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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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How To Treat Lower Back, Thighs / Pelvic Pain Caused By Vertebral Protrusion?

I have been dealing with pain in my low back, pelvic region and upper legs for a couple of years now. My MRI showed an annular tear at L5 S1 with a broad base protrusion. There is no obvious impingement of the canal. My pain is worse after sitting for more than fifteen or twenty minutes and my legs are heavy and uncomfortable for the first few steps after sitting. My low back also pops and snaps a lot with movement. I had previously gone to a pain clinic and they tried injections with little, then no relief. I ve seen another pain doctor who tells me that there is no reason that he can see for my pain, other than inflammation in my SI. He injected those and I seemed to get some relief at first, but it didn t last through one lawn mowing.
Mon, 23 Feb 2015
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Radiologist,  's  Response
The spine is made up of an alignment of small bones. These bones have sponge like discs between them and the spinal cord passes along the back of these bones through the spinal canal. Between the bones we also have nerve roots originating in the spinal cord and passing through foramen between bones.

You seem to be having discs at a particular level that is protruding between the bones and this protrusion is backwards and causing symptoms.

The discs protruding at level L 5 - S 1 with a tear at the periphery of the disc. It might also cause obliteration of lateral recess and neural foraminal compromise. This is leading to pinching of nerves causing severe pain.

There are patients who get relief by doing physiotherapy and taking neurogenic pain relievers for up to a year. Injections are also given for relief. However this might not always happen. If your pain is severe and not responding to medical treatment then the disc protrusion needs to be removed by doing a small surgery at the lower back region by a neurosurgeon. Presently, laser assisted surgical techniques and radio frequency ablation is also available.

The inflammation at SI joint requires regular injections.

You can try to feel more comfortable at work by taking small breaks every 30 minutes and not straining your spine especially the painful areas.
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How To Treat Lower Back, Thighs / Pelvic Pain Caused By Vertebral Protrusion?

The spine is made up of an alignment of small bones. These bones have sponge like discs between them and the spinal cord passes along the back of these bones through the spinal canal. Between the bones we also have nerve roots originating in the spinal cord and passing through foramen between bones. You seem to be having discs at a particular level that is protruding between the bones and this protrusion is backwards and causing symptoms. The discs protruding at level L 5 - S 1 with a tear at the periphery of the disc. It might also cause obliteration of lateral recess and neural foraminal compromise. This is leading to pinching of nerves causing severe pain. There are patients who get relief by doing physiotherapy and taking neurogenic pain relievers for up to a year. Injections are also given for relief. However this might not always happen. If your pain is severe and not responding to medical treatment then the disc protrusion needs to be removed by doing a small surgery at the lower back region by a neurosurgeon. Presently, laser assisted surgical techniques and radio frequency ablation is also available. The inflammation at SI joint requires regular injections. You can try to feel more comfortable at work by taking small breaks every 30 minutes and not straining your spine especially the painful areas.