Avoiding Herniated Disc Surgery in a CrossFit Athlete

Chris Centeno, MD - A Herniated Disc is usually one of those things that just happens either due to trauma or an “oops” moment. Back before 2000, it was almost a sure thing you would get surgery, but that’s changed quite a bit with modern Interventional Spine techniques. Today we’ll explore the case of a woman who avoided the knife by getting an Intradiscal PRP injection. Let’s jump in.

What Is a Herniated Disc?

The Discs act as shock absorbers between the Spinal vertebrae. They are made from a tough outer covering called the Annulus and a gel-filled center called the Nuclear Pulposis. When the outer Annulus tears, the inside gel can squirt out and that’s called a Disc Herniation. That’s different than a Disc Bulge which is when the Annulus is damaged and the Nucleas is still contained. If you want to learn more about different types of low back problems, see my video below:


Epidurals and Surgery

If you go through physical therapy and fail to have your back and leg pain resolve, usually the next step is an Epidural steroid injection. The good news is that this can provide enough relief to buy time and allow your body to clean up the mess in your Disc. However, the bad news is that the high-dose steroids can damage local natural repair cells and tissues. Hence, we stopped performing high-dose steroid Epidurals about 15 years ago and switched out to using Platelet-based procedures.

Karrah’s Story

Karrah was a 26-year-old woman with a several-year history of worsening low back pain for 6 years. She was an avid CrossFit enthusiast at the time and noticed low back pain when she increased her training regimen. In particular, a double-under jump rope workout seemed to cause the initial issue. When she would impact the ground while jumping rope, she began to get zingers down her left leg. Eventually, she was able to stop CrossFit and transition to bodybuilding, which helped. However, she went back to CrossFit and in March 2020, a kettlebell workout really aggravated her back. At that point, she began to get more intense numbness and tingling down her right leg. In March of this year, she aggravated the injury again. She tried Chiropractic and saw a Sports Medicine physician who recommended getting a corticosteroid Epidural, but after further research, she declined. Chiropractic care seemed to help, but Decompression therapy aggravated things.

She first saw Dr. Markle at our Colorado HQ site in May of 2021. In June of last year, Dr. Markle injected high dose PRP into her Herniated Discs and then injected other Platelet products Epidural and into the Facet joints and ligaments. This was her result below:

On the left is a large Herniated Disc at the bottom (L5-S1). 6 months after the procedure on the right, her Disc Herniation is now greatly reduced in size. She initially reported 90% improvement, but then after another crossfit injury she’s down to 70%. The goal now is to get her stronger in physical therapy and then see if she needs another treatment.

What Happened?

While some Disc Herniations can resolve with time, Karrah’s was there for a while and not changing. What we believe happened is that by injecting high-dose PRP inside and around the Disc, we were able to improve the blood supply and activity of macrophages who can dismantle and remove Herniated Disc material. This is obviously better than surgery, as this approach doesn’t leave the back wall of the Annulus weaker. Remember that the surgical approach removes part of the back wall, leading to frequent re-herniations.

The upshot? This is a great result for Karrah. Now hopefully between more physical therapy and perhaps another round of injections, we can help her avoid the knife!

Source: https://regenexx.com/blog/avoiding-herniated-disc-surgery-in-a-crossfit-athlete/



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