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Sacral pain, MRI showed disc bulge, hypertrophy of joint facet. Numbness in toes. Will the sacrum pain go away?

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Orthopaedic Surgeon
Practicing since : 1994
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Hello Dr.

I have been suffering from a pain in the sacrum area for a while now. it worsens in days and some it goes away. the time that makes me really notice the pain is when i wake up, bend over and try to look down to the XXXXXXX point i could.

I went to the Dr and did an M.R.I for the lumbar and sacrum area. sacrum results were normal but the lumbar result says (MILD POSTERIOR DIFFUSE DISC BULGE L4-L5, ASSOCIATED WITH HYPERTROPHY OF JOINT FACET AND LIGAMENTUM FLAVUM, COMPROMISING SLIGHTLY THE THECAL SAC AND BILATERAL CORRESPONDING NEURAL FORMINA EXIT).

so the Dr. told me to start physiotherapy and i did. now it has been more than 24 sessions but the sacrum pain is just not going away!

i used to feel a very slight numbness in middle 2 toes of right foot but now it went away. im doing all the stretching and strengthening exercises at home and the gym, they (the clinic) are doing what they do in therapy with all the machines of ultra sounds and so,,,

the questions that are really concerning me,

Will that sacrum pain Ever go away?
Is my case serious ?
Will i go back to my normal activities, strong, healthy & worry free from this matter again?

Because i have been doing everything I've been told to do but the pain is still there and it has been over 5 weeks now of therapy.

I'll be waiting for a thorough answer if possible please.
Thank you very much DR.
Posted Mon, 30 Apr 2012 in Bones, Muscles and Joints
 
 
Answered by Dr. Praveen Tayal 1 hour later
Hello,

Thanks for posting your query.

Pain in the sacrum with no detectable abnormality on MRI (Magnetic Resonant Imaging) scan is most likely caused by sacroiliac ligament sprain or sacroiliac joint dysfunction.

Other possible cause is inflammation of the sacro-coccygeal joint.

Taking appropriate anti inflammatory medicines and doing a hot fomentation or soaking in a tub of hot water will help in relieving the pin. Avoid sitting on any hard surface.

Your problem is a minor one and is not worrisome.

Adequate medicines and physiotherapy will help in restoring your normal functions without any pain. Please do not worry.

You can get a suitable anti inflammatory prescribed from your treating orthopedician.

I hope this answers your query.
In case you have additional questions or doubts, you can forward them to me, and I shall be glad to help you out.

Wishing you good health.
Regards.
Dr. Praveen Tayal.
Above answer was peer-reviewed by
 
Follow-up: Sacral pain, MRI showed disc bulge, hypertrophy of joint facet. Numbness in toes. Will the sacrum pain go away? 2 days later
Thank Dr. XXXXXXX Tayal for answering so soon.

I just wanted to know if its ok to run and go to gym lift weights? Im not a hardcore bodybuilder but i tend to keep my body fit and toned.

Would any injections steroidal or non of any kind help heal this pain and not to only relief it for a while?

im not going to use your answer as something to hold you responsible for, i only want to know if my Dr is missing something that might help. some new research or any kind of updated info/technique you might know and consider for your patient similar to my case.

Thank you very much Dr. XXXXXXX Tayal
 
 
Answered by Dr. Praveen Tayal 1 hour later
Hello.
Thanks for writing again.
In sacral pain, going to gym and lifting weights will not harm you. So you can do your bit by exercising regularly.
Steroidal injections in the joint space will help in reducing the inflammation and thus will help in reducing the pain. If the pain is persistent, then good muscle relaxants like thiocolchicoside and alternative therapies like accupuncture may be helpful. I would suggest that you speak with your treating physician about this.
Few other options of treatment which may be useful in reducing pain and maintaining functional lifestyle are 'Transcutaneous Electric Nerve stimulation (TENS) units', relaxation techniques, occupational and physical therapy approaches under the guidance of your physiotherapist.
Hope my answer is helpful.
Do accept my answer in case there are no further queries.
Regards.
Above answer was peer-reviewed by
 
Follow-up: Sacral pain, MRI showed disc bulge, hypertrophy of joint facet. Numbness in toes. Will the sacrum pain go away? 40 minutes later
Thank you very much Dr and if there is anything else i will not hesitate to ask.

Thank you very much.
 
 
Answered by Dr. Praveen Tayal 1 minute later
You are most welcome.
Wish you a trouble free early recovery.
Above answer was peer-reviewed by
 
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