips to rotate forward. There a many ways to counteract this but my favorite is the standing hip flexor stretch. For strength my favorite is the kettlebell swing. Basically these 2 movements are the opposite of sitting. Obviously there are many others. Here is a good video by an expert kettlebell trainer Mike Mahler.

https://www.youtube.com/watch?v=XMI1ztzvf08

I have had a fusion/cage a year ago. It was the best thing I have ever had done. The technology now is significantly better than it was 10 years ago. It looks gruesome but the outcome for me has me back to a completely normal life.

I had my first spinal fusion more than 10 years ago. i needed a second one in 2013 due to stress on the level directly above the previous fusion. My back is OK for the most part but now I have constant ache in my neck and shoulders. I wonder if it has to do with the unnatural curve if my spine. I dont even want to think about another surgery to correct the curve because it will require breaking the first fusion. Is there anything I can do for the shoulder pain such as wear a brace or something..please advice...
Thank you

Bahij Salman @Rabia: I have been wearing a hard brace for 32 days now. The Surgeon wants me to start wearing the soft collar a few hours a day and slowly switch to that. I am also starting PT 6 weeks after my surgery. Things look good. Pressure is relieved while everything heels.

Best Wishes.

A family member has had 2 back surgeries, 1 after a crushing vertebral fracture that resulted in a partial disability. After talking with physical therapists, orthopedic surgeons, chiropractors, and personal trainers, I believe the best prevention for just about every disorder is the following:

Eat right, don't smoke, exercise, maintain normal weight, get plenty of sleep, and try to keep stress at a minimum. Oh yeah, one last thing: don't get old. :-)

Ken Lukes Old, taxes and death. No escape. Just a choice in how we spend our time here. Thanks for your thoughts.

Rick Gerace Exercise is good, but make sure your doing some specific exercises to strengthen the core. What most people don't realize is that a significant amount of back pain is associated with de-conditioned abdominal muscles. As we get older and sometimes due to injury, the abdominal muscles that make up part of the natural muscular corset of the core weaken, resulting in a larger portion of the load/stress being placed on the back, especially the lumbar, muscles.

Bogdan Baudis Yes, the stomach and back muscle exercises also will keep the scar tissue form getting stiff!
Also the side muscles.

Word of caution: some of the core exercises may not work for some people or make things worse. From my POV twisting (rotational) exercises should be attempted carefully. Most of the time I irritated my back in the gym was from the rotations.

Actually ALL the exercises should be done with care and awareness, if something makes things worse: stop it, you may try it again when you recover but if it ALWAYS makes things worse then not only never do it for exercising, also mark these moves and try to avoid them outside the gym too.

You have to learn the difference between "good" and "bad" pain ... and that is quite hard.
Exercise is most effective when it is a conscious activity, this is not just collection of repeated moves while the mind can drift away ... pay attention what your body is trying to tell you!

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