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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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How To Overcome The Disc Bulge And Grade 1 Annual Tear Problem?

I have disc bulge on L5-S1 traversing the root nerve and slight Grade 1 Annular tear in L4-L5 with slight disc bulge. Been resting in bed for 2 weeks but it's improving very slowly. I have 2 good days and then 1 not so good day. What do you recommend I do?
Tue, 25 Feb 2014
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Orthopaedic Surgeon, Joint Replacement 's  Response
Hi, thanks for writing to HCM.

The initial management of lumbar disc disease is always by conservative (non surgical) methods as follows -

- Avoid lifting heavy weights as it imparts more strain on your back
- Take rest breaks throughout the day, but avoid sitting for long periods of time.
- Change your daily activities so that you avoid movements that can cause further pain, especially bending forward and lifting as it will worsen the disc protrusion.
- Use a lumbosacral back support to stabilize your spinal muscles
- After the initial pain has subsided, remedial exercises to strengthen the spine are very important to restore normal spinal movements and muscle strength.
- Use analgesics like advil or aleve and muscle relaxants to relieve pain and muscle spasm, as needed. Vitamin B12 supplements & Pregabalin may be helpful in controlling the neuropathic pain.
If your fail to improve with the above measures, an Epidural steroid injection may provide good symptom relief for a few months. There is good evidence that epidural injections can be successful in 60-70% of patients who have not been helped by 6 weeks or more of conservative management ( nonsurgical care).
- Maintain optimum body weight,if you are obese

Hope this information is helpful. Good day
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How To Overcome The Disc Bulge And Grade 1 Annual Tear Problem?

Hi, thanks for writing to HCM. The initial management of lumbar disc disease is always by conservative (non surgical) methods as follows - - Avoid lifting heavy weights as it imparts more strain on your back - Take rest breaks throughout the day, but avoid sitting for long periods of time. - Change your daily activities so that you avoid movements that can cause further pain, especially bending forward and lifting as it will worsen the disc protrusion. - Use a lumbosacral back support to stabilize your spinal muscles - After the initial pain has subsided, remedial exercises to strengthen the spine are very important to restore normal spinal movements and muscle strength. - Use analgesics like advil or aleve and muscle relaxants to relieve pain and muscle spasm, as needed. Vitamin B12 supplements & Pregabalin may be helpful in controlling the neuropathic pain. If your fail to improve with the above measures, an Epidural steroid injection may provide good symptom relief for a few months. There is good evidence that epidural injections can be successful in 60-70% of patients who have not been helped by 6 weeks or more of conservative management ( nonsurgical care). - Maintain optimum body weight,if you are obese Hope this information is helpful. Good day