Suggest treatment for bulging of discs in neck and lower back
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My name is XXXX I'm a 37 year old female I'm 5"7 weight 312 I have congenital developmental cervical spinal stenosis 7mm c3-c5 I'm short of breath sharp pain shooting down my left shoulder lower back pain burning nucleus leakage l-5-s-1 three herniated disc in my neck bony spurs broad based annular effacement of the the cal sac c-4-5 disc protrudes 4mm beyond endplate margins indenting and flattening of ventral surface of the cord c-5-6 pragmatically to the left by 2-3mm coming into contact with the cord and potentially contacting the c-6 nerve root that's not done in Sept of 2013 now for XXXXXXX 7th of this year. Cervical kyphosis no degree given. C-4c-5 disc osteophyte complex with defacement of anterior thecal sac c-5-c-6 broad based disc osteophyte complex My neurosurgeon has suggested injections physical therapy and gabapentin for the permitted sign I experience on a daily bases for a year now just started the gabapentin two days ago. What are your thoughts or suggestions?
Posted Wed, 19 Mar 2014 in Brain and Spine
Answered by Dr. Sudhir Kumar 8 hours later
Brief Answer: I agree with your neurosurgeons treatment approach Detailed Answer: Hi, Thank you for posting your query. I have noted your symptoms and the MRI findings. These findings suggest bulging of discs at multiple levels in the neck and lower back region, resulting in narrowing of canal/foramen with pinching of nerves in the neck and lower back regions. This can result in neck and low back pain, pain in arm and legs, with tingling and numbness in the same regions. Initial treatment is with physical therapy and medications such as gabapentin (as suggested by your neurosurgeon). Other medications that could help are pregabalin and duloxetine capsules. Epidural injections can be given if above do not help. In about 10% of patients, injections, medications and physical therapy do not provide adequate pain relief. In those patients, surgery can be done to relieve compression of the neves. I hope it helps. Please get back if you have any follow up queries. Best wishes, Dr Sudhir Kumar MD DM (Neurology) XXXXXXX Consultant Neurologist